28595059	The present study reports a preliminary evaluation of D.A.R.E.'s new elementary school keepin' it REAL substance abuse prevention program. Given the widespread dissemination of D.A.R.E., this evaluation, even though of short term effects, has important implications for national prevention efforts. The new prevention curriculum teaches social and emotional competencies such as decision making and resistance skills. Social and emotional competencies and other risk factors were examined among students (N=943) in 26 classrooms, 13 classrooms in the treatment condition (n=359) and 13 classrooms in the control condition (n=584) using a quasi-experimental matched group design. Pretest comparisons of treatment and control groups were completed, along with attrition analyses, and hierarchical logistic and linear regressions were computed to assess the intervention. The results revealed that the intervention produced significant effects on preventative factors such as the likelihood of resisting peer pressure, increased responsible decision making knowledge and decision-making skills, and confidence in being able to explain why they would refuse offers of cigarettes. The results of this study suggest that D.A.R.E.'s elementary keepin' it REAL program has promise as a social and emotional learning (SEL) based prevention program.
28594309	Antimicrobial resistance (AMR) imperils health for people across the world. This enormous challenge is being met with the rationalisation of prescription, dispensing and consumption of antimicrobials in clinical settings and in the everyday lives of members of the general population. Individuals need to be reached outside clinical settings to prepare them for the necessary changes to the pharmaceutical management of infections; efforts that depend on media and communications and, therefore, how the AMR message is mediated, received and applied. In 2016, the UK Review on Antimicrobial Resistance called on governments to support intense, worldwide media activity to promote public awareness and to further efforts to rationalise the use of antimicrobial pharmaceuticals. In this article, we consider this communications challenge in light of contemporary currents of thought on media publics, including: the tendency of health communications to cast experts and lay individuals in opposition; the blaming of individuals who appear to 'resist' expert advice; the challenges presented by negative stories of AMR and their circulation in public life, and; the problems of public trust tied to the construction and mediation of expert knowledge on the effective management of AMR.
28594270	Written text contains verbal immediacy cues-word form or grammatical cues that indicate positive attitude or liking towards an object, action, or person. We asked if adults with moderate-severe traumatic brain injury (TBI) would respond to these cues, given evidence of TBI-related social communication impairments.Sixty-nine adults with TBI and 74 healthy comparison (HC) peers read pairs of sentences containing different types of immediacy cues (e.g., speaker A said "these Canadians" vs. B said "those Canadians.") and identified which speaker (A or B) had a more positive attitude towards the underlined entity (Task 1); and pairs of sentences comprised of a context sentence (e.g., Fred is asked, "Did you visit Joan and Sue?") and a statement sentence (Fred says, "I visited Sue and Joan.") and were asked to indicate how much Fred liked or disliked the underlined words (Task 2).	HC group scores were significantly higher on Task 1, indicating more sensitivity to cues. On Task 2, TBI and HC group ratings differed across cue types and immediacy types, and the TBI group appeared to have less sensitivity to these cues.	Findings suggest that TBI-related impairments may reduce sensitivity to subtle social cues in text.	
28593698	Evidence suggests that language and social, emotional and behavioural (SEB) difficulties are associated in children and adolescents. When these associations emerge and whether they differ by language or SEB difficulty profile is unclear. This knowledge is crucial to guide prevention and intervention programmes for children with language and SEB difficulties.To determine whether receptive and expressive language skills are associated with internalizing and externalizing behaviours in slow-to-talk toddlers.	In a community-based prospective study of 200 slow-to-talk children, language was measured at 24 and 36 months using Preschool Language Scale 4th Edition and at 48 months using Clinical Evaluation of Language Fundamentals-Preschool 2nd Edition. Internalizing and externalizing behaviours were measured by parent report at each age. Longitudinal data were analysed using repeated-measures regression, with up to three observations per child. Robust standard errors were used to account for non-independence of measures within participants. The shape of the associations were examined by fitting quadratic and cubic terms. The effects of confounders on the associations were examined.	Receptive language had a negative linear association with internalizing behaviours after adjusting for confounders (β = -0.16, 95% [CI = -0.26, -0.07], p = .001); and a negative curved association with externalizing behaviours after adjusting for biological confounders (βquadratic = 0.08 [0.01, 0.15], p = .03, βcubic = -0.04 [-0.07, -0.02], p = .001), attenuating after adjusting for environmental confounders (βquadratic = 0.06 [-0.01, 0.13], p = .09, βcubic = -0.03 [-0.06, -0.003], p = .03). The curvature suggests that the negative association with externalizing behaviours only existed for children with either very low or very high receptive language scores. After controlling for confounders, there was no evidence that expressive language scores were associated with internalizing (β = -0.08, 95% [CI = -0.17, 0.01], p = .10) or externalizing behaviours (β = 0.03, 95% [CI = -0.09, 0.18], p = .61). Tests of interaction revealed no evidence of a differential association by age.	In 24-48-month-old slow-to-talk children, lower receptive language scores were associated with higher internalizing behaviours. The magnitude of the association was small. For children with very poor receptive language scores, lower receptive language skills were associated with higher externalizing behaviours. Young children with low receptive language abilities may be at risk of internalizing difficulties; those with very low receptive language skills may be at particular risk of externalizing difficulties. This has clinical implications for interventions for young children with receptive language difficulties.	
28592997	A small percentage of people with autism spectrum disorders (ASD) have alterations in chromosome 15q11.2-q3, the critical region for Prader-Willi syndrome (PWS). Data are limited, however, on the rates and characteristics of ASD in PWS. Previous estimates of ASD in PWS (25 to 41%) are questionable as they are based solely on autism screeners given to parents. Inaccurate diagnoses of ASD in PWS can mislead intervention and future research.One hundred forty-six children and youth with PWS aged 4 to 21 years (M = 11) were assessed with the Autism Diagnostic Observation Schedule-2 (ADOS-2). An expert clinical team-made best-estimate ASD diagnoses based on ADOS-2 videotapes, calibrated severity scores, and children's developmental histories and indices of current functioning. Children were also administered the Kaufman Brief Intelligence Test-2, and parents completed the Repetitive Behavior Scale-Revised and Vineland Adaptive Behavior Scales. Scores were compared across children with PWS + ASD versus PWS only. The performance of an ASD screener, the Social Communication Questionnaire (SCQ) and the ADOS-2 were evaluated in relation to best-estimate diagnoses.	Best-estimate diagnoses of ASD were made in 18 children, or 12.3% of the sample, and the majority of them had the maternal uniparental disomy (mUPD) PWS genetic subtype. Compared to the PWS-only group, children with PWS + ASD had lower verbal and composite IQ's and adaptive daily living and socialization skills, as well as elevated stereotypies and restricted interests. Regardless of ASD status, compulsivity and insistence on sameness in routines or events were seen in 76-100% of children and were robustly correlated with lower adaptive functioning. The SCQ yielded a 29-49% chance that screen-positive cases will indeed have ASD. The ADOS-2 had higher sensitivity, specificity and predictive values. Communication problems were seen in children who were ADOS-2 positive but deemed not to have ASD by the clinical team.	Autism screeners should not be the sole index of probable ASD in PWS; children need to be directly observed and evaluated. Compulsivity and insistence on sameness are salient in PWS and likely impede adaptive functioning. Most children with PWS only evidenced sub-threshold problems in social interactions that could signal risks for other psychopathologies.	
28592863	The ability to assess another person's direction of attention is paramount in social communication, many studies have reported a similar pattern between gaze and arrow cues in attention orienting. Neuroimaging research has also demonstrated no qualitative differences in attention to gaze and arrow cues. However, these studies were implemented under simple experiment conditions. Researchers have highlighted the importance of contextual processing (i.e., the semantic congruence between cue and target) in attentional orienting, showing that attentional orienting by social gaze or arrow cues could be modulated through contextual processing. Here, we examine the neural activity of attentional orienting by gaze and arrow cues in response to contextual processing using functional magnetic resonance imaging. The results demonstrated that the influence of neural activity through contextual processing to attentional orienting occurred under invalid conditions (when the cue and target were incongruent versus congruent) in the ventral frontoparietal network, although we did not identify any differences in the neural substrates of attentional orienting in contextual processing between gaze and arrow cues. These results support behavioural data of attentional orienting modulated by contextual processing based on the neurocognitive architecture.
28592687	Autism spectrum disorder (ASD) is a developmental disability that is poorly understood. ASD can influence communication, social interaction, and behavior. Children with ASD often have sensory hypersensitivities, including auditory hypersensitivity (hyperacusis). In adults with hyperacusis who are otherwise neurotypical, the medial olivocochlear (MOC) efferent reflex is stronger than usual. In children with ASD, the MOC reflex has been measured, but without also assessing hyperacusis. We assessed the MOC reflex in children with ASD by measuring the strength of MOC-induced inhibition of transient-evoked otoacoustic emissions (TEOAEs), a noninvasive physiological measure that reflects cochlear amplification. MOC activity was evoked by contralateral noise. Hyperacusis was assessed subjectively on the basis of the children's symptoms. We found a significant correlation between hyperacusis scores and MOC strength in children with ASD. When children were divided into ASD-with-severe-hyperacusis (ASDs), ASD-with-not-severe-hyperacusis (ASDns), and neurotypical (NT) groups, the last two groups had similar hyperacusis and MOC reflexes, whereas the ASDs group, on average, had hyperacusis and MOC reflexes that were approximately twice as strong. The MOC inhibition of TEOAEs averaged larger at all frequencies in the ASDs compared with ASDns and NT groups. The results suggest that the MOC reflex can be used to estimate hyperacusis in children with ASD and might be used to validate future questionnaires to assess hyperacusis. Our results also provide evidence that strong MOC reflexes in children with ASD are associated with hyperacusis and that hyperacusis is a comorbid condition and is not a necessary, integral part of the abnormal neural processing associated with ASD.NEW & NOTEWORTHY Children with autism spectrum disorder (ASD) are a heterogeneous group, some with hyperacusis and some without. Our research shows that hyperacusis can be estimated in children with ASD by using medial olivocochlear (MOC) reflex measurements. By establishing that an objective measure correlates with attributes of hyperacusis, our results enable future work to enable subtyping of children with ASD to provide improved individualized treatments to at-risk children and those without adequate language to describe their hyperacusis symptoms.
28592674	Differences in vocal fundamental (F0) and average formant (Fn) frequencies covary with body size in most terrestrial mammals, such that larger organisms tend to produce lower frequency sounds than smaller organisms, both between species and also across different sex and life-stage morphs within species. Here we examined whether three-month-old human infants are sensitive to the relationship between body size and sound frequencies. Using a violation-of-expectation paradigm, we found that infants looked longer at stimuli inconsistent with the relationship-that is, a smaller organism producing lower frequency sounds, and a larger organism producing higher frequency sounds-than at stimuli that were consistent with it. This effect was stronger for fundamental frequency than it was for average formant frequency. These results suggest that by three months of age, human infants are already sensitive to the biologically relevant covariation between vocalization frequencies and visual cues to body size. This ability may be a consequence of developmental adaptations for building a phenotype capable of identifying and representing an organism's size, sex and life-stage.
28592475	Awareness of patient-centered and family-centered care research can assist clinicians to promote patient and family engagement in the intensive care unit. Project Dispatch (Disseminating Patient-Centered Outcomes Research to Healthcare Professionals) was developed to disseminate patient- and family-centered care research and encourage its application in clinical practice. The 3-year project involved the development of an interactive website platform, online educational programming, social media channels, a podcast and webcast series, and electronic and print media. The project's webpages received more than 5200 page views with over 4000 unique visitors from 36 countries. The podcast series has download numbers ranging from 35 596 for "Family Presence in the ICU" to 25 843 for "Improving Patient and Family satisfaction in the ICU" and 22 148 for "Family Satisfaction in the ICU." The project therefore successfully developed resources for critical care health care professionals to promote the patient- and family-centric perspective.
28592298	It is widely accepted that a healthy lifestyle may decrease the probability of developing cancer. This study aimed to describe a study protocol that makes it possible to explore preventive health lifestyles of Iranian women and their received social support for the purpose of developing cultural strategies to increase breast cancer prevention.A mixed-methods study will be accomplished in two sequential parts. First, a cross-sectional study will be conducted in which 2,250 Iranian women are recruited by using a random multistage cluster sampling of 20 health care centers. Structured face-to-face interviews will be conducted to obtain information on the participants' health lifestyle and perceived social support. Data will be analyzed using both multivariate regression and structural equation modeling techniques. Then, a qualitative study will be conducted among employed women using a purposive sampling design. Data will be collected by means of focus groups and semi-structured interviews and will be analyzed using a conventional content analysis approach. The results of the quantitative and qualitative study will be used to develop breast cancer preventive strategies.	Researchers need to acquire knowledge regarding the lifestyle and perceived social support of Iranian women that will foster culturally competent approaches to promote healthy lifestyles to develop breast cancer preventive strategies. Examining breast cancer preventive lifestyles provides valuable information for designing applicable intervention programs for improving women's health.	
28590669	New techniques for identifying cell types, tracing their synaptic partners, imaging and manipulating their activity in behaving organisms have made mice a widely used model for linking brain circuits to behavior. Most behaviors are tied to vision: identifying objects, guiding movements of body parts, navigating through the environment, and even social interactions. Reason enough to focus on the mouse visual cortex. To find our way around in the occipital cortex, we needed a map. We took a classic approach and traced in the same animal the outputs from multiple retinotopic sites of primary visual cortex (V1) and compared the relative location of projections in the extrastriate cortex. We found nine extrastriate maps and showed by single unit recordings that each of the connectional maps contained visually responsive neurons whose receptive fields were mapped in orderly fashion and completely covered the visual field. Remarkably, a tiny region of one sixth of a dime contained a two- to three-times larger number of areas than the highly developed somatosensory and auditory cortices. By tracing the connections, we found that each of the ten visual areas projected to 25–35 cortical targets and interconnected virtually all of the areas reciprocally with one another. Although the binary graph density of the connection matrix was nearly complete, the connection strengths between areas within the ventral and dorsal cortex differed, indicating that the information from V1 flowed into distinct but interconnected streams. Unit recordings and calcium imaging studies showed that the ventral and dorsal streams processed different spatiotemporal information, which aligned with known properties of streams in primates. Analyses of the laminar patterns of interareal projections showed that areas were organized at multiple levels, suggesting that each stream represented a processing hierarchy.
28591771	The use of social media in the urologic community is common and increasing. Although the potential benefits of platforms like Twitter have been described in the literature, the use of social media in the clinical context of Urology has not been explored.In this case report, we describe how we used Twitter to share ideas about the clinical management of a complex urologic patient. By posting a clinical scenario, a timely discussion was generated with global participation and expert suggestions. This knowledge was applied to the surgical management of a patient with positive clinical outcomes.The ability of Twitter to facilitate rapid communication with a wide network of contributors makes it a potentially useful tool for clinical decision making. Care must be taken to ensure patient confidentiality and caution used appropriately when evaluating the sources and content of the clinical information shared.
28590900	Degraded hearing in older adults has been associated with reduced postural control and higher risk of falls. Both hearing loss (HL) and falls have dramatic effects on older persons' quality of life (QoL). A large body of research explored the comorbidity between the two domains.The aim of the current review is to describe the comorbidity between HL and objective measures of postural control, to offer potential mechanisms underlying this relationship, and to discuss the clinical implications of this comorbidity.	PubMed and Google Scholar were systematically searched for articles published in English up until October 15, 2015, using combinations of the following strings and search words: for hearing: Hearing loss, "Hearing loss," hearing, presbycusis; for postural control: postural control, gait, postural balance, fall, walking; and for age: elderly, older adults.	Of 211 screened articles, 7 were included in the systematic review. A significant, positive association between HL and several objective measures of postural control was found in all seven studies, even after controlling for major covariates. Severity of hearing impairment was connected to higher prevalence of difficulties in walking and falls. Physiological, cognitive, and behavioral processes that may influence auditory system and postural control were suggested as potential explanations for the association between HL and postural control.	There is evidence for the independent relationship between HL and objective measures of postural control in the elderly. However, a more comprehensive understanding of the mechanisms underlying this relationship is yet to be elucidated. Concurrent diagnosis, treatment, and rehabilitation of these two modalities may reduce falls and increase QoL in older adults.	
28590885	Based on a survey of prescription drug users (N = 408), this study revealed that: (a) the frequency of consumers' personal experience of prescription medicine adverse reactions negatively related to the extent of their optimistic bias about the chances of such events, (b) consumers' perceived personal control over adverse reactions positively related to optimistic bias, and (c) optimistic bias related more negatively to intentions to seek risk information when consumer skepticism toward direct-to-consumer advertising was high. When skepticism was low to average, optimistic bias did not inhibit such intentions. Implications and recommendations for the practice of direct-to-consumer advertising are provided.
28590834	To compare the effects a pharmaceutical industry decision guide and International Patient Decision Aids Standard (IPDAS) compliant patient decision aids (PtDA) on patient medication beliefs and choice to intensify therapy.Rheumatoid arthritis (RA) patients, who had never taken etanercept (Enbrel), took part in a mail survey. They were presented with a hypothetical decision scenario where they were asked to consider adding etanercept to their current regimen. Each patient was randomized to review 1 of 3 forms of an etanercept-specific decision support: a long PtDA (LONG DA), a short PtDA (SHORT DA), or the manufacturer's Enbrel decision guide (Pharm Booklet).	We had 402 RA patients participate in the study (response rate, 52%). Of the patients randomized to the Pharm Booklet, 30.6% elected to initiate etanercept. Only 14.6% and 14.0% of patients who reviewed the LONG DA or SHORT DA choose to take etanercept (χ2 = 15.7; P < 0.001). Patients who reviewed the LONG DA or SHORT DA had a greater increase in knowledge about etanercept than those who reviewed the Pharm Booklet. There was no difference in decisional conflict among the groups. A logistic regression model explained 44.2% (R2 = 0.442) of patient choice to intensify therapy by initiating etanercept. The strongest predictor of choice to intensify therapy were beliefs about etanercept's ability to improve symptoms (OR = 2.56, 96%CI [1.71, 3.80]), and its use by others like the respondent (OR = 2.24, 95%CI [1.49, 3.35]). Mediation analysis confirmed the presence of a partial mediating effect of decision support on patients' intent to take etanercept (OR = 0.59, 95%CI [0.39, 0.89]).	Patients supported by the Pharm Booklet were twice as likely to choose to intensify therapy. The Pharm Booklet's effects are partially mediated through persuasive communication techniques that influence patients' beliefs that symptoms will improve, and increase social normative beliefs, rather than by increasing the relevant knowledge, clarifying patient values about positive or negative treatment outcomes, or increasing their self-efficacy.	
28590164	Burn specialists have long recognized the need for and have role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many U.S. hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context. This Perspective gives an overview of burn care; focuses on pain and other symptoms in burn intensive care unit settings; addresses special needs of critically ill burned patients, their families, and clinicians for high-quality palliative care; and highlights potential benefits of integrating primary and specialist palliative care in burn critical care. MEDLINE and the Cumulative Index to Nursing and Allied Health Literature were searched, and an e-mail survey was used to obtain information from U.S. Burn Fellowship Program directors about palliative medicine training. The Improving Palliative Care in the Intensive Care Unit Project Advisory Board synthesized published evidence with their own research and clinical experience in preparing this article. Mortality and severe morbidity for critically ill burned patients remains high. American Burn Association guidelines lay the foundation for a robust system of palliative care delivery, embedding palliative care principles and processes in intensive care by burn providers. Understanding basic burn care, challenges for symptom management and communication, and the culture of the particular burn unit, can optimize quality and integration of primary and specialist palliative care in this distinctive setting.
28590153	Research using video recordings can advance understanding of healthcare communication and improve care, but making and using video recordings carries risks.To explore views of hospice patients, carers and clinical staff about whether videoing patient-doctor consultations is acceptable for research and training purposes.	We used semi-structured group and individual interviews to gather hospice patients, carers and clinical staff views. We used Braun and Clark's thematic analysis.	Interviews were conducted at one English hospice to inform the development of a larger video-based study. We invited patients with capacity to consent and whom the care team judged were neither acutely unwell nor severely distressed (11), carers of current or past patients (5), palliative medicine doctors (7), senior nurses (4) and communication skills educators (5).	Participants viewed video-based research on communication as valuable because of its potential to improve communication, care and staff training. Video-based research raised concerns including its potential to affect the nature and content of the consultation and threats to confidentiality; however, these were not seen as sufficient grounds for rejecting video-based research. Video-based research was seen as acceptable and useful providing that measures are taken to reduce possible risks across the recruitment, recording and dissemination phases of the research process.	Video-based research is an acceptable and worthwhile way of investigating communication in palliative medicine. Situated judgements should be made about when it is appropriate to involve individual patients and carers in video-based research on the basis of their level of vulnerability and ability to freely consent.	
28590057	Fragile X syndrome (FXS) is a developmental disorder caused by a mutation in the X-linked FMR1 gene, coding for the FMRP protein which is largely involved in synaptic function. FXS patients present several behavioral abnormalities, including hyperactivity, anxiety, sensory hyper-responsiveness, and cognitive deficits. Autistic symptoms, e.g., altered social interaction and communication, are also often observed: FXS is indeed the most common monogenic cause of autism. Mouse models of FXS are therefore of great interest for research on both FXS and autistic pathologies. The Fmr1-KO2 mouse line is the most recent FXS model, widely used for brain studies; surprisingly, little is known about the face validity of this model, i.e., its FXS-like behavioral phenotype. Furthermore, no data are available for the age-related expression of the pathological phenotypes in this mouse line, a critical issue for modelling neurodevelopmental disorders. Here we performed an extensive behavioral characterization of the KO2 model at infancy, adolescent and adult ages. Hyperactivity, altered emotionality, sensory hyper-responsiveness and memory deficits were already present in KO mice at adolescence and remained evident at adulthood. Alterations in social behaviors were instead observed only in young KO animals: during the first 2 weeks of life, KOs emitted longer ultrasonic vocalizations compared to their WT littermates and as adolescents they displayed more aggressive behaviors towards a conspecific. These results strongly support the face validity of the KO2 mouse as a model for FXS, at the same time demonstrating that its ability to recapitulate social autistic-relevant phenotypes depends on early testing ages. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28589797	The care paradigm for patients with human immunodeficiency virus (HIV) has changed from managing an infectious condition with a suboptimal prognosis, to managing a long-term chronic disease. The wellness thermometer is a tool that was developed to assist with monitoring the biological, psychological, social and spiritual well-being of patients with HIV. Aim To evaluate the effectiveness of using the wellness thermometer in healthcare consultations with patients with HIV. Method This was a service evaluation that was undertaken in three UK HIV clinics in 2014. After using the wellness thermometer, patients and healthcare professionals completed a survey to indicate whether they felt the tool improved their consultations. Results A total of 231 patients completed the survey. It was found that 80% (n=185) of patients felt the wellness thermometer helped to identify their concerns, while 79% (n=182) of patients felt the wellness thermometer improved their conversation with the healthcare professional. Of the 12 healthcare professionals who completed the survey, most felt that the tool helped patients to identify their concerns (n=10) and that it was easy to use (n=11). Conclusion There are several benefits associated with using the wellness thermometer in healthcare consultations, and it may support patients with HIV to report any concerns they have in relation to their treatment and quality of life. The authors envisage that the tool will become a routine part of the care of these patients.

28589494	The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), Module 4 is considered a "gold-standard" instrument for diagnosing autism spectrum disorder (ASD) in adults. Although the ADOS-2 shows good sensitivity and specificity in lab-based settings, it is unknown whether these results hold in community clinics that serve a more psychiatrically impaired population. This study is the first to evaluate the diagnostic accuracy of the ADOS-2 among adults in community mental health centers (n = 75). The ADOS-2 accurately identified all adults with ASD; however, it also had a high rate of false positives among adults with psychosis (30%). Findings serve as a reminder that social communication difficulties measured by the ADOS-2 are not specific to ASD, particularly in clinically complex settings.
28588959	In September 2011, the Nunavik Regional Board of Health and Social Services began supporting the Arctic Char Distribution Project (AC/DP) for pregnant women. This initiative promoted consumption of the fish Arctic char-a traditional Inuit food-by pregnant women living in villages of Nunavik, an area in northern Quebec (Canada) inhabited predominantly by people of Inuit ethnicity. This intervention was intended to reduce exposure to contaminants and improve food security in Inuit communities.We assessed the project's implementation based on data collected from background documentation, field notes and qualitative interviews with project recipients and implementers. Themes emerging from the data are critically discussed in the light of the framework for implementation fidelity developed by Carroll et al in 2007.	Pregnant women fully embraced the initiative because of its cultural appropriateness. However, project implementation was incomplete: first because it did not cover all intended geographic areas, and second because of a recurring inconsistency in the supply and distribution of the fish. In addition, the initiative has been inconsistently funded and relies on multiple funding sources.	This work highlights the extent to which project complexity can impede successful implementation, particularly in terms of communication and coordination. We provide recommendations for improving project implementation and suggest amendments to the implementation fidelity framework.	
28588529	The performance of school children has been studied by considering partial relationships between several personal variables such as the link between cognition and motivation. However, contextual variables, such as a child's willingness to accept social responsibility, also influence students' social and academic performance. Thus, students with greater responsibility have a better attitude toward their studies, resulting in higher academic achievement. This 2-year study aims to reveal to what extent an intervention program affects student performance and is based on the Theory of Positive Action among young people proposed by Don Hellison and the Theory of Reasoned Action by Fishbein and Ajzen. The program focuses on positive influences on social and personal responsibility, taking into consideration parental styles, gender, and academic performance. The program was a part of the educational curricula in participating schools and it targeted four main areas: (a) teaching units using academic texts about social responsibility, (b) student training in mediation processes, (c) teacher training, and (d) family training and involvement. A total of 271 students took part from first and second year of Secondary Education (12-14 years old). The experimental group was made up of 132 students while the remaining 139 formed the control group. All participants completed the Assessment Scale of Social Responsibility Attitudes in Secondary Education and the Parent-Adolescent Communication Scale. Results show that students in the experimental group performed significantly better than those in the control group. Additionally, the issue of social responsibility seems to be related to commitment, self-discipline and perseverance. Regarding gender, males appear to score higher in the factor for well-mannered, friendly and tidy. Finally, a positive relationship has been identified between social responsibility attitudes and parenting with an open communicational style. This paper discusses the results so that schools can include programs aimed at improving social and personal responsibility.
28588465	People with Autism spectrum disorder (ASD) show difficulty in social communication, especially in the rapid assessment of emotion in faces. This study examined the processing of emotional faces in typically developing adults with high and low levels of autistic traits (measured using the Autism Spectrum Quotient-AQ). Event-related potentials (ERPs) were recorded during viewing of backward-masked neutral, fearful and happy faces presented under two conditions: subliminal (16 ms, below the level of visual conscious awareness) and supraliminal (166 ms, above the time required for visual conscious awareness). Individuals with low and high AQ differed in the processing of subliminal faces, with the low AQ group showing an enhanced N2 amplitude for subliminal happy faces. Some group differences were found in the condition effects, with the Low AQ showing shorter frontal P3b and N4 latencies for subliminal vs. supraliminal condition. Although results did not show any group differences on the face-specific N170 component, there were shorter N170 latencies for supraliminal vs. subliminal conditions across groups. The results observed on the N2, showing group differences in subliminal emotion processing, suggest that decreased sensitivity to the reward value of social stimuli is a common feature both of people with ASD as well as people with high autistic traits from the normal population.
28587940	Infants learn about cause and effect through hands-on experience; however, they also can learn about causality simply from observation. Such observational causal learning is a central mechanism by which infants learn from and about other people. Across three experiments, we tested infants' observational causal learning of both social and physical causal events. Experiment 1 assessed infants' learning of a physical event in the absence of visible spatial contact between the causes and effects. Experiment 2 developed a novel paradigm to assess whether infants could learn about a social causal event from third-party observation of a social interaction between two people. Experiment 3 compared learning of physical and social events when the outcomes occurred probabilistically (happening some, but not all, of the time). Infants demonstrated significant learning in all three experiments, although learning about probabilistic cause-effect relations was most difficult. These findings about infant observational causal learning have implications for children's rapid nonverbal learning about people, things, and their causal relations.
28587494	Objectives Information and communication technology is often lauded as the key to enhancing communication among health care providers. However, its impact on interprofessional collaboration is unclear. The objective of this study was to determine the extent to which it improves communication and, subsequently, enhances interprofessional collaboration in chronic disease management. Methods A systematic review of academic literature using two electronic platforms: HealthSTAR and Web of Science (core collection and MEDLINE). To be eligible for inclusion in the review, articles needed to be peer-reviewed; accessible in English and focused on how technology supports, or might support, collaboration (through enhanced communication) in chronic disease management. Studies were assessed for quality and a narrative synthesis conducted. Results The searches identified 289 articles of which six were included in the final analysis (three used qualitative methods, two were descriptive and one used mixed methods). Various forms of information and communication technology were described including electronic health records, online communities/learning resources and telehealth/telecare. Three themes emerged from the studies that may provide insights into how communication that facilitates collaboration in chronic disease management might be enhanced: professional conflict, collective engagement and continuous learning. Conclusions The success of technology in enhancing collaboration for chronic disease management depends upon supporting the social relationships and organization in which the technology will be placed. Decision-makers should take into account and work toward balancing the impact of technology together with the professional and cultural characteristics of health care teams.
28586949	We report a longitudinal assessment of health-related quality of life (HRQOL) in patients with glioblastoma (GBM) treated on a prospective dose escalation trial of 5-fraction stereotactic radiosurgery (25-40 Gy in 5 fractions) with concurrent and adjuvant temozolomide.HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire core-30 (QLQ-C30) general, the EORTC quality of life questionnaire-brain cancer specific module (QLQ-BN20), and the M.D. Anderson Symptom Inventory-Brain Tumor (MDASI-BT). Questionnaires were completed at baseline and at every follow-up visit after completion of radiosurgery. Changes from baseline for 9 predefined HRQOL measures (global quality of life, physical functioning, social functioning, emotional functioning, motor dysfunction, communication deficit, fatigue, insomnia, and future uncertainty) were calculated at every time point.	With a median follow-up time of 10.4 months (range, 0.4-52 months), 139 total HRQOL questionnaires were completed by the 30 patients on trial. Compliance with HRQOL assessment was 76% at 12 months. Communication deficit significantly worsened over time, with a decline of 1.7 points per month (P=.008). No significant changes over time were detected in the other 8 scales of our primary analysis, including global quality of life. Although 8 patients (27%) experienced adverse radiation effects (ARE) on this dose escalation trial, it was not associated with a statistically significant decline in any of the primary HRQOL scales. Disease progression was associated with communication deficit, with patients experiencing an average worsening of 13.9 points per month after progression compared with 0.7 points per month before progression (P=.01).	On this 5-fraction dose escalation protocol for newly diagnosed GBM, overall HRQOL remained stable and appears similar to historical controls of 30 fractions of radiation therapy. Tumor recurrence was associated with worsening communication deficit, and ARE did not correlate with a decline in HRQOL.	
28586830	The purposes of this study were to test the predictions that lower self-esteem and higher shyness in individuals with a history of language impairment (LI) would continue from adolescence into early adulthood and that those with LI would have lower social self-efficacy in early adulthood.Participants were young people with a history of LI and a comparison group of age-matched peers. Both groups were tested at ages 17 and 24 years. Participants completed measures of language ability, nonverbal IQ, shyness, global self-esteem, and (at age 24 years only) social self-efficacy.	Young adults with LI scored lower than age-matched peers on self-esteem, higher on shyness, and lower on social self-efficacy (medium to large effect sizes). In line with expectations, in the group with LI, language ability in adolescence predicted shyness in young adulthood, which, in turn, was negatively associated with self-esteem. There was also a direct association between language ability in adolescence and self-esteem in young adulthood.	Young people with a history of LI are likely to be entering adulthood less socially confident than their peers. Interventions may be desirable for young adults with LI, and the present findings indicate social self-efficacy as a key area of social confidence that calls for practitioners' attention.	
28586826	This study tested whether behavioral mimicry can alter drinking behavior. It was hypothesized that participants would increase drinking behaviors given increased confederate drinking but not cup touching.Nineteen healthy adults (Mage = 20.32 years) completed 2 picture description tasks; during 1 task, a confederate frequently sipped water (complete drinking gesture), and during the other, the confederate touched her cup but did not drink (partial gesture). Outcome measures included number of drinks per minute, number of cup touches per minute, percentage of time spent drinking, and percentage of time spent touching the cup.	Participants spent more time drinking and had an increased drinking rate during the drinking condition versus the cup-touching condition. For a majority of participants, drinking rate increased during the drinking condition versus baseline. Drinking, but not cup touching, rate also increased given increased confederate cup touching for many.	Mimicry likely contributes to social modeling of drinking behaviors. This effect appears more robust given a complete target gesture (full drink); however, a partial goal-directed drinking gesture may also yield a mimicked response. Beyond the theoretical implications, these results provide directions for research investigating more naturalistic mechanisms for increasing dietary intake in various patient populations (e.g., individuals with dysphagia).	
28586711	Eye tracking systems are used to investigate eyes position and gaze patterns presumed as eye contact in humans. Eye contact is a useful biomarker of social communication and known to be deficient in patients with autism spectrum disorders (ASDs). Interestingly, the same eye tracking systems have been used to directly compare face scanning patterns in some non-human primates to those in human. Thus, eye tracking is expected to be a useful translational technique for investigating not only social attention and visual interest, but also the effects of psychiatric drugs, such as oxytocin, a neuropeptide that regulates social behavior. In this study, we report on a newly established method for eye tracking in common marmosets as unique New World primates that, like humans, use eye contact as a mean of communication. Our investigation was aimed at characterizing these primates face scanning patterns and evaluating the effects of oxytocin on their eye contact behavior. We found that normal common marmosets spend more time viewing the eyes region in common marmoset's picture than the mouth region or a scrambled picture. In oxytocin experiment, the change in eyes/face ratio was significantly greater in the oxytocin group than in the vehicle group. Moreover, oxytocin-induced increase in the change in eyes/face ratio was completely blocked by the oxytocin receptor antagonist L-368,899. These results indicate that eye tracking in common marmosets may be useful for evaluating drug candidates targeting psychiatric conditions, especially ASDs.
28586520	This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits.Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs.	Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care.	Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES).	The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice.	The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.	
28586442	To elucidate the association between health-related quality of life and shared decision-making among patients in Hong Kong after adjustment for potential confounding variables.A telephone survey was conducted with patients attending all public specialist outpatient clinics in Hong Kong between July and December 2014. The Specialist Outpatient Patient Experience Questionnaire and EQ-5D questionnaire were used to evaluate shared decision-making and quality of life, respectively. We performed a Tobit regression analysis to examine the associations between shared decision-making and quality of life after adjustment for known social, economic and health-related factors.	Twenty-six of the Hospital Authority's specialist outpatient clinics.	Patients aged 18 years or older who attended one of the Hospital Authority's specialist outpatient clinics between July and November 2014.	Shared decision-making and quality of life score.	Overall, 13 966 patients completed the study. The group reporting partial involvement in decision-making had slightly higher EQ-5D scores than the 'not involved' group and the 'fully involved' group. EQ-5D scores were higher among subjects who were younger, male, and had a higher level of education. Respondents living alone and living in institutions scored lower on the EQ-5D than patients living with families.	Important differences in the relationship between the attitudes towards shared decision-making and quality of life were identified among patients. These associations should be taken into consideration when promoting patient-centred care and improving health professional-patient communication.	
28586425	Traditional research examining the communicational choices made by families with deaf children tends to emanate from the premise that families engage with either of the two grand discourses on deafness (i.e., the medical or cultural-linguistic perspective). This study investigated hearing mother's engagement with the educational options for their child from a dynamic, poststructural perspective. Three Flemish mothers were interviewed in-depth at the child's ages of 6, 9, 12, 18, and 24 months. The data were analyzed within a theoretical model that describes the positioning process of the mothers. This method yielded alternative explanations for former findings concerning mothers' decision-making processes, especially the difficulty of learning sign language as a second language in an effort to provide a bilingual-bicultural education, and highlighted the importance of having rich experiences. It further showed that a bilingual-bicultural position was scarcely available and poorly supported for these mothers. These findings are discussed in relation to recent international consensus statements on best practices in early intervention.
28586270	In this article, we contribute to the current literature on the difficulties that social scientists encounter with IRBs, but with a focus on the distinct challenges that health communication scholars face in dealing with IRBs at their own institutions and elsewhere. Although health communication researchers, like other communication researchers, can expect to face many of the same challenges that their social science colleagues face during the IRB process, the researcher narratives we present in this article suggest that health communication research presents some distinct challenges because the communication interactions that we investigate occur in highly protected, private spaces, including the medical exam room, online patient forums, and electronic health records. To that end, we present a series of examples in which health communication researchers were able to find solutions or workarounds to the challenges they faced in gaining IRB approval for their research. In every case that we present, the researcher had to revise her initial study design to get around the constraints imposed by IRB requirements, and in every case, the researcher reports having experienced points of incommensurability similar to those reported by many other social scientists. In some situations, investigators even express frustration that the IRB's needs and demands superseded those of healthcare professionals and the patients whom they serve. Additionally, in some situations, investigators' understandings of human subjects' protection actually go further to protect patients' privacy and confidentiality than the IRB required. But, in all four cases that we present, the health communication research was ultimately successful.
28586261	Social neuroscience research investigating autism spectrum disorder (ASD) has yielded inconsistent findings, despite ASD being well-characterized by difficulties in social interaction and communication through behavioral observation. In particular, specific etiologies and functional and structural assays of the brain in autism have not been consistently identified. To date, most social neuroscience research has focused on a single person viewing static images. Research utilizing interactive social neuroscience featuring dual-brain recording offers great promise for the study of neurodevelopmental disabilities. Reward processing has been implicated in the pathology of ASD, yet mixed findings have brought uncertainty about the role reward processing deficits may play in ASD. The current study employed dual-brain EEG recording to examine reward processing during live interaction and its relation to autistic traits. Sixteen typically developing (TD) adults played a competitive treasure-hunt game against a computer and against a human partner. EEG results revealed enhanced neural sensitivity to reward outcome during live interaction with a human competitor. Further, individuals with higher levels of autistic traits demonstrated reduced sensitivity to reward outcome during live interaction. These findings provide novel insight into reward processing mechanisms associated with autistic traits, as well as support the necessary utility of interactive social neuroscience techniques to study developmental disorders.
28586249	This study examines nonsmokers' responses to antismoking messages. Informed by construal-level theory (CLT), it investigates whether and how evidence type (narrative vs. non-narrative) and social distance might interact to influence nonsmokers' attitudes toward others' quitting smoking and intentions to persuade others to quit smoking. Results of a controlled experiment (N = 281) revealed an approximately significant two-way interaction pertaining to attitudes. Simple effects analyses revealed that narratives produced less-favorable attitudes toward others' quitting smoking than nonnarratives when participants thought about their best friend. Yet, there was no difference in attitudes between narratives and nonnarratives when participants thought about socially distant others. The results also indicated that nonnarratives overpowered narratives to influence participants' attitudes toward others' quitting smoking. Moreover, social distance had a consistent impact on their risk beliefs, such that they perceive fewer health risks of their close friends than an average college student. Theoretical and practical implications of the results are discussed.
28586239	Based on social cognitive theory and narrative engagement theory, the current study examined hypothesized indirect effects of engagement with keepin' it REAL (kiR) curriculum entertainment-education (E-E) videos on youth alcohol use via youth drug offer refusal efficacy. Students in 7th grade (N = 1,464) at 25 public schools in two Midwestern states were randomly assigned to one of the two versions of the kiR curriculum, the kiR urban version and the kiR rural version. Each version had their own set of five culturally-grounded E-E videos depicting communicative skills to refuse drug offers. Differential effects for engagement components were expected depending on the degree of cultural matching. Pre/post surveys were administered at the beginning and the end of 7th grade. Structural equation modeling analysis resulted in partial support for the research hypotheses. Rural youth receiving the urban curriculum who reported higher interest in the E-E videos were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Rural youth receiving the rural curriculum who identified with the E-E video main characters were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Implications for E-E health promotion are discussed.
28585073	Little is known about the psychological well-being and social barriers among immigrant Chinese American breast cancer survivors. The aim of the present study was to explore the social needs and challenges of Chinese American immigrant breast cancer survivors.This study used the expressive writing approach to explore the experiences among 27 Chinese American breast cancer survivors. The participants were recruited through community-based organizations in Southern California, most of whom were diagnosed at stages I and II (33 and 48%, respectively). Participants, on average, had been living in the USA for 19 years. Participants were asked to write three 20-min essays related to their experience with breast cancer (in 3 weeks). Participants' writings were coded with line-by-line analysis, and categories and themes were generated.	Emotion suppression, self-stigma, and perceived stigma about being a breast cancer survivor were reflected in the writings. Interpersonally, participants indicated their reluctance to disclose cancer diagnosis to family and friends and concerns about fulfilling multiple roles. Some of them also mentioned barriers of communicating with their husbands. Related to life in the USA, participants felt unfamiliar with the healthcare system and encountered language barriers.	Counseling services addressing concerns about stigma and communication among family members may benefit patients' adjustments. Tailor-made information in Chinese about diagnosis and treatment for breast cancer and health insurance in the USA may also help patients go through the course of recovery.	
28584869	Zielsetzung: Im Kabinett wurde am 28.4.2014 vom Freistaat Bayern die Gründung einer medizinischen Fakultät an der Universität Augsburg und die Umwandlung des kommunalen Klinikums Augsburg in ein staatliches Universitätsklinikum beschlossen. Hierfür sollte ein kompetenzorientiertes Modellcurriculum entwickelt werden.Methodik: In zwei interdisziplinären Arbeitsgruppen wurde gemäß dem Modell von Thumser-Dauth & Öchsner ein Spiralcurriculum (nach R. Harden) entwickelt, das sich an definierten Kompetenzbereichen orientiert: medizinische Fachkompetenz, selbständiges wissenschaftliches Denken, Argumentieren und Arbeiten sowie soziale und kommunikative Kompetenzen.Ergebnisse: Das Spiralcurriculum wurde als Hybridcurriculum angelegt. Der modulare Aufbau berücksichtigt den Fächerkanon der Approbationsordnung durch organ- und systemorientierte Blöcke, die horizontal und vertikal integriert gestaltet werden. Die Grundlagen sind in den Blöcken Bewegung, Gleichgewicht und Kontakt realisiert, während die klinische Medizin in 6 Säulen abgebildet ist, die jeweils dreimal durchlaufen werden (konservative Medizin, operative Medizin, Kind-Frau-Mann-Medizin, Sinnesmedizin, Medizin des Nervensystems und der Psyche, Allgemeine Medizin). Ergänzend wird ein klinischer Longitudinalkurs mit übergeordneten Inhalten realisiert. Besonderer Schwerpunkt liegt auf der wissenschaftlichen Ausbildung. Diese wird durch einen wissenschaftlichen Longitudinalkurs, zwei wissenschaftliche Blockpraktika und zwei Projektarbeiten realisiert. Hieran beteiligen sich auch andere, nicht-medizinische Fakultäten der Universität Augsburg. Schlussfolgerung: Insbesondere die Integration und Intensität der wissenschaftlichen Ausbildung, aber auch die gezielte Förderung wissenschaftlicher, sozialer und kommunikativer Kompetenzen werden im Augsburger Curriculum in bisher nicht beschriebener Weise realisiert. Das Konzept wurde am 8. Juli 2016 vom Wissenschaftsrat einstimmig positiv begutachtet. Neben der wissenschaftlichen Begleitung des Augsburger Modellcurriculums werden auch die Auswirkungen der Fakultätsgründung auf Klinikum und Universität Gegenstand künftiger Forschung sein.Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills. Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung) into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks "Movement," "Balance" and "Contact." The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men's-women's-children's medicine, the senses, the nervous system and the mind, and general medicine) which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments), block practicums, and two scientific projects. Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum and the impact of the new medical school on the hospital and university in Augsburg.	
28584544	Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators.This ethnographic study was conducted in 2014-2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. The study was carried out in 15 months. Data analysis was performed using constant comparison based on Strauss and Corbin.	Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Initiator factors, with subcategories of patient suffering, patient communication demands, and patient emotional and psychological necessity are also needed to start compassionate behaviors.	The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Indeed, creating a care environment with compassion, regardless of any shortcomings in the work condition, would help in the development of effective nursing.	
28583948	In recent years, biofilms have become a central subject of research in the fields of microbiology, medicine, agriculture, or systems biology amongst others. The sociomicrobiology of multispecies biofilms, however, is still poorly understood. Here, we report a screening system that allowed us to identify soil bacteria, which induce architectural changes in biofilm colonies when cocultured with B. subtilis We identified the soil bacterium Lysinibacillus fusiformis M5 as inducer of wrinkle-formation in B. subtilis colonies mediated by a diffusible signaling molecule. This compound was isolated by bioassay-guided chromatographic fractionation. The elicitor was identified to be the purine hypoxanthine using mass spectrometry and nuclear magnetic resonance (NMR) spectroscopy. We show that the induction of wrinkle formation by hypoxanthine is not dependent on signal recognition by the histidine kinases KinA, KinB, KinC, and KinD, which are generally involved in phosphorylation of the master regulator Spo0A. Likewise, we show that hypoxanthine signaling does not induce the expression of biofilm-matrix related operons epsA-O and tasA-sipW-tapA Finally, we demonstrate that the purine permease PbuO, but not PbuG, is necessary for hypoxanthine to induce an increase in wrinkle formation of B. subtilis biofilm colonies. Our results suggest that hypoxanthine-stimulated wrinkle development is not due to a direct induction of biofilm-related gene expression, but rather caused by the excess of hypoxanthine within B. subtilis cells, which may lead to cell stress and death.Importance Biofilms are a bacterial lifestyle with high relevance regarding diverse human activities. Biofilms can be favorable, for instance in crop protection. In nature, biofilms are commonly found as multispecies communities displaying complex social behaviors and characteristics. The study of interspecies interactions will thus lead to a better understanding and use of biofilms as they occur outside laboratory conditions. Here, we present a screening method suitable for the identification of multispecies interactions, and showcase L. fusiformis as a soil bacterium that is able to live alongside B. subtilis and modify the architecture of its biofilms.
28583905	Health apps are increasingly used with important implications for health. Hong Kong is one of the most technologically advanced and connected cities-smartphone ownership and Internet access rates are among the highest in the world.We investigated the prevalence of health app possession and related sociodemographic factors and health behaviors among smartphone or tablet owners in Hong Kong.	A territory-wide population-based dual (landline and mobile) telephone survey was conducted in 2016. Respondents were asked whether they had health-related apps on their smartphones or tablets and what functions were available on the apps (eg, tracking physical activity and logging health records). Logistic regression was used to calculate the adjusted odds ratio (aOR) and 95% CI of health app possession for different demographic characteristics, socioeconomic position (education, employment, and income), health behaviors (smoking, alcohol, and physical activity) and health (body mass index and chronic diseases).	Of the 4129 smartphone or tablet owners (81.28%, 4129/5080 respondents), 995 (24.10%) had a health app. Tracking physical activity (67.0% of 995) and logging health records (43.0% of 995) were the most common functions of the health apps. Overall, younger age, higher education, and household income were associated with having health apps (all P<.001). Compared with physical inactivity, engaging in moderate physical activity ≥1 day/week was associated with having health apps (aOR 1.45 [95% CI 1.20-1.75] for 1-3 days/week, and aOR 1.32 [95% CI 1.07-1.62] for ≥4 days/week). Having a history of chronic diseases was associated with having health apps (aOR 1.36 [95% CI 1.11-1.68]).	We have shown a lower prevalence of use of information and communication technologies (ICTs) in respondents with lower education and income in the most developed Chinese city. This could be seen as a confirmation of the "Inverse information law," which suggests that those most in need have less use of services and hence receive less benefits from advancements in medicine and health related ICTs.	
28583698	To analyse changes in health professionals' and immigrant users' perceptions of the quality of care provided to the immigrant population during the crisis.A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated.	Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals' working conditions and users' attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems.	The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants.	
28583426	Web 2.0 technologies (e.g., blogs, social networks, and wikis) are increasingly being used by medical schools and postgraduate training programs as tools for information dissemination. These technologies offer the unique opportunity to track metrics of user engagement and interaction. Here, we employ Web 2.0 tools to assess academic behaviors among neurosurgery residents.We performed a retrospective review of all educational lectures, part of the core Neurosurgery Residency curriculum at the University of Toronto, posted on our teaching website (www.TheBrainSchool.net). Our website was developed using publicly available Web 2.0 platforms. Lecture usage was assessed by the number of clicks, and associations were explored with lecturer academic position, timing of examinations, and lecture/subspecialty topic.	The overall number of clicks on 77 lectures was 1079. Most of these clicks were occurring during the in-training examination month (43%). Click numbers were significantly higher on lectures presented by faculty (mean = 18.6, standard deviation ± 4.1) compared to those delivered by residents (mean = 8.4, standard deviation ± 2.1) (p = 0.031). Lectures covering topics in functional neurosurgery received the most clicks (47%), followed by pediatric neurosurgery (22%).	This study demonstrates the value of Web 2.0 analytic tools in examining resident study behavior. Residents tend to "cram" by downloading lectures in the same month of training examinations and display a preference for faculty-delivered lectures.	
28583170	Across the developing world, countries are increasingly adopting the integrated community case management of childhood illnesses (iCCM) strategy in efforts to reduce child mortality. This intervention's effectiveness is dependent on community adoption and changes in care-seeking practices. We assessed the implementation process of a theory-driven community dialogue (CD) intervention specifically designed to strengthen the support and uptake of the newly introduced iCCM services and related behaviours in three African countries.A qualitative process evaluation methodology was chosen and used secondary project data and primary data collected in two districts of each of the three countries, in purposefully sampled communities. The final data set included 67 focus group discussions and 57 key informant interviews, totalling 642 respondents, including caregivers, CD facilitators community leaders, and trainers. Thematic analysis of the data followed the 'Framework Approach' utilising both a deduction and induction process.	Results show that CDs contribute to triggering community uptake of and support for iCCM services through filling health information gaps and building cooperation within communities. We found it to be an effective approach for addressing social norms around child care practices. This approach was embraced by communities for its flexibility and value in planning individual and collective change.	Regular CDs can contribute to the formation of new habits, particularly in relation to seeking timely care in case of child sickness. This study also confirms the value of process evaluation to unwrap the mechanisms of community mobilisation approaches in context and provides key insights for improving the CD approach.	
28583120	The HIV epidemic among people who inject drugs (PWID) in Russia continues to spread. This exploratory study examines how HIV-prevention measures are perceived and experienced by PWID in the northwestern region of Russia.Purposive sampling was used to obtain a variety of cases that could reflect possible differences in perception and experience of HIV-prevention efforts. We conducted 22 semi-structured interviews with PWID residing in the Arkhangelsk and St. Petersburg regions.	The main sources of prevention information on HIV for PWID were media campaigns directed to the general population. These campaigns were effective with regard to communicating general knowledge on HIV but were ineffective in terms of risk behavior change. The subjects generally had trust in medical professionals and their advice but did not follow prevention recommendations. Most informants had no or very little prior contact with harm reduction services. On the level of attitudes towards HIV prevention efforts, we discovered three types of fatalism among PWID: "personal fatalism" - uselessness of HIV prevention efforts, if one uses drugs; "prevention-related fatalism" - prevention programs are low effective, because people do not pay attention to them before they get infected; "state-related fatalism" - the lack of belief that the state is concerned with HIV prevention issues. Despite this fatalism the participants opined that NGOs would do a better job than the state as they are "really working" with risk groups.	As HIV prevention campaigns targeted at the general population and prevention advice received from medical professionals are not sufficiently effective for PWID in terms of risk behavior change, prevention programs, such as community-based and peer-based interventions specifically tailored to the needs of PWID are needed, which can be achieved by a large expansion of harm reduction services in the region. Personal communication should be a crucial element in such interventions in addition to harm reduction materials provision. Training programs, peer outreach, and culture-change interventions which try to alter widespread fatalistic norms or attitudes towards their health are especially needed, since this study indicates that fatalism is a major barrier for behavior change.	
28582251	People with Motor Neuron Disease (MND), of which amyotrophic lateral sclerosis (ALS) is the most common form in adults, typically experience difficulties with communication and disabilities associated with movement. Assistive technology is essential to facilitate everyday activities, promote social support and enhance quality of life.This study aimed to explore the types of mainstream and commonly available communication technology used by people with MND including software and hardware, to identify the levels of confidence and skill that people with MND reported in using technology, to determine perceived barriers to the use of technology for communication, and to investigate the willingness of people with MND to adopt alternative modes of communication.	An on-line survey was distributed to members of the New South Wales Motor Neuron Disease Association (MND NSW). Descriptive techniques were used to summarize frequencies of responses and cross tabulate data. Free-text responses to survey items and verbal comments from participants who chose to undertake the survey by telephone were analyzed using thematic analysis.	Responses from 79 MND NSW members indicated that 15-21% had difficulty with speaking, writing and/or using a keyboard. Commonly used devices were desktop computers, laptops, tablets and mobile phones. Most participants (84%) were connected to the Internet and used it for email (91%), to find out more about MND (59%), to follow the news (50%) or for on-line shopping (46%). A third of respondents used Skype or its equivalent, but few used this to interact with health professionals.	People with MND need greater awareness of technology options to access the most appropriate solutions. The timing for people with MND to make decisions about technology is critical. Health professionals need skills and knowledge about the application of technology to be able to work with people with MND to select the best communication technology options as early as possible after diagnosis. If people with MND are willing to trial telehealth technology, there is potential for tele-consultations via Skype or its equivalent, with health professionals. People with MND can benefit from health professional involvement to match technology to their functional limitations and personal preferences. However, health professionals need a comprehensive understanding of the application of available technology to achieve this.	
28582250	In the United Kingdom, stroke is the most significant cause of adult disability. Stroke survivors are frequently left with physical and psychological changes that can profoundly affect their functional ability, independence, and social participation. Research suggests that long-term, intense, task- and context-specific rehabilitation that is goal-oriented and environmentally enriched improves function, independence, and quality of life after a stroke. It is recommended that rehabilitation should continue until maximum recovery has been achieved. However, the increasing demand on services and financial constraints means that needs cannot be met through traditional face-to-face delivery of rehabilitation. Using a participatory design methodology, we developed an information communication technology-enhanced Personalized Self-Managed rehabilitation System (PSMrS) for stroke survivors with integrated insole sensor technology within an "intelligent shoe.". The intervention model was based around a rehabilitation paradigm underpinned by theories of motor relearning and neuroplastic adaptation, motivational feedback, self-efficacy, and knowledge transfer.To understand the conditions under which this technology-based rehabilitation solution would most likely have an impact on the motor behavior of the user, what would work for whom, in what context, and how. We were interested in what aspects of the system would work best to facilitate the motor behavior change associated with self-managed rehabilitation and which user characteristics and circumstances of use could promote improved functional outcomes.	We used a Realist Evaluation (RE) framework to evaluate the final prototype PSMrS with the assumption that the intervention consists of a series of configurations that include the Context of use, the underlying Mechanisms of change and the potential Outcomes or impacts (CMOs). We developed the CMOs from literature reviews and engagement with clinicians, users, and caregivers during a series of focus groups and home visits. These CMOs were then tested in five in-depth case studies with stroke survivors and their caregivers.	While two new propositions emerged, the second importantly related to the self-management aspects of the system. The study revealed that the system should also encourage independent use and the setting of personalized goals or activities.	Information communication technology that purports to support the self-management of stroke rehabilitation should give significant consideration to the need for motivational feedback that provides quantitative, reliable, accurate, context-specific, and culturally sensitive information about the achievement of personalized goal-based activities.	
28581333	Young children with developmental disabilities experience known deficits in salient child behaviors, such as social behaviors, communication, and aspects of daily living, behaviors that generally improve with chronological age. The purpose of this study was to examine the mediating effects of motor skills on relations of age and salient child behaviors in a group of young children with developmental disabilities, thus tapping into the potential influences of motor skills in the development of salient child behaviors. One hundred thirteen young children with developmental disabilities participated in this study. Independent mediation analysis, with gender as a moderator between the mediating and outcome variable, indicated that motor skills meditated relations between age and socialization, communication, and daily living skills in young male children with developmental disabilities, but not female participants. Findings suggest motor skill content needs to be considered in combination with other child behaviors commonly focused on in early intervention.
28581262	Lay public's concerns around health and health information are increasing. In response, governments and government agencies are establishing websites to address such concerns and improve health literacy by providing better access to validated health information. Since 2011, the Korean government has constructed the National Health Information Portal (NHIP) website run in collaboration with the Korean Academy of Medical Sciences (KAMS). This study therefore aimed to 1) examine consumer use of NHIP, with respect to the usage patterns, evaluation on health information provided, and perceived effectiveness of the site; and 2) identify factors that may impact perceived effectiveness of the site. An online survey was conducted with 164 NHIP users, recruited through a popup window on the main screen of the portal website from October to November 2015. The significant predicting factors supported by the data include the relevance of health information on the site, the usefulness of information in making health decisions, and the effective visualization of information. These factors can inform future efforts to design more effective health information websites, possibly based on metadata systems, to further advance the lay public's information seeking and health literacy.
28581156	Biochemistry and cellular biology courses for medical students at Tongji University include the assessment that provides students with feedback to enhance their learning, which is a type of formative assessment. However, frequent instant feedback and guidance for students is often absent or inconsistently included in the teaching process. WeChat, the most popular Chinese social media, was introduced in biochemistry and cellular biology course. A WeChat official account (OA) was set up as an instant interactive platform. Over a period of two semesters, OA sent 73 push notifications. The components included course notices, preclass thought questions, after-class study materials, answer questions and feedback, simulation exercises, teacher-student interaction, and research progress relevant to the course. WeChat OA served as an active-learning teaching tool, provided more frequent feedback and guidance to students, and facilitated better student-centered communication in the teaching process. Using the WeChat OA in medical teaching emphasized interactive, interoperable, effective, engaging, adaptable, and more participatory teaching styles. As a new platform, WeChat OA was free, Internet-reliant, and easily managed. Using this new medium as a communication tool accelerated further advancement of instant feedback and improvement in teaching activities. Notifications and interactive feedback via the mobile social medium WeChat OA anytime and anywhere facilitated a student-centered teaching mode. Use of WeChat OA significantly increased the proportion of students interactively participating and resulted in a high degree of student satisfaction. © 2017 by The International Union of Biochemistry and Molecular Biology, 2017.
28581037	Individuals' perceptions and their interpersonal communication about a risk event, or risk talk, can play a significant role in the formation of societal responses to the risk event. As they formulate their risk opinions and speak to others, risk information can circulate through their social networks and contribute to the construction of their risk information environment. In the present study, Japanese citizens' risk perception and risk talk were examined in the context of the Fukushima Daiichi nuclear radiation risk. We hypothesized and found that the risk information environment and risk literacy (i.e., competencies to understand and use risk information) interact to influence their risk perception and risk talk. In particular, risk literacy tends to stabilize people's risk perceptions and their risk communications. Nevertheless, there were some subtle differences between risk perception and communication, suggesting the importance of further examination of interpersonal risk communication and its role in the societal responses to risk events.
28579951	A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy). Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT). This diagnostic instrument requires patients to produce target words in two conditions: (i) utterance-centered object naming, and (ii) communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT). Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10-20 min) than for the AAT (60-90 min). Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy.
28579840	This study investigates the factors predicting positive self-disclosure on social networking sites (SNSs). There is a formidable body of empirical research relating to online self-disclosure, but very few studies have assessed the antecedents of positive self-disclosure. To address this literature gap, the current study tests the effects of self-esteem, life satisfaction, social anxiety, privacy concerns, public self-consciousness (SC), and perceived collectivism on positive self-disclosure on SNSs. Data were collected online via Qualtrics in April 2013. Respondents were undergraduate students from the University of Connecticut. Using ordinary least squares regression, the current study found that self-esteem and perceived collectivism increased positive self-disclosure, life satisfaction, and privacy concerns decreased positive self-disclosure, and the effects of social anxiety and public SC were not significant.

28578849	To assess the efficacy of a motivational interviewing (MI) training programme on trainee nutritionists.A repeated measures design was applied to assess clinician behaviours in a 'helping' conversation. Participants were 32 nutrition students, assessed at baseline and one-month follow-up.	The training significantly reduced the use of closed questions and MI non-adherent behaviours (MINA) (P for both=<0.001). Trainees significantly increased reflections, affirmations, summaries (P for all=<0.001) and the use of open questions (P=<0.013) which are all key indicators of MI beginner-competence. The talk-time ratio of the nutritionists also changed significantly, in favour of the client which serves as an indication of MI being used effectively. There were also significant increases in 'global' scores for empathy, direction, autonomy/support, collaboration and evocation.	Newly trained nutritionists 1 month post-training have a consultation style which suggested positive outcomes for clients. The trainees' scores at the one month post-training assessment were verifiable as 'beginning proficiency'.	Behaviour change counselling skills for nutritionists were enhanced, at one month post-training. MI training workshops with video feedback enhances communication skills which are likely to lead to positive consultation-behaviour changes in the trainee nutritionists.	
28578379	Faces convey valuable information for social cognition, effective interpersonal interaction, and non-verbal communication. Face perception is believed to be atypical in autism, but the origin of this deficit is controversial. Dominant featural face encoding is suggested to be responsible for face tuning scarcity. Here we used a recently developed Face-n-Food paradigm for studying face tuning in individuals with autistic spectrum disorders (ASD). The key benefit of these images is that single components do not explicitly trigger face processing. In a spontaneous recognition task, adolescents with autism and typically developing matched controls were presented with a set of Face-n-Food images in different degree resembling a face (slightly bordering on the Giuseppe Arcimboldo style). The set of images was shown in a predetermined order from the least to most resembling a face. Thresholds for recognition of the Face-n-Food images as a face in ASD individuals were substantially higher than in typically developing controls: they did not report seeing a face on the images, which controls easily recognized as a face, and gave overall fewer face responses. This outcome not only lends support to atypical face tuning, but provides novel insights into the origin of face encoding deficits in autism.
28578131	Neural activity in medial prefrontal cortex (MPFC), identified as engaging in self-related processing, predicts later health behavior change. However, it is unknown to what extent individual differences in neural representation of content and lived experience influence this brain-behavior relationship. We examined whether the strength of content-specific representations during persuasive messaging relates to later behavior change, and whether these relationships change as a function of individuals' social network composition. In our study, smokers viewed anti-smoking messages while undergoing fMRI and we measured changes in their smoking behavior one month later. Using representational similarity analyses, we found that the degree to which message content (i.e. health, social, or valence information) was represented in a self-related processing MPFC region was associated with later smoking behavior, with increased representations of negatively valenced (risk) information corresponding to greater message-consistent behavior change. Furthermore, the relationship between representations and behavior change depended on social network composition: smokers who had proportionally fewer smokers in their network showed increases in smoking behavior when social or health content was strongly represented in MPFC, whereas message-consistent behavior (i.e., less smoking) was more likely for those with proportionally more smokers in their social network who represented social or health consequences more strongly. These results highlight the dynamic relationship between representations in MPFC and key outcomes such as health behavior change; a complete understanding of the role of MPFC in motivation and action should take into account individual differences in neural representation of stimulus attributes and social context variables such as social network composition.
28577609	Autism spectrum disorders (ASDs) are neurodevelopmental disorders whose core features of impaired social communication and atypical repetitive behaviors and/or restrictions in range of interests emerge in toddlerhood and carry significant implications at successive stages of development. The ability to reliably identify most cases of the condition far earlier than the average age of diagnosis presents a novel opportunity for early intervention, but the availability of such an intervention is disparate across US communities, and its impact is imperfectly understood. New research may transform the clinical approach to these conditions in early childhood.
28576949	OBJECTIVES Although youth cigarette smoking has declined in the United States, use of alternative tobacco products, such as hookah, has increased. This study assesses changes in prevalence of use from 2011 to 2013, and examines factors associated with current hookah use among North Carolina high school students in 2013.METHODS Data came from the North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). STATA (StataCorp LLC) logistic regression survey procedures account for the complex survey design and sampling weights.RESULTS Prevalence of reported current hookah use significantly increased from 3.6% (95% CI: 2.8-4.5) in 2011 to 6.1% (95% CI: 4.9-7.5) in 2013 while reported lifetime hookah use increased from 9.8% (95% CI: 8.0-12.0) in 2011 to 12.6% (95% CI: 11.0-14.4) in 2013. Correlates of current hookah use included having a weekly disposable income over $50 (adjusted odds ratio (AOR) = 2.05, 95% CI: 1.25-3.35), currently smoking cigarettes (AOR = 4.57, 95% CI: 1.80-11.62), and living with hookah users (AOR = 6.45, 95% CI: 3.21-12.93). Participant self-reports of "liking" or positively commenting on tobacco products on social media were associated with current hookah use (AOR = 1.83, 95% CI: 1.84-4.52). Frequent exposure to online tobacco advertisements (AOR = 1.61, 95% CI: 1.13-2.28) were also associated with current hookah use.CONCLUSIONS Comprehensive product specific communication and policy interventions are needed to educate youth about the dangers of hookah use and reduce social acceptability among youth. To decrease hookah use in North Carolina, policymakers should consider restoring funding for comprehensive tobacco prevention and control programs, and equalizing tobacco tax rates for all tobacco product types.
28575775	The purpose of this report was to describe social behaviors and preferences in adults with epilepsy, including self-reported use of various socialization media (face-to-face and indirect communication) as well as perceived social barriers.1320 consecutive persons with epilepsy (PWEs) confirmed through inpatient video-EEG monitoring were administered a questionnaire on the day of their first appointment. The questionnaire was designed to assess preferences in socialization practices, frequency of interpersonal contact, use of social media, and perceived barriers to socialization. The survey was developed to gain a better understanding of the socialization behaviors and preferences of our patients for the future development of customized activities in our wellness program.	Our sample revealed higher rates of unemployment and single status as compared to the US Census of 2012. With regard socialization however, many were quite social (86% reported daily/weekly communication with friends and family via telephone, 71% saw relatives in person weekly, 68% saw friends weekly, and 65% reported using the computer daily/weekly to socialize). Facebook® was the preferred on-line social media. Indoor/solitary activities were most common with 63% stating they watch TV/read/use the computer followed by physical exercise and spending time outdoors (36%). The frequency of socialization with friends, relatives, and coworkers decreased with the respondents' age and the longer the respondent had carried the diagnosis of epilepsy. Respondents who were taking a greater number of AEDs or were considered refractory were less likely to consider participating in socialization-enhancing activities. The primary barriers to socialization that respondents endorsed were driving prohibition and medication side-effects. Respondents expressed the greatest interest in online support groups or educational programs (31%), office-based support groups (25%), and volunteering (19%).	Although the respondents indicate that they do face barriers to socialization, a majority report frequent communication with relatives and friends via phone, in-person and social media. When designing wellness interventions with this group of patients in the future, online, as well as face to face options for support appear to be desired by a number of PWEs.	
28575768	Early-life seizures are known to cause long-term deficits in social behavior, learning, and memory, however little is known regarding their acute impact. Ultrasonic vocalization (USV) recordings have been developed as a tool for investigating early communicative deficits in mice. Previous investigation from our lab found that postnatal day (PD) 10 seizures cause male-specific suppression of 50-kHz USVs on PD12 in 129 SvEvTac mouse pups. The present study extends these findings by spectrographic characterization of USVs following neonatal seizures. On PD10, male C57BL/6 pups were administered intraperitoneal injections of kainic acid or physiological saline. On PD12, isolation-induced recordings were captured using a broad-spectrum ultrasonic microphone. Status epilepticus significantly suppressed USV quantity (p=0.001) and total duration (p<0.05). Seizure pups also utilized fewer complex calls than controls (p<0.05). There were no changes in call latency or inter-call intervals. Spectrographic analysis revealed increased peak amplitude for complex, downward, short, two-syllable, and upward calls, as well as reduced mean duration for short and two-syllable calls in seizure mice. This investigation provides the first known spectrographic characterization of USVs following early-life seizures. These findings also enhance evidence for USVs as an indicator of select communicative impairment.
28575506	Schizophrenia is characterized by social interaction deficits contributing to poor functional outcome. Hand gesture use is particularly impaired, linked to frontal lobe dysfunction and frontal grey matter deficits. The functional neural correlates of impaired gesturing are currently unclear. We therefore investigated aberrant brain activity during impaired gesturing in schizophrenia. We included 22 patients with schizophrenia and 25 healthy control participants matched for age, gender, and education level. We obtained functional magnetic resonance imaging data using an event-related paradigm to assess brain activation during gesture planning and execution. Group differences in whole brain effects were calculated using factorial designs. Gesture ratings were performed by a single rater, blind to diagnoses and clinical presentation. During gesture planning and execution both groups activated brain areas of the praxis network. However, patients had reduced dorsolateral prefrontal cortex (DLPFC) and increased inferior parietal lobe (IPL) activity. Performance accuracy was associated with IPL activity in patients. Furthermore, patients activated temporal poles, amygdala and hippocampus during gesture planning, which was associated with delusion severity. Finally, patients demonstrated increased dorsomedial prefrontal cortex activity during planning of novel gestures. We demonstrate less prefrontal, but more IPL and limbic activity during gesturing in schizophrenia. IPL activity was associated with performance accuracy, whereas limbic activity was linked to delusion severity. These findings may reflect impaired social action planning and a limbic interference with gestures in schizophrenia contributing to poor gesture performance and consequently poor social functioning in schizophrenia.
28575109	Problems with social-emotional processing are known to be an important contributor to the development and maintenance of eating disorders (EDs). Diminished facial communication of emotion has been frequently reported in individuals with anorexia nervosa (AN). Less is known about facial expressivity in bulimia nervosa (BN) and in people who have recovered from AN (RecAN). This study aimed to pilot the use of computerised facial expression analysis software to investigate emotion expression across the ED spectrum and recovery in a large sample of participants.297 participants with AN, BN, RecAN, and healthy controls were recruited. Participants watched film clips designed to elicit happy or sad emotions, and facial expressions were then analysed using FaceReader.	The finding mirrored those from previous work showing that healthy control and RecAN participants expressed significantly more positive emotions during the positive clip compared to the AN group. There were no differences in emotion expression during the sad film clip.	These findings support the use of computerised methods to analyse emotion expression in EDs. The findings also demonstrate that reduced positive emotion expression is likely to be associated with the acute stage of AN illness, with individuals with BN showing an intermediate profile.	
28574760	Biobanking is a relatively new concept in the Arab region. Targeting different stakeholders to introduce the concept of biobanking and develop an acceptance of it among them is important for the growth of biobanking in the region. Undergraduate students of life sciences represent an important segment of stakeholders, since they constitute potential future biobank customers. Limited funding, lack of awareness of the existence of the term "biobanking" itself among these students, and questions regarding best marketing strategies presented challenges to planning for the most effective message delivery to this target group.A specific course was designed for undergraduate students of life sciences, which was conducted at the Faculty of Medicine, Cairo University, Egypt. The course was conducted twice in 2016 and included lectures covering biobanking, quality, ethics, information technology, and translational research. Facebook and word-of-mouth were used for marketing and advertising.	A total number of 125 participants attended both courses cumulatively. Facebook appeared to have been an effective marketing outlet, especially when paid advertisements were used. Evaluation of knowledge, measured using a pretest and posttest, demonstrated some improvement in knowledge of participants. Evaluation forms filled after the course showed positive attitude toward content and message delivery by a majority of participants. Facebook was also used as an evaluation method through analysis of engagement with posts created after course completion.	Biobanking education can be carried out effectively with limited resources. Understanding the needs of the target group and using appropriate methods of communication are essential prerequisites to a well-tailored curriculum and effective message delivery. Using Facebook appears to be an effective and affordable method of communication and advertising. Targeting undergraduate students of life sciences interested in research is a good investment and can be very effective in increasing awareness about biobanking inside the research community.	
28574719	Social networking sites (SNSs) are social platforms that facilitate communication. For adolescents, peers play a crucial role in constructing the self online through displays of group norms on SNSs. The current study investigated the role of online social identity (OSI) in the relationship between adolescent exposure to alcohol-related content posted by peers on SNSs and alcohol use. In a sample (N = 929) of Australian adolescents (Age M = 17.25, SD = 0.31) higher levels of exposure to alcohol-related content on SNSs was associated with higher levels of alcohol use. Importantly, the association was stronger when the participants reported higher OSI particularly when also reporting low or moderate amount of time spent on SNS. The findings can be explained by social identity literature that demonstrates individuals align their behaviors with other members of their social group to demonstrate, enact, and maintain social identity. The results of this study reflect the importance of considering the construction of the "self" through online and offline constructs.
28574573	Mass media interventions can be used as a way of delivering preventive health messages. They have the potential to reach and modify the knowledge, attitudes and behaviour of a large proportion of the community.To assess the effects of mass media interventions on preventing smoking in young people, and whether it can reduce smoking uptake among youth (under 25 years), improve smoking attitudes, intentions and knowledge, improve self-efficacy/self-esteem, and improve perceptions about smoking, including the choice to follow positive role models.	We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE and Embase in June 2016. This is an update of a review first published in 1998.	Randomized trials, controlled trials without randomization and interrupted time-series studies that assessed the effect of mass media campaigns (defined as channels of communication such as television, radio, newspapers, social media, billboards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person-to-person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years. We define smoking behaviour as the presence or absence of tobacco smoking or other tobacco use, or both, and the frequency of tobacco use. Eligible comparators included education or no intervention.	Two review authors independently extracted information relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risks of bias. We combined studies using qualitative narrative synthesis. We assessed the risks of bias for each study using the Cochrane 'Risk of bias' tool, alongside additional domains to account for the nature of the intervention. We assessed the quality of evidence contributing to outcomes using GRADE.	We identified eight eligible studies reporting information about mass media smoking campaigns, one of which is new for this update. Seven of the studies used a controlled trial design and one an interrupted time-series analysis. Risks of bias were high across all included studies and there was considerable heterogeneity in study design, intervention and population being assessed.Three studies (n = 17,385), one of which compared a mass media intervention to no intervention and two of which evaluated mass media interventions as adjuncts to school-based interventions, found that the mass media interventions reduced the smoking behaviour of young people. The remaining five studies (n = 72,740) did not detect a significant effect on smoking behaviour. These included three studies comparing a mass media intervention to no intervention, one study evaluating a mass media intervention as an adjunct to a school-based intervention, and one interrupted time-series study of a social media intervention. The three campaigns which found a significant effect described their theoretical basis, used formative research in designing the campaign messages, and used message broadcast of reasonable intensity over extensive periods of time. However, some of the campaigns which did not detect an effect also exhibited these characteristics. Effective campaigns tended to last longer (minimum 3 years) and were more intense (more contact time) for both school-based lessons (minimum eight lessons per grade) and media spots (minimum four weeks' duration across multiple media channels with between 167 and 350 TV and radio spots). Implementation of combined school-based components (e.g. school posters) and the use of repetitive media messages delivered by multiple channels (e.g. newspapers, radio, television) appeared to contribute to successful campaigns.	Certainty about the effects of mass media campaigns on smoking behaviour in youth is very low, due to inconsistency between studies in both design and results, and due to methodological issues amongst the included studies. It would therefore be unwise to offer firm conclusions based on the evidence in this review. Methodologically rigorous studies investigating the effect of social media and novel forms of technology as part of tobacco prevention campaigns for youth are needed.	
28574442	When a speaker talks, the consequences of this can both be heard (audio) and seen (visual). A novel visual phonemic restoration task was used to assess behavioral discrimination and neural signatures (event-related potentials, or ERP) of audiovisual processing in typically developing children with a range of social and communicative skills assessed using the social responsiveness scale, a measure of traits associated with autism. An auditory oddball design presented two types of stimuli to the listener, a clear exemplar of an auditory consonant-vowel syllable /ba/ (the more frequently occurring standard stimulus), and a syllable in which the auditory cues for the consonant were substantially weakened, creating a stimulus which is more like /a/ (the infrequently presented deviant stimulus). All speech tokens were paired with a face producing /ba/ or a face with a pixelated mouth containing motion but no visual speech. In this paradigm, the visual /ba/ should cause the auditory /a/ to be perceived as /ba/, creating an attenuated oddball response; in contrast, a pixelated video (without articulatory information) should not have this effect. Behaviorally, participants showed visual phonemic restoration (reduced accuracy in detecting deviant /a/) in the presence of a speaking face. In addition, ERPs were observed in both an early time window (N100) and a later time window (P300) that were sensitive to speech context (/ba/ or /a/) and modulated by face context (speaking face with visible articulation or with pixelated mouth). Specifically, the oddball responses for the N100 and P300 were attenuated in the presence of a face producing /ba/ relative to a pixelated face, representing a possible neural correlate of the phonemic restoration effect. Notably, those individuals with more traits associated with autism (yet still in the non-clinical range) had smaller P300 responses overall, regardless of face context, suggesting generally reduced phonemic discrimination.
28573835	Adults with learning disabilities may be at higher risk of poor oral health. The community outreach programme attached to Plymouth University Peninsula Dental School used established links with local agencies for this group to try out an intervention using service users as dental ambassadors. A programme was developed to meet the needs of the group and training in oral health key messages was provided along with support in presentation skills. Early evaluation shows promise in terms of feasibility, interest and improved self-care. Public health competencies being illustrated: Strategic leadership, communication, teaching and training, and collaborative working for health and oral health improvement.
28573448	In the past decade, there has been an increase in the development and use of oral anti-cancer medications (OAMs), especially for breast cancer-the most prevalent cancer in women. However, adherence rates for OAMs are often suboptimal, leading to lower survival rate, increased risk of recurrence, and higher healthcare costs. Our goal was to identify potentially modifiable psychosocial facilitators and barriers that may be targeted to increase OAM adherence for breast cancer patients.We systematically searched PubMed for studies published in the U.S. by June 15, 2016 that addressed the following: (1) OAMs for breast cancer; (2) medication adherence; and (3) at least one psychosocial aspect of adherence.	Of the 1752 papers screened, 21 articles were included and analyzed. The most commonly reported motivators for adherence are patient-provider relationships (n = 11 studied, 82% reported significant association) and positive views and beliefs of medication (n = 9 studied, 89% reported significant association). We also identified consistent evidence of the impact of depression and emotions, perception of illness, concern of side effects, self-efficacy in medication management and decision making, knowledge of medication, and social support on OAM adherence.	Compared to traditional demographic, system, and clinical-related factors that have been well documented in the literature but are not easily changed, these cognitive, psychological, and interpersonal factors are more amendable via intervention and therefore could generate greater benefit in improving patient compliance and health outcomes. As OAMs shift treatment administration responsibility onto patients, continuous provider communication and education on illness and regimen are the keys to supporting patients' medication behavior.	
28573356	Active involved community partnerships (AICPs) are essential to co-create implementation infrastructure and translate evidence into real-world practice. Across varied forms, AICPs cultivate community and tribal members as agents of change, blending research and organizational knowledge with relationships, context, culture, and local wisdom. Unlike selective engagement, AICPs enable active involvement of partners in the ongoing process of implementation and sustainability. This includes defining the problem, developing solutions, detecting practice changes, aligning organizational supports, and nurturing shared responsibility, accountability, and ownership for implementation. This paper builds on previously established active implementation and scaling functions by outlining key AICP functions to close the research-practice gap. Part of a federal initiative, California Partners for Permanency (CAPP) integrated AICP functions for implementation and system change to reduce disproportionality and disparities in long-term foster care. This paper outlines their experience defining and embedding five AICP functions: (1) relationship-building; (2) addressing system barriers; (3) establishing culturally relevant supports and services; (4) meaningful involvement in implementation; and (5) ongoing communication and feedback for continuous improvement. Planning for social impact requires the integration of AICP with other active implementation and scaling functions. Through concrete examples, authors bring multilevel AICP roles to life and discuss implications for implementation research and practice.
28573021	Vocal expressions of emotions follow simple rules to encode the inner state of the caller into acoustic parameters, not just within species, but also in cross-species communication. Humans use these structural rules to attribute emotions to dog vocalizations, especially to barks, which match with their contexts. In contrast, humans were found to be unable to differentiate between playful and threatening growls, probably because single growls' aggression level was assessed based on acoustic size cues. To resolve this contradiction, we played back natural growl bouts from three social contexts (food guarding, threatening and playing) to humans, who had to rate the emotional load and guess the context of the playbacks. Listeners attributed emotions to growls according to their social contexts. Within threatening and playful contexts, bouts with shorter, slower pulsing growls and showing smaller apparent body size were rated to be less aggressive and fearful, but more playful and happy. Participants associated the correct contexts with the growls above chance. Moreover, women and participants experienced with dogs scored higher in this task. Our results indicate that dogs may communicate honestly their size and inner state in a serious contest situation, while manipulatively in more uncertain defensive and playful contexts.
28572868	Men with low- to intermediate-risk prostate cancer are typically asked to choose from a variety of treatment options, including active surveillance, radical prostatectomy, or brachytherapy. The Prolaris cell cycle progression test is intended to provide additional information on personal risk status to assist men with prostate cancer in their choice of treatment. To assist with assessing that new technology, this report synthesizes qualitative research on how men with prostate cancer use information to make decisions about treatment options.We performed a systematic review and qualitative meta-synthesis to retrieve and synthesize findings across primary qualitative studies that report on patient perspectives during prostate cancer treatment decision-making.	Of 8,610 titles and abstracts reviewed, 29 studies are included in this report. Most men diagnosed with prostate cancer express that their information-seeking pathway extends beyond the medical information received from their health care provider. They access other social resources to attain additional medical information, lived-experience information, and medical administrative information to help support their final treatment decision. Men value privacy, trust, honesty, control, power, organization, and open communication during interactions with their health care providers. They also emphasize the importance of gaining comfort with their treatment choice, having a chance to confirm their health care provider's recommendations (validation of treatment plan), and exercising their preferred level of independence in the treatment decision-making process.	Although each prostate cancer patient is unique, studies suggest that most patients seek extensive information to help inform their treatment decisions. This may happen before, during, and after the treatment choice is made. Given the amount of information patients may access, it is important that they also establish the trustworthiness of the various types and sources of information. When information conflicts, patients may be unsure about how to proceed. Open collaboration between patients and their health care providers can help patients manage and navigate their concerns so that their values and perspectives are captured in their treatment choices.	
28572606	Millions of people globally are at high risk for neurodegenerative disorders, infertility or having children with a disability as a result of the Fragile X (FX) premutation, a genetic abnormality in FMR1 that is underdiagnosed. Despite the high prevalence of the FX premutation and its effect on public health and family planning, most FX premutation carriers are unaware of their condition. Since genetic testing for the premutation is resource intensive, it is not practical to screen individuals for FX premutation status using genetic testing. In a novel approach to phenotyping, we have utilized audio recordings and cognitive profiling assessed via self-administered questionnaires on 200 females. Machine-learning methods were developed to discriminate FX premutation carriers from mothers of children with autism spectrum disorders, the comparison group. By using a random forest classifier, FX premutation carriers could be identified in an automated fashion with high precision and recall (0.81 F1 score). Linguistic and cognitive phenotypes that were highly associated with FX premutation carriers were high language dysfluency, poor ability to organize material, and low self-monitoring. Our framework sets the foundation for computational phenotyping strategies to pre-screen large populations for this genetic variant with nominal costs.
28572007	Touch is central to interpersonal interactions. Touch conveys specific emotions about the touch provider, but it is not clear whether this is a purely socially learned function or whether it has neurophysiological specificity. In two experiments with healthy participants (N = 76 and 61) and one neuropsychological single case study, we investigated whether a type of touch characterised by peripheral and central neurophysiological specificity, namely the C tactile (CT) system, can communicate specific emotions and mental states. We examined the specificity of emotions elicited by touch delivered at CT-optimal (3cm/s) and CT-suboptimal (18cm/s) velocities (Experiment 1) at different body sites which contain (forearm) vs. do not contain (palm of the hand) CT fibres (Experiment 2). Blindfolded participants were touched without any contextual cues, and were asked to identify the touch provider's emotion and intention. Overall, CT-optimal touch (slow, gentle touch on the forearm) was significantly more likely than other types of touch to convey arousal, lust or desire. Affiliative emotions such as love and related intentions such as social support were instead reliably elicited by gentle touch, irrespective of CT-optimality, suggesting that other top-down factors contribute to these aspects of tactile social communication. To explore the neural basis of this communication, we also tested this paradigm in a stroke patient with right perisylvian damage, including the posterior insular cortex, which is considered as the primary cortical target of CT afferents, but excluding temporal cortex involvement that has been linked to more affiliative aspects of CT-optimal touch. His performance suggested an impairment in 'reading' emotions based on CT-optimal touch. Taken together, our results suggest that the CT system can add specificity to emotional and social communication, particularly with regards to feelings of desire and arousal. On the basis of these findings, we speculate that its primary functional role may be to enhance the 'sensual salience' of tactile interactions.
28571171	Each year, millions of patients around the world are affected by Health Care Associated Infections (HCAIs). Understanding and assessing the global burden of HCAI is one of the key areas of work to improve the hand hygiene.To assess the patient empowerment and awareness on hand hygiene among online users.	A web-based cross-sectional survey was conducted during September 2013 to December 2013 among adults. A predesigned questionnaire to assess the awareness on hand hygiene was sent to volunteers through emails and social networking sites. The data were transferred to excel sheet and analyzed in Epi info and represented in proportions and percentages.	Total 94 (57%) participants responded to the survey among which 51.1% were males and 48.9% were females. Majority of them belongs to the age group of 20 to 35 years. Only 28.7% of them said they will ever ask health care worker to wash their hands before they examine. A 27.7% of the participants reported that their country/community have a program that educates/communicates with patients about the importance of hand hygiene.	Adherence and compliance to hand hygiene practices is suboptimal among people. There seems to be a lack of knowledge regarding hand hygiene.	
28569746	Communication provides the basis for social life. In ant colonies, the prevalence of local, often chemically mediated, interactions introduces strong links between communication networks and the spatial distribution of ants. It is, however, unknown how ants identify and maintain nest chambers with distinct functions. Here, we combine individual tracking, chemical analysis and machine learning to decipher the chemical signatures present on multiple nest surfaces. We present evidence for several distinct chemical 'road-signs' that guide the ants' movements within the dark nest. These chemical signatures can be used to classify nest chambers with different functional roles. Using behavioural manipulations, we demonstrate that at least three of these chemical signatures are functionally meaningful and allow ants from different task groups to identify their specific nest destinations, thus facilitating colony coordination and stabilization. The use of multiple chemicals that assist spatiotemporal guidance, segregation and pattern formation is abundant in multi-cellular organisms. Here, we provide a rare example for the use of these principles in the ant colony.
28569621	To investigate the impact of childhood cancer on parents' adult attachment, social support, marital adjustment, anxiety, and depression.30 parents of children with childhood cancer and 30 matched controls completed the following questionnaires: Experiences in Close Relationships-Revised, Dyadic Adjustment Scale-4, Multidimensional Scale of Perceived Social Support, State-Trait Anxiety Inventory - form Y, and Beck Depression Inventory.	Parents of children with childhood cancer had a significantly lower dyadic adjustment than controls, and higher levels of insecure-avoidant attachment, state anxiety, and depression.	It is important for health-care personnel to take into account these parents' propensity to show increased levels of avoidant attachment during children's treatment to foster effective communication and supportive relationships between clinicians, pediatric patients, and parents.	
28569534	To assess family caregivers' opinions about level of interaction with the environment in their relatives with disorders of consciousness (DOCs) and to explore psychological features of caregivers whose opinions diverge from clinicians' diagnosis.Forty-five family caregivers of 38 DOC inpatients without communication abilities answered 2 questions assessing their opinion about level of interaction with the environment in their relatives. Self-report questionnaires were used to evaluate caregivers' depression, anxiety, psychophysiological disturbances, prolonged grief disorder, coping strategies, quality of perceived needs and social support.	Fifteen caregivers (5 relatives of patients in vegetative state and 10 of patients in minimally conscious state) considered their relatives able to communicate, in contrast with clinical diagnosis. These caregivers had significantly higher depressive symptoms, and higher worries about possible death of their relatives with respect to the remaining caregivers.	Caregivers of DOC patients detected some interaction with the environment in their relatives more often than care professionals. This is likely related to caregivers' beliefs and expectations, but is also based on observations closer and longer than those possible for physicians. These considerations are important to build a therapeutic alliance with caregivers and to involve them in the diagnostic process and rehabilitative program. (PsycINFO Database Record	
28569395	General practitioners (GPs) engage with patients about a variety of social issues distinct from direct clinical work ("non-health" issues), such as health-related benefits and debt. Co-located welfare advice services could provide support to practices but have usually been considered in terms of patient rather than practice outcomes. We aimed to develop an initial programme theory for how the provision of co-located advice supports specific practice outcomes, and to identify salient barriers and enabling factors. Twenty-four semi-structured interviews with general practice staff, advice staff and service funders in two UK urban localities were conducted between January and July 2016. Data were thematically analysed and a modified Realist Evaluation approach informed the topic guide, thematic analysis and interpretation. Two outcomes are described linked to participant accounts of the impact of such non-health work on practices: reduction of GP consultations linked to non-health issues and reduced practice time spent on non-health issues. We found that individual responses and actions influencing service awareness were key facilitators to each of the practice outcomes, including proactive engagement, communication, regular reminders and feedback between advice staff, practice managers and funders. Facilitating implementation factors were: not limiting access to GP referral, and offering booked appointments and advice on a broader range of issues responsive to local need. Key barriers included pre-existing sociocultural and organisational rules and norms largely outside of the control of service implementers, which maintained perceptions of the GP as the "go-to-location". We conclude that co-location of welfare advice services alone is unlikely to enable positive outcomes for practices and suggest several factors amenable to intervention that could enhance the potential for co-location to meet desired objectives.
28569151	Research into relational care in hospitals will be facilitated by a focus on staff-patient interactions. The Quality of Interactions Schedule (QuIS) uses independent observers to measure the number of staff-patient interactions within a healthcare context, and to rate these interactions as 'positive social'; 'positive care'; 'neutral'; 'negative protective'; or 'negative restrictive'. QuIS was developed as a research instrument in long term care settings and has since been used for quality improvement in acute care. Prior to this study, its use had not been standardised, and reliability and validity in acute care had not been established.In 2014 and 2015 a three - phase study was undertaken to develop and test protocols for the use of QuIS across three acute wards within one NHS trust in England. The phases were: (1) A pilot of 16 h observation which developed implementation strategies for QuIS in this context; (2) training two observers and undertaking 16 h of paired observation to inform the development of training protocols; (3) training four nurses and two lay volunteers according to a finalised protocol followed by 36 h of paired observations to test inter-rater agreement. Additionally, patients were asked to rate interactions and to complete a shortened version of the Patient Evaluation of Emotional Care during Hospitalisation (PEECH) questionnaire.	Protocols were developed for the use of QuIS in acute care. Patients experienced an average of 6.7 interactions/patient/h (n = 447 interactions). There was close agreement between observers in relation to the number of interactions observed (Intraclass correlation coefficient (ICC) = 0.97) and moderate to substantial agreement on the quality of interactions (absolute agreement 73%, kappa 0.53 to 0.62 depending on weighting scheme). There was 79% agreement (weighted kappa 0.40: P < 0.001; indicating fair agreement) between patients and observers over whether interactions were positive, negative or neutral.	Observers using clear QuIS protocols can achieve levels of agreement that are acceptable for the use of QuIS as a research instrument. There is fair agreement between observers and patients' rating of interactions. Further research is needed to explore the relationship between QuIS measures and reported patient experience.	
28568910	This study is the largest to date examining executive function and adaptive skills in females with autism spectrum disorder (ASD). Its primary aim was to utilize parent ratings of real-world executive functioning and adaptive behavior to better understand whether females with ASD differ from males with ASD in these areas of everyday functioning. We compared 79 females with ASD to 158 males with ASD (ages 7-18) who were statistically matched on age, IQ, and level of ADHD or ASD traits. All participants were assessed using the Behavior Rating Inventory of Executive Function (BRIEF) and a subset (56 females and 130 males) also received the Vineland Adaptive Behavior Scales (VABS). Females were rated by parents as having greater problems with executive function on the BRIEF. Parents also rated females as exhibiting more difficulties than males on the Daily Living Skills domain of the VABS. There was a correlation between increased global EF difficulty and decreased adaptive ability in both males and females. Our results indicate relative weaknesses for females compared to males diagnosed with ASD on executive function and daily living skills. These differences occur in the absence of sex differences in our sample in age, IQ, clinician ratings of core ASD symptomatology, parent ratings of ADHD symptoms, and parent-reported social and communication adaptive skills on the VABS. These findings indicate specific liabilities in real world EF and daily living skills for females with ASD and have important implications for targeting their treatments. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28568480	The objective of this paper is to identify attribute patterns of influential individuals in intensive care units using unsupervised cluster analysis.Despite the acknowledgement that culture of an organisation is critical to improving patient safety, specific methods to shift culture have not been explicitly identified.	A social network analysis survey was conducted and an unsupervised cluster analysis was used.	A total of 100 surveys were gathered. Unsupervised cluster analysis was used to group individuals with similar dimensions highlighting three general genres of influencers: well-rounded, knowledge and relational.	Culture is created locally by individual influencers. Cluster analysis is an effective way to identify common characteristics among members of an intensive care unit team that are noted as highly influential by their peers. To change culture, identifying and then integrating the influencers in intervention development and dissemination may create more sustainable and effective culture change. Additional studies are ongoing to test the effectiveness of utilising these influencers to disseminate patient safety interventions.	This study offers an approach that can be helpful in both identifying and understanding influential team members and may be an important aspect of developing methods to change organisational culture.	
28567546	Developing positive peer relationships is important. Unfortunately, due to challenges in social communication and increased complexity of peer groups during adolescence, many secondary students with autism spectrum disorder (ASD) engage in limited positive social interactions with peers. This study examined the effects of a peer network intervention implemented with three high school students with ASD. A multiple-baseline across participants design was used to evaluate the intervention on initiations and responses to and from students with ASD. The impact on frequency of victimization of students with ASD was also explored. Results indicate peer networks are effective at increasing social interactions of secondary students with ASD and provide preliminary support for the use of peer networks to reduce rates of bullying victimization.
28567414	Education methods have undergone transformation over the centuries. Use of technology is the cornerstone for innovation in teaching methods. Hence, blended learning which includes face to face and online modalities is being increasingly explored as effective method for learning. This pilot study determines the perceptions of faculty members in a private international university on barriers influencing adoption of technology for teaching and learning.A cross-sectional survey was conducted through a self-reported questionnaire using 'survey monkey'. The data was entered and analyzed using Statistical Package for the Social Sciences (SPSS version 20). Frequencies and proportions are reported.	Findings indicated that 51.6% faculty members perceived the importance of integration of technology in their teaching. Around 54% of the participants recognized that they do possess the ability and accessibility to integrate information communication technology (ICT) in teaching and learning, but there is a need to hone the basic information technology (IT) skills to initiate technology driven teaching. Findings revealed that 55% faculty members acknowledged the constraint of not getting protective time to develop and deliver technology driven courses. Further, results showed that 45% faculty members perceived that their innovation efforts in terms of teaching as blended learning do not count towards their professional promotion or recognition, as usually priority is given to research over teaching innovation. The findings also indicated that 54.5% participants asserted that university lack mentorship in the field of blended learning.	Therefore, study suggests that universities should provide adequate mentorship programmes for the faculty members in enhancing their skills of integrating technology in their teaching.	
28567137	Injuries concerning the skull, the mouth and thus potentially involving the mouth and teeth are characterized as major public health problems due to their high prevalence and very serious functional and aesthetic consequences. Pain, aesthetic and functional problems arising from dental trauma significantly disrupt normal function, and impact, often dramatically, on young patients' quality of life.With regards to the behavior management approach to a child who has suffered a dental trauma, dentist's first step is to be to reassure child and parents. They should feel that the emergency is being properly treated on the part of the dentist and feel safe. The dentist should offer psychological support to child and parents and focus on alleviating any possible pain the child may feel. But, before that, a good level of communication with the child should be established.	This can be achieved through the tell-show-do technique, a presentation of the special session's structure, the positive reinforcement method, the attention distraction method and exploiting the child's imagination. The detailed description of the treatment to be followed is crucial for reducing the child's level of stress, as well as that of the parents. Immediately after the completion of treatment, dentist should give listening time to the parents for any queries and include the child who probably wants to share their experience.	
28566999	Communication consists of social interaction, recognition, and information transmission. Communication ability is the most affected component in children with autism spectrum disorder (ASD). Recently, we reported that the CD157/BST1 gene is associated with ASD, and that CD157 knockout (Cd157-/-) mice display severe impairments in social behavior that are improved by oxytocin (OXT) treatment. Here, we sought to determine whether Cd157-/- mice can be used as a suitable model for communication deficits by measuring ultrasonic vocalizations (USVs), especially in the early developmental stage. Call number produced in pups due to isolation from dams was higher at postnatal day (PND) 3 in knockout pups than wild-type mice, but was lower at PNDs 7 and 10. Pups of both genotypes had similarly limited voice repertoires at PND 3. Later on, at PNDs 7 and 10, while wild-type pups emitted USVs consisting of six different syllable types, knockout pups vocalized with only two types. This developmental impairment in USV emission was rescued within 30 min by intraperitoneal OXT treatment, but quickly returned to control levels after 120 min, showing a transient effect of OXT. USV impairment was partially observed in Cd157+/- heterozygous mice, but not in Cd157-/- adult male mice examined while under courtship. These results demonstrate that CD157 gene deletion results in social communication insufficiencies, and suggests that CD157 is likely involved in acoustic communication. This unique OXT-sensitive developmental delay in Cd157-/- pups may be a useful model of communicative interaction impairment in ASD.
28566569	 Recently, the practice of active learning has spread, increasingly recognized as an essential component of academic studies. Classes incorporating small group discussion (SGD) are conducted at many universities. At present, assessments of the effectiveness of SGD have mostly involved evaluation by questionnaires conducted by teachers, by peer assessment, and by self-evaluation of students. However, qualitative data, such as open-ended descriptions by students, have not been widely evaluated. As a result, we have been unable to analyze the processes and methods involved in how students acquire knowledge in SGD. In recent years, due to advances in information and communication technology (ICT), text mining has enabled the analysis of qualitative data. We therefore investigated whether the introduction of a learning system comprising the jigsaw method and problem-based learning (PBL) would improve student attitudes toward learning; we did this by text mining analysis of the content of student reports. We found that by applying the jigsaw method before PBL, we were able to improve student attitudes toward learning and increase the depth of their understanding of the area of study as a result of working with others. The use of text mining to analyze qualitative data also allowed us to understand the processes and methods by which students acquired knowledge in SGD and also changes in students' understanding and performance based on improvements to the class. This finding suggests that the use of text mining to analyze qualitative data could enable teachers to evaluate the effectiveness of various methods employed to improve learning.
28564623	This qualitative study explored the challenges that Greek parents/caregivers of children with controlled epilepsy (CwE) face regarding the disorder.Interviews were conducted based on open-ended questions guided by a review of the literature. A total of 91 parents/caregivers were recruited by neurologists at the neurology clinics of two Athens public hospitals. A hermeneutic phenomenological approach was used to explore parent/caregiver experiences. The data were grouped and analyzed through a textual interpretation.	Two key challenges were identified for parents of CwE: the disclosure of epilepsy and the absence of adequate information about coping with epilepsy. Parents in Greece were hesitant to reveal their child's epilepsy to school staff and their wider social milieu. Also, although satisfied with the patient-centered approach they experienced with their hospital doctor, parents/caregivers found that they needed more education about the existing sources of psychosocial and emotional support to cope with their child's epilepsy personally and as a family. Finally, the parents/caregivers who let their child know about the epilepsy and discussed the implications with the child found that parent-child communication improved.	This study provides valuable insight into the impact of epilepsy on parents of CwE, which might help hospital and school staff support families with greater understanding, sensitivity, and skill. The findings suggest that Greek authorities should staff hospitals and schools with experts and more systematically advertise sources of information about epilepsy and ways to cope with it.	
28562271	Children in child care centers represent an important population to consider in attempts to mitigate the spread of an influenza pandemic. This national survey, conducted in 2008 and 2016, assessed directors' reports of their child care centers' pandemic influenza preparation before and after the 2009 H1N1 novel influenza pandemic.This was a telephone-based survey of child care center directors randomly selected from a national database of licensed US child care centers who were queried about their preparedness for pandemic influenza. We grouped conceptually related items in 6 domains into indexes: general infection control, communication, seasonal influenza control, use of health consultants, quality of child care, and perceived barriers. These indexes, along with other center and director characteristics, were used to predict pandemic influenza preparedness.	Among 1500 and 518 child care center directors surveyed in 2008 and 2016, respectively, preparation for pandemic influenza was low and did not improve. Only 7% of directors had taken concrete actions to prepare their centers. Having served as a center director during the 2009 influenza pandemic did not influence preparedness. After adjusting for covariates, child care health consultation and years of director's experience were positively associated with pandemic influenza preparation, whereas experiencing perceived barriers such as lack of knowing what to do in the event of pandemic influenza, was negatively associated with pandemic influenza preparedness.	Pandemic influenza preparedness of child care center's directors needs to improve. Child care health consultants are likely to be important collaborators in addressing this problem.	
28562251	According to the temporal theory of autism spectrum disorders (ASDs), audiovisual changes in environment, particularly those linked to facial and verbal language, are often too fast to be faced, perceived, and/or interpreted online by many children with ASD, which could help explain their facial, verbal, and/or socioemotional interaction impairments. Our goal here was to test for the first time the impact of slowed-down audiovisual information on verbal cognition and behavior in 2 boys with ASD and verbal delay. Using 15 experimental sessions during 4 months, both boys were presented with various stimuli (eg, pictures, words, sentences, cartoons) and were then asked questions or given instructions regarding stimuli. The audiovisual stimuli and instructions/questions were presented on a computer's screen and were always displayed twice: at real-time speed (RTS) and at slowed-down speed (SDS) using the software Logiral. We scored the boys' verbal cognition performance (ie, ability to understand questions/instructions and answer them verbally/nonverbally) and their behavioral reactions (ie, attention, verbal/nonverbal communication, social reciprocity), and analyzed the effects of speed and order of the stimuli presentation on these factors. According to the results, both participants exhibited significant improvements in verbal cognition performance with SDS presentation compared with RTS presentation, and they scored better with RTS presentation when having SDS presentation before rather than after RTS presentation. Behavioral reactions were also improved in SDS conditions compared with RTS conditions. This initial evidence of a positive impact of slowed-down audiovisual information on verbal cognition should be tested in a large cohort of children with ASD and associated speech/language impairments.
28562094	Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents' use of social media, and online communication platforms have exposed adolescents to another mode of bullying- cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.
28561885	In the aftermath of the A/H1N1 pandemic, health authorities were criticized for failures in crisis communication efforts, and the media were accused of amplifying the pandemic. Considering these criticisms, A/H1N1 provides a suitable case for examining risk amplification processes that may occur in the transfer of information from press releases to print news media during a health crisis. We integrated the social amplification of risk framework with theories of news decisions (news values, framing) in an attempt to contribute to existing research both theoretically and empirically. We conducted a quantitative content analysis of press releases disseminated by health and governmental authorities, as well as the quality and tabloid press in 10 European countries between March 2009 and March 2011. Altogether 243 press releases, 1,243 quality press articles, and 834 tabloid press articles were coded. Consistent with research on news values and framing the results suggest that quality and tabloid papers alike amplified A/H1N1 risks by emphasizing conflict and damage, presenting information in a more dramatized way, and using risk-amplifying frames to a greater extent and risk-attenuating frames to a lesser extent than press releases. To some extent, the quality and tabloid press differed in how risk information was presented. While tabloid press articles seemed to follow the leading quality press with regards to content and framing of health crisis coverage, they exhibited a stronger emphasis on drama and emotion in the way they presented information.
28561727	Social media has become an established method of communication, and many physicians are finding these interactive tools and platforms to be useful for both personal and professional use. Risks of social media, or barriers to its use, include perceived lack of time, privacy concerns, and the risk of damage to one's reputation by unprofessional behavior. Of the social media platforms, Twitter has become favored by physicians and other health care professionals. Although one of the most obvious uses of social media is for rapid dissemination and receipt of information, oncologists are finding that social media is important for networking through blogs, Facebook, and Twitter. These platforms also have potential for providing opportunities for professional development, such as finding collaborators through networking, participation in Twitter journal clubs, and participating in online case-based tumor boards. Social media can also be used for patient engagement, such as through participation in tweet chats. There is emerging data that patient engagement through these platforms may lead to improvement in some health-related outcomes; however, data are sparse for oncology-specific outcomes. Efforts are underway to determine how to assess how social media engagement impacts health outcomes in oncology patients.
28557875	The benefits of having a support system, such as social relationships with close friends and family, have been well documented for patients with serious health issues. As scientific evidence has shown, individuals who have the lowest level of involvement in social relationships face a greater mortality risk. Support systems, however, are not infallible. Relationship stress can have a negative impact on people-patient and caregiver alike-behaviorally, psychosocially, and physiologically. The purpose of this article is to encourage case managers who take a patient-centered approach to also consider the existence and extent of the support system, as well as any stresses or tensions that are observable within the support system. Although the case manager is ethically obliged to advocate for the individual receiving case management services, that advocacy can be extended to the support system for the good of all.This discussion applies to numerous case management practices and work settings including (but not limited to) hospital-based case management, home health, geriatrics, catastrophic case management, mental health, palliative care, and end of life/hospice.	As part of the assessment phase of the case management process, case managers determine the extent of the patient's support system or social support network such as family and close friends. Although their advocacy is primarily for the patient receiving case management services, case managers also become aware of the needs of the support system members as they face their loved one's serious illness, severe injury, geriatric care demands, or end of life. Case managers can use their communication skills, especially motivational interviewing, with patients and their support systems to identify stresses and issues that can impact the pursuit of health goals. In addition, case managers ensure that individuals and their support systems are kept informed such as about the health condition, stage of disease, plan of care, treatment options, and care transition plan.	Professional case managers expand their role as advocates, serving primarily the patients ("clients") who receive case management services and also members of the support system. By becoming more aware and sensitive to the needs of the support system, case managers help reduce stress on the support system, which can contribute to positive outcomes for patients ("clients").	
28557640	Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.
28557247	To support clinical decision-making in central neurological disorders, a physical examination is used to assess responses to passive muscle stretch. However, what exactly is being assessed is expressed and interpreted in different ways. A clear diagnostic framework is lacking. Therefore, the aim was to arrive at unambiguous terminology about the concepts and measurement around pathophysiological neuromuscular response to passive muscle stretch.During two consensus meetings, 37 experts from 12 European countries filled online questionnaires based on a Delphi approach, followed by plenary discussion after rounds. Consensus was reached for agreement ≥75%.	The term hyper-resistance should be used to describe the phenomenon of impaired neuromuscular response during passive stretch, instead of for example 'spasticity' or 'hypertonia'. From there, it is essential to distinguish non-neural (tissue-related) from neural (central nervous system related) contributions to hyper-resistance. Tissue contributions are elasticity, viscosity and muscle shortening. Neural contributions are velocity dependent stretch hyperreflexia and non-velocity dependent involuntary background activation. The term 'spasticity' should only be used next to stretch hyperreflexia, and 'stiffness' next to passive tissue contributions. When joint angle, moment and electromyography are recorded, components of hyper-resistance within the framework can be quantitatively assessed.	A conceptual framework of pathophysiological responses to passive muscle stretch is defined. This framework can be used in clinical assessment of hyper-resistance and will improve communication between clinicians. Components within the framework are defined by objective parameters from instrumented assessment. These parameters need experimental validation in order to develop treatment algorithms based on the aetiology of the clinical phenomena.	
28556273	Risk research has theorized a number of mechanisms that might trigger, prolong, or potentially alleviate individuals' distress following terrorist attacks. These mechanisms are difficult to examine in a single study, however, because the social conditions of terrorist attacks are difficult to simulate in laboratory experiments and appropriate preattack baselines are difficult to establish with surveys. To address this challenge, we propose the use of computational focus groups and a novel analysis framework to analyze a social media stream that archives user history and location. The approach uses time-stamped behavior to quantify an individual's preattack behavior after an attack has occurred, enabling the assessment of time-specific changes in the intensity and duration of an individual's distress, as well as the assessment of individual and social-level covariates. To exemplify the methodology, we collected over 18 million tweets from 15,509 users located in Paris on November 13, 2015, and measured the degree to which they expressed anxiety, anger, and sadness after the attacks. The analysis resulted in findings that would be difficult to observe through other methods, such as that news media exposure had competing, time-dependent effects on anxiety, and that gender dynamics are complicated by baseline behavior. Opportunities for integrating computational focus group analysis with traditional methods are discussed.
28555774	Based on an in-depth study with 56 informants (25 women and 31 men), across the ICT (information and communication technology), creative and academic sectors in one city/regional hub in Ireland, this article investigates the so-called revolution in work/life practices associated with the post-Fordist labour processes of the Knowledge Economy from the perspectives of workers themselves. Recent theorizations of post-Fordist work patterns emphasize a rearranging of work and life place boundaries; a reconfiguring of work and life time boundaries; and a dissolving of the gendered boundaries of work and life (production and social reproduction) (Adkins and Dever ; Morini and Fumagalli ; Gill and Pratt ; Weeks ; Hardt and Negri ). Our findings suggest that, instead of dissolving boundaries, workers constantly struggle to draw boundaries between what counts as work and as life, and that this varies primarily in relation to gender and stage in a gendered life trajectory. Work extensification is compensated for via a perceived freedom to shape one's own life, which is articulated in terms of individualized boundary-drawing. While younger men embraced 'always on' work, they also articulated anxieties about how these work habits might interfere with family aspirations. This was also true for younger women who also struggled to make time for life in the present. For mothers, boundary drawing was articulated as a necessity but was framed more in terms of personal choice by fathers. Although all participants distinguished between paid work and life as distinct sites of value, boundaries were individually drawn and resist any easy mapping of masculinity and femininity onto the domains of work and life. Instead, we argue that it is the process of boundary drawing that reveals gendered patterns. The personalized struggles of these relatively privileged middle-class workers centre on improving the quality of their lives, but raise important questions about the political possibilities within and beyond the world of post-Fordist labour.
28555167	Impaired recognition of emotion after stroke can have important implications for social competency, social participation, and consequently quality of life. We describe a case of left hemispheric ischemic stroke with impaired recognition of specifically faces expressing fear. Three months later, the patient's spouse reports that the patient was irritable and slow in communication, which may be caused by the impaired emotion recognition. The case is discussed in relation to the literature concerning emotion recognition and its neural correlates. Our case supports the notion that emotion recognition, including fear recognition, is regulated by a network of interconnected brain regions located in both hemispheres. We conclude that impaired emotion recognition is not uncommon after stroke and can be caused by dysfunction of this emotion-network.
28554888	Pain remains a problem for people with cancer despite effective treatments being available. We aimed to explore current pain management strategies used by patients, caregivers and professionals and to investigate opportunities for digital technologies to enhance cancer pain management.A qualitative study comprising semistructured interviews and focus groups. Patients with cancer pain, their caregivers and health professionals from Northeast Scotland were recruited from a purposive sample of general practices. Professionals were recruited from regional networks.	Fifty one participants took part in 33 interviews (eight patients alone, six patient/caregiver dyads and 19 professionals) and two focus groups (12 professionals). Living with cancer was hard work for patients and caregivers and comparable to a 'full-time job'. Patients had personal goals which involved controlling pain intensity and balancing this with analgesic use, side effects, overall symptom burden and social/physical activities.Digital technologies were embraced by most patients, and made living life with advanced cancer easier and richer (eg, video calls with family). Technology was underutilised for pain and symptom management. There were suggestions that technology could support self-monitoring and communicating problems to professionals, but patients and professionals were concerned about technological monitoring adding to the work of managing illness.	Cancer pain management takes place in the context of multiple, sometimes competing personal goals. It is possible that technology could be used to help patients share individual symptom experiences and goals, thus enhancing tailored care. The challenge is for digital solutions to add value without adding undue burden.	
28554500	To examine current vaccine sentiment on social media by constructing and analyzing semantic networks of vaccine information from highly shared websites of Twitter users in the United States; and to assist public health communication of vaccines.Vaccine hesitancy continues to contribute to suboptimal vaccination coverage in the United States, posing significant risk of disease outbreaks, yet remains poorly understood.	We constructed semantic networks of vaccine information from internet articles shared by Twitter users in the United States. We analyzed resulting network topology, compared semantic differences, and identified the most salient concepts within networks expressing positive, negative, and neutral vaccine sentiment.	The semantic network of positive vaccine sentiment demonstrated greater cohesiveness in discourse compared to the larger, less-connected network of negative vaccine sentiment. The positive sentiment network centered around parents and focused on communicating health risks and benefits, highlighting medical concepts such as measles, autism, HPV vaccine, vaccine-autism link, meningococcal disease, and MMR vaccine. In contrast, the negative network centered around children and focused on organizational bodies such as CDC, vaccine industry, doctors, mainstream media, pharmaceutical companies, and United States. The prevalence of negative vaccine sentiment was demonstrated through diverse messaging, framed around skepticism and distrust of government organizations that communicate scientific evidence supporting positive vaccine benefits.	Semantic network analysis of vaccine sentiment in online social media can enhance understanding of the scope and variability of current attitudes and beliefs toward vaccines. Our study synthesizes quantitative and qualitative evidence from an interdisciplinary approach to better understand complex drivers of vaccine hesitancy for public health communication, to improve vaccine confidence and vaccination coverage in the United States.	
28554148	While the social burden of epilepsy has been extensively studied, an evaluation of social media related to epilepsy may provide novel insight into disease perception, patient needs and access to treatments. The objective of this study is to assess patterns in social media and online communication usage related to epilepsy and its associated topics.We searched two major social media platforms (Facebook and Twitter) for public accounts dedicated to epilepsy. Results were analyzed using qualitative and quantitative methodologies. The former involved thematic and word count analysis for online posts and tweets on these platforms, while the latter employed descriptive statistics and non-parametric tests.	Facebook had a higher number of pages (840 accounts) and users (3 million) compared to Twitter (137 accounts and 274,663 users). Foundation and support groups comprised most of the accounts and users on both Facebook and Twitter. The number of accounts increased by 100% from 2012 to 2016. Among the 403 posts and tweets analyzed, "providing information" on medications or correcting common misconceptions in epilepsy was the most common theme (48%). Surgical interventions for epilepsy were only mentioned in 1% of all posts and tweets.	The current study provides a comprehensive reference on the usage of social media in epilepsy. The number of online users interested in epilepsy is likely the highest among all neurological conditions. Surgery, as a method of treating refractory epilepsy, however, could be underrepresented on social media.	
28553702	Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression. Within the area of serious mental disorders, the aim of the therapy is to help people improve their emotional and relational competencies, and address issues they may not be able to using words alone.To review the effects of music therapy, or music therapy added to standard care, compared with placebo therapy, standard care or no treatment for people with serious mental disorders such as schizophrenia.	We searched the Cochrane Schizophrenia Group's Trials Study-Based Register (December 2010 and 15 January, 2015) and supplemented this by contacting relevant study authors, handsearching of music therapy journals and manual searches of reference lists.	All randomised controlled trials (RCTs) that compared music therapy with standard care, placebo therapy, or no treatment.	Review authors independently selected, quality assessed and data extracted studies. We excluded data where more than 30% of participants in any group were lost to follow-up. We synthesised non-skewed continuous endpoint data from valid scales using a standardised mean difference (SMD). We employed a fixed-effect model for all analyses. If statistical heterogeneity was found, we examined treatment dosage (i.e. number of therapy sessions) and treatment approach as possible sources of heterogeneity.	Ten new studies have been added to this update; 18 studies with a total 1215 participants are now included. These examined effects of music therapy over the short, medium, and long-term, with treatment dosage varying from seven to 240 sessions. Overall, most information is from studies at low or unclear risk of biasA positive effect on global state was found for music therapy compared to standard care (medium term, 2 RCTs, n = 133, RR 0.38 95% confidence interval (CI) 0.24 to 0.59, low-quality evidence, number needed to treat for an additional beneficial outcome NNTB 2, 95% CI 2 to 4). No binary data were available for other outcomes. Medium-term continuous data identified good effects for music therapy on negative symptoms using the Scale for the Assessment of Negative Symptoms (3 RCTs, n = 177, SMD - 0.55 95% CI -0.87 to -0.24, low-quality evidence). General mental state endpoint scores on the Positive and Negative Symptoms Scale were better for music therapy (2 RCTs, n = 159, SMD -0.97 95% CI -1.31 to -0.63, low-quality evidence), as were average endpoint scores on the Brief Psychiatric Rating Scale (1 RCT, n = 70, SMD -1.25 95% CI -1.77 to -0.73, moderate-quality evidence). Medium-term average endpoint scores using the Global Assessment of Functioning showed no effect for music therapy on general functioning (2 RCTs, n = 118, SMD -0.19 CI -0.56 to 0.18, moderate-quality evidence). However, positive effects for music therapy were found for both social functioning (Social Disability Screening Schedule scores; 2 RCTs, n = 160, SMD -0.72 95% CI -1.04 to -0.40), and quality of life (General Well-Being Schedule scores: 1 RCT, n = 72, SMD 1.82 95% CI 1.27 to 2.38, moderate-quality evidence). There were no data available for adverse effects, service use, engagement with services, or cost.	Moderate- to low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms), social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcome measures in relation to music therapy.	
28553692	The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women with a self-reported traumatic childbirth experience. Women were recruited in March 2016 through social media, including specific parent support groups. They filled out a 35-item questionnaire of which the most important items were (1) self-reported attributions of the trauma and how they believe the traumatic experience could have been prevented (2) by the caregivers or (3) by themselves. The responses most frequently given were (1) Lack and/or loss of control (54.6%), Fear for baby's health/life (49.9%), and High intensity of pain/physical discomfort (47.4%); (2) Communicate/explain (39.1%), Listen to me (more) (36.9%), and Support me (more/better) emotionally/practically (29.8%); and (3) Nothing (37.0%), Ask for (26.9%), or Refuse (16.5%) certain interventions. Primiparous participants chose High intensity of pain/physical discomfort, Long duration of delivery, and Discrepancy between expectations and reality more often and Fear for own health/life, A bad outcome, and Delivery went too fast less often than multiparous participants. Women attribute their traumatic childbirth experience primarily to lack and/or loss of control, issues of communication, and practical/emotional support. They believe that in many cases, their trauma could have been reduced or prevented by better communication and support by their caregiver or if they themselves had asked for or refused interventions.
28553240	Humans use both verbal and non-verbal communication to interact with others and their environment and increasingly these interactions are occurring in a digital medium. Whether live or digital, learning to communicate requires overcoming the correspondence problem: There is no direct mapping, or correspondence between perceived and self-produced signals. Reconciliation of the differences between perceived and produced actions, including linguistic actions, is difficult and requires integration across multiple modalities and neuro-cognitive networks. Recent work on the neural substrates of social learning suggests that there may be a common mechanism underlying the perception-production cycle for verbal and non-verbal communication. The purpose of this paper is to review evidence supporting the link between verbal and non-verbal communications, and to extend the hMNS literature by proposing that recent advances in communication technology, which at times have had deleterious effects on behavioral and perceptual performance, may disrupt the success of the hMNS in supporting social interactions because these technologies are virtual and spatiotemporal distributed nature.
28552599	The Fmr1 knockout (KO) mouse has commonly been used to investigate communication impairments, one of the key diagnostic symptoms observed in Fragile X syndrome (FXS) and Autism spectrum disorder (ASD). Many studies have found alterations in ultrasonic vocalizations (USVs) in neonatal Fmr1 KO mice, however, there is limited research investigating whether these deficits continue into adulthood. In the present study, we examine differences in female urine-induced ultrasonic vocalizations, scent marking behavior, odor discrimination, and open field activity in adult male Fmr1 KO and wildtype (WT) mice. Overall, we found extensive alterations between genotypes in both spectral and temporal properties of ultrasonic vocalizations. There was no difference in the average number of calls emitted by both genotypes, however, Fmr1 KO mice emitted calls of a higher frequency, decreased amplitude, and shorter duration than WT mice. Spectrographic analyses revealed statistically significant differences between genotypes in the types of calls emitted. Contrastingly, we found no differences in scent marking behavior, a form of social communication, or in odor discrimination and activity levels of the mice. The results corroborate previous studies emphasizing the importance of qualitative differences observed in vocalization behavior of Fmr1 KO mice, rather than quantitative measurements such as number of calls emitted. Overall, the study confirms the presence of abnormalities in vocalization behavior in adult Fmr1 KO mice that we believe are consistent with communication deficits seen in the syndrome.
28551752	Autism spectrum disorder (ASD) is a neurodevelopmental condition primarily characterised by alterations in social interaction and communication combined with the presence of restricted interests and stereotyped behaviours. Mutations in several genes have been associated with ASD resulting in the generation of corresponding mouse models. Here, we focus on the behavioural (social and stereotyped behaviours), functional and structural traits of mice with mutations in genes encoding defined synaptic proteins including adhesion proteins, scaffolding proteins and subunits of channels and receptors. A meta-analysis on ASD mouse models shows that they can be divided into two subgroups. Cluster I gathered models highly impaired in social interest, stereotyped behaviours, synaptic physiology and protein composition, while Cluster II regrouped much less impaired models, with typical social interactions. This distribution was not related to gene families. Even within the large panel of mouse models carrying mutations in Shank3, the number of mutated isoforms was not related to the severity of the phenotype. Our study points that the majority of structural or functional analyses were performed in the hippocampus. However, to robustly link the structural and functional impairments with the behavioural deficits observed, brain structures forming relevant nodes in networks involved in social and stereotyped behaviours should be targeted in the future. In addition, the characterisation of core ASD-like behaviours needs to be more detailed using new approaches quantifying the variations in social motivation, recognition and stereotyped behaviours.
28551750	Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects more than 1% of children per current estimates. It has been characterised by the following two core behavioural phenotypes: (1) deficits in social interaction and communication and (2) repetitive behaviours, restricted interests and activities. Due to the complex nature of ASD, there are currently no effective treatments. The reason behind this is the clinical and genetic heterogeneity between affected individuals on the one hand and the lack of understanding of the underpinning pathophysiological mechanisms on the other hand. Induced pluripotent stem cells (iPSCs) are reprogrammed stem cells from adult cells. These have the capacity to self-renew and differentiate into any type of cells in the body. Therefore, human iPSCs provide a unique opportunity to study the human cellular and molecular phenotypes associated with ASD. Here, we systematically review various ASD variants and co-morbid diseases modelled using human iPSCs.
28551004	Health information seeking on behalf of others is an important form of social support by which laypeople provide important sources of information for patients. Based on social network theory, we analyze whether this phenomenon also occurs in offline sources. We also seek to learn more about the type of relationships between information seekers and patients, as research to date indicates that surrogate seeking mostly occurs in close relationships between the seeker and the patient.Using a large-scale representative survey from the 28 member states of the European Union (N=26,566), our data comprise all respondents who reported seeking health information online or offline (n=18,750; 70.6%).	Within the past year, 61.0% of the online health information seekers and 61.1% of the offline health information seekers had searched on behalf of someone else. Independent of the information channel, surrogate seekers primarily searched for health information for family members (online: 89.8%; offline: 92.8%); they were significantly less likely to search for information on behalf of someone with whom they had weaker ties, such as colleagues (online: 25.1%; offline: 24.4%). In a multilevel generalized linear model, living together with someone was by far the most relevant determinant for surrogate seeking, with differences between countries or Internet activity being less important.	These results support the assumptions of social network theory. Implications are discussed, especially with regard to the provision of adequate health information.	
28550458	Chinese and Japanese university students make an exchanging of opinions regarding the topic "making a mobile phone call in the bus". Both sides of the communication can achieve different changes of cognition through different ways. This paper focuses on Chinese university students, and analyzes their cognition of the traffic etiquette in Japan and China. Unlike Japanese university students' change of cognition, Chinese university students have made more negative evaluation on Japanese traffic etiquette after the communication. However, this does not mean to shield their traffic etiquette. They have the two-way changes of cognition in both social etiquette and personal behavior. These changes may be related to the unbalanced dialogue relationship, as well as the generation of hot issues. How to generate the hot issues, and promote the two-way movement of understanding are the important clues for the design of communication curriculum to enhance the cultural understanding.
28549702	This article reports the findings of a survey on end-of-life (EOL) care in nursing homes of 18 long-term care experts across 15 countries. The experts were chosen as a convenience-based sample of known experts in each country. The survey was administered in 2016 and included both open-ended responses for defining hospice care, palliative care, and "end of life," and a series of questions related to the following areas-attitudes toward EOL care, current practice and EOL interventions, structure of care, and routine barriers. Overall experts strongly agreed that hospice and palliative care should be available in long-term care facilities and that both are defined by holistic, interdisciplinary approaches using measures of comfort across domains. However, it appears the experts felt that in most countries the reality fell short of what they believed would be ideal care. As a result, experts call for increased training, communication, and access to specialized EOL services within the nursing home.
28549472	Senegal's government has pledged to reduce contraceptive stockouts, which have been frequent in public sector health facilities. An innovative distribution system called the Informed Push Model (IPM) addresses supply chain obstacles through direct regional-to-facility delivery of contraceptives and use of private sector logistics operators. Following promising pilot results, Senegal's Ministry of Health and Social Action committed to a three-year (2013-2016) expansion of IPM to all public health facilities nationwide.From August 2014-July 2016, IPM's six logisticians made 29,319 visits to restock public sector health facilities. During these regular facility visits, the logisticians conducted a physical inventory to flag contraceptive stockouts (no usable stock of any single method available) and asked facility staff to identify the primary reason for documented stockouts. Our descriptive study examines stockout trends over the course of IPM scale-up. We also describe trends in contraceptive consumption over the three-year period using facility-level data collected by the logisticians.	Contraceptive consumption rose by 91% over 35 months in the first three IPM regions, and by 118% in the next five regions (over 26 months). After scale-up to 1,394 health facilities, nationwide consumption rose by 48% over one year. On average, logisticians documented stockouts at fewer than 2% of facility visits. In comparison, two pre-IPM studies in 2011 identified stockouts of selected modern contraceptives at 60-70% of facilities visited, with 84% of clients reporting stockouts in the past year. Six factors (including consumption spikes, IPM-preventable causes, and community outreach) explained most remaining stockouts.	IPM has been highly successful in ensuring full availability of contraceptives across regions and health facilities. The model also has facilitated the flow of essential data on consumption and stockouts from facilities up to district, regional, and central-level managers. These achievements highlight the relevance of professionalizing supply chain management while continuing to mitigate stockouts through enhanced stakeholder communication and improved training, coaching, and supervision of third-party logistics operators. Supply reliability is critical in shaping demand for and regular use of contraception. The government is transitioning the IPM to full management by the National Supply Pharmacy.	
28549233	Previous research suggests that when individuals encounter new information, they interpret it through perceptual 'filters' of prior beliefs, relevant social identities, and messenger credibility. In short, evaluations are not based solely on message accuracy, but also on the extent to which the message and messenger are amenable to the values of one's social groups. Here, we use the release of Pope Francis's 2015 encyclical as the context for a natural experiment to examine the role of prior values in climate change cognition. Based on our analysis of panel data collected before and after the encyclical's release, we find that political ideology moderated views of papal credibility on climate change for those participants who were aware of the encyclical. We also find that, in some contexts, non-Catholics who were aware of the encyclical granted Pope Francis additional credibility compared to the non-Catholics who were unaware of it, yet Catholics granted the Pope high credibility regardless of encyclical awareness. Importantly, papal credibility mediated the conditional relationships between encyclical awareness and acceptance of the Pope's messages on climate change. We conclude by discussing how our results provide insight into cognitive processing of new information about controversial issues.

28548547	Recent A(H1N1) studies suggest that intrapersonal and interpersonal factors may exert influence on people's preventive behaviors for avoiding the flu during pandemics.Nonpharmaceutical interventions (NPIs) and vaccinations play key roles in containing disease transmission during a pandemic. We examined how intrapersonal and interpersonal factors influenced adoption of NPIs and vaccine uptake during the A(H1N1) pandemic of 2009.	The data come from a nationally representative sample survey of 1,569 American adults. Hierarchical multivariable logistic regression was conducted to investigate the association between socioeconomic position, concern and knowledge about the threat, social networks for health advice or health care seeking, health consultations with doctors, and NPIs (including individual's social distancing behaviors and hygiene practices) and vaccine acceptance.	People with higher scores on health-related social networks, more knowledge or concern about A(H1N1), and those who have consulted their doctor were more likely than others to adopt NPIs. There was a significant association between being concerned about A(H1N1), having consulted a doctor, and seeking a vaccine.	These findings suggest that interpersonal communication factors, such as health-related social networks and consultations with doctors, and intrapersonal factors, such as concern and knowledge, play a critical role in NPIs and vaccine uptake during pandemics and offer avenues for intervention.	
28547864	To identify spatial disparities in dental caries experience (measured by dmft (decayed missing filled teeth) index) of children in the city of Braunschweig and to evaluate whether these disparities can be explained by sociodemographic characteristics.We examined the dental health of children aged 3-6 years visiting a daycare centre (DCC) in the metropolitan area of Braunschweig between 2009 and 2014 by combining data on dental health from the annual visits of the local health service with aggregated data on sociodemographic factors for Braunschweig's city districts. We assessed longitudinal patterns of change in average dmft index at district level from 2009 to 2014 using a finite mixture model. We analysed spatial autocorrelation of the district's average dmft indices by Moran's I to identify spatial clusters. With a spatial lag model, we evaluated whether sociodemographic risk factors (data from 2012) were associated with high dmft scores (data from 2014) and whether spatial disparities remained after adjusting for these sociodemographic characteristics.	The average dmft index decreased slightly (β=-0.048; P<.03; CI 95% [-0.079; -0.017]) from 2009 to 2014. The finite mixture model resulted in four different groups of trajectories over time. While three groups showed a decrease in dmft score, one group showed an increase from 2009 to 2014. Moran's I test statistic showed strong evidence for spatial clustering (Moran's I 0.30, P=.002). A cluster of districts with high dmft values was identified in the centre of the city. The spatial lag model showed that both the proportion of unemployed persons (aged 16-65) and the proportion of persons with migration background were associated with the dmft values at district level. After adjusting for these, no further spatial heterogeneity was observed.	We identified regional clusters for poor dental health in a German city and showed that these clusters can be explained by sociodemographic characteristics. The findings support the need of targeted interventions and prevention measures in regions with less favourable sociodemographic characteristics.	
28546968	Nonscholastic abilities among medical students are an important area of concern for the health professionals. Very few studies had been conducted in the past with regard to it.This study was an exploratory study aimed to assess the nonscholastic abilities among medical students in a medical institution in coastal South India.	This study assessed three broad domains of nonscholastic abilities namely personal qualities, interpersonal activities, and communication skills among 106 medical students using a structured questionnaire (27 questions with a total score of 27). The data were analyzed by independent t-test and linear regression model.	About 41.5% (44) of the subjects were males and 52.8% (56) of them were belonged to 18-19 years age group. Overall mean score of nonscholastic abilities was found to be 19.40 (standard deviation = 3.27). Percentile distribution of subjects is at score 17 (25th percentile), 20 (50th percentile), and 22 (75th percentile). Mean personal quality domain score was found to be proportionately lesser than other domains of nonscholastic abilities. Nonscholastic ability score was significantly associated with marks obtained in the previous examination (P = 0.006). However, linear regression analysis revealed that the presence of family problems (P = 0.005) and alcohol use (P = 0.026) were associated with low nonscholastic ability score among medical students.	Nonscholastic abilities are still a required need in medical student's career. Further analytical studies will help in identifying the in-depth evaluation of factors associated with it.	
28545826	We sought to determine if a daily gamified microblogging project improves American Board of Surgery In-Service Training Examination (ABSITE) scores for participants.In July 2016, we instituted a gamified microblogging project using Twitter as the platform and modified questions from one of several available question banks. A question of the day was posted at 7-o׳clock each morning, Monday through Friday. Respondents were awarded points for speed, accuracy, and contribution to discussion topics. The moderator challenged respondents by asking additional questions and prompted them to find evidence for their claims to fuel further discussion. Since 4 months into the microblogging program, a survey was administered to all residents. Responses were collected and analyzed. After 6 months of tweeting, residents took the ABSITE examination. We compared participating residents׳ ABSITE percentile rank to those of their nonparticipating peers. We also compared residents׳ percentile rank from 2016 to those in 2017 after their participation in the microblogging project.	The University of Connecticut general surgery residency is an integrated program that is decentralized across 5 hospitals in the central Connecticut region, including Saint Francis Hospital and Medical Center, located in Hartford.	We advertised our account to the University of Connecticut general surgery residents. Out of 45 residents, 11 participated in Twitter microblogging (24.4%) and 17 responded to the questionnaire (37.8%).	In all, 100% of the residents who were participating in Twitter reported that daily microblogging prompted them to engage in academic reading. Twitter participants significantly increased their ABSITE percentile rank from 2016 to 2017 by an average of 13.7% (±14.1%) while nonparticipants on average decreased their ABSITE percentile rank by 10.0% (±16.6) (p = 0.003).	Microblogging via Twitter with gamification is a feasible strategy to facilitate improving performance on the ABSITE, especially in a geographically distributed residency.	
28545471	One effective model for studying cigarette smoking cessation is the transtheoretical model (TTM). In order to assess to what degree interventions can make variations in individuals' behavior, several questionnaires have been developed based on the TTM. This study aims to describe the development of the Persian version of the Decisional Balance Inventory (DBI) for smoking cessation in Iran and to evaluate its psychometric properties.The forward-backward technique was used to translate the DBI from English into Persian. After linguistic validation and a pilot test among 30 male smoking young adults, a cross-sectional study was performed, and psychometric properties of the Persian version of the DBI were assessed. Using a convenience sampling method, 120 male smokers between 16 and 24 years of age were recruited from three factories in Nowshahr, Iran. In order to assess the reliability of the DBI, internal consistency and test-retest methods were performed. Additionally, face and content validity were assessed, and the construct validity of the DBI was calculated by performing both exploratory and confirmatory factor analysis. Data were analyzed using SPSS and AMOS.	The mean age of the sample (n = 120) was 20.19 (SD = 2.13) years. The mean scores for the content validity index (CVI) and the content validity ratio (CVR) were .94 and .89, respectively. The results of exploratory factor analysis (EFA) showed a three-factor solution for the DBI that accounted for 55.4% of observed variance. The results achieved from the confirmatory factor analysis (CFA) displayed that the data fit the model: the relative chi-square (×2/df) = 1.733 (p < .001) and the root mean square error of approximation (RMSEA) = .07 (90% CI = .05-.105). All comparative indices of the model including GFI, AGFI, CFI, NNFI, and NFI were more than .80 (.87, .83, .91, .89, and .81, respectively). The Cronbach's alpha ranged from .78 to .83, indicating an acceptable reliability. Furthermore, the intraclass correlation coefficient (ICC) ranged from .72 to .89, confirming a satisfactory result.	The results from the present study indicate that the Persian version of the DBI has good psychometric properties and is suitable to measure smoking behaviors among Iranian adolescent and young adult smokers. Consequently, the instrument could be used in planning cigarette smoking cessation interventions among Iranian adolescents and young adults.	
28545415	To address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities' physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms. This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to: 1) Describe and compare age-friendly key components of communities across Canada 2) Identify key components best associated with positive health, social participation and health equity of aging adults 3) Explore how these key components foster positive health, social participation and health equity METHODS: A mixed-method sequential explanatory design will be used. The quantitative part will involve a survey of Canadian communities and secondary analysis of cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The survey will include an age-friendly questionnaire targeting key components in seven domains: physical environment, housing options, social environment, opportunities for participation, community supports and healthcare services, transportation options, communication and information. The CLSA is a large, national prospective study representative of the Canadian aging population designed to examine health transitions and trajectories of adults as they age. In the qualitative part, a multiple case study will be conducted in five Canadian communities performing best on positive health, social participation and health equity.Building on new and existing collaborations and generating evidence from real-world interventions, the results of this project will help communities to promote age-friendly policies, services and structures which foster positive health, social participation and health equity at a population level.	
28544926	Public engagement in collaborative natural resource management necessitates shared understanding and collaboration. Empathic perspective-taking is a critical facilitator of shared understanding and positive social interactions, such as collaboration. Yet there is currently little understanding about how to reliably generate empathic perspective-taking and collaboration, particularly in situations involving the unequal distribution of environmental resources or power. Here we examine how experiencing the loss or gain of social power influenced empathic perspective-taking and behavior within a computer-mediated scenario. Participants (n = 180) were randomly assigned to each condition: high resources, low resources, lose resources, gain resources. Contrary to our expectations, participants in the perspective-taking condition, specifically those who lost resources, also lost perspective taking and exhibited egoistic behavior. This finding suggests that resource control within the collaborative process is a key contextual variable that influences perspective-taking and collaborative behavior. Moreover, the observed relationship between perspective-taking and egoistic behavior within a collaborative resource sharing exercise suggests that when resource control or access is unequal, interventions to promote perspective-taking deserve careful consideration.
28544871	By some accounts, global economic inequality is at its highest point on record. The pernicious effects of this broad societal trend are striking: Rising inequality is linked to poorer health and well-being across countries, continents, and cultures. The economic and psychological forces that perpetuate inequality continue to be studied, and in this theoretical review, we examine the role of daily experiences of economic inequality-the communication of social class signals between interaction partners-in this process. We theorize that social class signals activate social comparison processes that strengthen group boundaries between the haves and have nots in society. In particular, we argue that class signals are a frequent, rapid, and accurate component of person perception, and we provide new data and analyses demonstrating the accuracy of class signaling in 60-s interactions, Facebook photographs, and isolated recordings of brief speech. We suggest that barriers to the reduction of economic inequality in society arise directly from this class signaling process through the augmentation of class boundaries and the elicitation of beliefs and behaviors that favor the economic status quo.
28544637	Despite housing ∼18% of the world's population, India does not yet have an estimate of prevalence of autism. This study was carried out to estimate the prevalence of autism in a selected population of school-children in India. N = 11,849 children (mean age = 5.9 [SD = 1.3], 39.5% females) were selected from various school types from three boroughs in Kolkata, India. Parents/caregivers and teachers filled in the social and communication disorders checklist (SCDC). Children meeting cutoff on parent-reported SCDC were followed up with the social communication questionnaire (SCQ). SCQ-positive children were administered the autism diagnostic observation schedule (ADOS). Teacher report on SCDC was available on all 11,849 children. Parent-report SCDC scores were obtained for 5,947 children. Mean scores on teacher SCDC were significantly lower than parent SCDC. Out of 1,247 SCDC-positive children, 882 answered the SCQ, of whom 124 met the cutoff score of 15. Six of these children met criteria for autism, autism spectrum disorder (ASD), or broader autism spectrum on the ADOS. The weighted estimate of supra-threshold SCQ scores was 3.54% (CI: 2.88-4.3%). The weighted prevalence estimate of positive scores (for broader autism spectrum + ASD + autism) was 0.23% (0.07-0.46%). As ∼20% children in this state are known to be out of the school system, and ASD prevalence is likely to be higher in this group, this estimate is likely to represent the lower-bound of the true prevalence. This study provides preliminary data on the prevalence of broader-spectrum autism and supra-threshold autistic traits in a population sample of school children in Eastern India. Autism Res 2017. ©2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
28542465	Research has examined the benefits and costs of employing adults with autism spectrum disorder (ASD) from the perspective of the employee, taxpayer and society, but few studies have considered the employer perspective. This study examines the benefits and costs of employing adults with ASD, from the perspective of employers. Fifty-nine employers employing adults with ASD in open employment were asked to complete an online survey comparing employees with and without ASD on the basis of job similarity. The findings suggest that employing an adult with ASD provides benefits to employers and their organisations without incurring additional costs.
28542455	Recreational sports are important leisure activities. However, most studies investigating barrier factors and motivation for participation in recreational sports have been limited to specific areas (e.g., a city or school) or demographic groups (e.g., adolescents). Therefore, this study set out to gain a more comprehensive understanding of the behavioral and socioeconomic factors influencing interest in recreational sports participation in Taiwan, as well as to evaluate the effect of any urban-rural divide.This study analyzed data collected by the "Taiwan Social Change Survey" (program five, wave 3) "Leisure Life" questionnaire. We used hierarchical linear modeling to assess respondent interest in recreational sports participation and evaluated the influence of behavioral factors, socioeconomic factors, and residence location (urban/rural).	Of the 2,146 participants in this study, 50.3% were male, and the average age was 43.9 years. Location of residence (urban/rural) accounted for 35.3% of the variation in interest in recreational sports participation, while the remaining 64.7% came from the individual level. Participants who lived in rural settings were less interested in recreational sports than their urban counterparts. Gender, educational attainment, participation frequency, health-motivated interest, and appearance-motivated interest were also associated with interest in recreational sports participation.	Different communication strategies may be needed to effectively reach different demographic groups. We suggest that future public health campaigns aiming to increase recreational sports participation include tailored interventions and messages to effectively encourage leisure physical activities among all, regardless of demographic boundaries.	
28542018	The cochlear implant (CI) has been shown to be associated with better hearing, cognitive abilities, and functional independence. There is variability however in how much benefit each recipient derives from his or her CI. This study's primary objective is to determine the effects of individual and environmental characteristics on CI outcomes.Seventy-six adults who developed postlingual severe to profound hearing loss and received their first unilateral CI at 65 years and older were eligible for the study. Fifty-five patients were asked to participate and the 33 (60%) with complete data were classified as "group 1." The remaining patients were placed in "group 2." Primary outcomes included changes in quality of life and open-set speech perception scores. Independent variables included age, health status, trait emotional intelligence (EI), comfort with technology, and living arrangements. Survey outcomes and audiological measurements were collected prospectively at 12 months after surgery, whereas preoperative data were collected retrospectively. Comparisons between groups 1 and 2 were made. Wilcoxon signed rank test, Spearman correlations, Mann-Whitney tests, Chi-square tests, and linear regressions were performed only on group 1 data.	Having a CI was associated with improved quality of life and speech perception. Familiarity with electronic tablets was associated with increased 12-month postoperative AzBio gains when adjusted for preoperative AzBio scores (adjusted p = 0.019), but only marginally significant when a family-wise error correction was applied (p = 0.057). Furthermore, patients who lived with other people scored at least 20 points higher on the AzBio sentences than those who lived alone (adjusted p = 0.046). Finally, consultation with an auditory rehabilitation therapist was associated with higher self-reported quality of life (p = 0.035).	This study suggests that in a cohort of older patients cochlear implantation is associated with a meaningful increase in both quality of life and speech perception. Furthermore, it suggests the potential importance of adjunct support and services, including the tailoring of CI rehabilitation sessions depending on the patient's familiarity with technology and living situation. Investment in rehabilitation and other services is associated with improvements in quality of life and may mitigate clinical, individual and social risk factors for poor communication outcome.	
28541240	Homosexuality and pedophilia in ancient Greece greatly concerned many researchers who were mainly interested in highlighting the social aspect of this phenomenon in ancient Greek society. An important source on the subject was the paintings of a man and his lover in attic black and red figured pottery, up to the end of the 5th century BC. Another main source was the information that derived from the texts of ancient Greek literature, especially poetry. Homosexuality was not only referring to relationships between males, but it was also manifested in lesbian love. It is believed that in the Homeric world homosexuality was not favored. In Greek society of the archaic period, the restriction of women at home, the satisfaction of sexual needs with courtesans, the marriage for the purpose of maintaining and managing the property, put women aside, marginalizing them in terms of social life, impeding the cultivation of emotional relationships between sexes. At the same time, in the society of those times, the aristocratic ideal, the constant communication of men during military training and the war, the male nudity in sports and the promotion of beauty and bravery in athletic contests, as well as the gatherings and the entertainment of men at the symposia, created a suitable substrate in which male homosexuality could develop. In this context, pedophile relationships were developed mainly during the archaic period, as recorded on vase paintings, where a mature man developed a special relationship with a teenager of the same social class. The mature man had the role of mentor for the juvenile, he would look after him and cover his living expenses and education cost. In this relationship, exhibiting predominantly the social dimension of an initiation process and introduction to adult life, the erotic homosexual intercourse could find a place to flourish. The above-mentioned relationship could not last forever, given that this would later transform into an emotional connection of friendship and trust. Besides, the constant homosexual relationships and male prostitution were considered to be reprehensible behaviors. Regarding the lesbian love, the main example was Sappho and her poems that praised love between women. Nevertheless, the relationship with the girls in the poems is considered to be similar to that Socrates had with his students, an intense personal relationship which would not involve sexual love and could probably be a platonic love. Ancient Greek physicians used their methodological tools in order to interpret homosexuality as a mental disease, but ancient medical dogmas such as the theory of humors, stereopathology and their variations could not offer an explanation for homosexuality.
28541088	Reports an error in "When risk communication backfires: Randomized controlled trial on self-affirmation and reactance to personalized risk feedback in high-risk individuals" by Natalie Schüz, Benjamin Schüz and Michael Eid (Health Psychology, 2013[May], Vol 32[5], 561-570). Several errors appear in the data in the Results section. The corrected information is provided. It is noted that, in all cases, the statistical conclusions remain the same. (The following abstract of the original article appeared in record 2013-14977-010.) Objective: Health promotion often faces the problem that populations with high behavioral risk profiles respond defensively to health promotion messages by negating risk or reactant behavior. Self-affirmation theory proposes that defensive reactions are an attempt of the self-system to maintain integrity. In this article, we examine whether a self-affirmation manipulation can mitigate defensive responses to personalized visual risk feedback in the skin cancer prevention context (ultraviolet [UV] photography), and whether the effects pertain to individuals with high behavioral risk status (high personal relevance of tanning).We conducted a full-factorial randomized controlled trial (N = 292; age 11-71) following a 2 * 2 design (UV photo yes/no, self-affirmation yes/no). Follow-up period was 2 weeks. Subsequent tanning behavior, sun avoidance intentions, and risk perception.	A multivariate analysis of variance (MANOVA) revealed a three-way interaction between risk feedback, the self-affirmation manipulation, and risk status for the three outcome measures. Follow-up analyses of variance (ANOVAs) indicated that high-risk individuals receiving only the risk feedback intervention reacted defensively and reported higher exposure. A self-affirmation manipulation mitigates this reactance effect both on the level of cognitions and behavior.	Self-affirmation has influential implications not only for Social Psychology but also for health prevention measures. The findings support the effectiveness of self-affirmation in reducing reactant and defensive reactions to personalized visual risk feedback. Interactions with health risk status indicate that self-affirmation might increase the effectiveness of health promotion messages in high-risk populations. (PsycINFO Database Record	
28540367	Background: Suicide is a significant public health concern, which impacts on health outcomes. Few suicide research studies have been interdisciplinary. We combined a psychobiographical autopsy with a visual arts autopsy, in which families donated stories, images and objects associated with the lived life of a loved one lost to suicide. From this interdisciplinary research platform, a mediated exhibition was created (Lived Lives) with artist, scientist and families, co-curated by communities, facilitating dialogue, response and public action around suicide prevention. Indigenous ethnic minorities (IEMs) bear a significant increased risk for suicide. Irish Travellers are an IEM with social and cultural parallels with IEMs internationally, experiencing racism, discrimination, and poor health outcomes including elevated suicide rates (SMR 6.6). Methods: An adjusted Lived Lives exhibition, Lived Lives: A Pavee Perspective manifested in Pavee Point, the national Traveller and Roma Centre. The project was evaluated by the Travelling Community as to how it related to suicide in their community, how it has shaped their understanding of suicide and its impacts, and its relevance to other socio-cultural contexts, nationally and internationally. The project also obtained feedback from all relevant stakeholders. Evaluation was carried out by an international visual arts research advisor and an independent observer from the field of suicide research. Results: Outputs included an arts-science mediated exhibition with reference to elevated Irish Traveller suicide rates. Digital online learning materials about suicide and its aftermath among Irish Travellers were also produced. The project reached its target audience, with a high level of engagement from members of the Travelling Community. Discussion: The Lived Lives methodology navigated the societal barriers of stigma and silence to foster communication and engagement, working with cultural values, consistent with an adapted intervention. Feedback from this project can inform awareness, health promotion, education and interventions around suicide and its aftermath in IEMs.
28540044	Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients' and next of kin's experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs.Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation.	The experiences of supportive care were captured in one main category: 'once again haunted by death' and three sub-categories: 'when life turns and death once again snorts down your neck', 'the importance of information', and 'perceptions of support'. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown.	This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.	
28539517	Sophisticated vocal communication systems of birds and mammals, including human speech, are characterized by a high degree of plasticity in which signals are individually adjusted in response to changes in the environment. Here, we present, to our knowledge, the first evidence for vocal plasticity in a reptile. Like birds and mammals, tokay geckos (Gekko gecko) increased the duration of brief call notes in the presence of broadcast noise compared to quiet conditions, a behaviour that facilitates signal detection by receivers. By contrast, they did not adjust the amplitudes of their call syllables in noise (the Lombard effect), which is in line with the hypothesis that the Lombard effect has evolved independently in birds and mammals. However, the geckos used a different strategy to increase signal-to-noise ratios: instead of increasing the amplitude of a given call type when exposed to noise, the subjects produced more high-amplitude syllable types from their repertoire. Our findings demonstrate that reptile vocalizations are much more flexible than previously thought, including elaborate vocal plasticity that is also important for the complex signalling systems of birds and mammals. We suggest that signal detection constraints are one of the major forces driving the evolution of animal communication systems across different taxa.
28539192	Peru has achieved sustained development in the last two decades. However, despite this achievement, it has not been matched with improvements in the quality of education and health; investment in both sectors is among the lowest in the region. This situation perpetuates huge gaps in infrastructure and also conditions a poor literacy level of the population specifically in health. Currently, there is a fragmented model of patient care, in which the systems are exclusive of each other. They do not cooperate or communicate with each other; and if there is no vertical communication within the system, preventing referral of patients directly from the basic level to the complex level of care when needed. In addition, there has been no progress in the development of an empathetic, respectful or person-centered clinical practice; instead, economic, social and educational differences perpetuate a paternalistic clinical practice. The task of orienting medical training towards the development of humanism is pending. The patient is the center of the medical act and the main objective of doctors' actions. A humanistic care approach will not only empower the person in the clinical encounter - to participate and make decisions related to his/her health care - but it will allow us to move towards an empathetic, caring, respectful and kind model of clinical practice.
28538285	Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention.Young men have varying views on contraception as well as which partner(s) should be responsible for its use. Limited contraception knowledge reduces young men's sexual health communication as well as their contraception use. Healthcare providers play a major role as one of the main sources of sexual health information for young men, but there are gaps in young men's sexual health care so new guidelines have emerged.	Recent literature highlights young men's range of views on contraception as well as their low sexual health knowledge and sexual health communication. To address teenage pregnancy and improve young men's overall wellness, healthcare providers should routinely address sexual health. Healthcare providers may use our newly proposed acronym, HIS BESTT, (Hello. Initiate. Sexual health assessment. Both condoms and female dependent methods. Examine genitals. STI screening. Talking to partner(s). Talking to parent(s) or guardians), to incorporate current clinical recommendations.	
28538231	To describe peer-assisted learning (PAL) groups formed by dental undergraduate students in a biomedical course and investigate the association of individual and group characteristics with academic performance.In 2015, 92 4th yr. students (males: 43; females: 49) in the College of Dentistry, University of Dammam, Saudi Arabia were invited to form PAL groups to study a unit in a biomedical course. An examination was used to assess their knowledge after two weeks. Also, a questionnaire and social network analysis were used to investigate students' attributes: gender, role, subject matter knowledge, grade last year, teaming with friends, previous communication with teammates and content discussion and group attributes: group teacher's previous grade, number of colleagues a student connected with, teaming with friends, similarity of teammates' previous grades and teacher having higher previous grades than other teammates. Regression analysis was used to assess the association of examination scores with individual and group attributes.	Response rate was 80.4% (74 students, 36 males and 38 females). Students who previously scored A and B grades had higher examination scores than students with C/less grades (regression coefficient= 18.50 and 13.39) within the groups. Higher scores were not associated with working in groups including friends only (regression coefficient= 1.17) or when all students had similar previous grades (regression coefficient= 0.85).	Students with previous high grades benefited to a greater extent from working in PAL groups. Similarity of teammates in PAL groups was not associated with better scores.	
28537860	Recently named one of the most influential phone applications, Instagram continues to grow in popularity [1]. Instagram consists of images and video posts, making it ideal for education and communication within the visual field of dermatology. In this study, we seek to determine the presence of dermatology-related content with regard to the most common cutaneous diseases of the world. We searched the account types and hashtags associated with the eight most common skin diseases globally as identified by the Global Burden of Disease (GBD) study by Hollenstein et al.: eczema, psoriasis, acne,pruritus, alopecia, decubitus ulcer, urticaria, andscabies [9]. The majority of Instagram accounts included patient experiences (n=73), private accounts(n=52), and disease advocacy and awareness groups(n=20), (total n=221). We further investigated over 2 million skin disease hashtags. The greatest numbersof hashtags were the following: #acne (n = 1,622,626),#alopecia (n = 317,566), and #eczema (n = 196,115). Our results demonstrate that patients interact withone another through Instagram. As social networking platforms become more frequently used as a source of information for patients and patient support, medical professionals must gain awareness of content available through Instagram and consider it as a means to educate the public.
28537815	Anticancer treatments such as aggressive chemotherapy and radiotherapy have deleterious gonadotoxic side effects and are considered the most common causes of pathological and iatrogenic fertility loss in women. Areas covered: In order to preserve fertility of young women and girls with cancer, several established, experimental, and debatable options can be offered in the emerging field of oncofertility. This article reviews the effects of anticancer treatments on female fertility and discusses the current challenges and future directions of fertility preservation options that can be offered to the female patients with cancer. Expert commentary: Although promising, several medical, economic, social and legal barriers face oncofertility practice around the globe especially in underserved areas. To overcome such barriers, more effective solutions should be provided to spread awareness and enhance communication between patients, oncologists and gynecologists. Early referral by oncologists before initiation of chemotherapy and radiotherapy is an important key factor for success in female fertility preservation strategies.
28537486	This article uses grounded theory methodology to analyze in-depth interviews conducted with mourners who used social networking sites during bereavement. The social media mourning (SMM) model outlines how social networking sites are used to grieve using one or more of the following: (a) one-way communication, (b) two-way communication, and (c) immortality communication. The model indicates causal conditions of SMM: (a) sharing information with family or friends and (sometimes) beginning a dialog, (b) discussing death with others mourning, (c) discussing death with a broader mourning community, and (d) commemorating and continuing connection to the deceased. The article includes actions and consequences associated with SMM and suggests several ways in which SMM changes or influences the bereavement process.
28537211	In South Africa, inequitable access to healthcare information has made many young people with limited resources more vulnerable to health risks. Mobile phones present a unique opportunity to address this problem due to the high penetration of mobile phones in South Africa and the popularity of these devices among young adults.This research sought to examine the adoption of mobile phones to access health information among students at a traditional university in the Eastern Cape, South Africa.	A cross-sectional survey approach was used to collect information from a convenience sample of 202 university students (58 males; 104 females), the majority (71.3%) of whom were aged between 18 and 27 years and of Black African ethnicity (75.2%). The unified theory of acceptance and use of technology (UTAUT) framework formed the theoretical foundation for the questionnaire. A research model was developed to test the hypotheses that behavioural intention to use a mobile phone to access health information would be influenced by: perceived usefulness (PU), perceived effort, social influence (SI), attitude towards technology (AT) and mobile phone experience.	Factor analyses indicated that the research model explained 36% of the variance in behavioural intention to use mobile devices to search for health-related queries, with PU being the largest predictor, followed by mobile experience, SI, and AT. Perceived effort did not make a statistically significant contribution.	Using mobile phones to disseminate health information to students is a useful, convenient, and cost-effective health-promotion strategy. This research has contributed to the body of knowledge concerning the applicability of the UTAUT framework to study the adoption of technology and provided useful information to guide future research and implementation of mHealth initiatives.	
28536956	Recent research suggests that children with autism spectrum disorder (ASD) may now be reliably identified in later infancy, highlighting the need for empirically-validated interventions for infants and toddlers with early symptoms of ASD. Using a multiple baseline design across 15- to 21-month-old toddlers, this study implemented a brief, parent-mediated, Pivotal Response Treatment program, focusing on improving expressive communication. The results indicated that verbal communication improved as a consequence of the intervention, with concomitant improvements in untreated areas for all participants. Following the intervention, symptoms of autism decreased and parents reported satisfaction with the program's ease of implementation and observed child gains. The results are discussed in terms of developing very early interventions to improve developmental trajectories for infants and toddlers.
28536874	Autism spectrum disorders (ASD) are pervasive developmental disorders comprising problems in social interaction, communication, and stereotyped behavior and interests. They show a prevalence of around 0.8% in children, adolescents, and adults, and a skewed sex distribution (about 4:1 = male:female). ASD are predominantly genetically determined disorders. Heritability estimates from twin studies range between 64 and 91%. Recurrence risk in siblings is 20-fold elevated. De novo and inherited monogenetic disorders, mutations, sex chromosomal abnormalities, cytogenetic and imprinting disorders as well as common variants are associated with ASD. Genetic disorders implicating a specific additional intervention are of specific clinical relevance. Genetic testing and counselling should be provided for all families and individuals with ASD. This article gives an overview on current basic genetic research in ASD, its clinical relevance and genetic counselling in ASD.
28536751	Dynamic engineering models have yet to be evaluated in the context of feminist engineering ethics. Decision-making concerning gender in dynamic modeling design is a gender and ethical issue that is important to address regardless of the system in which the dynamic modeling is applied. There are many dynamic modeling tools that operationally include the female population, however, there is an important distinction between females and women; it is the difference between biological sex and the social construct of gender, which is fluid and changes over time and geography. The ethical oversight in failing to represent or misrepresenting gender in model design when it is relevant to the model purpose can have implications for model validity and policy model development. This paper highlights this gender issue in the context of feminist engineering ethics using a dynamic population model. Women are often represented in this type of model only in their biological capacity, while lacking their gender identity. This illustrative example also highlights how language, including the naming of variables and communication with decision-makers, plays a role in this gender issue.
28536549	Selfies, digital images characterized by the desire to frame the self in a picture taken to be shared with an online audience, are important reflections of the contemporary self. Much extant psychological research on selfies has taken a pathologizing view of the phenomenon, focusing on its relationship to narcissism. Our investigation seeks to contribute to a holistic, contextualized and cultural perspective. We focus on the context of museums, places where art, history, education, and culture merge into the selfie taking behaviors of patrons. First, we explore theory salient to our topic of selfie taking, finding selfies to be an important way to construct ongoing series of narratives about the self. We use concepts of identity work, dramaturgy, and impression management to understand it in this light. We relate embodiment within the museum to the selfie's performative acts and expand upon notions that emphasize and distinguish the aesthetic elements present in many aspects of everyday life. We also question the ability of the museum selfie to destabilize. We also explore the contextual effects of mimicry and social norms. After describing our ethnographic and netnographic method, we investigate the museum selfie phenomenon. We begin with some observations on the extent of selfie-taking in contemporary culture as well as its evolution. Then, we consider selfies as a type of dynamic art form. Our analysis identifies a range of different types of museum selfies: art interactions, blending into art, mirror selfies, silly/clever selfies, contemplative selfies, and iconic selfies. Considered and studied in context, the museum selfie phenomenon reveals far more than the narcissism of the sort explored by past psychological research. The museum provides a stage for identity work that offers an opportunity for the selfie to be used not only for superficial performances but also in the pursuit of more profound self-reflection and its communication. Our ethnographic exploration of the selfie sees it as more than a quest for attention but less than a genuinely destabilizing social force. Selfie taking is complex and multidimensional, a cultural and social act, a call for connection, an act of mimicry, and part of people's ever-incomplete identity projects.
28536096	Social media technologies offer a novel opportunity for scalable health interventions that can facilitate user engagement and social support, which in turn may reinforce positive processes for behavior change.By using principles from health communication and social support literature, we implemented a Facebook group-based intervention that targeted smoking reduction and cessation. This study hypothesized that participants' engagement with and perceived social support from our Facebook group intervention would predict smoking reduction.	We recruited 16 regular smokers who live in the United States and who were motivated in quitting smoking at screening. We promoted message exposure as well as engagement and social support systems throughout the intervention. For message exposure, we posted prevalidated, antismoking messages (such as national antismoking campaigns) on our smoking reduction and cessation Facebook group. For engagement and social support systems, we delivered a high degree of engagement and social support systems during the second and third week of the intervention and a low degree of engagement and social support systems during the first and fourth week. A total of six surveys were conducted via Amazon Mechanical Turk (MTurk) at baseline on a weekly basis and at a 2-week follow-up.	Of the total 16 participants, most were female (n=13, 81%), white (n=15, 94%), and between 25 and 50 years of age (mean 34.75, SD 8.15). There was no study attrition throughout the 6-time-point baseline, weekly, and follow-up surveys. We generated Facebook engagement and social support composite scores (mean 19.19, SD 24.35) by combining the number of likes each participant received and the number of comments or wall posts each participant posted on our smoking reduction and cessation Facebook group during the intervention period. The primary outcome was smoking reduction in the past 7 days measured at baseline and at the two-week follow-up. Compared with the baseline, participants reported smoking an average of 60.56 fewer cigarettes per week (SD 38.83) at the follow-up, and 4 participants out of 16 (25%) reported 7-day point prevalence smoking abstinence at the follow-up. Adjusted linear regression models revealed that a one-unit increase in the Facebook engagement and social support composite scores predicted a 0.56-unit decrease in cigarettes smoked per week (standard error =.24, P=.04, 95% CI 0.024-1.09) when baseline readiness to quit, gender, and baseline smoking status were controlled (F4, 11=8.85, P=.002).	This study is the first Facebook group-based intervention that systemically implemented health communication strategies and engagement and social support systems to promote smoking reduction and cessation. Our findings imply that receiving one like or posting on the Facebook-based intervention platform predicted smoking approximately one less cigarette in the past 7 days, and that interventions should facilitate user interactions to foster user engagement and social support.	
28536087	Estimation of renal filtration using dynamic contrast-enhanced imaging (DCE-MRI) requires a series of analysis steps. The possible number of distinct post-processing chains is large and grows rapidly with increasing number of processing steps or options. In this study we introduce a framework for systematic evaluation of the post-processing chains. The framework is later used to highlight the workflow processing chain sensitivity towards accuracy in estimation of glomerular filtration rate (GFR).Twenty healthy volunteers underwent DCE-MRI examinations as well as iohexol clearance for reference GFR measurements. In total, 692 different combinations of post-processing steps were explored for analysis, including options for kidney segmentation, B1 inhomogeneity correction, placement of arterial input function, gadolinium concentration estimation as well as handling of motion-corrupted volumes and breathing motion. The evaluation of various processing chains is presented using a classification tree framework and random forest ensemble learning.	Among the processing steps subject to testing, methods for calculating the gadolinium concentration as well as B1 inhomogeneity correction had the largest impact on accuracy of GFR estimations. Different segmentation methods did not play an important role in the post-processing of the MR data except from one processing chain where the automated segmentation outperformed the manual segmentation.	The proposed classification trees were efficiently used as a statistical tool for visualization and communication of results to distinguish between important and less influential processing steps in renal DCE-MRI. We also identified several crucial factors in the processing chain.	
28535928	Vocal interactions in many birds are characterized by imitation or the matching of vocalizations whereby one individual makes its vocalizations more similar to those of a conspecific. This behaviour is aided by vocal learning, which allows birds to change the vocalizations already in their repertoires, or to add new ones. The majority of studies on vocal similarity have been focussing on the songs of birds rather than their calls, with evidence for vocal similarity in calls being rather scarce. Here, we investigated whether ravens make their calls acoustically similar to one another by analysing the extent to which short- and long-distance calls of their vocal repertoires exhibited vocal similarity. Our results showed that long-distance calls, but not short-distance calls, are highly similar between pair partners. This effect may be explained by the different functions underlying short- and long-distance communication in ravens, with vocal similarity possibly being scaffolded by specific social matrices such as pair-bonds and/or strong social relationships.
28535842	Aim To examine general practitioners' (GPs) clinical expertise in assessing, communicating with, and managing suicidal young people aged 14-25 to inform the development of an educational intervention for GPs on youth suicide prevention.Suicide is the second leading cause of death for young people worldwide. GPs are ideally suited to facilitate early identification and assessment of suicide risk. However, GPs' levels of competence, knowledge, and attitudes towards suicidal young people have not yet been explored.	A cross-sectional survey on GPs' levels of confidence in assessing and managing young people at risk of suicide; knowledge of risk factors and warning signs of suicide in young people; attitudes towards young suicidal people; and training preferences on managing suicide risk. Findings Seventy GPs completed the survey (30 males). The majority of GPs reported high levels of confidence in assessing and managing suicidality in young people. Experienced GPs demonstrated high levels of knowledge of suicide risk factors in young people but low levels of knowledge of warning signs that might indicate heightened risk. Although 48% of GPs disagreed that maintaining compassionate care is difficult with those who deliberately self-harm, GPs perceived communication with young people to be difficult, with one-third reporting frustration in managing those at risk of suicide. A total of 75% of GPs said they would be interested in receiving further training on assessing and managing young people at risk of suicide. The study has important implications for providing specialist training to support GPs in assessing and managing youth suicide risk and facilitating attitudinal change. GP education on youth suicide risk assessment and management should promote a holistic understanding and assessment of risk and its individual, social and contextual influences in line with clinical recommendations to facilitate therapeutic engagement and communication with young people.	
28535495	Uptake of cervical cancer screening in the United Kingdom (UK) is falling year on year, and a more sophisticated understanding of non-participation may help design interventions to reverse this trend. This study ascertained the prevalence of different non-participant types using the Precaution Adoption Process Model (PAPM).Home-based computer-assisted interviews were carried out with 3113 screening-eligible women in Britain. Survey items assessed self-reported screening uptake and intention to attend in future. Responses to these items were used to classify women into one of five different types of non-participants.	Of 793 non-participants, 28% were unaware of screening, 15% had decided not to attend and 51% were intending to have screening but were currently overdue. Younger women were more likely to be unaware of screening or to intend to be screened, while older women were more likely to have decided not to be screened. Women from ethnic minority backgrounds were more likely to be unaware of screening than white women. Being in a lower social grade was associated with increased odds of all three types of non-participation.	The majority of cervical cancer screening non-participants are not making an active decision not to attend but rather are either unaware or unable to act. There are clear sociodemographic differences between non-participant types, which could be used to identify where tailored interventions may be best targeted.	
28534732	Children with hearing loss experience significant difficulty understanding speech in noisy and reverberant situations. Adaptive noise management technologies, such as fully adaptive directional microphones and digital noise reduction, have the potential to improve communication in noise for children with hearing aids. However, there are no published studies evaluating the potential benefits children receive from the use of adaptive noise management technologies in simulated real-world environments as well as in daily situations.The objective of this study was to compare speech recognition, speech intelligibility ratings (SIRs), and sound preferences of children using hearing aids equipped with and without adaptive noise management technologies.	A single-group, repeated measures design was used to evaluate performance differences obtained in four simulated environments. In each simulated environment, participants were tested in a basic listening program with minimal noise management features, a manual program designed for that scene, and the hearing instruments' adaptive operating system that steered hearing instrument parameterization based on the characteristics of the environment.	Twelve children with mild to moderately severe sensorineural hearing loss.	Speech recognition and SIRs were evaluated in three hearing aid programs with and without noise management technologies across two different test sessions and various listening environments. Also, the participants' perceptual hearing performance in daily real-world listening situations with two of the hearing aid programs was evaluated during a four- to six-week field trial that took place between the two laboratory sessions.	On average, the use of adaptive noise management technology improved sentence recognition in noise for speech presented in front of the participant but resulted in a decrement in performance for signals arriving from behind when the participant was facing forward. However, the improvement with adaptive noise management exceeded the decrement obtained when the signal arrived from behind. Most participants reported better subjective SIRs when using adaptive noise management technologies, particularly when the signal of interest arrived from in front of the listener. In addition, most participants reported a preference for the technology with an automatically switching, adaptive directional microphone and adaptive noise reduction in real-world listening situations when compared to conventional, omnidirectional microphone use with minimal noise reduction processing.	Use of the adaptive noise management technologies evaluated in this study improves school-age children's speech recognition in noise for signals arriving from the front. Although a small decrement in speech recognition in noise was observed for signals arriving from behind the listener, most participants reported a preference for use of noise management technology both when the signal arrived from in front and from behind the child. The results of this study suggest that adaptive noise management technologies should be considered for use with school-age children when listening in academic and social situations.	
28534217	Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe clinical symptoms such as the deficiency of the social communication, repetitive and stereotyped behaviors, and restricted interests. Although complex genetic and environmental factors are thought to contribute to the development of ASD, the precise etiologies are largely unknown. Neuroanatomical observations have been made of developmental abnormalities in different brain regions, including dentate gyrus of hippocampus, which is widely accepted as the center for learning and memory. However, little is known about what roles ASD-associated genes play in the development of hippocampal dentate granule cells. In this article, we summarized functions and pathophysiological significance of 6 representative ASD-associated genes, SEMA5A, PTEN, NLGN, EN-2, FMR1, and MECP2, by focusing on the development of dentate gyrus. We then introduced a recently developed gene transfer method directed to neonatal dentate granule cells. This new method will be useful for elucidating physiological as well as pathophysiological significance of ASD-associated genes in the development of hippocampal formation.
28533516	Autism spectrum disorder (ASD) is a behaviorally defined condition that manifests in infancy or early childhood as deficits in communication skills and social interactions. Often, restricted and repetitive behaviors (RRBs) accompany this disorder. ASD is polygenic and genetically complex, so we hypothesized that focusing analyses on intermediate core component phenotypes, such as RRBs, can reduce genetic heterogeneity and improve statistical power. Applying this approach, we mined Caucasian genome-wide association studies (GWAS) data from two of the largest ASD family cohorts, the Autism Genetics Resource Exchange and Autism Genome Project (AGP). Of the 12 RRBs measured by the Autism Diagnostic Interview-Revised, seven were found to be significantly familial and substantially variable, and hence, were tested for genome-wide association in 3104 ASD-affected children from 2045 families. Using a stringent significance threshold (P<7.1 × 10-9), GWAS in the AGP revealed an association between 'the degree of the repetitive use of objects or interest in parts of objects' and rs2898883 (P<6.8 × 10-9), which resides within the sixth intron of PHB. To identify the candidate target genes of the associated single-nucleotide polymorphisms at that locus, we applied chromosome conformation studies in developing human brains and implicated three additional genes: SLC35B1, CALCOCO2 and DLX3. Gene expression, brain imaging and fetal brain expression quantitative trait locus studies prioritize SLC35B1 and PHB. These analyses indicate that GWAS of single heritable features of genetically complex disorders followed by chromosome conformation studies in relevant tissues can be successful in revealing novel risk genes for single core features of ASD.Molecular Psychiatry advance online publication, 23 May 2017; doi:10.1038/mp.2017.114.
28533389	First impressions based on facial appearance predict many important social outcomes. We investigated whether such impressions also influence the communication of scientific findings to lay audiences, a process that shapes public beliefs, opinion, and policy. First, we investigated the traits that engender interest in a scientist's work, and those that create the impression of a "good scientist" who does high-quality research. Apparent competence and morality were positively related to both interest and quality judgments, whereas attractiveness boosted interest but decreased perceived quality. Next, we had members of the public choose real science news stories to read or watch and found that people were more likely to choose items that were paired with "interesting-looking" scientists, especially when selecting video-based communications. Finally, we had people read real science news items and found that the research was judged to be of higher quality when paired with researchers who look like "good scientists." Our findings offer insights into the social psychology of science, and indicate a source of bias in the dissemination of scientific findings to broader society.
28533385	Social animals must communicate to define group membership and coordinate social organization. For social insects, communication is predominantly mediated through chemical signals, and as social complexity increases, so does the requirement for a greater diversity of signals. This relationship is particularly true for advanced eusocial insects, including ants, bees, and wasps, whose chemical communication systems have been well-characterized. However, we know surprisingly little about how these communication systems evolve during the transition between solitary and group living. Here, we demonstrate that the sensory systems associated with signal perception are evolutionarily labile. In particular, we show that differences in signal production and perception are tightly associated with changes in social behavior in halictid bees. Our results suggest that social species require a greater investment in communication than their solitary counterparts and that species that have reverted from eusociality to solitary living have repeatedly reduced investment in these potentially costly sensory perception systems.
28533367	Collective cell movement is critical to the emergent properties of many multicellular systems, including microbial self-organization in biofilms, embryogenesis, wound healing, and cancer metastasis. However, even the best-studied systems lack a complete picture of how diverse physical and chemical cues act upon individual cells to ensure coordinated multicellular behavior. Known for its social developmental cycle, the bacterium Myxococcus xanthus uses coordinated movement to generate three-dimensional aggregates called fruiting bodies. Despite extensive progress in identifying genes controlling fruiting body development, cell behaviors and cell-cell communication mechanisms that mediate aggregation are largely unknown. We developed an approach to examine emergent behaviors that couples fluorescent cell tracking with data-driven models. A unique feature of this approach is the ability to identify cell behaviors affecting the observed aggregation dynamics without full knowledge of the underlying biological mechanisms. The fluorescent cell tracking revealed large deviations in the behavior of individual cells. Our modeling method indicated that decreased cell motility inside the aggregates, a biased walk toward aggregate centroids, and alignment among neighboring cells in a radial direction to the nearest aggregate are behaviors that enhance aggregation dynamics. Our modeling method also revealed that aggregation is generally robust to perturbations in these behaviors and identified possible compensatory mechanisms. The resulting approach of directly combining behavior quantification with data-driven simulations can be applied to more complex systems of collective cell movement without prior knowledge of the cellular machinery and behavioral cues.
28532504	Congenital Hyperinsulinism (CHI) is a disease of severe hypoglycaemia caused by excess insulin secretion and associated with adverse neurodevelopment in a third of children. The Vineland Adaptive Behavior Scales Second Edition (VABS-II) is a parent report measure of adaptive functioning that could be used as a developmental screening tool in patients with CHI. We have investigated the performance of VABS-II as a screening tool to identify developmental delay in a relatively large cohort of children with CHI. VABS-II questionnaires testing communication, daily living skills, social skills, motor skills and behaviour domains were completed by parents of 64 children with CHI, presenting both in the early neonatal period (Early-CHI, n = 48) and later in infancy (Late-CHI, n = 16). Individual and adaptive composite (Total) domain scores were converted to standard deviation scores (SDS). VABS-II scores were tested for correlation with objective developmental assessment reported separately by developmental paediatricians, clinical and educational psychologists. VABS-II scores were also investigated for correlation with the timing of hypoglycaemia, gender and phenotype of CHI.Median (range) total VABS-II SDS was low in CHI [-0.48 (-3.60, 4.00)] with scores < -2.0 SDS in 9 (12%) children. VABS-II Total scores correctly identified developmental delay diagnosed by objective assessment in the majority [odds ratio (OR) (95% confidence intervals, CI) 0.52 (0.38, 0.73), p < 0.001] with 95% specificity [area under curve (CI) 0.80 (0.68, 0.90), p < 0.001] for cut-off < -2.0 SDS, although with low sensitivity (26%). VABS-II Total scores were inversely correlated (adjusted R2 = 0.19, p = 0.001) with age at presentation (p = 0.024) and male gender (p = 0.036), males having lower scores than females in those with Late-CHI [-1.40 (-3.60, 0.87) v 0.20 (-1.07, 1.27), p = 0.014]. The presence of a genetic mutation representing severe CHI also predicted lower scores (R2 = 0.19, p = 0.039).	The parent report VABS-II is a reliable and specific tool to identify developmental delay in CHI patients. Male gender, later age at presentation and severity of disease are independent risk factors for lower VABS-II scores.	
28532303	A plethora of new development goals and funding institutions have greatly increased the demand for internationally comparable health estimates in recent years, and have brought important new players into the field of health estimate production. These changes have rekindled debates about the validity and legitimacy of global health estimates. This paper draws on country case studies and personal experience to support our opinion that the production and use of estimates are deeply embedded in specific social, economic, political and ideational contexts, which differ at different levels of the global health architecture. Broadly, most global health estimates tend to be made far from the local contexts in which the data upon which they are based are collected, and where the results of estimation processes must ultimately be used if they are to make a difference to the health of individuals. Internationally standardised indicators are necessary, but they are no substitute for data that meet local needs, and that fit with local ideas of what is credible and useful. In other words, data that are both technically and socially robust for those who make key decisions about health. We suggest that greater engagement of local actors (and local data) in the formulation, communication and interpretation of health estimates would increase the likelihood that these data will be used by those most able to translate them into health gains for the longer term. Besides strengthening national information systems, this requires ongoing interaction, building trust and establishing a communicative infrastructure. Local capacities to use knowledge to improve health must be supported.

28531228	Video-sharing social media like YouTube provide access to diverse cultural products from all over the world, making it possible to test theories that the Web facilitates global cultural convergence. Drawing on a daily listing of YouTube's most popular videos across 58 countries, we investigate the consumption of popular videos in countries that differ in cultural values, language, gross domestic product, and Internet penetration rate. Although online social media facilitate global access to cultural products, we find this technological capability does not result in universal cultural convergence. Instead, consumption of popular videos in culturally different countries appears to be constrained by cultural values. Cross-cultural convergence is more advanced in cosmopolitan countries with cultural values that favor individualism and power inequality.
28531176	To explore the ways in which stigma is experienced in healthcare and dental settings by patients with a history of addiction and mental illness.Audio-recorded, semi-structured interviews with a purposefully selected convenience sample of residents from two community treatment centres in Vancouver, Canada were conducted. The interview guide contained questions about experiences while seeking health and dental care and was based on an existing framework of labeling, stereotyping, exclusion, discrimination, and power imbalance. Interviews were transcribed verbatim for coding and thematic analysis.	Twenty-five participants between 23 and 67 years of age were interviewed; 17 were males. Most had a self-reported history of depression combined with use of alcohol and crack-cocaine; most of them only sought dental care for emergency purposes. Textual analysis of more than 300 pages of transcribed interviews revealed that participants perceived stigma when they were negatively stereotyped as 'unworthy', labeled as 'different', excluded from the decision-making process, discriminated against, 'treated unfairly', and felt powerless when interacting in the heath and dental care systems. Conversely, positive experiences were characterized by empathy, reassurance and good communication, which were empowering for patients.	When associated with stigma, mental illness and addictions have negative implications for accessing health and dental care. From our participants' perspectives, it seems that the lack of understanding about their life conditions by the healthcare professionals was the origin of stigma. We suggest that an increased social awareness of these health issues be enhanced among current and future health and dental care professionals to help improve care experiences for this marginalized population.	
28530532	There is limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia.The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data.	The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independents t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p&lt;0.001), behavioral problems with others (t=5.44, p&lt;0.001), and self-care (t=4.70, p&lt;0.001). No significant differences were observed from pretest to post test in control group.	The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia.	
28530039	The number of adolescents with perinatally or behaviourally acquired HIV is increasing in low-income countries, and especially in sub-Saharan Africa where HIV prevalence and incidence are the highest. As they survive into adulthood in the era of antiretroviral therapy, there is a pressing need to transfer them from paediatric to adult care, known as the transition of care. We conducted a narrative review of recent evidence on their transition outcomes in Africa, highlighting the specific needs and challenges in these populations and settings, and the different models of care for transition.We searched PubMed bibliographic database, HIV conference content, and grey literature from January 2000 to August 2016 with the following keywords: HIV infections AND (adolescents or youth) AND transition AND Africa. All qualitative and quantitative, experimental and observational studies including HIV-infected patients aged 10-24 years with information on transition were eligible.	Few data on transition outcomes for HIV-infected adolescents are available from Africa settings. Studies mainly from Southern and East Africa reported on the barriers to successful transition, highlighting several gaps. These included lack of adequate infrastructure, staff training and communication between paediatric and adult clinicians as well as the fear of stigma of adolescents and youth living with HIV. Most countries have no specific national guidelines on when to disclose HIV status or when and how to transition to adult care. Several models of care adapted to the adolescent transition question have been implemented in specific settings. These models include teen clinics, peer educators or the use of social media. However, regardless of the model, services are increasingly overburdened and have insufficient human resources. Furthermore, very high attrition has been observed among adolescents and youth compared to younger children or older adults. There is a need to identify sub-groups at higher risk of loss to follow-up for targeted care and peer support.	Although the available HIV-related data on adolescent transition outcomes are limited, there is evidence of their increased vulnerability during this period. Standardized data gathering, analysis, and reporting systems specific to adolescent transition are essential to improve understanding and adolescent outcomes in Africa.	

28529369	The Government of India (GOI) has recommended the use of Indian Disability Evaluation and Assessment Scale (IDEAS) for the assessment and certification of disability in patients with mental illness. Although data are available in terms of internal consistency and construct validity of IDEAS, concurrent validity of IDEAS has rarely been evaluated.The aim was to study the concurrent validity of IDEAS with Global Assessment of Functioning (GAF) and Social and Occupational Functioning Scale (SOFS) in patients with schizophrenia.	One hundred and seventy-eight consenting patients with schizophrenia in remission were assessed for disability, functioning, and psychopathology using the IDEAS, SOFS, GAF, and Positive and Negative symptom scale (PANSS) respectively.	Mean total PANSS score was 51.3 (standard deviation SD -11.19). Disability (>40%) was present in 84.8% of the sample. All the component scores of IDEAS (self-care, interpersonal activities, communication, and work), total IDEAS score, and Global IDEAS score correlated significantly (P < 0.001) with the three domains of SOFS (adaptive life skills, social appropriateness and communication, and interpersonal relationships) along with the total SOFS score. GAF total score had significant negative correlation (P < 0.001) with all the components of IDEAS, total IDEAS score and global IDEAS score. Higher residual psychopathology was also associated with overall higher disability as assessed by total IDEAS score and Global IDEAS score.	This study shows that the GOI-modified IDEAS had good concurrent validity with global and sociooccupational functioning as assessed by GAF and SOFS respectively.	
28529138	As an influenza epidemic poses a serious public health threat, it is important for the public to adopt behaviors that effectively prevent influenza infection.In the winter of 2009, by using a structured questionnaire, we conducted an Internet survey with respect to residents (n=2788) in Fukui prefecture, Japan. The main aim is to obtain information about effective prevention, factors related to preventive awareness and behaviors during the influenza epidemic. A factor analysis and linear regression models were used in the analysis.	Three types of preventive awareness were identified by factor analysis: "avoidance of influenza infection," "awareness of the benefits of mask use," and "awareness of the need for a rapid diagnosis." Gender, age, residence, being medical person and being vaccinated were related to these preventive awareness and behaviors. Avoidance of influenza Infection was related to all preventive behavior, awareness of the benefits of mask use was related to hand disinfectant use, and awareness of the need for a rapid diagnosis was related to avoidance of face touch, gargling and attention to health care, respectively.	Three types of preventive awareness during the influenza epidemic were emerged, and were related to preventive behaviors against influenza infection.	
28528929	Conspicuous colouration is an important way of social communication in many taxa. The role of ultraviolet (UV) signals in intraspecific communication has only recently been studied in lizards, and there is not a general understanding of the adaptive role of UV colouration. Colour ornaments can signal male quality in mate choice and are therefore suitable for reliably predicting the outcome of female preference. Here, we tested the potential role of UV colouration in female spatial preference in a non-territorial teiid lizard, Cnemidophorus ocellifer. We experimentally manipulated the UV reflectance of size-matched male pairs and tested the effects of our treatment on females' spatial distribution. We found that females associated with males of higher UV reflectance, suggesting that UV colour can be an important clue during mate preference decisions. Our results provide the first empirical evidence for the importance of UV colouration in female preference in a mutually ornamented lizard species.
28528329	The Autism Diagnostic Interview-Revised (ADI-R) is considered a first choice assessment tool in autism spectrum disorder. Nevertheless, despite its wide use in psychiatric practice and recommendations by various clinical guidelines, its interrater reliability has predominantly been confirmed in research settings by specially trained, research reliability interviewers. The reliability of ADI-R assessments among clinicians has not yet been established. Therefore, this study examined the spontaneous interrater reliability of the ADI-R in a naturalistic clinical multicenter setting.Ten video-recorded ADI-R administrations were rated by 5 different raters each from a pool of 11 raters affiliated to 8 different clinical sites.	The interrater reliability for the 12 diagnostic criteria operationalizing autism spectrum disorders according to DSM-IV/ICD-10 in the ADI-R algorithms ranged between G(q,k) (analogous to intraclass correlations) = 0.96 and 0.99 for reciprocal social interaction, 0.96 and 1.00 for communication, and 0.91 and 0.97 for repetitive and restricted behavior. Reliability of diagnostic classification was ĸCohen 0.83.	The findings endorse the psychometric properties of ADI-R in terms of interrater reliability previously reported from research settings and support their generalization to common clinical settings. Limitations of this study include an unbalanced sample composition.	
28528077	To explore the role of socioeconomic status (SES) in participation, programme attendance, programme acceptability, adherence to lifestyle guidelines, drop-out, and effectiveness in the SLIMMER diabetes prevention intervention.SLIMMER was a randomised controlled intervention, carried out in a real-world setting, targeting 40- to 70-year-old adults at increased risk of developing type 2 diabetes (n=316). The intervention group participated in a 10-month combined dietary and physical activity programme. Measurements were carried out at baseline, 12months, and 18months. Effectiveness was determined for fasting insulin, HbA1c, weight, BMI, waist circumference, and waist-to-height-ratio. Differences between the low SES (no, primary, or lower secondary school) and higher SES group were tested using logistic regression and ANCOVA.	Fifty-two percent of the SLIMMER participants had a low SES. No differences in participation were observed between the low and higher SES group. The most important reason for non-participation in the low SES group was 'lack of interest' (32%), whereas in the higher SES group this was 'I already exercise enough' (31%). Attendance, acceptability, adherence, drop-out, and effectiveness after 12months were similar in the low and higher SES group. After 18months, the low SES group seemed to maintain slightly better effects for fasting insulin, HbA1c, and waist circumference.	The current study showed that participation, attendance, acceptability, adherence, drop-out, and effectiveness of the SLIMMER intervention were in general not modified by socioeconomic status. The SLIMMER intervention can contribute to health promotion for individuals in both low and higher socioeconomic groups.	
28527508	The use of social media has become very instinctive to many. It has become part of a daily routine. Enhanced communication, liberated expressions of self, becoming updated with all the trends and news, and marketing promotion are only some of the reasons why most people use social media. Health care providers including physicians should take advantage of these platforms for professional purposes. Social media extends far beyond the famous platforms such as Facebook, Twitter, Pinterest, and Instagram, used mostly for social connections. There are sites dedicated to serve professionals, for example, LinkedIn, or even physician-specific forums such as Sermo. The physical medicine and rehabilitation community has a forum (Phyzforum) created by the American Academy of Physical Medicine and Rehabilitation to share questions, comments, and ideas. Moreover, there are broadcast media (Podcast) and blogging sites (WordPress) used by many physiatrists. Surveys show that physicians actively use an average of 2-4 hours of professional-leaning networking sites per week; for example, 44% of physicians use Sermo and 42% use LinkedIn. The participation also extends to more popular sites, with 40%, 25%, and 20% physician participation in YouTube, Blogging, and Twitter, respectively. There are numerous guidelines available for medical practitioners pertaining to professional use of social media. Strategies such as timing of postings and posting content as well as methods to maintain your online reputation are discussed. Various benefits and potential pitfalls with regards to social media use are also analyzed, including how to engage followers and addressing negative comments and reviews.
28526663	Peer support services have the potential to support children who survive cancer by handling the physical, mental, and social challenges associated with survival and return to everyday life. Involving the children themselves in the design process allows for adapting services to authentic user behaviors and goals. As there are several challenges that put critical requirements on a user-centered design process, we developed a design method based on personas adapted to the particular needs of children that promotes health and handles a sensitive design context.The purpose of this study was to evaluate the effects of using child personas in the development of a digital peer support service for childhood cancer survivors.	The user group's needs and behaviors were characterized based on cohort data and literature, focus group interviews with childhood cancer survivors (n=15, 8-12 years), stakeholder interviews with health care professionals and parents (n=13), user interviews, and observations. Data were interpreted and explained together with childhood cancer survivors (n=5) in three explorative design workshops and a validation workshop with children (n=7).	We present findings and insights on how to codesign child personas in the context of developing digital peer support services with childhood cancer survivors. The work resulted in three primary personas that model the behaviors, attitudes, and goals of three user archetypes tailored for developing health-promoting services in this particular use context. Additionally, we also report on the effects of using these personas in the design of a digital peer support service called Give Me a Break.	By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that were successfully used to design and develop health-promoting services for children in vulnerable life stages. The child-personas serve as effective collaboration and communication aids for both internal and external purposes.	
28526515	Previous investigations by our group have shown that prenatal exposure to lipopolysaccharide (LPS), which mimics infection by gram-negative bacteria, induces social, cognitive, and communication deficits. For a complete screening of autistic-like behaviors, the objective of this study was to evaluate if our rat model also induces restricted and repetitive stereotyped behaviors. Thus, we studied the self-grooming microstructure. We also studied the neurochemistry of hypothalamus and frontal cortex, which are brain areas related to autism to better understand central mechanisms involved in our model. Prenatal LPS exposure on gestational day 9.5 increased the head washing episodes (frequency and time), as well as the total self-grooming. However, body grooming, paw/leg licking, tail/genital grooming, and circling behavior/tail chasing did not vary significantly among the groups. Moreover, prenatal LPS induced dopaminergic hypoactivity (HVA metabolite and turnover) in the hypothalamus. Therefore, our rat model induced restricted and repetitive stereotyped behaviors and the other main symptoms of autism experimentally studied in rodent models and also found in patients. The hypothalamic dopaminergic impairments seem to be associated with the autistic-like behaviors.
28526055	Social care-related quality of life is a key outcome indicator used in the evaluation of social care interventions and policy. It is not, however, always possible to collect quality of life data by self-report even with adaptations for people with cognitive or communication impairments. A new proxy-report version of the Adult Social Care Outcomes Toolkit (ASCOT) measure of social care-related quality of life was developed to address the issues of wider inclusion of people with cognitive or communication difficulties who may otherwise be systematically excluded. The development of the proxy-report ASCOT questionnaire was informed by literature review and earlier work that identified the key issues and challenges associated with proxy-reported outcomes.To evaluate the acceptability and content validity of the ASCOT-Proxy, qualitative cognitive interviews were conducted with unpaid carers or care workers of people with cognitive or communication impairments. The proxy respondents were invited to 'think aloud' while completing the questionnaire. Follow-up probes were asked to elicit further detail of the respondent's comprehension of the format, layout and content of each item and also how they weighed up the options to formulate a response.	A total of 25 unpaid carers and care workers participated in three iterative rounds of cognitive interviews. The findings indicate that the items were well-understood and the concepts were consistent with the item definitions for the standard self-completion version of ASCOT with minor modifications to the draft ASCOT-Proxy. The ASCOT-Proxy allows respondents to rate the proxy-proxy and proxy-patient perspectives, which improved the acceptability of proxy report.	A new proxy-report version of ASCOT was developed with evidence of its qualitative content validity and acceptability. The ASCOT-Proxy is ready for empirical testing of its suitability for data collection as a self-completion and/or interview questionnaire, and also evaluation of its psychometric properties.	
28525792	The incorporation of team context into research and practice regarding team effectiveness in NGOs projects is a constant challenge. The research seeks to address the gap and identify the critical determinants of team effectiveness in projects undertaken by non-governmental organizations. Using a systematic process, the study involved both literature and focus group discussions to generate the required items. A total of 157 respondents (Team Members and Team Leaders) were part of the study that filled the questionnaires. Using exploratory factor analysis followed by confirmatory factor analysis, both convergent and discriminant validity was established. The present study found that team effectiveness in NGO social projects has a total of seven dimensions namely: Inter team coordination, community social linkage, team performance, knowledge, skills, and attitudes, leadership communication and engagement, decision making and information sharing, and team formation. There is a significant lack of research on team effectiveness in NGO projects. Where considerably large proportion of research on team effectiveness has focused on the corporate sector, the non-governmental teams have been neglected. This study clearly highlights the determinants that make up team effectiveness in NGOs. The determinants identified will help to specifically look at the effectiveness of teams in NGO projects. The study would help NGOs identify the dimensions in which they may be performing in a weaker manner and direct their energies in improving the factors.
28524075	22q11.2 deletion syndrome (22q11.2DS) is a genomic disorder reported to associate with autism spectrum disorders (ASDs) in 15-50% of cases; however, others suggest that individuals with 22q11.2DS present psychiatric or behavioral features associated with ASDs, but do not meet full criteria for ASD diagnoses. Such wide variability in findings may arise in part due to methodological differences across studies. Our study sought to determine whether individuals with 22q11.2DS meet strict ASD diagnostic criteria using research-based guidelines from the Collaborative Programs of Excellence in Autism (CPEA), which required a gathering of information from three sources: the Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observational Schedule (ADOS), and a clinician's best-estimate diagnosis. Our study examined a cohort of children, adolescents, and young adults (n = 56) with 22q11.2DS, who were ascertained irrespective of parents' behavioral or developmental concerns, and found that 17.9% (n = 10) of the participants met CPEA criteria for an ASD diagnosis, and that a majority showed some level of social-communication impairment or the presence of repetitive behaviors. We conclude that strictly defined ASDs occur in a substantial proportion of individuals with 22q11.2DS, and recommend that all individuals with 22q11.2DS be screened for ASDs during early childhood.
28523960	Health literacy studies have primarily focused on the cognitive and social skills of individuals needed to gain access to, understand, and use health information. This area of study is undergoing a paradigm shift with increased attention being paid to the skills of practitioners and an examination of their contribution to the link between literacy and health outcomes. The aim of this study was to describe the health literacy related competencies of General Practice (GP) trainees who will soon be responsible for the clinical encounter.A cross-sectional survey of a convenience sample of 206 GP trainees was conducted online. Univariate and bivariate analysis methods were used to describe GP trainees' health literacy-related competencies.	GP trainees overestimated the numeracy and literacy levels of the English population and did not regard the improvement of patient health literacy as a GP responsibility. GP trainees rated their general communication skills highly but the skills that are important for patients in health decision-making such as coaching skills, explaining risk and using visual aids to clarify were rated low.	This study demonstrates that health literacy is insufficiently addressed in the undergraduate and postgraduate medical education of GPs to enable them to fulfil the core competence which is part of building an effective partnership with patients.	
28523465	Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework.We conducted a multi-country cross-sectional study.	Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed.	Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities.	The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.	
28523119	The doctor-patient interaction (DPI) plays an important role in the way patients view physicians. Thus, response to the question of ''Who is a great physician?'' is related to DPI experiences of patients. The aim of this qualitative study was to explore patients' views regarding this subject. Based on critical ethnography in one educational hospital in Shiraz, Iran, the study was performed based on 156 clinical consultations, 920 hours of participant observations, and 6 focus groups with patients and their relatives. The results revealed that asymmetrical power relationships exist in this context. Based on the general views of participants and their recent DPI experiences, a great physician should be kind, empathetic, friendly, and a good listener. Considering the presence of an asymmetrical power relationships in this context, results showed that doctors do not participate in an active interaction. Based on sociological theories, it can be concluded that the concept of a great physician is not only limited to obligations as in the Parsonian view, but is also related to active communication between both sides which is presented in the critical view. Through active communication‎, asymmetrical power relationships can be reduced. Thus, if a physician wants to become a great physician, he/she must strengthen his/her humanistic dimensions and communicative skills alongside his/her medical skills.
28522923	Responding to older people's distress by acknowledging or encouraging further discussion of emotions is central to supportive, person-centred communication, and may enhance home care outcomes and thereby promote healthy aging. This observational study describes nursing staff's responses to older people's emotional distress, and identify factors that encourage further emotional disclosure.Audio-recorded home care visits in Norway (n = 196), including 48 older people and 33 nursing staff, were analysed with the Verona Coding Definitions of Emotional Sequences, identifying expressions of emotional distress and subsequent provider responses. The inter-rater reliability (two coders), Cohen's kappa, was >0.6. Sum categories of emotional distress were constructed: a) verbal and non-verbal expressions referring to emotion, b) references to unpleasant states/circumstances, and c) contextual hints of emotion. A binary variable was constructed based on the VR response codes, differentiating between emotion-focused responses and responses that distanced emotion. Fisher's exact test was used to analyse group differences and determined variables included in a multivariate logistic regression analysis to identify factors promoting emotion-focused responses.	Older people's expressions of emotional distress (n = 635) comprised 63 explicit concerns and 572 cues. Forty-eight per cent of nursing staff responses (n = 638) were emotion-focused. Emotion-focused responses were observed more frequently when nursing staff elicited the expression of emotional distress from the patients (54%) than when patients expressed their emotional distress on their own initiative (39%). Expressions with reference to emotion most often received emotion-focused responses (60%), whereas references to unpleasant states or circumstances and contextual hints of emotion most often received non-emotion-focused responses (59%). In a multivariate logistic model, nursing staff's elicitation of the emotional expression (vs patients initiating it) and patients' expression with a reference to an emotion (vs reference to unpleasant states or contextual hints) were both explanatory variables for emotion-focused responses.	Emotion-focused responses were promoted when nursing staff elicited the emotional expression, and when the patient expression referred to an emotion. Staff responded most often by acknowledging the distress and using moderately person-centred supportive communication. More research is needed to establish generalizability of the findings and whether older people deem such responses supportive.	
28522893	Impaired hearing is related to poor health outcomes, including compromised cognitive function, in aging individuals. Hearing loss is the third most common chronic health condition after arthritis and heart disease in older adults and the fourth most detrimental condition related to quality of life in older adults. Only 18% of aging adults who have impactful hearing loss actually use custom-fit amplification. Therefore, the majority of aging individuals entering senior living facilities will have untreated hearing loss. Older adults move to senior communities to maintain or increase their social engagement, to receive care from qualified staff, and to ultimately enhance their quality of life. We know that the majority of individuals over 65 years of age have significant hearing loss, which leaves them with complex listening needs due to low incidence of hearing aid use, group communication situations that are common for social activities, interactive dining environments, and the need for telephone use to connect with loved ones. Busy staff and family members may not be aware of the impact of decreased hearing on quality of life, as well as caregiver burden. HearCARE (Hearing and Communication Assistance for Resident Engagement) is an initiative to provide communication assistance on a day-to-day basis in senior living facilities in a cost-effective manner. This innovative model for delivering audiology services and communication assistance in senior living communities employing communication facilitators who are trained and supervised by an audiologist will be described. Data related to the communication facilitator training, daily activities, interactions with the audiologist, use of devices, and impact on residents, staff, and families will be described.
28522892	For many adults with dementia, age-related hearing loss is undiagnosed and/or untreated. Untreated hearing loss can exacerbate common dementia-related behavioral symptoms, such as depression, apathy, agitation. Despite the potential benefits to the individual and the family, pursuing and adopting hearing aids for persons with dementia presents with many challenges. As such, this group of vulnerable older adults is well suited for alternative approaches that adopt an interventional audiology framework. This article reviews alternative hearing care models that we have tested when working with older adults with cognitive impairments. We have found that some individuals show improvements in dementia-related problem behaviors and/or in measures of social engagement after brief aural rehabilitation interventions that provide non-custom amplification. We have developed simple training materials to help family and professional caregivers use communication strategies and non-custom amplification. Providing services that can be integrated into the person's broader dementia care has the potential to improve communication and quality of life for individuals and families. There are opportunities in this population to provide basic, simple strategies and make substantial improvements as long as we adopt approaches that bring the services to the people, instead of bringing the people to us in the audiology clinic.
28521799	The purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes.A cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman's approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery. The Intensity of Interprofessional Collaboration Scale included two subscales: care sharing activities, and interprofessional coordination. In total, 697 LTC staff were given surveys, including personal support workers, support staff (housekeeping, kitchen, recreation, laundry, dietician aids, office staff), and registered staff (licensed nurses, physiotherapists, social workers, pharmacists, physicians).	A total of 317 participants completed the survey (126 personal support workers, 109 support staff, 82 registered staff) for a response rate of 45%. Significant differences emerged among occupational groups across all scales and subscales. Specifically, support staff rated their comfort of working with dying patients significantly lower than both nurses and PSWs. Support staff also reported significantly lower ratings of care sharing activities and interprofessional coordination compared to both registered staff and personal support workers.	These study findings suggest there are differing educational needs and sense of interprofessional collaboration among LTC staff, specific to discipline group. Both the personal support workers and support staff groups appeared to have higher needs for education; support staff also reported higher needs related to integration on the interdisciplinary team. Efforts to build capacity within support staff related to working with dying residents and their families are needed. Optimal palliative care may require resources to increase the availability of support for all staff involved in the care of patients.	
28521748	The HIV epidemic among men who have sex with men (MSM) continues to expand globally. The addition of an efficacious, prophylactic vaccine to combination prevention offers immense hope, particularly in low- and middle- income countries which bear the greatest global impact. However, in these settings, there is a paucity of vaccine preparedness studies that specifically pertain to MSM. Our study is the first vaccine preparedness study among MSM and female sex workers (FSWs) in Kenya. In this paper, we explore willingness of Kenyan MSM to participate in HIV vaccine efficacy trials. In addition to individual and socio-cultural motivators and barriers that influence willingness to participate (WTP), we explore the associations or linkages that participants draw between their experiences with or knowledge of medical research both generally and within the context of HIV/AIDS, their perceptions of a future HIV vaccine and their willingness to participate in HIV vaccine trials.Using a social network-based approach, we employed snowball sampling to recruit MSM into the study from Kisumu, Mombasa, and Nairobi. A field team consisting of seven community researchers conducted in-depth interviews with a total of 70 study participants. A coding scheme for transcribed and translated data was developed and the data was then analysed thematically.	Most participants felt that an HIV vaccine would bring a number of benefits to self, as well as to MSM communities, including quelling personal fears related to HIV acquisition and reducing/eliminating stigma and discrimination shouldered by their community. Willingness to participate in HIV vaccine efficacy trials was highly motivated by various forms of altruism. Specific researcher responsibilities centred on safe-guarding the rights and well-being of participants were also found to govern WTP, as were reflections on the acceptability of a future preventive HIV vaccine.	Strategies for engagement of communities and recruitment of trial volunteers for HIV vaccine efficacy trials should not only be grounded in and informed by investigations into individual and socio-cultural factors that impact WTP, but also by explorations of participants' existing experiences with or knowledge of medical research as well as attitudes and acceptance towards a future HIV vaccine.	
28521155	The capacity to predict what should happen next and to minimize any discrepancy between an expected and an actual sensory input (prediction error) is a central aspect of perception. Particularly in vocal communication, the effective prediction of an auditory input that informs the listener about the emotionality of a speaker is critical. What is currently unknown is how the perceived valence of an emotional vocalization affects the capacity to predict and detect a change in the auditory input. This question was probed in a combined event-related potential (ERP) and time-frequency analysis approach. Specifically, we examined the brain response to standards (Repetition Positivity) and to deviants (Mismatch Negativity - MMN), as well as the anticipatory response to the vocal sounds (pre-stimulus beta oscillatory power). Short neutral, happy (laughter), and angry (growls) vocalizations were presented both as standard and deviant stimuli in a passive oddball listening task while participants watched a silent movie and were instructed to ignore the vocalizations. MMN amplitude was increased for happy compared to neutral and angry vocalizations. The Repetition Positivity was enhanced for happy standard vocalizations. Induced pre-stimulus upper beta power was increased for happy vocalizations, and predicted the modulation of the standard Repetition Positivity. These findings indicate enhanced sensory prediction for positive vocalizations such as laughter. Together, the results suggest that positive vocalizations are more effective predictors in social communication than angry and neutral ones, possibly due to their high social significance.
28520929	Focusing on sex, the most salient topic featured in ageist jokes, this study aims at exploring the extent to which seniors' own humor reflects common ageist stereotypes or rather echoes contemporary consumer society representations of seniors' sexuality.The study was based on a quantitative content analysis of 300 humorous sex-related messages posted during one full year by members of 14 leading online communities for seniors.	Findings indicated that whereas the portrayal of older adults in humor typically relied on negative ageist stereotypes, their representation in seniors' online sex-related humor depended on the social identity of the butt of this humor. If it was an in-group member (oneself, another community member, or the community as a whole), the portrayal was rather positive, but when the butt belonged to the out-group (older adults in general), the depiction was far more ageist. Nonetheless, the representation of older butts of humor was generally more positive than that of the younger ones.	These findings suggest that seniors tend to identify with current cultural representations of sexuality in later life and use sex-related humor as a personal means of resisting ageism. They apply two principal strategies: Distancing-reproducing certain ageist stereotypes by ascribing them to other older adults, but less so to their own group and even less than that to themselves-and equalizing older and younger individuals, even according the former an advantage regarding sexuality.	
28520498	Palliative care for Parkinson's disease (PD) is an emerging area of interest for clinicians, patients and families. Identifying the palliative care needs of caregivers is central to developing and implementing palliative services for families affected by PD. The objective of this paper was to elicit PD caregiver needs, salient concerns, and preferences for care using a palliative care framework.11 PD caregivers and one non-overlapping focus group (n = 4) recruited from an academic medical center and community support groups participated in qualitative semi-structured interviews. Interviews and focus group discussion were digitally recorded, transcribed and entered into ATLAS.ti for coding and analysis. We used inductive qualitative data analysis techniques to interpret responses.	Caregivers desired access to emotional support and education regarding the course of PD, how to handle emergent situations (e.g. falls and psychosis) and medications. Participants discussed the immediate impact of motor and non-motor symptoms as well as concerns about the future, including: finances, living situation, and caretaking challenges in advanced disease. Caregivers commented on the impact of PD on their social life and communication issues between themselves and patient. All participants expressed interest and openness to multidisciplinary approaches for addressing these needs.	Caregivers of PD patients have considerable needs that may be met through a palliative care approach. Caregivers were receptive to the idea of multidisciplinary care in order to meet these needs. Future research efforts are needed to develop and test the clinical and cost effectiveness of palliative services for PD caregivers.	
28520478	To examine the relationship between household ownership of information and communication technologies (ICTs) and justifications for wife beating.Women aged 15 to 49 years in 20 countries were surveyed via UNICEF's Multiple Indicator Cluster Surveys between 2006 and 2014. Multivariate logistic regressions accounted for individual-, household-, and structural-level variables.	Household ownership of any ICT (radio, computer, fixed phone, or mobile phone but not television) was associated with increased odds of women rejecting wife beating. The largest association was with computer ownership: women in homes with a computer were more likely to reject wife beating (adjusted odds ratio [AOR] = 1.81; 97.5% confidence interval [CI] = 1.69, 1.93). Number of ICTs was important: women in households with 1, 2, 3, 4, and 5 ICTs (vs 0) were more likely to reject wife-beating justifications (AOR = 1.10 [97.5% CI = 1.03, 1.17]; AOR = 1.10 [97.5% CI = 1.03, 1.18]; AOR = 1.19 [97.5% CI = 1.11, 1.29]; AOR = 1.71 [97.5% CI = 1.54, 1.88]; and AOR = 2.85 [97.5% CI = 2.48, 3.26]; respectively).	Independent of household wealth, country development, and other sociodemographic factors, the more ICTs in a household, the more likely that women will reject wife-beating justifications. Policymakers and program planners should consider potential implications of ICT access relating to intimate partner violence.	
28518074	Mice produce ultrasonic vocalizations (USVs) in a variety of social contexts throughout development and adulthood. These USVs are used for mother-pup retrieval1, juvenile interactions2, opposite and same sex interactions3,4,5, and territorial interactions6. For decades, the USVs have been used by investigators as proxies to study neuropsychiatric and developmental or behavioral disorders7,8,9, and more recently to understand mechanisms and evolution of vocal communication among vertebrates10. Within the sexual interactions, adult male mice produce USV songs, which have some features similar to courtship songs of songbirds11. The use of such multisyllabic repertoires can increase potential flexibility and information they carry, as they can be varied in how elements are organized and recombined, namely syntax. In this protocol a reliable method to elicit USV songs from male mice in various social contexts, such as exposure to fresh female urine, anesthetized animals, and estrus females is described. This includes conditions to induce a large amount of syllables from the mice. We reduce recording of ambient noises with inexpensive sound chambers, and present a quantification method to automatically detect, classify and analyze the USVs. The latter includes evaluation of call-rate, vocal repertoire, acoustic parameters, and syntax. Various approaches and insight on using playbacks to study an animal's preference for specific song types are described. These methods were used to describe acoustic and syntax changes across different contexts in male mice, and song preferences in female mice.
28516470	The involvement of patients and the public in the development, implementation and evaluation of health care services and research is recognized to have tangible benefits in relation to effectiveness and credibility. However, despite >96% of children and young people surviving critical illness or injury, there is a paucity of published reports demonstrating their contribution to informing the priorities for aftercare services and outcomes research. We aimed to identify the service and research priorities for Paediatric Intensive Care Unit survivors with children and young people, their families and other stakeholders. We conducted a face-to-face, multiple-stakeholder consultation event, held in the Midlands (UK), to provide opportunities for experiences, views and priorities to be elicited. Data were gathered using write/draw and tell and focus group approaches. An inductive content analytical approach was used to categorize and conceptualize feedback. A total of 26 individuals attended the consultation exercise, including children and young people who were critical care survivors; their siblings; parents and carers; health professionals; academics; commissioners; and service managers. Consultation findings indicated that future services, interventions and research must be holistic and family-centred. Children and young people advisors reported priorities that focused on longer-term outcomes, whereas adult advisors identified priorities that mapped against the pathways of care. Specific priorities included developing and testing interventions that address unmet communication and information needs. Furthermore, initiatives to optimize the lives and longer-term functional and psycho-social outcomes of Paediatric Intensive Care Unit survivors were identified. This consultation exercise provides further evidence of the value of meaningful patient and public involvement in identifying the priorities for research and services for Paediatric Intensive Care Unit survivors and illuminates differences in proposed priorities between children, young people and adult advisors.
28516425	We examined the reliability, validity and factor structure of the Eye Contact Avoidance Scale (ECAS), a new 15-item screening tool designed to measure eye contact avoidance in individuals with fragile X syndrome (FXS). Internal consistency of the scale was acceptable to excellent and convergent validity with the Social Responsiveness Scale, Second Edition (SRS-2) and the Anxiety, Depression, and Mood Scale (ADAMS) was good. Boys with a comorbid ASD diagnosis obtained significantly higher scores on the ECAS compared to boys without ASD, when controlling for communication ability. A confirmatory factor analysis indicated that a two-factor model (avoidance and aversion) provided an excellent fit to the data. The ECAS appears to be a promising reliable and valid tool that could be employed as an outcome measure in future pharmacological/behavioral treatment trials for FXS.
28514911	Purpose The purpose of this paper is to explore how action learning concepts were used in two healthcare projects undertaken many decades apart. The specific purpose in both cases was to examine how action learning can contribute to shared learning across key stakeholders in a complex socio-technical system. In each case study, action learning supported joint design programmes and the sharing of perspectives about the complex system under investigation. Design/methodology/approach Two action learning projects are described: first, the Hospital Internal Communications (HIC) project led by Reg Revans in the 1960s. Senior staff in ten London hospitals formed action learning teams to address communication issues. Second, in the Better Outcomes for People with Learning Disabilities: Transforming Care (BOLDTC) project, videoconferencing equipment enabled people with learning disabilities to increase their opportunities to communicate. A mutual learning process was established to enable stakeholders to explore the potential of the technical system to improve individual care. Findings The HIC project demonstrated the importance of evidence being shared between team members and that action had to engage the larger healthcare system outside the hospital. The BOLDTC project confirmed the continuing relevance of action learning to healthcare today. Mutual learning was achieved between health and social care specialists and technologists. Originality/value This work draws together the socio-technical systems tradition (considering both social and technical issues in organisations) and action learning to demonstrate that complex systems development needs to be undertaken as a learning process in which action provides the fuel for learning and design.
28514533	To explore Iranian nurses' perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients' relatives, colleagues and superiors.Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence.	Qualitative descriptive design.	In this qualitative study, 22 unstructured, in-depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data.	Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients' relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses.	Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses' individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession.	Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence.	
28514530	To describe young children's demonstrated participation in healthcare situations while using an interactive communication tool.Participation is a multidimensional concept influenced by situational and contextual issues. In child participation, verbal and nonverbal communicative expressions are of interest, as both demonstrate the child's perspective. Children have a right to participate in all situations that matter to them, for instance healthcare situations. Children, understood as social actors, express a wish and a need to participate in these situations to get information and to enable preparation.	In a pilot study, video observations were used to capture the children's use of the interactive communication tool in healthcare situations. A hermeneutic analysis was conducted to achieve a deeper understanding of the children's demonstrated cues of participation.	The expressed cues of participation were understood as having either a curious, thoughtful or affirmative meaning of participation and there was a continuous movement between them. Curious cues were expressed when introducing or reintroducing the tool in the situation and demonstrated a wish to get knowledge of the things shown on the screen or to perform the virtual tasks. Thoughtful cues slowed down the progression of the situation when the children needed time to think or adapt to the virtual procedures. Affirmative cues were self-rewarding and demonstrated at successful task performance.	An interactive communication tool used in healthcare situations can promote young children's understanding and facilitate their situated participation, which potentially reduces feelings of distress or anxiety. This innovative use of interactive technology within paediatric health care provides new ways of revealing the child's perspective in the situation.	Interactive technology improves understanding and participation of children in healthcare situations, which impact them positively, both in the present and for the future. A communication tool enhances professionals' opportunities to adopt a child-centred approach by responding sensitively to the children's expressions.	
28514199	As an art form, drawings can facilitate the tangible expression of patients' inner images and feelings in a range of health conditions. However, there are currently no published studies investigating adults' perspectives of asthma using drawings. This study aimed to explore how adults' drawings illustrate their perceptions and experiences of asthma.Adults with asthma participated in a one-on-one drawing activity. Analysis was grounded in the participants' accounts of their drawing, which were examined alongside the relevant image. A coding approach was used to cluster thematic material and map the data according to the Common-Sense Model of Self-Regulation (CSM).	Eighteen participants took part. Three themes emerged: (1) asthma is constrictive and restrictive, (2) feeling alone, feeling different, and (3) the life journey of asthma. The drawings aligned with several domains of the CSM, in particular consequences. The images drawn by the participants and their subsequent discussions highlighted the prominence of the emotional burden of asthma.	The drawings provided powerful and evocative communication of the experience of asthma. Future research using drawings can further both healthcare professionals' and patients' understanding of the physical, social and emotional demands of living with asthma, and support the development of asthma self-management practices.	
28513972	This paper explores how earthquake scientists conceptualise earthquake prediction, particularly given the conviction of six earthquake scientists for manslaughter (subsequently overturned) on 22 October 2012 for having given inappropriate advice to the public prior to the L'Aquila earthquake of 6 April 2009. In the first study of its kind, semi-structured interviews were conducted with 17 earthquake scientists and the transcribed interviews were analysed thematically. The scientists primarily denigrated earthquake prediction, showing strong emotive responses and distancing themselves from earthquake 'prediction' in favour of 'forecasting'. Earthquake prediction was regarded as impossible and harmful. The stigmatisation of the subject is discussed in the light of research on boundary work and stigma in science. The evaluation reveals how mitigation becomes the more favoured endeavour, creating a normative environment that disadvantages those who continue to pursue earthquake prediction research. Recommendations are made for communication with the public on earthquake risk, with a focus on how scientists portray uncertainty.
28513185	This qualitative study seeks evidence of retained social awareness in individuals with moderate dementia residing in care-homes, when engaged in interactive family visits.Speech/non-speech data collected from 10/15-minute video-recorded family interactions of five family groups (12 individuals; 2 sessions per family group) were coded using thematic analysis.	Interactional patterns embedded in familiar bonds provided the context for the superordinate theme: relational social engagement (RSE). This overarched two subthemes: in-step and out-of-step; highlighting that RSE, can occur as a result of both positive and negative familial communication patterns. When familial communication was in-step, despite changed communication pathways, the resident's attempts at social engagement appeared open, relaxed, and responsive. A sense of trust, and familiarity appeared to facilitate reciprocal understanding and the striving of resident family members to retain family group membership. When familial communication was out-of-step, active attempts at reciprocity or open engagement from visiting family members were not observed. At such times, communication became discordant, and frustrated in their efforts to remain an integral part of the family group, the resident appeared disinterested or guarded often retorting with annoyance at visiting family members.	The construct of RSE appears specific to prior meaningful relationships, where optimal social awareness and communication, positive and negative, can occur. Currently, dementia assessment and care does not include RSE during family interactions. Implications are discussed.	
28512766	To assess the relationship between developmental coordination disorder (DCD) and mental health outcomes in late adolescence.Data were analyzed from the Avon Longitudinal Study of Parents and Children. Moderate-to-severe DCD was defined at 7 to 8 years according to the DSM-IV-TR criteria. Mental health was assessed at 16 to 18 years using self-reported questionnaires: Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire, and the Warwick-Edinburgh Mental Well-being Scale. Logistic and linear regressions assessed the associations between DCD and mental health, using multiple imputation to account for missing data. Adjustments were made for socio-economic status, IQ, and social communication difficulties.	Adolescents with DCD (n=168) had an increased risk of mental health difficulties (total Strengths and Difficulties Questionnaire score) than their peers (n=3750) (odds ratio 1.78, 95% confidence interval 1.12-2.83, adjusted for socio-economic status and IQ). This was, in part, mediated through poor social communication skills. Adolescent females with DCD (n=59) were more prone to mental health difficulties than males. Greater mental well-being was associated with better self-esteem (β 0.82, p<0.001).	Individuals with DCD, particularly females, had increased risk of mental health difficulties in late adolescence. Interventions that aim to promote resilience in DCD should involve improving social communication skills and self-esteem.	
28512080	Patient-reported outcome measures (PROMs) and mobile technology have the potential to change the way patients are monitored following joint replacement surgery.The aim of this study was to determine the feasibility of text messaging to record PROMs in long-term follow-up of hip and knee arthroplasty. Our participants were 17 patients 2-years-plus post hip or knee arthroplasty attending clinic with a mobile telephone number on record.	A simple PROM (Oswestry Very Short Form) was texted to the patient. Responses were compared to clinical, radiographic, and existing PROM findings. Patients were interviewed to discover their opinions on this use of texting.	A total of 11 patients engaged with the text messaging. Reasons for not engaging included wrong numbers, physical barriers, and lack of understanding. A total of 8 patients attending clinic allowed comparison of text messaging with clinical findings. The average age was 70 years. A total of 4 patient text messaging responses matched clinical and radiographic findings; 3 also matched PROM scores collected in clinic. The 3 patients with mixed responses had abnormal clinical, radiographic, or PROM findings. One patient's text responses conflicted with clinical outcome. Analysis of patients' views showed a generally positive opinion: patients were happy to communicate with surgeons by text. Practical problems, PROM limitations, and trustworthiness of texting were highlighted.	Engaging with changing technology creates challenges for patients and health care professionals. Despite this, our results suggest text messaging is a promising way to communicate with arthroplasty patients. Earlier integration of text communication in the patient pathway may be important and needs further research.	
28511803	This study examines how group members' questions shape member participation in health counselling and health education groups.The study applies conversation analytic principles as a method. The data consist of video-recorded health education lessons in secondary school and health counselling sessions for adults with a high risk of Type 2 diabetes.	Group members' questions accomplish a temporary change in participatory roles. They are used to 1) request counselling, 2) do counselling or 3) challenge previous talk. They are usually treated as relevant and legitimate actions by the participants, but are occasionally interpreted as transitions outside the current action or topic.	Group members' questions result in a shift from leader-driven to member-driven discussion. Thus they constitute a pivot point for detecting changes in participation in group interventions.	Observing the occurrence of group members' questions helps group leaders to adjust their own actions accordingly and thus facilitate or guide group participation. Comparison of the type and frequency of members' questions is a way to detect different trajectories for delivering group interventions and can thus be used to develop methods for process evaluation of interventions.	
28511484	Autism Spectrum Disorder (ASD) is a neuro developmental disorder which appears at early childhood age between 18 and 36 months. Apart from behaviour problems ASD children also suffer from sleep and Gastrointestinal (GI) problems. Major behaviour problems of ASD children are lack of social communication and interaction, less attention span, repetitive and restrictive behaviour, lack of eye to eye contact, aggressive and self-injurious behaviours, sensory integration problems, motor problems, deficiency in academic activities, anxiety and depression etc. Our hypothesis is that structured yoga intervention will brings significant changes in the problems of ASD children.The aim of this study was to find out efficacy of structured yoga intervention for sleep problems, gastrointestinal problems and behaviour problems of ASD children.	It was an exploratory study with pre-test and post-test control design. Three sets of questionnaires having 61 questions developed by researchers were used to collect data pre and post yoga intervention. Questionnaires were based on three problematic areas of ASD children as mentioned above and were administered to parents by teachers under the supervision of researcher and clinical psychologists. Experimental group was given yoga intervention for a period of 90 days and control group continued with school curriculum.	Both children and parents participated in this intervention. Significant changes were seen post yoga intervention in three areas of problems as mentioned above. Statistical analysis also showed significance value of 0.001 in the result.	Structured yoga intervention can be conducted for a large group of ASD children with parent's involvement. Yoga can be used as alternative therapy to reduce the severity of symptoms of ASD children.	
28511243	Einleitung Eine Brustkrebserkrankung geht mit erheblichen psychosozialen Belastungen für die Patientin und ihren Partner einher. Positive intradyadische Kommunikation und gegenseitige soziale Unterstützung wirken protektiv gegenüber diesen Belastungen. Individuelle emotionale Erregung gemessen über die Sprachgrundfrequenz (f0) gilt während partnerschaftlicher Interaktionen als wichtiger Aspekt des gegenseitigen Unterstützungsverhaltens und kann über die Sprachgrundfrequenz (f0-range) objektiv gemessen werden. Material & Methoden N=44 Paare führten siebenminütige Gespräche, bei denen der Mann als Sprecher seine Belastungen bezüglich der Krebserkrankung der Frau äußerte, während die Frau in der Zuhörerrolle Unterstützung bieten sollte. Mithilfe eines Akteur-Partner-Interdependenz-Modells (APIM) wurde die f0 beider Partner während der partnerschaftlichen Interaktion und ihr Zusammenhang mit dem Ausmaß an posttraumatischer Reifung (PTR) und Partnerschaftsqualität untersucht. Ergebnisse Eine größere PTR hing mit einer höheren eigenen f0 im Paargespräch bei den Männern zusammen (Akteur-Effekt) sowie tendenziell mit der f0 der Frau (Partner-Effekt). Es konnten keine Akteur- oder Partnereffekte bei den Frauen gefunden werden. Keine Effekte zeigten sich für Partnerschaftsqualität und f0. Diskussion Im Rahmen partnerschaftlicher Unterstützung scheint eine erhöhte emotionale Erregung f0 in Verbindung mit positiven psychologischen Faktoren zu stehen. Die f0 im Kontext der sozialen Unterstützung könnte mit einer positiven Selbstwirksamkeitserwartung zusammen hängen, die sich förderlich auf PTR auswirken und dem Sprecher Souveränität im emotionalen Ausdruck verleihen könnte. Diese Souveränität könnte sich wiederum in einer höheren Involviertheit und somit höheren f0 – Werten ausdrücken. Eine weitere Überprüfung dieser Ergebnisse ist erforderlich.Introduction Breast cancer is associated with significant psychosocial strains for both patients and partners. Constructive social support and positive communication behavior have been shown to be protective against the burdens associated with breast cancer. Individual levels of emotional arousal during social support interactions with one's spouse are an important aspect of couples' support behaviors and can be assessed via vocal fundamental frequency (f0). Methods N=44 couples had standardized seven-minute long interactions asking the male partner to describe his thoughts and feelings with regard to their wives' breast cancer. Using actor-partner interdependence models (APIM), f0's associations with individual posttraumatic growth (PTG) and perceived marital quality were differentially investigated. Results Significant actor effects for f0 and PTG were found for both husbands as well as tendencies for partner effects and wives. Perceived marital quality was not significantly associated with one's own levels of emotional arousal. No significant partner effects emerged for any of the variables of interest. Discussion Contrary to findings in couples' conflict discussions, higher levels of emotional arousal in social support interactions are associated with positive aspects of psychological functioning. F0 during social support could be associated with higher levels of self-efficacy, which might be beneficial for PTG and constructive ways of emotional expression. Constructive expression of emotional arousal could lead to heightened involvement in support interactions and may be voiced via higher levels of f0. Further analyses to replicate these findings are necessary.	
28510760	Although fertility preservation (FP) treatment options have increased, the existing evidence suggests that many women with cancer do not feel well supported in making these decisions, but find them stressful and complex and fail to take up fertility care at this crucial time. Whilst existing reviews have all made important contributions to our understanding of the FP decision-making process, none of them examine solely and specifically these processes for women of reproductive age with a diagnosis of any cancer, leaving a gap in the knowledge base. Given the expectation that care is patient-centred, our review aims to address this gap which may be of help to those managing patients struggling to make difficult decisions in the often brief period before potentially sterilizing cancer treatment is started.Underpinning this narrative review was the question 'What factors hinder the decision-making process for women with any cancer and contemplating FP treatment?' Our objectives were to (i) assess and summarize this existing literature, (ii) identify the factors that hinder this decision-making process, (iii) explore to what extent these factors may differ for women choosing different methods of FP and (iv) make recommendations for service delivery and future research.	A systematic search of the medical and social science literature from the 1 January 2005 up to the end of January 2016 was carried out using three electronic databases (Web of Science (PubMed), Ovid SP Medline and CINAHL via Ebsco). Included in the review were quantitative, qualitative and mixed-method studies. Reference lists of relevant papers were also hand searched. From the 983 papers identified, 46 papers were included. Quality assessment was undertaken using the Mixed Methods Appraisal Tool and thematic analysis was used to analyse the data.	From the analysis, 6 key themes with 15 sub-themes emerged: (i) fertility information provision (lack of information, timing of the information, patient-provider communication); (ii) fear concerning the perceived risks associated with pursuing FP (delaying cancer treatment, aggravating a hormone positive cancer and consequences of a future pregnancy); (iii) non-referral from oncology (personal situation, having a hormone positive cancer, FP not a priority and transition between service issues); (iv) the dilemma (in survival mode, whether to prioritize one treatment over another); (v) personal situation (parity, relationship status) and (iv) costs (financial concerns).	This review has found that a wide range of internal and external factors impact the FP decision-making process. Key external issues related to current service delivery such as the provision and timing of FP information, and lack of referral from oncology to the fertility clinic. However, internal issues such as women's fears concerning the perceived risks associated with pursuing FP also hindered decision-making but these 'risks' were typically overestimated and non-evidence based. These findings suggest that the implementation of a range of decision support interventions may be of benefit within the clinical care pathway of FP and cancer. Women would benefit from the provision of more evidence-based FP information, ideally received at cancer diagnosis, in advance of seeing a fertility specialist, for example through the implementation of patient decision aids. Healthcare professionals in both oncology and fertility services may also benefit from the implementation of training programmes and educational tools targeted at improving the communication skills needed to improve collaborative decision-making and deliver care that is patient-centred. Exploration of the current barriers, both intellectual and practical, that prevent some patients from accepting FP will help care providers to do better for their patients in the future. Finally, the extent to which a poorer prognosis and moral, ethical and religious beliefs influence the FP decision-making process also warrant further research.	
28509597	The technological development of communication aids for people with hearing loss has progressed rapidly over the last decades. Quality has improved and the number of different types of aids has increased. However, few studies have examined the prevalence of technology use and interpreting services use among people with hearing loss as they relate to demographic characteristics of this population.This study reports from national surveys of children and adults with hearing loss. Use of hearing aids, cochlear implants, other aids and interpreting services were analysed with regard to gender, age, degree of hearing loss, mode of communication, having an additional disability, level of educational achievement among adults, and whether or not children lived together with both of their parents.	269 children (0-15 years of age) and 839 adults (16-65 years of age).	Differences in technology and service use were associated with age, degree of hearing loss, and mode of communication among children and adults, and gender and level of educational achievement among adults.	Individual and social factors have an impact on technological hearing aid and interpreter use. More research about individual differences and clinical implications of support services is needed.	
28509404	Autism spectrum disorders (ASDs) are characterised by impairments in communication and reciprocal social interaction. These impairments can impact on relationships with family members, augment stress and frustration, and contribute to behaviours that can be described as challenging. Family members of individuals with ASD can experience high rates of carer stress and burden, and poor parental efficacy. While there is evidence to suggest that individuals with ASD and family members derive benefit from psychological interventions designed to reduce stress and mental health morbidity, and enhance coping, most studies to date have targeted the needs of either individuals with ASD, or family members. We wanted to examine whether family (systemic) therapy, aimed at enhancing communication, relationships or coping, is effective for individuals with ASD and their wider family network.To evaluate the clinical effectiveness and acceptability of family therapy as a treatment to enhance communication or coping for individuals with ASD and their family members. If possible, we will also seek to establish the economic costs associated with family therapy for this clinical population.	On 16 January 2017 we searched CENTRAL, MEDLINE, Embase, 10 other databases and three trials registers. We also handsearched reference lists of existing systematic reviews and contacted study authors in the field.	Randomised controlled trials (RCTs) and quasi-RCTs investigating the effectiveness of family therapy for young people or adults with ASD or family members, or both, delivered via any modality and for an unspecified duration, compared with either standard care, a wait-list control, or an active intervention such as an alternative type of psychological therapy.	Two authors independently screened each title and abstract and all full-text reports retrieved. To enhance rigour, 25% of these were independently screened by a third author.	The search yielded 4809 records. Of these, we retrieved 37 full-text reports for further scrutiny, which we subsequently excluded as they did not meet the review inclusion criteria, and identified one study awaiting classification.	Few studies have examined the effectiveness of family therapy for ASD, and none of these are RCTs. Further research studies employing methodologically robust trial designs are needed to establish whether family therapy interventions are clinically beneficial for enhancing communication, strengthening relationships, augmenting coping and reducing mental health morbidity for individuals with ASD and family members.	
28509335	Previous research has proposed that persons in need of palliative care often have a loss of functions and roles that affects social and existential self-image. Moreover, these individuals also commonly suffer from complex multisymptoms. This, together with the situation of facing an impending death, can lead to a loss of dignity. Therefore, supporting these persons' dignity is a crucial challenge for professional nurses. The 'Dignity Care Intervention' addresses the multidimensionality of dignity by identifying patients' dignity-related concerns and suggests care actions to address them. At the present, the Dignity Care Intervention is adapted for implementation in Swedish care settings. Because expressions of dignity are influenced by culture, and an overview of care actions in a Swedish context is lacking, this integrative review aimed to find suggestions from Swedish research literature on what kind of care actions can preserve dignity.An integrative literature review was conducted using the databases SwePub and SweMed+. Articles published from 2006 to 2015 and theses published from 2000 to 2015 were searched for using the terms 'dignity' and 'palliative care'. Result sections of articles and theses were reviewed for dignity-conserving care actions synthesised by thematic analysis and categorised under themes and subthemes in Chochinov's model of dignity.	Fifteen articles and 18 theses were included together providing suggestions of care actions in all themes and subthemes in the dignity model. Suggested care actions included listening, communication, information, symptom control, facilitating daily living and including patients in decision-making. Additionally, nurses' perceptiveness towards the patients was a core approach.	The review offers culturally relevant suggestions on how to address specific dignity-related concerns. The adapted Dignity Care Intervention will be a way for Swedish nurses to provide person-centred palliative care that will conserve patients' dignity.	
28508808	Primary health care (PHC) is currently being improved in all developed industries. The aim is to make healthcare more patient-centered and close to the patient's place of residence. In addition to the organizational and interdisciplinary reorientation, the use of digital media is increasingly being emphasized. Through literature research and an online survey among Austrian doctors and general practitioners, the current and future challenges for the use of digital media in networked and regional primary health care were identified and prioritized. It becomes clear that basic functions like documentation, communication and coordination in the individual medical practice are at the forefront. In the future it will be necessary to support regional and interprofessional networking through digital media.
28508155	Retention of participants in clinical trials is a central concern of HIV/STI behavioral researchers and research sponsors. This article describes the strategies used for addressing the challenges in retaining South African adolescents for a 54-month longitudinal study. The objective of the South African adolescent health promotion long-term follow-up trial was to test the sustainability of the effects of an HIV/STI risk reduction intervention, "Let Us Protect Our Future," on young adolescents as they aged into middle and late adolescence. Inaccurate contact information, invalid mobile telephone numbers, lack of transportation, transitory family addresses, and family relocation were among the challenges to retaining participants. Despite a significant gap in time of 36 months between the main trial and the long-term follow-up study, 99.2% of 1057 participants were retained. Solutions used for retaining the adolescents are discussed with suggestions offered for retaining adolescents in longitudinal HIV/STI prevention clinical trials in low resource countries.
28508018	Israel has provided immediate healthcare to Syrian children, civilians and fighters since early 2013 despite being in an official state of war with Syria since 1973. We present qualitative findings from a larger mixed-methods phenomenological study to understand how the geopolitical and social history of Israel and Syria influences healthcare providers and Syrian patient caregivers in northern Israel. Theories of humanization and cognitive dissonance guided this study and frame the beliefs and experiences of healthcare providers who treated wounded Syrians in Israeli hospitals. Findings indicate healthcare providers and Syrian caregivers adjusted their beliefs to allow for positive healthcare experiences. Qualitative analysis revealed two major themes: supportive and hindering systemic elements contributing to the healthcare provider-patient-caregiver relationship. Internal psychological developments, contextual factors, and relational processes influenced humanization of the other within the relationship. This study illuminates unique ethical and humanitarian demands relevant for healthcare workers and those with whom they interact.
28508017	This study elucidated Japanese home care nurses' experiences of supporting clients and families with anxiety. We interviewed 10 registered nurses working in home care agencies and analyzed the data using grounded theory to derive categories pertaining to the nurses' experiences of providing care. We conceptualized nurses' approaches to caring for anxiety into three categories: First, they attempted to reach out for anxiety even when the client/family did not make it explicit; second, they tried to alter the outlook of the situation; and third, they created comfort in the lives of the client/family. The conceptualizations of nurses' strategies to alleviate client/family anxiety may reflect Japanese/Eastern cultural characteristics in communication and their view of the person and social care system, but these conceptualizations may also inform the practice of Western nurses by increasing awareness of skills they may also have and use.
28507523	Autism spectrum disorders (ASD) and schizophrenia spectrum disorders (SSD) share clinical and genetic components that have long been recognized. The two disorders co-occur more frequently than would be predicted by their respective prevalence, suggesting that a complex, multifactor association is involved. However, DSM-5 maintains the distinction between ASD, with core social and communication impairments, and SSD, including schizophrenia (SCZ), with hallucinations, delusions, and thought disorder as essential features. ASD and SSD have common biological underpinnings that may emerge early in development and unfold over time. One of the hypotheses supporting the similarities in the social and cognitive disturbances of ASD and SSD relates to abnormalities in the ratio of excitatory to inhibitory cortical activity (E/I imbalance). E/I imbalance in neurodevelopmental disorders could be the consequence of abnormalities in genes coding for glutamatergic and GABAergic receptors or synaptic proteins followed by system derangements. SSD and ASD have been characterized as polygenic disorders in which to the onset and progression of disease is triggered by interactions among multiple genes. Mammalian target of rapamycin signaling is under intense investigation as a convergent altered pathway in the two spectrum disorders. Current understanding of shared and divergent patterns between ASD and SSD from molecular to clinical aspects is still incomplete and may be implemented by the research domain criteria approach.
28506309	Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care.In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy. He was diagnosed as having stage IIIA rectal cancer. Detailed history taking revealed that he experienced social isolation after the disaster, due to the evacuation of his friends, losing his regular opportunities for socialization. He additionally reported that the current diagnosis of rectal cancer made him feel he had lost his health in addition to his social relationships. Although radical surgery was attempted, it failed to resect the lesion completely, and thereafter his disease gradually progressed. As support from family or friends was not available, he was not able to receive palliative radiation therapy or home-based care in his end-of-life period. He died at a long-term care facility in February 2017.	This case suggests that intense social isolation after the Fukushima disaster was a likely contributor to the patient delay, poor treatment course, and poor outcome of an elderly patient with rectal cancer. Direct communication with family and friends may play an indispensable role in increasing health awareness and promoting health-seeking behaviors, and in the midst of social isolation, elderly patients with cancer may lose these opportunities and experience increased risk of patient delay. Although health care providers may be able to alleviate isolation-induced delay by promoting cancer knowledge and awareness widely among local residents, policy-led interventions at the community level may be essential to reducing social isolation and its health consequences.	
28506185	It has been recently theorized that atypical sensory processing in autism relates to difficulties in social communication. Through a series of tasks concurrently assessing multisensory temporal processes, multisensory integration and speech perception in 76 children with and without autism, we provide the first behavioral evidence of such a link. Temporal processing abilities in children with autism contributed to impairments in speech perception. This relationship was significantly mediated by their abilities to integrate social information across auditory and visual modalities. These data describe the cascading impact of sensory abilities in autism, whereby temporal processing impacts multisensory information of social information, which, in turn, contributes to deficits in speech perception. These relationships were found to be specific to autism, specific to multisensory but not unisensory integration, and specific to the processing of social information.
28506183	Communicating the diagnosis of cancer in cross-cultural clinical settings is a complex task. This qualitative research article describes the content and process of informing Zulu patients in South Africa of the diagnosis of cancer, using osteosarcoma as the index diagnosis. We used a descriptive research design with census sampling and focus group interviews. We used an iterative thematic data analysis process and Guba's model of trustworthiness to ensure scientific rigor. Our results reinforced the use of well-accepted strategies for communicating the diagnosis of cancer. In addition, new strategies emerged which may be useful in other cross-cultural settings. These strategies included using the stages of cancer to explain the disease and its progression and instilling hope using a multidisciplinary team care model. We identified several patients, professionals, and organizational factors that complicate cross-cultural communication. We conclude by recommending the development of protocols for communication in these cross-cultural clinical settings.
28505472	This study aimed to investigate whether hearing aids use is associated with improvement of older-person-specific QOL and whether social interactions modify the association.The WHOQOL-OLD questionnaire was answered by 105 older adults aged 60 to 90 years who were newly fitted hearing aids on the day of fitting and at 2 - 6 months afterward. The associations between the daily hours of hearing aid usage and social relations with changes in the WHOQOL-OLD total score after hearing aids fitting were estimated adjusting for possible confounders.	Older persons with hearing loss experienced significant increases in WHOQOL-OLD total score after hearing aid fitting. Regular use of hearing aid was associated with a greater increase in the total score. The combined categorical variable of social relations and hearing aid usage revealed no separate effects of these two variables, but a combined effect; only those with frequent social interactions who used their hearing aid regularly had a significantly greater increase in WHOQOL-OLD total score.	This study's findings indicate that hearing aid fitting may be associated with a subsequent improvement in older-person-specific QOL by improvements in hearing due to the hearing aid, and possibly enhanced communication opportunities.	
28505118	(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; (3) Results: Two overarching patterns of hope emerged. Those who experienced hope as particularized (focused on cure) cited communication about false hope, performing (faking it), and avoidance. Those who transitioned from particularized to generalized hope (hope for a good death) reported acceptance, the communication of hope as social support, prioritizing family, and balancing hope and honesty; (4) Conclusion: Family caregivers face myriad complexities in managing the bright and dark sides of hope. Interventions should encourage concurrent oncological and palliative care, increased perspective-taking among family members, and encourage the transition from particularized to generalized hope.
28504911	Humans routinely share information with one another. What drives this behavior? We used neuroimaging to test an account of information selection and sharing that emphasizes inherent reward in self-reflection and connecting with other people. Participants underwent functional MRI while they considered personally reading and sharing New York Times articles. Activity in neural regions involved in positive valuation, self-related processing, and taking the perspective of others was significantly associated with decisions to select and share articles, and scaled with preferences to do so. Activity in all three sets of regions was greater when participants considered sharing articles with other people rather than selecting articles to read themselves. The findings suggest that people may consider value not only to themselves but also to others even when selecting news articles to consume personally. Further, sharing heightens activity in these pathways, in line with our proposal that humans derive value from self-reflection and connecting to others via sharing.
28504353	Autism spectrum disorder (ASD) is a genetically heterogeneous group of disorders characterized by impairments in social communication and restricted interests. Though some patients with ASD have an identifiable genetic cause, the cause of most ASD remains elusive. Many ASD susceptibility loci have been identified through clinical studies. We report two patients with syndromic ASD and persistent gastrointestinal issues who carry de novo deletions involving the CMIP gene detected by genome-wide SNP microarray and fluorescence in situ hybridization (FISH) analysis. Patient 1 has a 517 kb deletion within 16q23.2q23.3 including the entire CMIP gene. Patient 2 has a 1.59 Mb deletion within 16q23.2q23.3 that includes partial deletion of CMIP in addition to 12 other genes, none of which have a known connection to ASD or other clinical phenotypes. The deletion of CMIP is rare in general population and was not found among a reference cohort of approximately 12,000 patients studied in our laboratory who underwent SNP array analysis for various indications. A 280 kb de novo deletion containing the first 3 exons of CMIP was reported in one patient who also demonstrated ASD and developmental delay. CMIP has previously been identified as a susceptibility locus for specific language impairment (SLI). It is notable that both patients in this study had significant gastrointestinal issues requiring enteral feedings, which is unusual for patients with ASD, in addition to unusually elevated birth length, further supporting a shared causative gene. These findings suggest that CMIP haploinsufficiency is the likely cause of syndromic ASD in our patients.
28504040	Facebook is a social networking site (SNS) for communication, entertainment and information exchange. Recent research has shown that excessive use of Facebook can result in addictive behavior in some individuals.To assess the patterns of Facebook use in post-graduate students of Yenepoya University and evaluate its association with loneliness.	A cross-sectional study was done to evaluate 100 post-graduate students of Yenepoya University using Bergen Facebook Addiction Scale (BFAS) and University of California and Los Angeles (UCLA) loneliness scale version 3. Descriptive statistics were applied. Pearson's bivariate correlation was done to see the relationship between severity of Facebook addiction and the experience of loneliness.	More than one-fourth (26%) of the study participants had Facebook addiction and 33% had a possibility of Facebook addiction. There was a significant positive correlation between severity of Facebook addiction and extent of experience of loneliness ( r = .239, p = .017).	With the rapid growth of popularity and user-base of Facebook, a significant portion of the individuals are susceptible to develop addictive behaviors related to Facebook use. Loneliness is a factor which influences addiction to Facebook.	
28503957	Many clinicians, educators, and employers lack disability confidence which can affect their interactions with, and inclusion of people with disabilities. Our objective was to explore how disability confidence developed among youth who volunteered with children who have a disability.We conducted 30 in-depth interviews (16 without a disability, 14 with disabilities), with youth aged 15-25. We analyzed our data using an interpretive, qualitative, thematic approach.	We identified four main themes that led to the progression of disability confidence including: (1) "disability discomfort," referring to lacking knowledge about disability and experiencing unease around people with disabilities; (2) "reaching beyond comfort zone" where participants increased their understanding of disability and became sensitized to difference; (3) "broadened perspectives" where youth gained exposure to people with disabilities and challenged common misperceptions and stereotypes; and (4) "disability confidence" which includes having knowledge of people with disabilities, inclusive, and positive attitudes towards them.	Volunteering is one way that can help to develop disability confidence. Youth with and without disabilities both reported a similar process of developing disability confidence; however, there were nuances between the two groups. Implications for Rehabilitation The development of disability confidence is important for enhancing the social inclusion of people with disabilities. Volunteering with people who have a disability, or a disability different from their own, can help to develop disability confidence which involves positive attitudes, empathy, and appropriate communication skills. Clinicians, educators, and employers should consider promoting working with disabled people through such avenues as volunteering or service learning to gain disability confidence.	
28503067	In-depth knowledge regarding interdisciplinary collaboration, a key feature in reablement, is scarce.To elucidate how the interdisciplinary collaboration in reablement worked in a Norwegian context.	Seven focus group interviews were conducted with 33 health care providers working in interdisciplinary reablement teams in seven municipalities across the country. The focus group interviews were transcribed and an hermeneutical analysis was conducted.	The analysis resulted in four main themes: "participant's own goals as a common interdisciplinary platform", "a positive professional community", "learning from each other's skills and competencies" and "new roles and joint efforts but specific competencies". The results show that interdisciplinary collaboration in reablement depends on participants defining their own rehabilitation goals, which function as a professional unifying platform for the interdisciplinary collaboration. The challenges for participants in reablement are often complex and include assessments, effort and a need for close collaboration between several different professionals. A tight interdisciplinary collaboration causes major changes in roles, often from a particular role to a more general role with broader job tasks. Although different professionals perform the same rehabilitation tasks, it is important that each professional contributes their unique competence and thus together they complete each other's competencies.	Factors that have a positive impact on interdisciplinary collaboration in reablement are participants' definitions of their goals, number and variety of professionals involved, how closely these professionals collaborate, the amount of time for communication and shared planning and decision making.	
28503021	The differences between direct ties (i.e., ties between a respondent and their nominees) and ties between nominees (indirect) are key to understanding network structure, yet remain understudied. Within a sample of 175 young men who have sex with men, we explored the corroboration of sex and drug ties, and factors associated with corroboration. The majority of instances in which there was no corroboration for either sex or drug ties was due to one individual not appearing in another respondent's network. When an individual did appear in another respondent's network, direct sex and drug ties were corroborated in most cases. We also found that more indirect sex ties were corroborated than direct sex ties (95.7% vs. 88.9%), but the reverse was true for indirect versus direct drug ties (73.1% vs. 84.1%). Strength of relationship and frequency of communication were both associated with confirmed direct ties, but not with indirect ties. Based on these findings, we recommend that direct and indirect ties be treated differently in network analyses.
28502913	The High Quality Communication intervention aims to stimulate interpersonal communication between individuals with congenital deaf-blindness (CDB) and their social partners. Found effective in multiple-case experiments, the intervention is based on Trevarthen's theory of inter-subjective development (Bråten &amp; Trevarthen, 2007), which describes children's innate and developing ability to share subjective states in interpersonal communication and social partners' mediating role in this development. One implication of this theory is that social partners can support the emergence of higher-complexity communication behaviors in individuals who are still developing these behaviors. To test this proposition, communication patterns between individuals with CDB and their parents, teachers, and professional caregivers were analyzed. Analysis of two-event sequences of communicative behaviors showed a highly significant correspondence between the behavior of the social partner and the subsequent behavior of the individual with CDB, confirming that social partners can scaffold higher-complexity communication within interpersonal communication.
28502837	Deficits in social behavior and communication skills are correlated with reduced gross motor skills in children with autism spectrum disorders (ASD). The ExerciseBuddy application (EB app) was designed to communicate these motor skills to those with ASD and integrates evidence-based practices such as visual support and video modeling supported by The National Professional Development Center on Autism Spectrum Disorders. The purpose of this study was to determine the effectiveness of the EB app in facilitating increased physiologic responses to physical activity via a continuous measurement of energy expenditure and heart rate versus practice-style teaching methods in children with ASD. Six children, ages 5 to 10years, diagnosed with ASD were recruited. Each participant performed a variety of locomotor or object control skills as defined by the Test of Gross Motor Development-2 once per week for 4weeks. Motor skills were communicated and demonstrated using either practice-style teaching methods or the instructional section of the EB app. Energy expenditure and heart rate were measured continuously during each 12-minute session. A Wilcoxon signed-rank test was performed to assess any differences between the use of the app and practice-style teaching methods. The use of the EB app elicited greater values for peak energy expenditure (p=0.043) and peak heart rate response (p=0.028) while performing locomotor skills but no differences were observed while performing object control skills. Similarities were observed with average physiologic responses between the use of the EB app and practice-style teaching methods. The use of the EB app may allow for a greater peak physiologic response during more dynamic movements and a similar average cardiovascular and metabolic response when compared to practice-style teaching methods in children with ASD.
28502406	Given the proliferation of 'intelligent' and 'socially-aware' digital assistants embodying everyday mobile technology - and the undeniable logic that utilising voice-activated controls and interfaces in cars reduces the visual and manual distraction of interacting with in-vehicle devices - it appears inevitable that next generation vehicles will be embodied by digital assistants and utilise spoken language as a method of interaction. From a design perspective, defining the language and interaction style that a digital driving assistant should adopt is contingent on the role that they play within the social fabric and context in which they are situated. We therefore conducted a qualitative, Wizard-of-Oz study to explore how drivers might interact linguistically with a natural language digital driving assistant. Twenty-five participants drove for 10 min in a medium-fidelity driving simulator while interacting with a state-of-the-art, high-functioning, conversational digital driving assistant. All exchanges were transcribed and analysed using recognised linguistic techniques, such as discourse and conversation analysis, normally reserved for interpersonal investigation. Language usage patterns demonstrate that interactions with the digital assistant were fundamentally social in nature, with participants affording the assistant equal social status and high-level cognitive processing capability. For example, participants were polite, actively controlled turn-taking during the conversation, and used back-channelling, fillers and hesitation, as they might in human communication. Furthermore, participants expected the digital assistant to understand and process complex requests mitigated with hedging words and expressions, and peppered with vague language and deictic references requiring shared contextual information and mutual understanding. Findings are presented in six themes which emerged during the analysis - formulating responses; turn-taking; back-channelling, fillers and hesitation; vague language; mitigating requests and politeness and praise. The results can be used to inform the design of future in-vehicle natural language systems, in particular to help manage the tension between designing for an engaging dialogue (important for technology acceptance) and designing for an effective dialogue (important to minimise distraction in a driving context).
28502063	Great apes give gestures deliberately and voluntarily, in order to influence particular target audiences, whose direction of attention they take into account when choosing which type of gesture to use. These facts make the study of ape gesture directly relevant to understanding the evolutionary precursors of human language; here we present an assessment of ape gesture from that perspective, focusing on the work of the "St Andrews Group" of researchers. Intended meanings of ape gestures are relatively few and simple. As with human words, ape gestures often have several distinct meanings, which are effectively disambiguated by behavioural context. Compared to the signalling of most other animals, great ape gestural repertoires are large. Because of this, and the relatively small number of intended meanings they achieve, ape gestures are redundant, with extensive overlaps in meaning. The great majority of gestures are innate, in the sense that the species' biological inheritance includes the potential to develop each gestural form and use it for a specific range of purposes. Moreover, the phylogenetic origin of many gestures is relatively old, since gestures are extensively shared between different genera in the great ape family. Acquisition of an adult repertoire is a process of first exploring the innate species potential for many gestures and then gradual restriction to a final (active) repertoire that is much smaller. No evidence of syntactic structure has yet been detected.
28501654	Prenatal exposure to organophosphate insecticides may be associated with autism spectrum disorders and related behaviors. This association may be modified by single nucleotide polymorphisms in the paraoxonase (PON1) enzyme.We examined the relationship of prenatal organophosphate insecticide biomarkers with reciprocal social, repetitive, and stereotypic behaviors in 8-year old children, and modification of this relationship by child PON1 polymorphisms.	Among 224 pregnant women, we quantified concentrations of six nonspecific dialkyl phosphate (DAP) metabolites of organophosphate insecticides in two urine samples collected at ~16 and ~26 weeks gestation. When children were eight years old, we administered the Social Responsiveness Scale (SRS), a continuous measure of various dimensions of interpersonal behavior, communication, and repetitive/stereotypic behaviors. We estimated the association between a 10-fold increase in the sum of six DAP concentrations (ΣDAP) and SRS scores. We examined whether child PON1192 and PON1-108 genotypes modified this association.	After covariate adjustment, ΣDAP concentrations were not associated with SRS scores [β=-1.2; 95% confidence interval (CI): -4.0, 1.6]. Among children with the PON1-108TT genotype, ΣDAP concentrations were associated with 2.5-point higher (95% CI: -4.9, 9.8) SRS scores; however, the association was not different from the 1.8-point decrease (95% CI: -5.8, 2.2) among children with PON1-108CT/CC genotypes (ΣDAP × PON1-108 p-value =0.54). The association between ΣDAP concentrations and SRS scores was not modified by PON1192 (ΣDAP × PON1192 p-value =0.89).	In this cohort, prenatal urinary DAP concentrations were not associated with children's social behaviors; these associations were not modified by child PON1 genotype.	
28501552	In the quest to bridge the gulf between the fields of linguistics and animal communication, interest has recently been drawn to turn-taking behavior in social interaction. Vocal turn-taking is the core form of language usage in humans, and has been examined in numerous species of birds and primates. Recent studies on great apes have shown that they engage in a bodily form, gestural turn-taking, to achieve mutual communicative goals. However, most studies on turn-taking neglected the fact that signals are prevalently perceived and produced in a multimodal format. Here, I propose that research on animal communication may benefit a more holistic and dynamic approach: studying turn-taking using a multimodal, conservation-analytic framework. I will discuss recent comparative research that implemented this approach via a specific set of parameters. In sum, I argue that a conversation-analytic framework might help substantially to pinpoint the ways in which crucial components of language are embodied in the 'human interaction engine'.
28500650	Autism spectrum disorder (ASD) is a class of neurodevelopmental disorders characterized by persistent deficits in social communication/interaction, together with restricted/repetitive patterns of behavior. ASD is among the most heritable neuropsychiatric conditions, and while available evidence points to a complex set of genetic factors, the SHANK gene family has emerged as one of the most promising candidates. Here, we assessed ASD-related phenotypes with particular emphasis on social behavior and cognition in Shank1 mouse mutants in comparison to heterozygous and wildtype littermate controls across development in both sexes. While social approach behavior was evident in all experimental conditions and social recognition was only mildly affected by genotype, Shank1-/- null mutant mice were severely impaired in object recognition memory. This effect was particularly prominent in juveniles, not due to impairments in object discrimination, and replicated in independent mouse cohorts. At the neurobiological level, object recognition deficits were paralleled by increased brain-derived neurotrophic factor (BDNF) protein expression in the hippocampus of Shank1-/- mice; yet BDNF levels did not differ under baseline conditions. We therefore investigated changes in the epigenetic regulation of hippocampal BDNF expression and detected an enrichment of histone H3 acetylation at the Bdnf promoter1 in Shank1-/- mice, consistent with increased learning-associated BDNF. Together, our findings indicate that Shank1 deletions lead to an aberrant cognitive phenotype characterized by severe impairments in object recognition memory and increased hippocampal BDNF levels, possibly due to epigenetic modifications. This result supports the link between ASD and intellectual disability, and suggests epigenetic regulation as a potential therapeutic target.
28500017	Many elderly people prefer to live at home independently. One of the major concerns raised by the family members is the safety and well-being of their elderly family members when living independently in a home environment. To address this issue, assistive technology solutions have been available in the market. Despite their availability and proliferation, these types of solutions are not popular with the elderly due to their intrusive nature, privacy-related issues, social stigma, and fear of losing human interaction. This study shares the experience in the development of a digital photo frame system that helps family members to check the well-being of the elderly, exploiting their desire to remain socially connected.The aim of this study was to iteratively design, implement, and assess the usability, user friendliness, and acceptability of a tablet-based system to check the well-being of the elderly.	Our study methodology comprises three separate stages: initial system development, contextual assessment, and comparative case study evaluation.	In the first stage, requirements were elicited from the elderly to design a well-being check prototype. In the second stage, areas for improvements (eg, privacy features) were identified. Also, additional features (such as medication prompts or food reminders) were suggested to help aged and health care service providers with effective but subtle monitoring of the elderly. These would lower their operating cost by reducing visits by care providers to the homes of the elderly. In the third stage, the results highlighted the difference (between users in India and Australia) in the levels of familiarity of the elderly with this technology. Some elderly participants at the Kalyani Institute for Study, Planning and Action for Rural Change, India latched onto this technology quickly while a few refused to use the system. However, in all cases, the support of family members was crucial for their willingness to use the technology.	This project has three major outcomes. First, a picture frame prototype was tested with the elderly to leverage the benefits of social communication. Second, the project helped us test and implement the "Silvercare" model for supporting the elderly through young retired people residing in the area. Finally, the project helped formalize the agile three-stage design methodology to develop information technology solutions for the elderly. Also, the project contributed to an ongoing European Union Project called Victoryahome, which involves more than 50 sites across 5 countries (Norway, Sweden, Netherlands, Portugal, and Australia) to assess the use of telepresence robots, wearable fall detectors, and medication dispensers for the elderly living independently.	
28499914	Autism spectrum disorders (ASD) are common heterogeneous neurodevelopmental disorders with typical triad of symptoms: impaired social interaction, language and communication abnormalities and stereotypical behavior. Despite extensive research, the etiology and pathogenesis of ASD remain largely unclear. The lack of solid knowledge on the mechanisms of these disorders decreases the opportunities for pathogenetic treatment of autism. Various theories where proposed in order to explain the pathophysiology underlying ASD. Despite the fact that none of them is able to completely explain the impairments in the nervous system of ASD patients, these hypotheses were instrumental in highlighting the most important mechanisms in the development of this complex disorder. Some new theories are based on neurovisualization studies, others on the data from genomic studies, which become increasingly available worldwide. As the research in this field is largely dependent on the animal models, there is an ongoing discussion and search for the most appropriate one adequately reproducing the pathology. Here we provide an overview of current theories of the origin and development of ASD discussed in the context of existing and proposed rodent models of ASD.
28499519	Relationship satisfaction is generally positively correlated with sexual satisfaction, but this relation has been poorly examined in people with cardiovascular disease who are at increased risk of sexual problems compared with the general population.To document reported changes to sex after a diagnosis of cardiac disease and determine whether there is an association between sexual function and relationship satisfaction.	Semistructured telephone interviews focused on relationship satisfaction and sexual problems were conducted with 201 people with cardiovascular disease who were currently in a sexual relationship with one main partner and were recruited from six hospital cardiac rehabilitation centers in Ireland. Comparisons between groups were conducted using t-tests and multivariate analysis of variance for continuous variables and χ2 tests for categorical variables. Predictors of relationship satisfaction were assessed using multiple linear regression analysis.	Data were gathered on demographic and clinical variables, sexual problems, and relationship satisfaction, including satisfaction with the physical, emotional, affection, and communication aspects of relationships.	Just less than one third of participants (n = 61, 30.3%) reported that sex had changed for the worse since their cardiac event or diagnosis, with approximately half of these stating that this was a serious problem for them. Satisfaction with relationships was high among patients surveyed; more than 70% of the sample reported being very or extremely satisfied with the physical and emotional aspects and showing affection during sex. Satisfaction with communication about sex was lower, with only 58% reporting being very or extremely satisfied. We did not find significant associations between reporting of sexual problems or deterioration of sex as a result of disease and relationship satisfaction.	Cardiac rehabilitation programs should address these sexual problems, potentially by enhancing communication within couples about sex.	The strength is that data are presented on the sexual experiences and relationship satisfaction of a relatively large sample of people diagnosed with cardiac disease, a relatively underexplored research area. Limitations include the possibility of selection bias of study participants and bias associated with self-report measurement.	Sexual problems were significant in this population but were not related to relationship satisfaction in this cross-sectional survey. Byrne M, Murphy P, D'Eath M, et al. Association Between Sexual Problems and Relationship Satisfaction Among People With Cardiovascular Disease. J Sex Med 2017;14:666-674.	
28498309	In mobile opportunistic networks, the social relationship among nodes has an important impact on data transmission efficiency. Motivated by the strong share ability of "circles of friends" in communication networks such as Facebook, Twitter, Wechat and so on, we take a real-life example to show that social relationships among nodes consist of explicit and implicit parts. The explicit part comes from direct contact among nodes, and the implicit part can be measured through the "circles of friends". We present the definitions of explicit and implicit social relationships between two nodes, adaptive weights of explicit and implicit parts are given according to the contact feature of nodes, and the distributed mechanism is designed to construct the "circles of friends" of nodes, which is used for the calculation of the implicit part of social relationship between nodes. Based on effective measurement of social relationships, we propose a social-based clustering and routing scheme, in which each node selects the nodes with close social relationships to form a local cluster, and the self-control method is used to keep all cluster members always having close relationships with each other. A cluster-based message forwarding mechanism is designed for opportunistic routing, in which each node only forwards the copy of the message to nodes with the destination node as a member of the local cluster. Simulation results show that the proposed social-based clustering and routing outperforms the other classic routing algorithms.
28498053	Autism Behavior Inventory (ABI) is a new measure for assessing changes in core and associated symptoms of autism spectrum disorder (ASD) in participants (ages: 3 years-adulthood) diagnosed with ASD. It is a web-based tool with five domains (two ASD core domains: social communication, restrictive and repetitive behaviors; three associated domains: mental health, self-regulation, and challenging behavior). This study describes design, development, and initial psychometric properties of the ABI.ABI items were generated following review of existing measures and inputs from expert clinicians. Initial ABI scale contained 161 items that were reduced to fit a factor analytic model, retaining items of adequate reliability. Two versions of the scale, ABI-full (ABI-F; 93 items) and ABI-short version (ABI-S; 36 items), were developed and evaluated for psychometric properties, including validity comparisons with commonly used measures. Both scales were administered to parents and healthcare professionals (HCPs) involved with study participants.	Test-retest reliability (intraclass correlation coefficient [ICC] = 0.79) for parent ratings on ABI was robust and compared favorably to existing scales. Test-retest correlations for HCP ratings were generally lower versus parent ratings. ABI core domains and comparison measures strongly correlated (r ≥ 0.70), demonstrating good concurrent validity.	Overall, ABI demonstrates promise as a tool for measuring change in core symptoms of autism in ASD clinical studies, with further validation required.	
28498046	While social media have been found useful in providing social support and health information, they have also been home to content advocating risky health behavior. This study focused on how content defending and even celebrating anorexia as a lifestyle are circulated among social media users, and investigates the characteristics that promote wide propagation of such messages. We captured anorexia-related content on Tumblr, a popular blog for talking about eating disorders, during a one-month period. Among the 35,432 posts collected, we examined the most highly propagated posts and coded them for message characteristics. Our findings revealed that posts in which the source of a narrative ("testimony") was identified (was either from an anorexic poster or about another's anorexia) and which were positive toward the pro-anorexia perspective were more likely to be propagated on Tumblr. In addition, posts containing content that references an anorexic person and contains an affective tone were more likely to be propagated. We also found that underweight bodies and bodies with a high degree of exposure were associated with propagation of posts. The present study suggested practical implications by focusing on the characteristics of highly propagated but potentially harmful content in social media.
28498041	Although research has explored the ways in which people form virtual communities to converse about media figures, television shows, and similar topics, little research has examined the link between virtual communities and the parasocial relationships (PSRs) that are often the focus of these conversations and users' experiences in those virtual communities. We examined sense of community (SOC) on Twitter and Instagram as a function of users' motives for use and users' PSR on the sites. In addition to examining the relative importance of different motives for using Twitter and Instagram, we predicted that PSR would mediate the association between motives for use and SOC. Results of an online survey revealed that Instagram users (n = 276) reported stronger social interaction motives than did Twitter users (n = 223). Social interaction and expressive information sharing motives were directly positively associated with SOC for users of both sites. Instagram users also exhibited indirect effects of expressive information sharing and companionship motives on SOC, through PSR. These findings suggest potentially influential differences between Twitter and Instagram, particularly regarding the role of PSR in fostering a general SOC.
28498034	Phenomenon: As we move toward competency-based medical education, greater emphasis is being placed on assessing a more comprehensive skill set, including the ability to communicate and collaborate effectively in the workplace. Nonphysician members on interprofessional (IP) teams have valuable perspectives on actual resident performance and are often not adequately engaged in the provision of feedback to residents. Based on the educational theories of collaborative evaluation and social constructivism, this research examined the ability of IP clinicians to provide feedback to residents. The aim of this study was to examine IP clinicians' perceptions of their ability to provide formative feedback, through their observations and assessments of developmental pediatric residents, compared to physician supervisors on the rotation, and to qualitatively explore potential barriers to the feedback process from their perspective.This explanatory, sequential mixed-methods design study first examined which and how many of the CanMEDS Communicator and Collaborator training objectives (N = 40) were considered to be observable and assessable by IP clinicians and physicians. A comparison of the mean number of objectives that were observed and practically assessed by (a) each group (IP clinicians vs. physicians) and (b) clinical service teams during the core developmental pediatrics rotations, were examined using independent t tests. Second, a thematic qualitative analysis of focus groups was used to develop a contextual understanding of the factors that influenced this process. Data were analyzed using three levels of open coding and descriptive qualitative analysis techniques.	Physicians reported they could observe (M = 33.3, SD = 5.2, 83.3%) and assess (M = 31.5, SD = 7.3, 79%) a larger number of objectives compared to the IP clinician group (M = 24.7, SD = 8.6, 61.8% and M = 20.3, SD = 10.6, 51%, respectively). There were no differences between the clinical service teams (i.e., preschool/school-age and pediatric rehabilitation). The objective that was most observable and assessable by the IP clinicians was "Demonstrates a respectful attitude towards other colleagues and members of an interprofessional team." Four themes identified by the IP clinicians provided more in-depth qualitative information: (a) assessment requires more than simple observation, (b) assumptions and indirect observation influence assessment, (c) clinic culture and structure shapes observation and assessment, and (d) specific assessment criteria are required by IP clinicians. Insights: IP clinicians have the desire and ability to provide formative feedback to residents. Formalized processes with specific evaluation criteria would facilitate meaningful feedback from IP clinicians in the assessment of residents as they journey toward competence.	
28498024	Increasingly, medication is being administered at home by family and friends of the care-recipient. This study aims to identify and analyse risks associated with potential drug administration errors made by informal carers at home. We mapped medication administration at home with a multidisciplinary team that included carers, health care professionals and patients. Evidence-based risk-analysis methodologies were applied: Healthcare Failure Modes and Effect Analysis (HFMEA), Systematic Human Error Reduction and Prediction Analysis (SHERPA) and Systems-Theoretic Accident Model and Processes (STAMP). The process of administration comprises seven sub-processes. Thirty-four possible failure modes were identified and six of these were rated as high risk. These highlighted that medications may be given with a wrong dose, stored incorrectly, not discontinued as instructed, not recorded, or not ordered on time, and often caused by communication and support problems. Combined risk analyses contributed unique information helpful to better understand the medication administration risks and causes within homecare. Practitioner Summary: Increasingly, medication is being administered at home by family and friends of the care-recipient. This study identifies risks associated with potential drug administration errors made by informal carers at home through consensus-based quantitative techniques. The different analyses contribute unique information helpful to better understand the administration risks and causes.
28497997	In what traits do people interact with others who are similar to them in completely anonymous online communication? Can those traits contribute to greater exchange of opinion and information across the sociodemographic boundaries that often limit interaction between social strata? To answer this question concerning online homophily, we combined survey data on 7,287 users (aged 18 and above) of a Korean online dating advice platform with their behavioral data from June 2015 to August 2015 and explored whether advice exchange occurred between users with similar sociodemographic and personality traits. On this platform, two types of interactions occurred as follows: (1) responses to a randomly distributed problem submitted by an advice seeker and (2) the seeker's indication of approval of any of the responses given. The study found that (1) a receiver was more likely to respond to problems submitted by seekers of a comparable age and that (2) seekers were more likely to approve of a response if the seeker and receiver had similar educational backgrounds. By contrast, homophily based on personality traits was not observed even though some personality traits significantly affected the likelihood of both response and approval. Our findings suggest that online communication may breed sociodemographic homophily, whether based on age or education, more than expected or intended while not easily fostering alternative forms of homophily, such as personality homophily, which can potentially cut across borders dividing sociodemographic groups.
28497530	In children with dyslexia, deficits in working memory have not been well-specified. We assessed second-grade children with dyslexia, with and without concomitant specific language impairment, and children with typical development. Immediate serial recall of lists of phonological (non-word), lexical (digit), spatial (location) and visual (shape) items were included. For the latter three modalities, we used not only standard span but also running span tasks, in which the list length was unpredictable to limit mnemonic strategies. Non-word repetition tests indicated a phonological memory deficit in children with dyslexia alone compared with those with typical development, but this difference vanished when these groups were matched for non-verbal intelligence and language. Theoretically important deficits in serial order memory in dyslexic children, however, persisted relative to matched typically developing children. The deficits were in recall of (1) spoken digits in both standard and running span tasks and (2) spatial locations, in running span only. Children with dyslexia with versus without language impairment, when matched on non-verbal intelligence, had comparable serial order memory, but differed in phonology. Because serial orderings of verbal and spatial elements occur in reading, the careful examination of order memory may allow a deeper understanding of dyslexia and its relation to language impairment. Copyright © 2017 John Wiley & Sons, Ltd.
28497358	Autism spectrum disorder (ASD) as a neurodevelopmental disorder is characterized by impairments in social interaction, communication, and restricted, repetitive behavior. Several and reproducible studies have suggested that oxidative stress may represent one of the primary etiological mechanism of ASD that can be targeted for therapeutic intervention. In the present study, multiple regression and combined receiver operating characteristic (ROC) analysis were used to search for a relationship between impaired energy and oxidative metabolic pathways in the etiology of ASD and to find the linear combination that maximizes the partial area under a ROC curve for a pre-identified set of markers related to energy metabolism and oxidative stress. Thirty children with ASD and 30 age and gender matched controls were enrolled in the study. Using either spectrophotometric or ELISA-colorimetric assay, levels of lipid peroxides, vitamin E, vitamin C, glutathione (GSH)/glutathione disulfide (GSSG) together with the enzymatic activity of catalase, plasma glutathione peroxidase (GPx), and blood superoxide dismutase (SOD), were measured in peripheral blood samples, as biomarkers related to oxidative stress. Creatine kinase, ectonucleotidases (ADPase and ATPase) Na+/K+ (ATPase), lactate, inorganic phosphate, and levels of adenosine monophosphate (AMP), adenosine diphosphate (ADP), and adenosine triphosphate (ATP) together with adenylate energy charge, were also measured as markers of impaired energy metabolism. Statistical analysis using ROC curves, multiple and logistic regression were performed. A remarkable increase in the area under the curve for most of the combined markers, representing both energy impaired metabolism or oxidative stress, was observed by using combined ROC analyses. Moreover, higher specificity and sensitivity of the combined markers were also reported. The present study indicated that the measurement of the predictive value of selected biomarkers related to energy metabolism and oxidative stress in children with ASD using ROC analysis should lead to the better identification of the etiological mechanism of ASD associated with metabolism and diet. Agents with activity against the impaired metabolic pathway associated with ASD including the metabolic defects and involved enzymes hold a promise as a novel therapy for ASD.
28497279	Research suggests that sexualizing media messages are present in teen media and negatively affect young girls' body image. Yet, it is unknown whether exposure to teen television programs is associated with girls' engagement in appearance management behaviors. Two-wave longitudinal data among 785 girls (Mage = 11.65 years) were collected. Results show that teen television exposure was longitudinally related to appearance management, while the reverse relation was not supported. Approximately half of the girls indicated to manage their appearance to some extent, and 13- to 14-year-old girls were more likely to invest in their appearance than younger girls. Thirty percent of those who did not manage their appearance at the start of the study indicated to have initiated appearance management 6 months later. Frequent viewers were four times, three times, and twice as more likely to style their hair, wear heels, and apply make-up compared to non-viewers.The current study showed that teen media exposure plays a role in young girls' appearance management. The findings point to a need to teach young girls about stereotypical messages in media content directed towards them. Prevention efforts should focus on girls who frequently watch teen media. What is Known: • Sexualizing media messages are present in teen media. • Gender identity development is one of the key tasks during adolescence. What is New: • Tween television exposure predicts 9- to 14-year-old girls' engagement in appearance management over time. • Engagement in appearance management behaviors did not predict 9- to 14-year-old girls' exposure to tween television programs.	
28495353	This study identifies the types of patient-related information problems (PIPs) that patient-care teams encounter during morning rounds, and how those PIPs are identified and managed. PIPs are any issues related to patient information (e.g., wrong, missing, incomplete information) that affect the patient-care team's ability to perform their work. Not addressing PIPs can lead to workflow challenges, delayed patient-care decisions, and negative impacts to the patient.We employed qualitative data collection methods by shadowing patient-care teams during 29 morning rounds resulting in 155h of observation. We observed the interactions between the rounding physicians and other patient-care team members, including: nurses, consulting physicians, care coordinators, pharmacists, social workers, and therapists.	This study resulted in identifying seven types of PIPs that occur during morning rounds. Additionally, the study presents the different ways that participants identified and managed the PIPs.	We discuss the potential negative effects of PIPs on the patient-care workflow. We also discuss socio-technical recommendations for organizational policies and training, as well as electronic health record (EHR) design improvements that could help patient-care teams more effectively identify and manage PIPs.	Hospital teams rely on accurate, available, and up-to-date information in order to make informed decisions on patient care. However, PIPs exist in EHR systems, paper documents, and verbal conversations. This study identifies a set of PIPs and how they are currently being identified and managed.	
28494648	Aim Research into social networking addiction has greatly increased over the last decade. However, the number of validated instruments assessing addiction to social networking sites (SNSs) remains few, and none have been validated in the Italian language. Consequently, this study tested the psychometric properties of the Italian version of the Bergen Social Media Addiction Scale (BSMAS), as well as providing empirical data concerning the relationship between attachment styles and SNS addiction. Methods A total of 769 participants were recruited to this study. Confirmatory factor analysis (CFA) and multigroup analyses were applied to assess construct validity of the Italian version of the BSMAS. Reliability analyses comprised the average variance extracted, the standard error of measurement, and the factor determinacy coefficient. Results Indices obtained from the CFA showed the Italian version of the BSMAS to have an excellent fit of the model to the data, thus confirming the single-factor structure of the instrument. Measurement invariance was established at configural, metric, and strict invariances across age groups, and at configural and metric levels across gender groups. Internal consistency was supported by several indicators. In addition, the theoretical associations between SNS addiction and attachment styles were generally supported. Conclusion This study provides evidence that the Italian version of the BSMAS is a psychometrically robust tool that can be used in future Italian research into social networking addiction.
28494201	Older women around the globe are generally depicted as asexual beings, which may impact patient-provider discussions about sex. We examined data on 703 aging women in the United States to compare factors associated with women perceiving sex as important and women discussing sex with their physicians since turning 50. While 65.1% of participants perceived sex to be important, only 23.8% discussed sex with their providers since turning 50. Factors related to discussing sex included age, education, having a chronic condition, and consuming alcohol. Provider training and tools about sexual health communication could help launch those discussions about sex and increase advocacy for older women's sexual health.
28493759	Reports an error in "Characterizing Autism-Relevant Social Behavior in Poodles via Owner Report" by Rachel M. Zamzow, Lisa Lit, Shelley Hamilton and David Q. Beversdorf (Journal of Comparative Psychology, Advanced Online Publication, Mar 13, 2017, np). In the article, the scientific name for the species was missing in the title. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2017-11247-001.) Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted, repetitive behaviors. It can be difficult to model the complex behavioral features of this disorder with rodent models, which have limited similarity to human behaviors. The domestic dog may be a promising model of complex human behavior, including core features of ASD. The present study examines ASD-relevant social behavior in Miniature and Standard Poodles using an owner-report questionnaire with questions adapted from the Autism Diagnostic Observation Schedule (Lord, Rutter, DiLavore, & Risi, 2000). A previous study identified 3 behavioral constructs examined by this questionnaire: initiation of reciprocal social behaviors, response to social interaction, and communication. In the present study, confirmatory and experimental factor analyses used to assess how collected data fit with the previous model revealed moderate model fit and a similar factorial structure. Between-breed comparisons across these factors and at the individual question level revealed differences between Miniature and Standard Poodles in showing behaviors. Cluster analyses used to group dogs within each breed according to social behavior identified smaller subgroups of dogs with less social behavior across all 3 factors compared with the average within each breed. Within- and between-breed differences in social behavior warrant investigation of genetic variation underlying this complex trait as it relates to ASD-relevant behavior. (PsycINFO Database Record
28492707	In 2003, a Committee of the Institute of Medicine of the National Academy of Sciences summarized hundreds of studies documenting that US racial minorities, especially African Americans, receive poorer quality health care for a wide variety of conditions than their White counterparts. These racial differences in health care persist after controlling for sociodemographic factors and patients' ability to pay for care. The Committee concluded that physicians' unconscious negative stereotypes of African Americans, and perhaps other people of color, likely contribute to these health care disparities. This paper selectively reviews studies published after 2003 on the likely contribution of physicians' unconscious bias to US health care disparities. All studies used the Implicit Association Test which quantifies the relative speed with which individuals associate positive attributes like "intelligent" with Whites compared to Blacks or Latino/as. In addition to assessing physicians' unconscious attitudes toward patients, some studies focused on the behavioral and affective dimensions of doctor-patient communication, such as physicians' "verbal dominance" and whether patients felt respected. Studies reviewed found a "pro-white" unconscious bias in physicians' attitudes toward and interactions with patients, though some evidence suggests that Black and female physicians may be less prone to such bias. Limited social contact between White physicians and racial/ethnic minorities outside of medical settings, plus severe time pressures physicians often face during encounters with patients who have complex health problems could heighten their susceptibility to unconscious bias.
28492116	Use of social media has increased exponentially throughout the world. Social media provides a platform for building social and professional relationships that can be used by all, including healthcare professionals. Alongside the benefits of creating networks and spreading information wider and faster than is possible with traditional communication channels, however, it presents ethical and legal challenges. For health professionals, it poses a threat to confidentiality and privacy owed to patients, colleagues and employers. It is vital for health professionals to acknowledge that the same ethical and legal standards apply both online and offline, and that they are accountable to professional bodies and the law for their online activities. This article seeks to explore the ethical and legal pitfalls facing health professionals using social media platforms. Importantly, it seeks to create awareness about the cyberpsychology phenomenon called the 'online disinhibition effect', responsible for lowering restraint during online activities.
28492091	Schizophrenia is the most common illness used today as a metaphor in the media and routinely appears associated with crime and violence with no medical or scientific rigor, reinforcing the stigma against this disorder. Evaluation of the presence of structural stigma in the Brazilian media by means of a survey of printed news and the Internet using the term schizophrenia and its correlates under three aspects: (a) medical and scientific uses, (b) assigning a diagnosis of schizophrenia to crime suspects with little or no medical or scientific rigor, and (c) the metaphorical use. The study was conducted in three stages: search for publications, classification of items found and analysis of the context in which they were published. The survey was conducted in two periods: 2008 and 2011, the first being restricted to the newspaper Folha de S. Paulo and the second extended to the homepage of the main Brazilian print media. We found 229 texts, distributed as follows: 89 (39%) records as science and health, with a tendency to impersonality; 62 (27%) records as crime and violence, in which the 'diagnosis' of schizophrenia is given by lay people and 'supported' by an archeology of the life of the suspect which enlists all sorts of non-standard behavior; and 78 (34%) records of metaphorical use, always with a negative meaning. Most of the texts found (a) does not give voice to people with schizophrenia and their suffering, (b) trivializes the use of this psychiatric illness out of context to describe contradictory or of dubious character political and economic decisions, and
28491828	Background: Despite the negative effect of fear of falling during functioning and social participation of patients with Parkinson' disease, so far, only few studies have investigated its effect on the quality of life in these patients. We aimed to investigate the association between fear of falling and quality of life controlling for balance impairments based on hip and ankle strategy in drug On- and Off-phase of patients with idiopathic Parkinson' disease. Methods: In this non-experimental cross-sectional study, 139 patients with idiopathic Parkinson' disease (100 male, 39 female) by mean± SD age of 60.2±12.27 years, mean±SD time since diagnosis of 6.7±5.53 years and mean±SD Hoehn and Yahr stage of 2.8±1.49 were selected by a simple non-probability method. Balance function was measured by a functional reach test with hip and ankle strategy. The Persian version of the selfcompleted Fall Efficacy Scale-International and Parkinson's disease quality of life questionnaire was used to evaluate fear of falling and quality of life, respectively. Results: The results showed that the score of all dimensions of quality of life (i.e., mobility, activities of daily living, emotional wellbeing, stigma, social support, cognition, communication and bodily discomfort) were significantly affected by the intensity of fear of falling. Multiple regression analysis indicated a significant association between fear of falling and quality of life in a way that fear of falling explained 11% to 47% and 12% to 43% of variance in drug On-phase, as well as 8% to 45% and 9% to 48% of variance in the drug Off-phase in dimensions of quality of life after controlling for balance function based on hip and ankle strategy, respectively. In the drug On-phase, the strongest association (R=0.85, p<0.001) was found between fear of falling and mobility dimension of quality of life. In the drug Off-phase, the strongest relation was observed between fear of falling and mobility (R=0.82, p<0.001) as well as activities of daily living (R=0.78-0.79, p<0.001) dimensions. Conclusion: This study found that fear of falling affects the quality of life of patients with Parkinson' disease beyond its relationship with balance impairments based on the hip and ankle strategy in both drug On- and Off-phase.
28490923	Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing.We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program. We determined the number of visits by breast cancer patients to a fp between the first medical oncology visit and the start of chemotherapy, a period when patients might be considering results of gep testing.	The fps and cancer specialists felt that ordering gep tests and explaining the results was the role of the oncologist. A new fp role was identified relating to the fp-patient relationship: supporting patients in making adjuvant therapy decisions informed by gep tests by considering the patient's comorbid conditions, social situation, and preferences. Lack of fp knowledge and resources, and challenges in fp-oncologist communication were seen as significant barriers to that role. Between 28% and 38% of patients visited a fp between the first oncology visit and the start of chemotherapy.	Our findings suggest an emerging role for fps in supporting patients who are making adjuvant treatment decisions after receiving the results of gep testing. For success in this new role, education and point-of-care tools, together with more effective communication strategies between fps and oncologists, are needed.	
28490882	Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs).A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics.	In total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and >30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45-65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (P<0.001), and younger people and those with higher education were associated with more active use.	Patients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.	
28489908	This study used the source and filter theory approach to analyse sex differences in the acoustic features of African elephant (Loxodonta africana) low-frequency rumbles produced in social contexts ('social rumbles'). Permuted discriminant function analysis revealed that rumbles contain sufficient acoustic information to predict the sex of a vocalizing individual. Features primarily related to the vocalizer's size, i.e. fundamental frequency variables and vocal tract resonant frequencies, differed significantly between the sexes. Yet, controlling for age and size effects, our results indicate that the pronounced sexual size dimorphism in African elephants is partly, but not exclusively, responsible for sexual differences in social rumbles. This provides a scientific foundation for future work investigating the perceptual and functional relevance of specific acoustic characteristics in African elephant vocal sexual communication.
28487267	Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research.	Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study's background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study's aims and outcomes.	This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a reduction in symptom severity.	ECAs for mental disorders are emerging. State-of-the-art techniques, involving, for example, communication through natural language or nonverbal behavior, are increasingly being considered and adopted for psychotherapeutic interventions in ECA research with promising results. However, evidence on their clinical application remains scarce. At present, their value to clinical practice lies mostly in the experimental determination of critical human support factors. In the context of using ECAs as an adjunct to existing interventions with the aim of supporting users, important questions remain with regard to the personalization of ECAs' interaction with users, and the optimal timing and manner of providing support. To increase the evidence base with regard to Internet interventions, we propose an additional focus on low-tech ECA solutions that can be rapidly developed, tested, and applied in routine practice.	
28487244	The term "food literacy" describes the idea of proficiency in food related skills and knowledge. This prevalent term is broadly applied, although its core elements vary from initiative to initiative. In light of its ubiquitous use-but varying definitions-this article establishes the scope of food literacy research by identifying all articles that define 'food literacy', analysing its key conceptualizations, and reporting outcomes/measures of this concept.A scoping review was conducted to identify all articles (academic and grey literature) using the term "food literacy". Databases included Medline, Pubmed, Embase, CAB Abstracts, CINAHL, Scopus, JSTOR, and Web of Science, and Google Scholar. Of 1049 abstracts, 67 studies were included. From these, data was extracted on country of origin, study type (methodological approach), primary target population, and the primary outcomes relating to food literacy.	The majority of definitions of food literacy emphasize the acquisition of critical knowledge (information and understanding) (55%) over functional knowledge (skills, abilities and choices) (8%), although some incorporate both (37%). Thematic analysis of 38 novel definitions of food literacy reveals the prevalence of six themes: skills and behaviours, food/health choices, culture, knowledge, emotions, and food systems. Study outcomes largely focus on knowledge generating measures, with very few focusing on health related outcome measures.	Current definitions of food literacy incorporate components of six key themes or domains and attributes of both critical and functional knowledge. Despite this broad definition of the term, most studies aiming to improve food literacy focus on knowledge related outcomes. Few articles address health outcomes, leaving an important gap (and opportunity) for future research in this field.	
28487170	Women with disabilities report fewer pregnancies than those without disabilities.To explore the range of factors involved in pregnancy decision-making among women with disabilities, and give insight into the decision making process.	Data were obtained from 4 focus groups conducted with 22 women of child-bearing age, who had a chronic physical or mental health condition or disability that influenced their pregnancy decisions. Group transcripts were analyzed using conventional content analysis to identify the types of factors that influence pregnancy decisions and themes related to pregnancy decision-making.	Most had a strong desire for motherhood, although there were varied decisions and some ambivalence over whether or not to attempt pregnancy. Decisions were influenced by an interplay of biomedical, social and personal factors that shaped assessments of three key areas of consideration: importance, feasibility, and costs of pregnancy/motherhood.	It is not just the 'biomedical facts' of health conditions that are relevant, but rather the meaning attributed to these facts and how they are weighed in relation to other significant non-medical factors. By moving beyond the medical model of disability to recognize the importance of social and personal factors, and engaging in patient-centered communication, healthcare providers can facilitate pregnancy decision-making that is consistent with the values and preferences of women with disabilities and improve quality of care and support. In order to make motherhood a more viable option for women with disabilities, societal attitudes and a lack of role models for these women also need to be addressed.	
28486952	Mathematical modeling and in silico analysis are widely acknowledged as complementary tools to biological laboratory methods, to achieve a thorough understanding of emergent behaviors of cellular processes in both physiological and perturbed conditions. Though, the simulation of large-scale models-consisting in hundreds or thousands of reactions and molecular species-can rapidly overtake the capabilities of Central Processing Units (CPUs). The purpose of this work is to exploit alternative high-performance computing solutions, such as Graphics Processing Units (GPUs), to allow the investigation of these models at reduced computational costs.LASSIE is a "black-box" GPU-accelerated deterministic simulator, specifically designed for large-scale models and not requiring any expertise in mathematical modeling, simulation algorithms or GPU programming. Given a reaction-based model of a cellular process, LASSIE automatically generates the corresponding system of Ordinary Differential Equations (ODEs), assuming mass-action kinetics. The numerical solution of the ODEs is obtained by automatically switching between the Runge-Kutta-Fehlberg method in the absence of stiffness, and the Backward Differentiation Formulae of first order in presence of stiffness. The computational performance of LASSIE are assessed using a set of randomly generated synthetic reaction-based models of increasing size, ranging from 64 to 8192 reactions and species, and compared to a CPU-implementation of the LSODA numerical integration algorithm.	LASSIE adopts a novel fine-grained parallelization strategy to distribute on the GPU cores all the calculations required to solve the system of ODEs. By virtue of this implementation, LASSIE achieves up to 92× speed-up with respect to LSODA, therefore reducing the running time from approximately 1 month down to 8 h to simulate models consisting in, for instance, four thousands of reactions and species. Notably, thanks to its smaller memory footprint, LASSIE is able to perform fast simulations of even larger models, whereby the tested CPU-implementation of LSODA failed to reach termination. LASSIE is therefore expected to make an important breakthrough in Systems Biology applications, for the execution of faster and in-depth computational analyses of large-scale models of complex biological systems.	
28486075	A successful patient-provider relationship ensures that patients are treated as individuals and receive appropriate care for their unique circumstances. For this to occur, the relationship needs open communication and trust. African American persons who inject drugs (PWIDs) and who smoke crack cocaine are at elevated risks of poor health outcomes and are often lost to care. In addition, providers often experience difficulty serving this population. Although some barriers are documented in the peer-reviewed literature, this study sought to provide in-depth context to the relationship and how it is constructed.Individual, semistructured interviews were conducted with human immunodeficiency virus (HIV) care providers and their patients, specifically PWIDs and persons who smoke crack cocaine, in publicly funded HIV clinics in low-resource urban communities. n = 31 patients and n = 7 providers were interviewed about their perceptions of the other and the relationship. Interview transcripts were coded and analyzed for common themes, which were used to generate a conceptual, constructionist model of the HIV care visit.	Common patient themes included the tendency to describe providers in familial terms, match between their current provider and ideal provider, concern about stigma related to their use, and expression of unmet needs. Provider themes revealed less match with their ideal patient-preferring patients who were both abstinent and adherent, and expressing frustration with patient refusal to change.	Thematic results were used to create a visual and conceptual model for the HIV care visit. The model demonstrates both the positive and negative perceptions that inform the visit, and the barriers that impede a more fruitful patient-provider dynamic with a shared power structure. Provider training in communication and other identified topics may begin to lay the foundation for a shift in this structure.	
28485700	In response to the same moral violation, some people report experiencing anger, and others report feeling disgust. Do differences in emotional responses to moral violations reflect idiosyncratic differences in the communication of outrage, or do they reflect differences in motivational states? Whereas equivalence accounts suggest that anger and disgust are interchangeable expressions of condemnation, sociofunctional accounts suggest that they have distinct antecedents and consequences. We tested these accounts by investigating whether anger and disgust vary depending on the costs imposed by moral violations and whether they differentially correspond with aggressive tendencies. Results across four studies favor a sociofunctional account: When the target of a moral violation shifts from the self to another person, anger decreases, but disgust increases. Whereas anger is associated with high-cost, direct aggression, disgust is associated with less costly indirect aggression. Finally, whether the target of a moral violation is the self or another person influences direct aggression partially via anger and influences indirect aggression partially via disgust.
28485691	The human papillomavirus (HPV) vaccine has recently attracted considerable attention in emerging countries, due to its potential to reduce the impact of HPV-related diseases. This case study sheds new light about the variety of HTA arrangements, methods and processes involved in the adoption and use of HPV vaccines in a selected sample of central, eastern and southern Europe and Latin America and the Caribbean, all of them emerging in the use of HTA.A multi-country case study was designed. Mixed methods, document review, semi-structured surveys and personal communication with experts, were used for data collection and triangulation.	This study shows that common elements of good practice exist in the processes and methods used, with all countries arriving at the same appraisal recommendations. However, the influence of socio-politico-economic factors appears to be determinant on the final decisions and restrictions to access made.	This case study intends to draw useful lessons for policymakers in emerging settings interested in the adoption of the HPV vaccine supported by evidence-informed processes, such as those offered by institutionalized HTA. Future studies are also recommended to elucidate the specific roles that social values and uncertainties play in vaccine decision-making across different societies.	
28485178	The human papillomavirus (HPV) vaccine has recently attracted considerable attention in emerging countries, due to its potential to reduce the impact of HPV-related diseases. This case study sheds new light about the variety of HTA arrangements, methods and processes involved in the adoption and use of HPV vaccines in a selected sample of central, eastern and southern Europe and Latin America and the Caribbean, all of them emerging in the use of HTA.A multi-country case study was designed. Mixed methods, document review, semi-structured surveys and personal communication with experts, were used for data collection and triangulation.	This study shows that common elements of good practice exist in the processes and methods used, with all countries arriving at the same appraisal recommendations. However, the influence of socio-politico-economic factors appears to be determinant on the final decisions and restrictions to access made.	This case study intends to draw useful lessons for policymakers in emerging settings interested in the adoption of the HPV vaccine supported by evidence-informed processes, such as those offered by institutionalized HTA. Future studies are also recommended to elucidate the specific roles that social values and uncertainties play in vaccine decision-making across different societies.	
28484884	Autism spectrum disorders (ASD) are neurodevelopmental disruptions usually diagnosed in the first three years of child's life that characterized by some impairments in verbal and nonverbal communication, problems in social interactions and repetitive behaviors. The neuropilin-2 (NRP2) gene has been shown to both guide axons and control neuronal migration in the central nervous system (CNS). In this study the association between the NRP2 gene and autism using a cohort of 120 Iranian children (50 cases with autism and 70 control cases) was analyzed. Single nucleotide polymorphism (SNP) was genotyped by the polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) analyses. There was significant difference between the genotype and allele frequency between control and patient groups (P = 0.003 and P = 0.01, respectively). The prevalence of genotype frequencies of TT and TG in autistic children were 40% and 60%, respectively, while in controls were 68.5% and 31.5%, respectively. The heterozyote TG was associated with an increased risk of autism compared with TT genotype (OR = 3.72, 95%CI = 1.53-6.95, P = 0.02). The allele frequencies of T and G in autistic children were 78.5% and 21.4%, respectively and in controls were 84.2% and 15.7%, respectively. The NRP2 G allele conferred a 2.29-fold increased risk to autism relative to the T allele (OR = 2.29, 95%CI = 1.23-4.29, P = 0.009). The results of this study showed that there is a significant association between rs849563 polymorphism and autism in the studied population. However in order to obtain a definitive conclusion larger studies with more samples are required to confirm the results of this study.
28484720	Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder with core impairments in the social relationships, communication, imagination, or flexibility of thought and restricted repertoire of activity and interest. In this work, a new computer aided diagnosis (CAD) of autism ‎based on electroencephalography (EEG) signal analysis is investigated. The proposed method is based on discrete wavelet transform (DWT), entropy (En), and artificial neural network (ANN). DWT is used to decompose EEG signals into approximation and details coefficients to obtain EEG subbands. The feature vector is constructed by computing Shannon entropy values from each EEG subband. ANN classifies the corresponding EEG signal into normal or autistic based on the extracted features. The experimental results show the effectiveness of the proposed method for assisting autism diagnosis. A receiver operating characteristic (ROC) curve metric is used to quantify the performance of the proposed method. The proposed method obtained promising results tested using real dataset provided by King Abdulaziz Hospital, Jeddah, Saudi Arabia.
28484628	Group coordination, when 'on the move' or when visibility is low, is a challenge faced by many social living animals. While some animals manage to maintain cohesion solely through visual contact, the mechanism of group cohesion through other modes of communication, a necessity when visual contact is reduced, is not yet understood. Meerkats (Suricata suricatta), a small, social carnivore, forage as a cohesive group while moving continuously. While foraging, they frequently emit 'close calls', soft close-range contact calls. Variations in their call rates based on their local environment, coupled with individual movement, produce a dynamic acoustic landscape with a moving 'vocal hotspot' of the highest calling activity. We investigated whether meerkats follow such a vocal hotspot by playing back close calls of multiple individuals to foraging meerkats from the front and back edge of the group simultaneously. These two artificially induced vocal hotspots caused the group to spatially elongate and split into two subgroups. We conclude that meerkats use the emergent dynamic call pattern of the group to adjust their movement direction and maintain cohesion. Our study describes a highly flexible mechanism for the maintenance of group cohesion through vocal communication, for mobile species in habitats with low visibility and where movement decisions need to be adjusted continuously to changing environmental conditions.
28484007	The cultural and technological achievements of the human species depend on complex social interactions. Nonverbal interpersonal coordination, or joint action, is a crucial element of social interaction, but the dynamics of nonverbal information flow among people are not well understood. We used joint music making in string quartets, a complex, naturalistic nonverbal behavior, as a model system. Using motion capture, we recorded body sway simultaneously in four musicians, which reflected real-time interpersonal information sharing. We used Granger causality to analyze predictive relationships among the motion time series of the players to determine the magnitude and direction of information flow among the players. We experimentally manipulated which musician was the leader (followers were not informed who was leading) and whether they could see each other, to investigate how these variables affect information flow. We found that assigned leaders exerted significantly greater influence on others and were less influenced by others compared with followers. This effect was present, whether or not they could see each other, but was enhanced with visual information, indicating that visual as well as auditory information is used in musical coordination. Importantly, performers' ratings of the "goodness" of their performances were positively correlated with the overall degree of body sway coupling, indicating that communication through body sway reflects perceived performance success. These results confirm that information sharing in a nonverbal joint action task occurs through both auditory and visual cues and that the dynamics of information flow are affected by changing group relationships.
28483824	Contacting a doctor for advice when experiencing a potential cancer symptom is an important step in early diagnosis, but barriers to consultation are commonly reported. Understanding barriers to consulting in primary care within the cancer context provides opportunities to improve earlier diagnosis of cancer AIM: To investigate patients' GP consultation preferences when presented with a potential cancer symptom, and to describe whether these preferences are mediated by variable levels of cancer risk.A UK-wide online survey of adults ≥50 years old, using quota sampling to reflect general population characteristics.	A discrete choice experiment examined participants' preferences for primary care consultation for three cancer symptom scenarios: risk level not mentioned, risk designated as 'low', or risk designated as 'high'. Scenarios based on length of consultation, time to getting an appointment, convenience, choice of GP, and GP listening skills were presented in a self-completed online questionnaire.	A total of 9616 observations were obtained from 601 participants. Participants expressed preferences for doctors with better listening skills, the ability to see a GP of their choice, and shorter waiting times. These findings were the same across risk conditions and demographic groups. Participants were willing to wait an extra 3.5 weeks for an appointment with a doctor with good/very good listening skills (versus very poor listening skills) and an extra week for an appointment with a GP of their choice (versus any GP).	Patient decisions about help seeking seem to be particularly influenced by the anticipated listening skills of doctors. Improving doctors' communication skills may in the longer term encourage people to seek prompt medical help when they experience a cancer symptom.	
28483804	As the recent inaugural Ethical, Legal, and Social Issues (ELSI) 2.0 conference made clear, the effects of information communication technology (ICT) are pervasive in biomedical research. Data initiatives are arising in all corners of biomedicine. Data sharing efforts already promised to surpass even the ambitious goals of the National Human Genome Research Institute, only 5 years after publication of its 10-year vision. ELSI research was established, in part, to address challenges of open data access and data sharing. However, by and large, ELSI research projects address particular concerns of a given population, jurisdiction, type of research practice or type of data. This does not necessarily facilitate coherent data policy for sustainable data stewardship. Forward-looking, data friendly strategies need to be considered. Orchestration strategies are needed which overcome barriers to collective action. Here we present challenges policymakers face, and suggest three basics steps towards meeting them. First, policymakers must recognise the systematic change that occurs when ICT enables dataflow itself to become an organising principle of biomedical research. Second, methods for identifying and gathering types of metadata suitable for ELSI research ought to be developed and regulated. Third, policymakers need to organise in ways that mirror the new vision for data-enabled research that data technologies are making possible, as ELSI 2.0 encourages researchers to do. Taking these steps will help ensure research evolves in ways that warrants trust of the public while still supporting widespread ethical access to necessary data, research subjects, samples and findings.
28483743	Web-based health behavior change interventions may be more effective if they offer autonomy-supportive communication facilitating the internalization of motivation for health behavior change. Yet, at this moment no validated tools exist to assess user-perceived autonomy-support of such interventions.The aim of this study was to develop and validate the virtual climate care questionnaire (VCCQ), a measure of perceived autonomy-support in a virtual care setting.	Items were developed based on existing questionnaires and expert consultation and were pretested among experts and target populations. The virtual climate care questionnaire was administered in relation to Web-based interventions aimed at reducing consumption of alcohol (Study 1; N=230) or cannabis (Study 2; N=228). Item properties, structural validity, and reliability were examined with item-response and classical test theory methods, and convergent and divergent validity via correlations with relevant concepts.	In Study 1, 20 of 23 items formed a one-dimensional scale (alpha=.97; omega=.97; H=.66; mean 4.9 [SD 1.0]; range 1-7) that met the assumptions of monotonicity and invariant item ordering. In Study 2, 16 items fitted these criteria (alpha=.92; H=.45; omega=.93; mean 4.2 [SD 1.1]; range 1-7). Only 15 items remained in the questionnaire in both studies, thus we proceeded to the analyses of the questionnaire's reliability and construct validity with a 15-item version of the virtual climate care questionnaire. Convergent validity of the resulting 15-item virtual climate care questionnaire was confirmed by positive associations with autonomous motivation (Study 1: r=.66, P<.001; Study 2: r=.37, P<.001) and perceived competence for reducing alcohol intake (Study 1: r=.52, P<.001). Divergent validity could only be confirmed by the nonsignificant association with perceived competence for learning (Study 2: r=.05, P=.48).	The virtual climate care questionnaire accurately assessed participants' perceived autonomy-support offered by two Web-based health behavior change interventions. Overall, the scale showed the expected properties and relationships with relevant concepts, and the studies presented suggest this first version of the virtual climate care questionnaire to be reasonably valid and reliable. As a result, the current version may cautiously be used in future research and practice to measure perceived support for autonomy within a virtual care climate. Future research efforts are required that focus on further investigating the virtual climate care questionnaire's divergent validity, on determining the virtual climate care questionnaire's validity and reliability when used in the context of Web-based interventions aimed at improving nonaddictive or other health behaviors, and on developing and validating a short form virtual climate care questionnaire.	
28482703	To explore the views of people with Parkinson's and their dance partners on the influence and issues surrounding dancing with an able-bodied dance partner during partnered ball room dance classes.In depth, semi-structured interviews explored purposively selected participants' experiences and views about dance classes. Fourteen people with Parkinson's and their dance partners (six spouses, two friends/relatives, five volunteers) were interviewed within a month of completing the 10-week dance class program. Data were analyzed thematically.	Generally, those partnered with a spouse or an experienced dancer, or when dance couples were able to develop good rapport, gained greater enjoyment and sense of achievement from dance classes in comparison to couples who did not enjoy dancing together or had clashing approaches to dance. Managing and negotiating who would "lead" in a dance was challenging for dance couples particularly among male people with Parkinson's.	People with Parkinson's experience of the dance classes were influenced by the relationship and compatibility with their dance partner. Dance partnerships may impact on recruitment, enjoyment, outcome and continued participation in dance classes. Potential effects of partnerships should be analyzed and reported in studies evaluating the outcomes of dance classes. Implications for rehabilitation We recommend that health professionals consider involving spouses in Parkinson's dance classes as this may improve recruitment, adherence, enjoyment and overall outcome of the dance classes. If volunteers are needed, aim to recruit those who already have good dancing ability, convey a love of dancing and have the sensitivity and social skills to interact positively with the person with Parkinson's. Consider dance partnership issues when advertising and promoting dance classes. Address partnership issues through open communication and by changing partners if the dance partnership is not working well.	
28482683	The Vygotsky Blocks Test assesses problem-solving styles within a theoretical framework for the development of higher mental processes devised by Vygotsky. Because both the theory and the associated test situate cognitive development within the child's social and linguistic context, they address conceptual issues around the developmental relation between language and thought that are pertinent to development in autism. Our aim was to document the performance of adults with autism spectrum disorder on the Vygotsky Blocks Test, and our results showed that they made more errors than the typically developing participants and that these errors correlated with performance IQ. The autism spectrum disorder group also required more cues than the typically developing group to discern the conceptual structure of the blocks, a pattern that correlated with Autism Diagnostic Observational Schedule-Communication and Imagination/Creativity sub-scales. When asked to categorize the blocks in new ways, the autism spectrum disorder participants developed fewer principles on which to base new categorizations, which in contrast to the typically developing group correlated with verbal IQ and with the Imagination/Creativity sub-scale of the ADOS. These results are in line with a number of existing findings in the autism spectrum disorder literature and confirm that conceptualization in autism spectrum disorder seems to rely more on non-verbal and less on imaginative processes than in typically developing individuals. The findings represent first steps to the possibility of outlining a testable account of psychological development in autism spectrum disorder that integrates verbal, non-verbal and social factors into the transition from elementary to higher level processes.
28482009	Accumulating evidence for the influence of the gut microbiota on the bidirectional communication along the gut-brain axis suggests a role of the gut microbiota in eating disorders (EDs) and alcohol and substance use disorders. The potential influence of altered gut microbiota (dysbiosis) on behaviors associated with such disorders may have implications for developing therapeutic interventions.A systematic review of preclinical and clinical studies evaluating the gut microbiota, EDs and alcohol and substance use disorders was conducted using MEDLINE, Embase and Web of Science databases with the objective being to examine the role of the gut microbiota in behavioral correlates of these disorders. Original papers focused on the gut microbiota and potential behavioral implications were deemed eligible for consideration.	The resulting 12 publications were limited to gut microbiota studies related to EDs and alcohol and substance use disorders. Some studies suggest that dysbiosis and gut microbial byproducts may influence the pathophysiology of EDs via direct and indirect interference with peptide hormone signaling. Additionally, dysbiosis was shown to be correlated with alcohol use disorder-related symptoms, i.e. craving, depression and anxiety. Finally, a mouse study suggests that manipulations in the gut microbiota may affect cocaine-related behaviors.	Promising, albeit preliminary, findings suggest a potential role of the gut microbiota in behavioral correlates of EDs and alcohol and substance use disorders.	Preliminary evidence exists supporting the role of the gut microbiota in eating disorders and alcohol and substance use disorders, although additional investigation is needed to determine what is causative versus epiphenomenological.	
28481777	When confronted with cancer, adolescents and young adults (AYAs) enter a psychosocial trajectory. Previous research has acknowledged the importance of care adjusted to the specific needs of AYAs. To develop AYA-focused care, in-depth knowledge about the experiences of AYAs with cancer is necessary.The purposes of this study were to discover the psychosocial experiences of and their meanings for AYAs enduring cancer, as well as its treatment and follow-up, and to capture the basic social psychological process that shaped these experiences.	This was a qualitative study in which individual semistructured interviews were conducted with 23 participants aged 15 to 25 years.	A 3-phase process was identified, which demonstrated alterations in the AYAs' experiences and their underlying meanings: (1) maintaining normal life was essential, (2) normal life was slipping away, and (3) evolving toward a new normal life after treatment. Certain core dynamics were present in these 3 phases. Throughout the cancer trajectory, the AYAs attempted to maintain control, redefine the self, and incorporate their cancer experience to the long-term course of life and had varying expectations of their social networks.	Understanding the process that AYAs with cancer go through and taking into account their experiences can facilitate better psychosocial care for this emotionally vulnerable population.	Healthcare professionals need to take a patient-centered approach, with a focus on communication, to meet the needs of AYAs throughout the cancer trajectory.	
28481610	Homelessness has serious consequences for youth that heighten the need for mental health services; however, these individuals face significant barriers to access. New models of intervention delivery are required to improve the dissemination of mental health interventions that tailor these services to the unique challenges faced by homeless youth. The purpose of this study was to better understand homeless youths' use of technology, mental health experiences and needs, and willingness to engage with technology-supported mental health interventions to help guide the development of future youth-facing technology-supported interventions. Five focus groups were conducted with 24 homeless youth (62.5% female) in an urban shelter. Youth were 18- to 20-years-old with current periods of homelessness ranging from 6 days to 4 years. Transcripts of these focus groups were coded to identify themes. Homeless youth reported using mobile phones frequently for communication, music, and social media. They indicated a lack of trust and a history of poor relationships with mental health providers despite recognizing the need for general support as well as help for specific mental health problems. Although initial feelings toward technology that share information with a provider were mixed, they reported an acceptance of tracking and sharing information under certain circumstances. Based on these results, we provide recommendations for the development of mental health interventions for this population focusing on technology-based treatment options. (PsycINFO Database Record

28481335	To assess the effectiveness of the SLIMMER combined dietary and physical activity lifestyle intervention on clinical and metabolic risk factors, dietary intake, physical activity, and quality of life after 12 months, and to investigate whether effects sustained six months after the active intervention period ended.SLIMMER was a randomised controlled intervention, implemented in Dutch primary healthcare. In total, 316 subjects aged 40-70 years with increased risk of type 2 diabetes were randomly allocated to the intervention group (10-month dietary and physical activity programme) or the control group (usual healthcare). All subjects underwent an oral glucose tolerance test and physical examination, and filled in questionnaires. Identical examinations were performed at baseline and after 12 and 18 months. Primary outcome was fasting insulin.	The intervention group showed significantly greater improvements in anthropometry and glucose metabolism. After 12 and 18 months, differences between intervention and control group were -2.7 kg (95% confidence interval (CI): -3.7; -1.7) and -2.5 kg (95% CI: -3.6; -1.4) for weight, and -12.1 pmol l-1 (95% CI: -19.6; -4.6) and -8.0 pmol l-1 (95% CI: -14.7; -0.53) for fasting insulin. Furthermore, dietary intake, physical activity, and quality of life improved significantly more in the intervention group than in the control group.	The Dutch SLIMMER lifestyle intervention is effective in the short and long term in improving clinical and metabolic risk factors, dietary intake, physical activity, and quality of life in subjects at high risk of diabetes.	
28481160	End-stage renal disease (ESRD) affects nearly 1400 new children each year in the United States. Morbidity and mortality rates remain high for pediatric patients with ESRD, including those that have received a renal transplant.To better understand ESRD patients referred to palliative care, including their physical symptoms, topics discussed, and themes emerging during initial palliative care consultation.	This study is a retrospective chart review of pediatric ESRD patients who received a palliative care consult. Physical symptoms, core topics, and themes were identified by the interprofessional study team.	The study team found 35 patients met inclusion criteria during the study period. The most common standard palliative care metric noted was "complex or time-intensive communication and interdisciplinary social support." Pain was the most common physical symptom addressed with goals of care and communication the most common topics discussed. Themes emerging described the emotional distress of patients and parents as well as prognostic discussions.	This study demonstrates one institution's experience with pediatric ESRD patients undergoing consultation with the pediatric palliative care service. More research is necessary in this population to better describe the best focus for palliative care teams.	
28480788	Social media has enabled information-sharing across massively large networks of people without spending much financial resources and time that are otherwise required in the print and electronic media. Mobile-based social media applications have overwhelmingly changed the information-sharing perspective. However, with the advent of such applications at an unprecedented scale, the privacy of the information is compromised to a larger extent if breach mitigation is not adequate. Since healthcare applications are also being developed for mobile devices so that they also benefit from the power of social media, cybersecurity privacy concerns for such sensitive applications have become critical. This article discusses the architecture of a typical mobile healthcare application, in which customized privacy levels are defined for the individuals participating in the system. It then elaborates on how the communication across a social network in a multi-cloud environment can be made more secure and private, especially for healthcare applications.
28480500	Prior studies reveal gaps in cancer survivors' discussions with health care providers about follow-up care and receipt of care plans; however, whether survivorship care planning may vary by cancer type is not known. We surveyed 615 survivors of breast, colorectal, prostate, lung cancer, and melanoma enrolled in three health plans to examine cancer survivors' self-reported discussions of follow-up care, including the need for surveillance, late and long-term effects, emotional needs, and health behaviors. We assessed whether cancer survivors received a written treatment summary and post-treatment care instructions. Most (92%) survivors reported having a discussion about the need for surveillance; 75%, late and long-term effects; 69%, lifestyle and health behaviors; and 53%, emotional and social needs. Most (88%) reported receiving post-treatment care instructions and 47%, a treatment summary. While there was little difference among survivors' receipt of surveillance or health behavior recommendations by cancer type (p = 0.85 and p = 0.66, respectively), discussions of late and long-term effects occurred among 82% of prostate, 78% of breast, 73% of melanoma, 72% of colorectal, and 67% of lung survivors (p = 0.06). Approximately half of survivors reported discussions of emotional needs, with modest differences by cancer type (p = 0.08). Our findings indicate that most patient-provider discussions cover information on surveillance, with less emphasis on late and long-term effects, lifestyle and health behaviors, and substantially less focusing on emotional and social needs. No or modest differences in discussions occurred by cancer type. Whether tailoring information to individual cancer survivor needs is beneficial should be examined.
28480173	Knowledge management plays a critical role in global health. Global health practitioners require knowledge in every aspect of their jobs, and in resource-scarce contexts, practitioners must be able to rely on a knowledge management system to access the latest research and practice to ensure the highest quality of care. However, we suggest that there is a gap in the way knowledge management is primarily utilized in global health, namely, the systematic incorporation of human and social factors. In this paper, we briefly outline the evolution of knowledge management and then propose a conceptualization of knowledge management that incorporates human and social factors for use within a global health context. Our conceptualization of social knowledge management recognizes the importance of social capital, social learning, social software and platforms, and social networks, all within the context of a larger social system and driven by social benefit. We then outline the limitations and discuss future directions of our conceptualization, and suggest how this new conceptualization is essential for any global health practitioner in the business of managing knowledge.
28480057	Interdisciplinary collaboration is a critical component of translation, dissemination, implementation, and improvement (TDII) science. Yet, little is known about effective frameworks and practices regarding interdisciplinary research in TDII.This study drew on data collected from an expert panel during a regional symposium.	Findings highlight facilitators and barriers to stimulating interdisciplinary TDII research in different domains: intrapersonal, interpersonal, organizational, power and hierarchy, physical environment, and communication and language.	Findings have significant implications for TDII of clinical practices.	
28479554	Online communities have been an integral part of tobacco cessation programs. They are rich in content, and offer insights into factors affecting an individual's behavior change efforts. We used word representation techniques to infer implicit meaning embedded in messages exchanged in a health-related online community. Our analysis of peer interactions revealed that individuals factor in safety, glamour, expense, and media projection when choosing a form of nicotine intake. When choosing pharmacotherapy techniques, individuals focus on brands, dosage, and side effects associated with each form (e.g. gums, patches). Our analysis sheds light on factors embedded in peer interactions, which might lead to opinion formation based on peer influence and knowledge dissemination in these social platforms. Such understanding enables design of high-engagement behavior change technologies, through personalization of content delivery by factoring in individual-level beliefs, behavioral state, and community-level influences.
28479537	Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.
28479530	Autism spectrum disorder shows deficits in social communication and interaction including nonverbal communicative behaviors (e.g., eye contact, gestures, voice prosody, and facial expressions) and restricted and repetitive behaviors as its core symptoms. These core symptoms are emerged as an atypical behavioral development in toddlers with the disorder. Atypical neural development is considered to be a neural underpinning of such behaviorally atypical development. A number of studies using voxel-based morphometry have already been conducted to compare regional brain volumes between individuals with autism spectrum disorder and those with typical development. Furthermore, more than ten papers employing meta-analyses of the comparisons using voxel based morphometry between individuals with autism spectrum disorder and those with typical development have already been published. The current review paper adds some brief discussions about potential factors contributing to the inconsistency observed in the previous findings such as difficulty in controlling the confounding effects of different developmental phases among study participants.
28479409	Terminally ill hospitalized patients and their families consistently rank effective communication and shared decision-making among their top priorities. Advance practice providers such as physician assistants (PAs) are increasingly providing care in the hospital setting and are often called to communicate with patients and families. A first step to improving PA communication is to better understand PAs' current experiences in their daily practices.This study aimed to explore roles PAs serve in communicating with terminally ill patients/families; PAs' attitudes and opinions about communication roles; and perceived barriers and facilitators of communication with patients/families in the hospital setting.	Five focus groups were conducted with PAs practicing on adult medical services at three acute care hospitals of an academic medical center in Bronx, New York. An open-ended question guide was used. An inductive thematic analysis strategy was used to examine the data from transcribed audiotapes of focus group sessions to identify emergent concepts and themes.	The overarching theme that emerged was being stuck in the middle. PAs experienced ambiguity around their roles and responsibilities in communications between the medical team as well as patients and families; gaps in knowledge and skills; and organizational or structural deficits in the patient care systems that placed them in uncomfortable situations.	Interventions aimed at improving PA communication with terminally ill patients and their families should target institutional structures, systems, and culture around roles and responsibilities in addition to skill and knowledge gaps to be most effective.	
28479131	Little is known about the long-term consequences of stroke on sexuality, and studies on how individuals with stroke communicate with health care professionals about information and/or interventions on sexuality are even sparser.To explore experiences of sexuality 6 years after stroke, including communication with health care professionals concerning sexuality.	This qualitative study was based on data collected by semistructured interviews with 12 informants 43 to 81 years old 6 years after stroke. Interviews were recorded and transcribed verbatim and thematic analysis was performed.	The analysis resulted in the following three themes. Not exclusively negative experiences in sexuality after stroke: Most informants experienced some change in their sexual life from before their stroke. Decreased sexual interest and function were ascribed to decreased sensibility, post-stroke pain, or fatigue. Some informants reported positive changes in sexuality, which were attributed to feelings of increased intimacy. Individual differences and variability on how to handle sexuality after stroke: Different strategies were used to manage unwanted negative changes such as actively trying to adapt by planning time with the partner and decreasing pressure or stress. Open communication about sexuality with one's partner also was described as important. Strikingly, most informants with negative experiences of sexual life attributed these to age or a stage in life and not to the stroke or health issues. Furthermore, they compared themselves with others without stroke but with changes in sexuality, thus achieving a sense of normality. Communication and counseling concerning sexuality-many unmet needs: Experiences of communication with health care professionals varied. Very few informants had received any information or discussed sexuality with health care professionals during the 6 years since the stroke, although such needs were identified by most informants.	When encountering individuals with previous stroke, there is a need for vigilance concerning individual experiences of stroke on sexuality to avoid under- or overestimating the impact and to raise the subject, which currently might be seldom.	Individuals with long-term diverse consequences of stroke and with different sociodemographic backgrounds were interviewed. Because most individuals in the present study had retained functioning, this could decrease transferability to populations with more severe sequelae after stroke.	The individuals in the present study had different experiences of sexuality after stroke. The results point to the importance of acknowledging sexual rehabilitation as part of holistic person-centered stroke rehabilitation. Nilsson MI, Fugl-Meyer K, von Koch L, Ytterberg C. Experiences of Sexuality Six Years After Stroke: A Qualitative Study. J Sex Med 2017;14:797-803.	
28479121	Amyotrophic lateral sclerosis (ALS) is not a curable disease, but it is treatable. By definition, much of the care provided to ALS patients is palliative, even though active life-sustaining strategies are available to prolong survival. Healthcare professionals must develop communication skills that help patients cope with the inexorable progression of the disease and the inevitability of death. Symptomatic treatments as well as respiratory insufficiency and nutritional life-sustaining therapies must be regularly evaluated as the disease progresses, without losing sight of the burden placed on the patient's non-professional caregivers. The decision-making process regarding tracheostomy with invasive ventilation (TIV) is of greater complexity. Providing full information is crucial. Several long interviews are necessary to explain, discuss and allow assimilation of the information. Also, physicians should be careful not to focus exclusively on the biomedical aspects of disease, as ALS patients generally welcome the opportunity to discuss end-of-life issues with their physicians. Psychological factors, education level and cognitive status (especially the level of executive dysfunction) have a major influence on their decisions. However, as many patients do not complete advance directives with regard to TIV, advance care planning may instead be suggested in anticipation of emergency interventions. This should be discussed by healthcare professionals and the patient, and based on the wishes of the patient and caregiver(s), and communicated to all healthcare professionals. Many healthcare professionals are involved in the management of an ALS patient: they include not only those at ALS centers who provide diagnosis, follow-up and treatment initiation (particularly for respiratory and nutritional care), but also the medical and social care networks involved in disability support and home care. Specialist palliative care teams can work in partnership with ALS centers early in the course of the disease, with the center coordinating information-sharing and collaborative discussions.
28479082	Social isolation in older adults is a major public health concern. An embodied conversational agent (ECA) has the potential to enhance older adults' social interaction. However, little is known about older adults' experience with an ECA. In this paper, we conducted a pilot study to examine the perceived acceptance and utility of a tablet-based conversational agent in the form of an avatar (termed "digital pet") for older adults. We performed secondary analysis of data collected from a study that employed the use of a digital pet in ten older adults' homes for three months. Most of the participants enjoyed the companionship, entertainment, reminders, and instant assistance from the digital pet. However, participants identified limited conversational ability and technical issues as system challenges. Privacy, dependence, and cost were major concerns. Future applications should maximize the agent's conversational ability and the system's overall usability. Our results can inform future designs of conversational agents for older adults, which need to include older adults as system co-designers to maximize usability and acceptance.
28479077	Polypathological patients have specific clinical, functional, psychoaffective, social, family and spiritual characteristics. These patients are generally elderly and frail and have frequent decompensations. They frequently use healthcare resources, have significant functional impairment and have a high index of dependence. This results in a significant social impact, high mortality and a high consumption of resources. The current healthcare models have not answered these needs, which causes problems with accessibility to healthcare services, a lack of coordination among these services, a higher probability of adverse events related to polypharmacy and a high consumption of resources. In the past decade, the healthcare models have changed and are characterized by work in multidisciplinary and interlevel teams, patient self-care, the availability of tools for decision making, information and communication systems and prevention. The goal is to have prepared and proactive health teams and an informed and active patient population. The assessment of health results, processes and the costs for these programs is still based on moderate to low evidence. It is therefore not an easy task to determine the type and intensity of interventions or to determine the patient groups that could gain more benefits.
28478355	Discourse skills - in which the right hemisphere has an important role - enables verbal communication by selecting contextually relevant information and integrating it coherently to infer the correct meaning. However, language research in epilepsy has focused on single word analysis related mainly to left hemisphere processing. The purpose of this study was to investigate discourse abilities in patients with right lateralized medial temporal lobe epilepsy (RTLE) by comparing their performance to that of patients with left temporal lobe epilepsy (LTLE).74 pharmacoresistant temporal lobe epilepsy (TLE) patients were evaluated: 34 with RTLE and 40 with LTLE. Subjects underwent a battery of tests that measure comprehension and production of conversational and narrative discourse. Disease related variables and general neuropsychological data were evaluated.	The RTLE group presented deficits in interictal conversational and narrative discourse, with a disintegrated speech, lack of categorization and misinterpretation of social meaning. LTLE group, on the other hand, showed a tendency to lower performance in logical-temporal sequencing.	RTLE patients showed discourse deficits which have been described in right hemisphere damaged patients due to other etiologies. Medial and anterior temporal lobe structures appear to link semantic, world knowledge, and social cognition associated areas to construct a contextually related coherent meaning.	
28477970	To explore associations among symptoms of urinary incontinence, severity of symptoms, and measures of psychosocial health that may be assessed during a well-woman screening examination and the possible contribution of these variables to the relationship satisfaction of partnered midlife women living with urinary incontinence.Exploratory correlational design using self-report questionnaires.	Community recruitment by posted fliers, advertisements, and social media.	Partnered women, ages 45 to 65 years, with urinary incontinence (N = 57).	Self-report measures of severity of incontinence symptoms, relationship satisfaction, self-concept/emotional health (self-esteem, body image, depression, anxiety), and relationship factors (sexual quality of life, incontinence-related communication). Data were analyzed using Spearman rho correlation with an exploration of the contribution of study factors to relationship satisfaction through standard multiple regression.	The severity of urinary incontinence symptoms had no significant correlation with scores on relationship satisfaction or psychosocial health. Measures of self-concept/emotional health and relationship factors were significantly correlated with each other (rs = .40-.75, p < .01) and with relationship satisfaction (rs = .35-.71, p < .05). Preliminary exploration of the contribution of study factors to relationship satisfaction through exploratory regression analysis showed unique contributions from sexual quality of life (18.7%, p < .001) and depression (8.7%, p = .004).	Midlife women with urinary incontinence, regardless of symptom severity, might benefit from screening for poorer sexual quality of life and mild depression symptoms because these two study factors significantly contributed to poorer intimate relationship satisfaction among this study's participants.	
28477929	Background Somaliland is a self-declared country with a population of 3.5 million. Most of its population reside in rural areas. The objective of this pilot near-miss study was to monitor the frequency and causes of maternal near-miss and deaths and the referral chain for women to access Skilled Birth Attendants (SBA).A facility-based study of all maternal near-miss and mortality cases over 5months using the WHO near-miss tool in a main referral hospital. Reasons for bypassing the Antenatal Care facility (ANC) and late arrival to the referral hospital were investigated through verbal autopsy.	One hundred and thirty-eight (138) women with severe maternal complications were identified: 120 maternal near-miss, 18 maternal deaths. There were more near-miss cases on arrival (74.2%) compared with events that developed inside the hospital (25.8%). Likewise, there were more maternal deaths (77.8%) on arrival than was the case during hospitalization (22.2%). The most common mode of referral among maternal near-miss events was family referrals (66.7%). Of 18 maternal deaths, 15 were family referrals. Reasons for bypassing ANC were as follows: lack of confidence in the service provided; lack of financial resources; and lack of time to visit ANC. Reasons for late arrival to the referral hospital were as follows: lack of knowledge and transportation; and poor communication. Conclusion and clinical implication: To increase the utilization of ANC might indirectly lower the number of near-miss and death events. Collaboration between ANC staff and referral hospital staff and a more comprehensive near-miss project are proposed.	
28477630	Confinement to an in-patient hospital ward impairs patients' sense of social support and connectedness. Providing the means, through communication technology, for patients to maintain contact with friends and family can potentially improve well-being at the end of life by minimizing social isolation and facilitating social connection. This study aimed to explore the feasibility of introducing internet-based communication and information technologies for in-patients and their families and to describe their experience in using this technology.A cross-sectional survey design was used to describe patient and family member experiences in using internet-based communication technology and health care provider views of using such technology in palliative care. Participants included 13 palliative in-patients, 38 family members, and 14 health care providers. An iPad or a laptop computer with password-protected internet access was loaned to each patient and family member for about two weeks or they used their own electronic devices for the duration of the patient's stay. Quantitative and qualitative data were collected from patients, families, and health care providers to discern how patients and families used the technology, its ease of use and its impact. Descriptive statistics and paired sample t-tests were used to analyze quantitative data; qualitative data were analyzed using constant comparative techniques.	Palliative patients and family members used the technology to keep in touch with family and friends, entertain themselves, look up information, or accomplish tasks. Most participants found the technology easy to use and reported that it helped them feel better overall, connected to others and calm. The availability of competent, respectful, and caring technical support personnel was highly valued by patients and families. Health care providers identified that computer technology helped patients and families keep others informed about the patient's condition, enabled sharing of important decisions and facilitated access to the outside world.	This study confirmed the feasibility of offering internet-based communication and information technologies on palliative care in-patient units. Patients and families need to be provided appropriate technical support to ensure that the technology is used optimally to help them accomplish their goals.	
28477069	Purpose To improve the mental health component of the Work Disability Functional Assessment Battery (WD-FAB), developed for the US Social Security Administration's (SSA) disability determination process. Specifically our goal was to expand the WD-FAB scales of mood & emotions, resilience, social interactions, and behavioral control to improve the depth and breadth of the current scales and expand the content coverage to include aspects of cognition & communication function. Methods Data were collected from a random, stratified sample of 1695 claimants applying for the SSA work disability benefits, and a general population sample of 2025 working age adults. 169 new items were developed to replenish the WD-FAB scales and analyzed using factor analysis and item response theory (IRT) analysis to construct unidimensional scales. We conducted computer adaptive test (CAT) simulations to examine the psychometric properties of the WD-FAB. Results Analyses supported the inclusion of four mental health subdomains: Cognition & Communication (68 items), Self-Regulation (34 items), Resilience & Sociability (29 items) and Mood & Emotions (34 items). All scales yielded acceptable psychometric properties. Conclusions IRT methods were effective in expanding the WD-FAB to assess mental health function. The WD-FAB has the potential to enhance work disability assessment both within the context of the SSA disability programs as well as other clinical and vocational rehabilitation settings.
28476685	Autism Spectrum Disorders (ASD) (MIM 209850) are a group of neurodevelopmental disorders distinguished by destructed social interaction and communication abilities along with peculiar repetitive behavior. Several genetic loci have been linked to this disorder. Vesicular monoamine transporter 1 (VMAT1/SLC18A1) is an attractive candidate gene for psychiatric disorders because of its participation in regulation monoamines. In the present case-control study, we evaluated the link between three non-synonymous single nucleotide polymorphisms (SNPs) (rs2270641 [Pro4Thr], rs2270637 [Thr98Ser] and rs1390938 [Thr136Ile]) and one intronic SNP (rs2279709) across the VMAT1 gene and ASD in a group of Iranian patients. Allele frequency analyses showed significant over-presentation of rs1390938-G allele in cases compared with controls (P<0.001). The analysis under different genetic models showed that the AA genotype of the rs1390938 was protective against ASD under dominant and recessive models. The rs2270641 SNP was associated with ASD risk only in over-dominant model. Other SNPs showed no significant difference in allele or genotype frequencies between two groups. Haplotype analysis revealed that C A T T and C A T G haplotypes (rs2270637, rs1390938, rs2279709 and rs2270641 respectively) have a protective effect against ASD. Consequently, the functional rs1390938 SNP in VMAT1 is associated with ASD in Iranian population. Considering the role of VMAT1 in regulation of monoamines, the dysregulated expression of this protein during early stages of brain development might be implicated in ASD.
28476357	Autism Spectrum Disorder (ASD) has an intriguing auditory processing profile. Individuals show enhanced pitch discrimination, yet often find seemingly innocuous sounds distressing. This study used two behavioural experiments to examine whether an increased capacity for processing sounds in ASD could underlie both the difficulties and enhanced abilities found in the auditory domain. Autistic and non-autistic young adults performed a set of auditory detection and identification tasks designed to tax processing capacity and establish the extent of perceptual capacity in each population. Tasks were constructed to highlight both the benefits and disadvantages of increased capacity. Autistic people were better at detecting additional unexpected and expected sounds (increased distraction and superior performance respectively). This suggests that they have increased auditory perceptual capacity relative to non-autistic people. This increased capacity may offer an explanation for the auditory superiorities seen in autism (e.g. heightened pitch detection). Somewhat counter-intuitively, this same 'skill' could result in the sensory overload that is often reported - which subsequently can interfere with social communication. Reframing autistic perceptual processing in terms of increased capacity, rather than a filtering deficit or inability to maintain focus, increases our understanding of this complex condition, and has important practical implications that could be used to develop intervention programs to minimise the distress that is often seen in response to sensory stimuli.
28476347	Certain aspects of a demonstration have been shown to influence infants' interpretation of an observational situation and result in selective imitation. Studying social factors that trigger selective imitation may improve our understanding of how infants encode certain situations. However, only a few studies have investigated the possible interactions among these factors. In our study, 18-month-old infants (N=54) observed an adult demonstrator retrieve a toy from under an opaque ("baited") container by manipulating another transparent empty one. Infants were assigned to one of four conditions representing all combinations of two social factors: ostensive communication during demonstration (Communicative vs. Non-communicative) and presence of the demonstrator during reenactment (D-present vs. D-not present). Results suggest that infants' choice behavior was formed in two steps: during the demonstration and during the test phase. Furthermore, an interaction between the effects of the two levels was observed. Communication during the demonstration triggered imitative learning. Infants tended to copy the observed manipulation to learn the communicatively assigned way to reach the goal. This choice behavior was not influenced later by the presence or absence of the demonstrator. The non-communicative demonstration, however, did not elicit a particular learning mechanism. Therefore, in this situation, infants' choice behavior was affected by the demonstrator's presence or absence. Infants developed an individual solution and chose the baited container in the D-not present condition, indicative of emulation. In the D-present situation, they were more likely to reproduce the observed manipulation, which can be interpreted as a tendency to communicate with or conform to the demonstrator.
28475904	mHealth has been proposed to address inefficiencies in the current South African healthcare system, including home-based HIV testing and counseling (HTC) programs. Yet wide-scale adoption of mHealth has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by stakeholders remains. We conducted focus group discussions (FGD) in South Africa in 2016 with 10 home-based HTC field staff, 12 community health workers (CHWs) and 10 persons living with HIV (PLH). Key informant (KI) interviews were conducted with five health officials. Perceptions about current home-based HTC practices, future mHealth systems and the use of biometrics for patient identification were discussed, recorded and transcribed for qualitative analysis. Themes were based on a conceptual model for perceived mHealth service quality. Stakeholders brought up a lack of communication in sharing patient health information between clinics, between clinics and CHWs, and between clinics and patients as major barriers to care that mHealth can address. CHWs need better patient information from clinics in terms of physical location and health status to plan visitation routes and address patient needs. CHWs perceive that communication barriers create distrust towards them by clinic staff. PLH want automated appointment and medication reminders. KI see mHealth as a way to improve health information transfer to government officials to better allocate healthcare resources. Stakeholders are also optimistic about the ability for biometrics to improve patient identification but disagreed as to which biometrics would be acceptable, especially in older patients. All stakeholders provided useful information towards the development of mHealth systems. Hospitals are adopting patient-centered approaches that solicit feedback from patients and incorporate them into decision-making processes. A similar approach is needed in the development of mHealth systems. Further, such systems are critical to the successful extension of the health system from health facilities into people's homes.
28475130	Art is defined as expression or application of human creative skill and imagination producing works to be appreciated primarily for their aesthetic value or emotional power. This definition encompasses two very important elements-the creation and reception of art-and by doing so it establishes a link, a dialogue between the artist and spectator. From the evolutionary biological perspective, activities need to have an immediate or remote effect on the population through improving survival, gene selection, and environmental adjustment, and this includes art. It may serve as a universal means of communication bypassing time, cultural, ethnic, and social differences. The neurological mechanisms of both art production and appreciation are researched by neuroscientists and discussed both in terms of healthy brain biology and complex neuronal networking perspectives. In this paper, we describe folk art and the issue of symbolic archetypes in psychoanalytic thought as well as offer neuronal mechanisms for art by emphasizing mirror/neurons and the role they play in it.
28474292	Media's prevailing thin-body ideal plays a vital role in adolescent girls' body image development, but the co-occurring impact of peer feedback is understudied. The present study used functional magnetic resonance imaging (fMRI) to test media imagery and peer feedback combinations on neural activity related to thin-body ideals. Twenty-four healthy female late adolescents rated precategorized body sizes of bikini models (too thin or normal), directly followed by ostensible peer feedback (too thin or normal). Consistent with prior studies on social feedback processing, results showed increased brain activity in the dorsal medial prefrontal cortex (dmPFC)/anterior cingulate cortex (ACC) and bilateral insula in incongruent situations: when participants rated media models' body size as normal while peer feedback indicated the models as too thin (or vice versa). This effect was stronger for girls with lower self-esteem. A subsequent behavioral study (N = 34 female late adolescents, separate sample) demonstrated that participants changed behavior in the direction of the peer feedback: precategorized normal sized models were rated as too thin more often after receiving too thin peer feedback. This suggests that the neural responses upon peer feedback may influence subsequent choice. Our results show that media-by-peer interactions have pronounced effects on girls' body ideals.
28473308	The 2005 International Health Regulations (IHRs) established parameters for event assessments and notifications that may constitute public health emergencies of international concern. These requirements and parameters opened up space for the use of nonofficial mechanisms (such as websites, blogs, and social networks) and technological improvements of communication that can streamline the detection, monitoring, and response to health problems, and thus reduce damage caused by these problems. Specifically, the revised IHR created space for participatory surveillance to function, in addition to the traditional surveillance mechanisms of detection, monitoring, and response. Participatory surveillance is based on crowdsourcing methods that collect information from society and then return the collective knowledge gained from that information back to society. The spread of digital social networks and wiki-style knowledge platforms has created a very favorable environment for this model of production and social control of information.The aim of this study was to describe the use of a participatory surveillance app, Healthy Cup, for the early detection of acute disease outbreaks during the Fédération Internationale de Football Association (FIFA) World Cup 2014. Our focus was on three specific syndromes (respiratory, diarrheal, and rash) related to six diseases that were considered important in a mass gathering context (influenza, measles, rubella, cholera, acute diarrhea, and dengue fever).	From May 12 to July 13, 2014, users from anywhere in the world were able to download the Healthy Cup app and record their health condition, reporting whether they were good, very good, ill, or very ill. For users that reported being ill or very ill, a screen with a list of 10 symptoms was displayed. Participatory surveillance allows for the real-time identification of aggregates of symptoms that indicate possible cases of infectious diseases.	From May 12 through July 13, 2014, there were 9434 downloads of the Healthy Cup app and 7155 (75.84%) registered users. Among the registered users, 4706 (4706/7155, 65.77%) were active users who posted a total of 47,879 times during the study period. The maximum number of users that signed up in one day occurred on May 30, 2014, the day that the app was officially launched by the Minister of Health during a press conference. During this event, the Minister of Health announced the special government program Health in the World Cup on national television media. On that date, 3633 logins were recorded, which accounted for more than half of all sign-ups across the entire duration of the study (50.78%, 3633/7155).	Participatory surveillance through community engagement is an innovative way to conduct epidemiological surveillance. Compared to traditional epidemiological surveillance, advantages include lower costs of data acquisition, timeliness of information collected and shared, platform scalability, and capacity for integration between the population being served and public health services.	
28472970	Mild cognitive impairment (MCI) has an uncertain etiology and prognosis and may be challenging for clinicians to discuss with patients and families. Amyloid imaging may aid specialists in determining MCI etiology and prognosis, but creates novel challenges related to disease labeling.We convened a workgroup to formulate recommendations for clinicians providing care to MCI patients.	Clinicians should use the MCI diagnosis to validate patient and family concerns and educate them that the patient's cognitive impairment is not normal for his or her age and education level. The MCI diagnosis should not be used to avoid delivering a diagnosis of dementia. For patients who meet Appropriate Use Criteria after standard-of-care clinical workup, amyloid imaging may position specialists to offer more information about etiology and prognosis. Clinicians must set appropriate expectations, including ensuring that patients and families understand the limitations of amyloid imaging. Communication of negative results should include that patients remain at elevated risk for dementia and that negative scans do not indicate a specific diagnosis or signify brain health. Positive amyloid imaging results should elicit further monitoring and conversations about appropriate advance planning. Clinicians should offer written summaries, including referral to appropriate social services.	In patients with MCI, there is a need to devote considerable time and attention to patient education and shared decision-making. Amyloid imaging may be a tool to aid clinicians. Careful management of patient expectations and communication of scan results will be critical to the appropriate use of amyloid imaging information.	
28472651	Vocalizations play a significant role in social communication across species. Analyses in rodents have used a limited number of spectro-temporal measures to compare ultrasonic vocalizations (USVs), which limits the ability to address repertoire complexity in the context of behavioral states. Using an automated and unsupervised signal processing approach, we report the development of MUPET (Mouse Ultrasonic Profile ExTraction) software, an open-access MATLAB tool that provides data-driven, high-throughput analyses of USVs. MUPET measures, learns, and compares syllable types and provides an automated time stamp of syllable events. Using USV data from a large mouse genetic reference panel and open-source datasets produced in different social contexts, MUPET analyzes the fine details of syllable production and repertoire use. MUPET thus serves as a new tool for USV repertoire analyses, with the capability to be adapted for use with other species.
28472621	Autism is a lifelong neurodevelopmental disorder characterized by impairments in social communication and interaction and by repetitive patterns of behavior, interests and activities. While autism has a strong genetic component, environmental factors including toxins, pesticides, infection and drugs are known to confer autism susceptibility, likely by inducing epigenetic changes. In particular, exposure to valproic acid (VPA) during pregnancy has been demonstrated to increase the risk of autism in children. Furthermore, rodents prenatally exposed to this drug display behavioral phenotypes characteristics of the human condition. Indeed, in utero exposure of rodents to VPA represents a robust model of autism exhibiting face, construct and predictive validity. This model might better represent the many cases of idiopathic autism which are of environmental/epigenetic origins than do transgenic models carrying mutations in single autism-associated genes. The VPA model provides a valuable tool to investigate the neurobiology underlying autistic behavior and to screen for novel therapeutics. Here we review the VPA-induced rodent model of autism, highlighting its importance and reliability as an environmentally-induced animal model of autism.
28472510	Adolescents with autism spectrum disorder (ASD) experience challenges achieving independence. Few studies assess both adolescents and caregivers' needs as adolescents transition to adult health care. This study explored and compared the health-related independence experiences of 27 adolescents with ASD and their caregivers. Caregivers participated in focus groups and adolescents participated in semi-structured interviews. Thematic analysis of dyads' responses highlighted three common themes: (a) efforts toward independence, (b) low self-efficacy for adolescents' independence, and (c) desire for independence. Nuances in responses indicated that although members of dyads shared many experiences, they were not communicating these experiences with each other. Results suggest both groups understand the importance of health-related independence and are motivated to achieve independence but lack skills and supports. Improved communication about experiences and goals between caregivers, adolescents, and the care team are needed. These findings can inform future interventions to better support adolescents' transition to adult health care.
28472111	Children with autism spectrum disorders (ASD) who have neurodevelopmental impairments in social communication often refuse to go to school because of difficulties in learning in class. The exact cause of maladaptation to school in such children is unknown. We hypothesized that these children have difficulty in paying attention to objects at which teachers are pointing. We performed gaze behavior analysis of children with ASD to understand their difficulties in the classroom. The subjects were 26 children with ASD (19 boys and 7 girls; mean age, 8.6 years) and 27 age-matched children with typical development (TD) (14 boys and 13 girls; mean age, 8.2 years). We measured eye movements of the children while they performed free viewing of two movies depicting actual classes: a Japanese class in which a teacher pointed at cartoon characters and an arithmetic class in which the teacher pointed at geometric figures. In the analysis, we defined the regions of interest (ROIs) as the teacher's face and finger, the cartoon characters and geometric figures at which the teacher pointed, and the classroom wall that contained no objects. We then compared total gaze time for each ROI between the children with ASD and TD by two-way ANOVA. Children with ASD spent less gaze time on the cartoon characters pointed at by the teacher; they spent more gaze time on the wall in both classroom scenes. We could differentiate children with ASD from those with TD almost perfectly by the proportion of total gaze time that children with ASD spent looking at the wall. These results suggest that children with ASD do not follow the teacher's instructions in class and persist in gazing at inappropriate visual areas such as walls. Thus, they may have difficulties in understanding content in class, leading to maladaptation to school.
28471764	To describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field.Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care.	The National Institutes of Health and the National Palliative Care Research Center convened researchers from several medical subspecialties to develop a national agenda for palliative care research. The surgeon work group reviewed the existing surgical literature to identify critical knowledge gaps.	To date, evidence to support the role of palliative care in surgical practice is sparse and palliative care research in surgery is encumbered by methodological challenges and entrenched cultural norms that impede appropriate provision of palliative care. Priorities for future research on palliative care in surgery include: 1) measuring outcomes that matter to patients, 2) communication and decision making, and 3) delivery of palliative care to surgical patients.	Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social and spiritual well-being and quality of life. We propose a research agenda to address major gaps in the literature and provide a road map for future investigation.	
28471273	The aim of this study was to explore parents' and professionals' thoughts of how a gaze-controlled computer can be beneficial to children with severe multiple disabilities. All systems were provided primarily for symbol-based communication, but were also used for other purposes such as play, leisure and school activities. A further aim was to investigate factors affecting usability, specifically for communication. The study used a qualitative approach, involving content analysis of semistructured interviews with the children's key persons (N = 11). The analysis yielded three categories and twelve subcategories. There were gains for the children in terms of empowerment, social interaction, learning opportunities and efficient computer use. Inaccessibility, liability issues and technical failure were seen as obstacles, while the prerequisites included time, collaboration, stimulating content, know-how and opportunities. To sum up, this study suggests that gaze-controlled technology can provide children who have multiple disabilities involving severe motor dysfunction and communicative and cognitive problems with new opportunities to communicate, interact and perform activities independently, as long as conditions are right.
28470821	Early psychosocial deprivation has profound adverse effects on children's brain and behavioural development, including abnormalities in physical growth, intellectual function, social cognition, and emotional development. Nevertheless, the domain of emotional face processing has appeared in previous research to be relatively spared; here, we test for possible sleeper effects emerging in early adolescence. This study employed event-related potentials (ERPs) to examine the neural correlates of facial emotion processing in 12-year-old children who took part in a randomized controlled trial of foster care as an intervention for early institutionalization. Results revealed no significant group differences in two face and emotion-sensitive ERP components (P1 and N170), nor any association with age at placement or per cent of lifetime spent in an institution. These results converged with previous evidence from this population supporting relative sparing of facial emotion processing. We hypothesize that this sparing is due to an experience-dependent mechanism in which the amount of exposure to faces and facial expressions of emotion children received was sufficient to meet the low threshold required for cortical specialization of structures critical to emotion processing. Statement of contribution What is already known on this subject? Early psychosocial deprivation leads to profoundly detrimental effects on children's brain and behavioural development. With respect to children's emotional face processing abilities, few adverse effects of institutionalized rearing have previously been reported. Recent studies suggest that 'sleeper effects' may emerge many years later, especially in the domain of face processing. What does this study add? Examining a cumulative 12 years of data, we found only minimal group differences and no evidence of a sleeper effect in this particular domain. These findings identify emotional face processing as a unique ability in which relative sparing can be found. We propose an experience-dependent mechanism in which the amount of social interaction children received met the low threshold required for cortical specialization.
28470774	To explore the experiences and preferences of population-based research participants to whom an incidental finding was communicated.Of the 2580 participants of the Netherlands Epidemiology of Obesity (NEO) study who underwent magnetic resonance imaging (MRI) scanning of the abdomen, heart, and/or brain, an incidental finding with presumed health importance was disclosed to 56 (2%) participants. These participants were invited to discuss their experiences regarding the communication of the finding by the NEO research team in a focus group discussion. Transcripts of the discussions were analyzed using thematic content analysis with an open coding system.	Twenty-three persons participated in four discussions: 57% male; mean age 58 years; 74% findings were suspect for a malignancy. Overall, the participants were grateful for the disclosure of the incidental finding. They had assumed that any finding would be disclosed, and this was an important reason to participate in research. None regretted their informed consent to be notified about incidental findings. Disclosure of the finding had great impact on the lives of most participants. Difficulties with the transition from research participant to patient were frequently mentioned.	This study provides information to improve the communication of incidental findings by 1) giving clear information about which findings will be disclosed, and 2) demarcating the transition from research participant to patient, by making clear arrangements with medical specialists to guarantee careful follow-up of the finding.	3 J. Magn. Reson. Imaging 2017.	
28470036	People draw automatic social inferences from photos of unfamiliar faces and these first impressions are associated with important real-world outcomes. Here we examine the effect of selecting online profile images on first impressions. We model the process of profile image selection by asking participants to indicate the likelihood that images of their own face ("self-selection") and of an unfamiliar face ("other-selection") would be used as profile images on key social networking sites. Across two large Internet-based studies (n = 610), in line with predictions, image selections accentuated favorable social impressions and these impressions were aligned to the social context of the networking sites. However, contrary to predictions based on people's general expertise in self-presentation, other-selected images conferred more favorable impressions than self-selected images. We conclude that people make suboptimal choices when selecting their own profile pictures, such that self-perception places important limits on facial first impressions formed by others. These results underscore the dynamic nature of person perception in real-world contexts.
28468265	In embodied theories on language, it is widely accepted that experience in acting generates an expectation of this action when hearing the word for it. However, how this expectation emerges during language acquisition is still not well understood. Assuming that the intermodal presentation of information facilitates perception, prior research had suggested that early in infancy, mothers perform their actions in temporal synchrony with language. Further research revealed that this synchrony is a form of multimodal responsive behavior related to the child's later language development. Expanding on these findings, this article explores the relationship between action-language synchrony and the acquisition of verbs. Using qualitative and quantitative methods, we analyzed the coordination of verbs and action in mothers' input to six-month-old infants and related these maternal strategies to the infants' later production of verbs. We found that the verbs used by mothers in these early interactions were tightly coordinated with the ongoing action and very frequently responsive to infant actions. It is concluded that use of these multimodal strategies could significantly predict the number of spoken verbs in infants' vocabulary at 24 months.
28467436	Rat ultrasonic vocalizations have been suggested to be either a byproduct of physical movement or, in the case of 50-kHz calls, a means to communicate positive affect. Yet there are up to 14 distinct types of 50-kHz calls, raising issues for both explanations. To discriminate between these theories and address the purpose for the numerous 50-kHz call types, we studied single juvenile rats that were waiting to play with a partner, a situation associated with a high number of 50-kHz calls. We used a Monte-Carlo shuffling procedure to identify vocalization-behavior correlations that were statistically different from chance. We found that certain call types ("split", "composite" and "multi-step") were strongly associated with running and jumping while other call types (those involving "trills") were more common during slower movements. Further, non-locomotor states such as resting and rearing were strongly predictive of a lack of vocalizations. We also found that the various sub-types of USVs can be clustered into 3-4 categories based on similarities in the way they are used. We did not find a one-to-one relationship between any movements and specific vocalizations, casting doubt on the motion byproduct theory. On the other hand, the use of specific calls during specific behaviors is problematic for the affect communication hypothesis. Based on our results, we suggest that ultrasonic calls may serve to coordinate moment-to-moment social interactions.
28467288	The authors examined the influence of social media involvement on health issues in sexual and gender minorities (SGMs). Demographic and technological characteristics of social media users and nonusers were identified, and the influence of social media involvement on these factors was assessed for its potential to influence health information needs and preferences. A survey of 2,274 SGM individuals revealed that age, sexual orientation, number of Internet access points, and use of smartphones predicted levels of social media involvement. Results suggest that a broader range of traditional and nontraditional communication channels is needed to meet a diversity of health information needs in SGMs.
28467145	Older Latinos with serious medical conditions such as cancer and other chronic diseases lack information about advance care planning (ACP). ACP Intervention (ACP-I Plan) was designed for informational and communication needs of older Latinos to improve communication and advance directives (ADs).To determine the feasibility of implementing ACP-I Plan among seriously ill, older Latinos (≥50 years) in Southern New Mexico with one or more chronic diseases (e.g., cancer, heart disease, renal/liver failure, stroke, hypertension, diabetes, chronic obstructive pulmonary disease, and HIV/AIDS).	We conducted a prospective, pretest/post-test, two-group, randomized, community-based pilot trial by using mixed data collection methods.	Older Latino/Hispanic participants were recruited from community-based settings in Southern New Mexico.	All participants received ACP education, whereas the intervention group added: (1) emotional support addressing psychological distress; and (2) systems navigation for resource access, all of which included interactive ACP treatment decisional support and involved motivational interview (MI) methods. Purposive sampling was guided by a sociocultural framework to recruit Latino participants from community-based settings in Southern New Mexico. Feasibility of sample recruitment, implementation, and retention was assessed by examining the following: recruitment strategies, trial enrollment, retention rates, duration of MI counseling, type of visit (home vs. telephone), and satisfaction with the program.	We contacted 104 patients, enrolled 74 randomized to usual care 39 (UC) and treatment 35 (TX) groups. Six dropped out before the post-test survey, three from TX before the post-test survey because of sickness (n = 1) or could not be located (n = 2), and the same happened for UC. Completion rates were 91.4% UC and 92.3% TX groups. All participants were Latino/Hispanic, born in the United States (48%) or Mexico (51.4%) on average in the United States for 25 years; majority were female, 76.5%; 48.6% preferred Spanish; and 31.4% had less than sixth-grade education. Qualitative data indicate satisfaction with the ACP-I Plan intervention.	Based on enrollment and intervention completion rates, time to completion tests, and feedback from qualitative post-study, follow-up interviews, the ACP-I Plan was demonstrated to be feasible and perceived as extremely helpful.	
28467123	Although research has documented a connection between media and body image for women, little research has explored this connection among pregnant or postpartum women. The purpose of this study was to explore women's perceptions of media and body image during the perinatal period. Fredrickson's objectification theory provided a theoretical framework for the study. Data collection involved semi-structured in-depth interviews with 50 pregnant or postpartum women in which they were asked to describe their perceptions of media depictions of pregnant or postpartum women and its impact on their body image. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Four major themes emerged: (1) participants questioned the realism of media depictions of pregnant and postpartum women, (2) participants described complex reactions to media messages including negative impacts on body image and strategies for mitigating negative impacts, (3) participants desired changes in media messages to be more realistic and to depict a more complex portrayal of the life stage, and (4) participants discussed the unique and complex role of social media including both negative and positive impacts. Implications of the findings for pregnant and postpartum women, communication scholars, and healthcare professionals are discussed.
28466701	Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium. In response, a dementia toolkit was developed by nurses and implemented on the unit to improve the care of patients with dementia. Findings Comparison of pre-implementation and post-implementation audit results indicated a significant improvement in all aspects of care for patients with dementia in the trauma and orthopaedics unit, as a result of the implementation of the dementia toolkit. Education and training were provided to staff on the ward to ensure the toolkit was implemented appropriately. Conclusion It is important to consider the specific needs of patients with dementia in acute care settings, not only the primary reason for their admission. The involvement and inclusion of staff in determining what change was needed on the unit, how change would be undertaken and the positive effects of change, demonstrates how action research can inform and improve clinical practice.
28465798	The World Health Organization (WHO) Responsiveness model showing the ability of health systems in fulfilling people's expectations in connection with nonclinical aspects is an appropriate pattern to assess healthcare. The purpose of this study was to determine the status of pregnancy care provisions based on the responsiveness model.This was a cross-sectional study conducted by randomly sampling 130 women visiting selected hospitals in Tehran in 2015. A researcher-made questionnaire based on the responsiveness model of WHO was used to collect data. We determined the face validity and content validity of the questionnaire, and its reliability was confirmed by Cronbach's alpha coefficient (0.94) and test-retest analysis (0.96). The obtained data were analyzed by SPSS version 20 descriptive statistics, t-test, one-way ANOVA, Pearson product-moment correlation coefficient, and Spearman correlation.	Total responsiveness from the perspective of service recipients was 69.46±14.65 from 100. The obtained scores showed that, in the range of 0 to 100, 73.02 were about basic amenities (the most score), 72.93 about dignity, 70.91 about communication, 70.76 about confidentiality, 66.30 about provision social needs, 65.96 about choice of provider, 65.92 about autonomy, and 52.65 about prompt attention (the lowest score), which are representing the average level of service quality. There were significant relationships between participating in preparation class of labor and dignity (p<0.001), autonomy (p=0.01), provision social needs (p=0.01), and overall responsiveness (p=0.03). It was obtained that there is a significant linear relationship between scores given to hospitals and dimensions of responsiveness (p=0.05). Findings indicated a significant relationship between insurance type and dimensions of choice of provider (p=0.03) and communication (p=0.03).	The mean score of service quality in the present investigation illustrated that nonclinical dimensions have been disregarded and it has potential to be better. So some grand plans are needed.	
28465434	Social ties are crucial for humans. Disruption of ties through social exclusion has a marked effect on our thoughts and feelings; however, such effects can be tempered by broader social network resources. Here, we use fMRI data acquired from 80 male adolescents to investigate how social exclusion modulates functional connectivity within and across brain networks involved in social pain and understanding the mental states of others (i.e., mentalizing). Furthermore, using objectively logged friendship network data, we examine how individual variability in brain reactivity to social exclusion relates to the density of participants' friendship networks, an important aspect of social network structure. We find increased connectivity within a set of regions previously identified as a mentalizing system during exclusion relative to inclusion. These results are consistent across the regions of interest as well as a whole-brain analysis. Next, examining how social network characteristics are associated with task-based connectivity dynamics, we find that participants who showed greater changes in connectivity within the mentalizing system when socially excluded by peers had less dense friendship networks. This work provides insight to understand how distributed brain systems respond to social and emotional challenges and how such brain dynamics might vary based on broader social network characteristics.
28465254	Autism spectrum disorder (ASD) is neurodevelopmental disorders characterized by stereotypical repetitive behavior, impaired social interaction, and deficits in communication. The BTBR T+ Itpr3tf/J (BTBR) mice have been extensively used as an animal model of the ASD-like phenotype. Adenosine A2A receptors (A2ARs) are considered potential targets in the treatment of neurodegenerative diseases. In this study, we used the A2AR antagonist SCH 5826 (SCH) and the A2AR agonist CGS 21680 (CGS) to investigate the activation of A2AR signaling in immune cells. Further, we examined the effects of A2ARs on the expression of the cytokines interleukin 2 (IL-2), IL-6, IL-9, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), and transforming growth factor β (TGF-β) in the spleen and in splenic CD4+ T cells. In addition, we assessed the mRNA and protein expression levels of these cytokines in the brain tissue. Our results showed that the levels of IL-2+, IL-6+, IL-9+, IFN-γ+, and TNF-α+ were significantly lower, whereas the levels of TGF-β+ in the spleen and in splenic CD4+ T cells were significantly higher in the CGS-treated mice than in the BTBR control and SCH-treated mice. In addition, reverse transcription polymerase chain reaction (RT-PCR) and western blot analysis showed a decrease in the mRNA and protein expression levels of IL-2, IL-6, IL-9, IFN-γ+, and TNF-α+ and an increase in the mRNA and protein expression levels of TGF-β in the CGS-treated mice, while treatment with BTBR alone and SCH resulted in increased Th1 levels and decreased Th2 levels in the brain tissue. Our results suggest that treatment the A2AR agonist CGS may be a promising therapeutic option for neuroimmune dysfunction.
28464857	Communication skills are essential in a patient-centred health service and therefore in medical teaching. Although significant differences in communication behaviour of male and female students are known, gender differences in the performance of students are still under-reported. The aim of this study was to analyse gender differences in communication skills of medical students in the context of an OSCE exam (OSCE = Objective Structured Clinical Examination).In a longitudinal trend study based on seven semester-cohorts, it was analysed if there are gender differences in medical students' communication skills. The students (self-perception) and standardized patients (SP) (external perception) were asked to rate the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests in SPSS 21.	Across all ratings in the self- and the external perception, there was a significant gender difference in favour of female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception between 2011 and 2014.	It is important to consider if gender-specific teaching should be developed, considering the reported differences between female and male students.	
28464352	A growing line of research has sought to characterize the different presentations of autism spectrum disorder (ASD) among boys and girls. Much less is known about maternal experience and mother-child relationship in children with ASD based on child gender. The present qualitative study aimed to investigate the mother-daughter relationship from the perspective of mothers who are raising girls with ASD with normal intelligence and functional verbal communication.Eleven in-depth interviews were conducted with mothers of girls with ASD, ages 10-19 years. Data were analysed in an interactive process commonly used in naturalistic inquiry. Results provide insight into the unique maternal experience of raising a daughter with ASD.	Mothers reported a sense of exclusion from the neurotypical population and male-dominant ASD population and transformation in relationship. Themes identified were skepticism and delayed diagnosis, disbelief from others, lack of information about girls with ASD, higher social demands in adolescence, puberty challenges around hygiene, disappointment about physical appearance, vulnerability in relationships and worries about future functioning. The mother-daughter relationship started with an early expectation of a close and intimate relationship that then underwent a transformation, which challenged maternal competence, reshaped expectations and created a different bond between mother and daughter.	The findings in this qualitative study highlight the impact of gender on the maternal experience of raising a daughter with ASD and contribute to a better understanding of the needs of both mothers and daughters. These results can help providers support the mother-daughter dyad by recognizing gender-specific challenges.	
28463445	Many students do not receive return to learn (RTL) services upon return to academics following a concussion.Using a mixed-methods approach, we conducted a survey of RTL practices and experiences in Washington State schools between January 2015 and June 2015. We then held a statewide summit of RTL stakeholders and used a modified Delphi process to develop a consensus-based RTL implementation model and process.	Survey participants included 83 educators, 57 school nurses, 14 administrators, and 30 parents, representing 144 schools in rural and urban areas. Unmet need domains and recommendations identified were (1) a current lack of school policies; (2) barriers to providing or receiving accommodations; (3) wide variability in communication patterns; and (4) recommendations shared by all stakeholder groups (including desire for readily available best practices, development of a formal school RTL policy for easy adoption and more training). Using stakeholder input from RTL summit participants and survey responses, we developed an RTL implementation model and checklist for RTL guideline adoption.	Washington State children have unmet needs upon returning to public schools after concussion. The student-centered RTL model and checklist for implementing RTL guidelines can help schools provide timely RTL services following concussion.	
28463420	Autism spectrum disorder (ASD) represents a heterogeneous group of disorders characterized by alterations in three behavioral symptom domains: Social interactions, verbal and nonverbal communication, and repetitive behaviors. Increasing prevalence of ASD in recent years suggests that exposure to environmental toxicants may be critical in modulating etiology of this disease. As clinical diagnosis of autism still relies on behavioral evaluation, it is important to be able to assess similar behavioral traits in animal models, to provide biological plausibility of associations between environmental exposures and ASD. Rodents naturally exhibit a large number of behaviors that can be linked to similar behaviors in human. In this unit, behavioral tests are described that are relevant to the domains affected in ASD. For the repetitive domain, the T-maze spontaneous alternation test and marble burying test are described. For the communication domain, neonatal ultrasonic vocalization and olfactory habituation test toward social and non-social odor are described. Finally, for the sociability domain, the three-chambered social preference test and the reciprocal interaction test are presented. © 2017 by John Wiley & Sons, Inc.
28462762	Hyperbole supports irony comprehension in adults by heightening the contrast between what is said and the actual situation. Because young children do not perceive the communication situation as a whole, but rather give precedence to either the utterance or the context, we predicted that hyperbole would reduce irony comprehension in six-year-olds (n = 40) by overemphasizing what was said. By contrast, ten-year-olds (n = 40) would benefit from hyperbole in the way that adults do, as they would perceive the utterance and context as a whole, highlighted by the speaker's ironic intent. Short animated cartoons featuring ironic criticisms were shown to participants. We assessed comprehension of the speaker's belief and speaker's intent. Results supported our predictions. The development of mentalization during school years and its impact on the development of irony comprehension is discussed.
28462535	Our voice provides salient cues about how confident we sound, which promotes inferences about how believable we are. However, the neural mechanisms involved in these social inferences are largely unknown. Employing functional magnetic resonance imaging, we examined the brain networks and individual differences underlying the evaluation of speaker believability from vocal expressions. Participants (n = 26) listened to statements produced in a confident, unconfident, or "prosodically unmarked" (neutral) voice, and judged how believable the speaker was on a 4-point scale. We found frontal-temporal networks were activated for different levels of confidence, with the left superior and inferior frontal gyrus more activated for confident statements, the right superior temporal gyrus for unconfident expressions, and bilateral cerebellum for statements in a neutral voice. Based on listener's believability judgment, we observed increased activation in the right superior parietal lobule (SPL) associated with higher believability, while increased left posterior central gyrus (PoCG) was associated with less believability. A psychophysiological interaction analysis found that the anterior cingulate cortex and bilateral caudate were connected to the right SPL when higher believability judgments were made, while supplementary motor area was connected with the left PoCG when lower believability judgments were made. Personal characteristics, such as interpersonal reactivity and the individual tendency to trust others, modulated the brain activations and the functional connectivity when making believability judgments. In sum, our data pinpoint neural mechanisms that are involved when inferring one's believability from a speaker's voice and establish ways that these mechanisms are modulated by individual characteristics of a listener. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.
28462351	This grounded theory study used in-depth, semi-structured interview to examine the information-seeking behaviors of 35 parents of children with Down syndrome. Emergent themes include a progressive pattern of behavior including information overload and avoidance, passive attention, and active information seeking; varying preferences between tacit and explicit information at different stages; and selection of information channels and sources that varied based on personal and situational constraints. Based on the findings, the author proposes a progressive model of health information seeking and a framework for using this model to collect data in practice. The author also discusses the practical and theoretical implications of a responsive, progressive approach to understanding parents' health information-seeking behavior.
28461225	Control of voice fundamental frequency (F0) relies in part on comparison of the intended F0 level and auditory feedback. This comparison impacts "sense of agency", or SoA, commonly defined as being the agent of one's own actions and plays a key role for self-awareness and social interactions. SoA is aberrant in several psychiatric disorders. Knowledge about brain activity reflecting SoA can be used in clinical practice for these disorders. It was shown that perception of voice feedback as one's own voice, reflecting the recognition of SoA, alters auditory sensory processing. Using a voice perturbation paradigm we contrasted vocal and bioelectrical brain responses to auditory stimuli that differed in magnitude: 100 and 400 cents. Results suggest the different magnitudes were perceived as a pitch error in self-vocalization (100 cents) or as a pitch shift generated externally (400 cents). Vocalizations and neural responses to changes in pitch of self-vocalization were defined as those made to small magnitude pitch-shifts (100 cents) and which did not show differential neural responses to upward versus downward changes in voice pitch auditory feedback. Vocal responses to large magnitude pitch shifts (400 cents) were smaller than those made to small pitch shifts, and neural responses differed according to upwards versus downward changes in pitch. Our results suggest that the presence of SoA for self-produced sounds may modify bioelectrical brain responses reflecting differences in auditory processing of the direction of a pitch shift. We suggest that this modification of bioelectrical response can be used as a biological index of SoA. Possible neuronal mechanisms of this modification of bioelectrical brain response are discussed.
28459382	African American males between ages 13 and 24 are disproportionately affected by unintended pregnancy and sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV/AIDS; indeed, they account for 50% of HIV infections among all youth. Clear communication between parents and their youth about sex is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse, which can prevent STIs and unintended pregnancy. However, barriers exist for parents to educate their youth about sexual health. The purpose of this article is to explore the values fathers communicate to their sons to prevent their risky sexual behaviors that lead to STIs, HIV, and adolescent parenthood. This was a qualitative study conducted from May and June 2015. African American fathers (N = 29) who had sons, ages 10 to 15 years, participated in five focus groups across metropolitan and rural North Carolina communities in barbershops. A qualitative content analysis revealed four themes regarding areas that fathers imparted their values onto their sons to protect them from sexual health risks: (a) sex, (b) sexuality, (c) relationships, and (d) marriage. The findings have implications for social work and public health practice.
28459379	Shifting cultural attitudes and legislation have increased focus on the health care needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient nondisclosure of LGBTQ identity creates a barrier to accessing care. This qualitative study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and nondisclosure to medical providers. Participants (n = 206, age range 18-27) completed questionnaires assessing health care access and use as part of a larger study. Participants' responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for nondisclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure and nondisclosure of LGBTQ identity. Reasons for participant nondisclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults' identity disclosure and provide avenues for health professionals' continuing education when working with LGBTQ patients.
28458395	Envisioning the future of older adults of 2050 is a challenging task given the heterogeneity of the older adult population. We consider primarily the domains of home, health, and social participation for individuals over age 65 and the potential role of information, communication, and robotic technology for enhanced independence, maintenance of autonomy, and enriched quality of life. We develop several scenarios to illustrate the diversity of circumstances, health, and living situations for older adults in the future. We discuss possible negative outcomes resulting from the proliferation of technology, including increased social isolation and a widening digital divide. However, we focus primarily on envisioning desired situations wherein older adults have autonomy and independence; are easily able to manage their health and wellness needs; have rich and rewarding opportunities for social connectedness, personal growth, continued life purpose, and overall high quality of life. To attain this future, we must be acting now: designing the technology with involvement by today's older adults who represent the needs and capabilities of tomorrow's older adults; developing the necessary infrastructure to support widespread availability and deployment of these technologies; and supporting the integration of technology into people's lives at younger ages with adaptive functionality to support changing needs and preferences.
28457867	The human brain has evolved for group living [1]. Yet we know so little about how it supports dynamic group interactions that the study of real-world social exchanges has been dubbed the "dark matter of social neuroscience" [2]. Recently, various studies have begun to approach this question by comparing brain responses of multiple individuals during a variety of (semi-naturalistic) tasks [3-15]. These experiments reveal how stimulus properties [13], individual differences [14], and contextual factors [15] may underpin similarities and differences in neural activity across people. However, most studies to date suffer from various limitations: they often lack direct face-to-face interaction between participants, are typically limited to dyads, do not investigate social dynamics across time, and, crucially, they rarely study social behavior under naturalistic circumstances. Here we extend such experimentation drastically, beyond dyads and beyond laboratory walls, to identify neural markers of group engagement during dynamic real-world group interactions. We used portable electroencephalogram (EEG) to simultaneously record brain activity from a class of 12 high school students over the course of a semester (11 classes) during regular classroom activities (Figures 1A-1C; Supplemental Experimental Procedures, section S1). A novel analysis technique to assess group-based neural coherence demonstrates that the extent to which brain activity is synchronized across students predicts both student class engagement and social dynamics. This suggests that brain-to-brain synchrony is a possible neural marker for dynamic social interactions, likely driven by shared attention mechanisms. This study validates a promising new method to investigate the neuroscience of group interactions in ecologically natural settings.
28457745	Sensory sensitivity is prevalent among young children with ASD, but its relation to social communication impairment is unclear. Recently, increased sensory hypersensitivity has been linked to greater activity of the neural salience network (Green et al., 2016). Increased neural sensitivity to stimuli, especially social stimuli, could provide greater opportunity for social learning and improved outcomes. Consistent with this framework, in Experiment 1 we found that parent report of greater sensory hypersensitivity at 2 years in toddlers with ASD (N=27) was predictive of increased neural responsiveness to social stimuli (larger amplitude event-related potential/ERP responses to faces at P1, P400 and Nc) at 4 years, and this in turn was related to parent report of increased social approach at 4 years. In Experiment 2, parent report of increased perceptual sensitivity at 6 months in infants at low and high familial risk for ASD (N=35) predicted larger ERP P1 amplitude to faces at 18 months. Increased sensory hypersensitivity in early development thus predicted greater attention capture by faces in later development, and this related to more optimal social behavioral development. Sensory hypersensitivity may index a child's ability to benefit from supportive environments during development. Early sensory symptoms may not always be developmentally problematic for individuals with ASD.
28456948	Advance care planning helps to ensure that patients' end-of-life preferences are understood and discussed with providers. It is an important component of patient-centered care, particularly when patients are facing life-limiting illness. It also has ethical implications for providers, yet evidence suggests that these conversations are not always occurring, particularly in underserved populations. The aim of this study was to understand the challenges and personal beliefs regarding ACP through interviews with patients undergoing active cancer treatment and their oncology providers. This study took place at an urban, multispecialty cancer center in the mid-Atlantic region where approximately 1400 patients are treated each year. Findings revealed differences among both patients and providers in terms of their ACP knowledge, preferences, and practices. Overall, 70% of patients were familiar with advance directives (100% of White patients and 45.5% of Black patients), yet only 35% of them reported having completed one (55.6% of White patients and 18.2% of Black patients, although not statistically significant). Most providers (70%) held ACP conversations with patients with advanced illness only. They tended to make assumptions about the amount of information that patients desired and noted the significant challenges that were inherent with these types of conversations. Overall, ethical implications are inherent in ACP as patients are making medical decisions without always having necessary information. There are various reasons why providers may not supply information regarding potential outcomes and end-of-life planning and why patients may not request (or know to request) more medical information.
28456615	Latinas/os with traumatic brain injuries (TBIs) and their caregivers experience worse outcomes than others.The study aimed to assess the acceptability and promise of Trabajadora de Salud on the functional abilities, hospital readmission, rehabilitation, employment, depression, somatic symptoms, and caregiver burden among Latinas/os with TBIs and their caregivers.	A pre-posttest experimental pilot study was conducted. A total of eight Latina/o adult patients (50% female) with mild or moderate TBI and six of their caregivers (66.7% female) were randomized to receive Trabajadora de Salud or a telephone only control group. Trabajadora de Salud, a three-month, in-home intervention administered by bilingual lay health workers, focused on: 1) providing empathy and validation of TBI symptoms, 2) addressing basic needs, 3) goal setting, and 4) improving communication with healthcare providers.	Trabajadora de Salud was widely accepted by patients, caregivers, and health professionals. The functional, depression, and somatic symptoms of the patients as well as the somatic symptoms and caregiver burden of the caregivers improved more for participants in the intervention group than the control group.	Trabajadora de Salud demonstrated promise in improving outcomes of Latinas/os with TBIs and their caregivers and should be further studied.	
28455605	Interdisciplinary relationships between Geography and Psychotherapy are an opportunity for innovation. Indeed, scientific works found on bibliographic databases and concerning this theme are scarce. Geographical sub-fields, such as the Geography of Emotions or Psychoanalytical Geography have started to emerge, theorizing about and interpreting feelings, emotions, moods, sufferings, of the chronically ill or diversified social groups and sites. But a less theoretical and more practical approach, in the sense of proposing, predicting and intervening, is lacking; as well as research into the possibilities offered by communication technologies and mobile phones. In the present work, we present the results of a review of the most relevant scientific works published internationally; we reflect on the contributions of Geography and mobile phones to psychosocial therapies and define the orientation and questions that should be posed in future research, from the point of view of geography and regarding psychotherapy. We conclude that the production of georeferenced data via mobile phones concerning the daily lives of people opens great possibilities for cognitive behavioural therapy and mental health. They allow for the development of personalized mood maps that locate the places where a person experiences greater or lesser stress on a daily basis; they allow for a cartography of emotions, a cognitive cartography of the places we access physically or through the Internet, of our feelings and psychosocial experiences. They open the door to the possibility of offering personalized psychotherapy treatments focusing on the ecological-environmental analysis of the places frequented by the person on a daily basis.
28455194	Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff.Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital.	At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns.	The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of communication along with aligning healthcare entity goals may help prevent medication-related errors.	
28455111	Bullying occurs frequently-and with significant negative outcomes-in workplace settings. Once established, bullying endures in the workplace, requiring the interaction of a bully perpetrator and an intended target who takes on the role of victim. Not every target becomes a victim, however. The purpose of this study is to investigate the processes by which targets, intended objects of bullies' affronts, become victims, those individuals who experience ongoing emotional injury in response to bullies' affronts, and to clarify how bullying victimization impedes inclusive excellence in the workplace.The design for this study was pragmatic utility, an inductive research approach grounded in assumptions of hermeneutics.	The pragmatic utility process involved the investigators' synthesis of descriptions from a broad, interdisciplinary published literature. Integrating knowledge from their previous research and practice experiences with the pragmatic utility process, they derived qualitative features of victims' experiences, differentiating target from victim in bullying encounters.	For those targets who ultimately are victimized, response to bullies' affronts extends far beyond the immediate present. Redolence of personal, lived experience revives bygone vulnerabilities, and naïve communication and relationship expectations reinforce a long-standing, impoverished sense. That sense couples with workplace dynamics to augment a context of exclusion.	Findings suggest that, as Heidegger contended, we are our histories. Personal history demonstrates a significance influence on the manifestation of bullying victimization, acting to distance them from their workplace peers and to impede inclusive excellence.	
28454517	Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants' self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice.The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references.	The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found.	Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and deteriorated or unchanged health needs is that participation was limited to one's own social group, and therefore had limited positive influence on health seeking behaviour. The lack of measurable improvements in health status could be explained by limitations in the study, in the theoretical assumptions underlying the intervention, and in the implementation of the intervention. Further research is needed to understand success factors in health promoting interventions among recently settled migrants better.	
28454488	Communication of risks must involve people with dementia meaningfully to ensure informed and inclusive decision-making processes. This qualitative study explored concepts of risk from the perspective of persons with dementia and their experiences of communicating risk with family members and professionals. Data was analysed using grounded theory. Seventeen people in Northern Ireland with mild-moderate dementia who had recently made a decision about their daily life or care involving consideration of risks were interviewed between November 2015 and November 2016. A wide range of actual or feared risks were identified relating to: daily activities; hobbies and socialising; mental health and medicines; and risks to and from others. 'Risk' often held emotional rather than probability connotations. Constructive communications to address issues were presented. Problem-solving models of both active and passive decision-making about risks were evident. Effective risk communication in informed decision-making processes about health and social care is discussed.
28453827	Patient engagement (PE) is warranted when treatment risks and outcomes are uncertain, as is the case for higher risk medical devices. Previous research found that patients were not engaged in discussions or decisions about implantable medical devices. This study explored physician views about engaging patients in such discussions.Qualitative interviews using a basic descriptive approach.	Canada.	Practicing cardiovascular and orthopaedic physicians.	Level, processes and determinants of PE in medical device discussions and decisions.	Views were largely similar among 10 cardiovascular and 12 orthopaedic physicians interviewed. Most said that it was feasible to inform and sometimes involve patients in discussions, but not to partner with them in medical device decision-making. PE was constrained by patient (comfort with PE, technical understanding, physiologic/demographic characteristics, prognosis), physician (device preferences, time), health system (purchasing contracts) and device factors (number of devices on market, comparative advantage). A framework was generated to help physicians engage patients in discussions about medical devices, even when decisions may not be preference sensitive due to multiple constraints on choice.	This study identified that patients are not engaged in discussions or decisions about implantable medical devices. This may be due to multiple constraints. Further research should establish the legitimacy, prevalence and impact of constraining factors, and examine whether and how different levels and forms of PE are needed and feasible.	
28452917	The aims of the study were to characterize handoffs in community pharmacies and to examine factors that contribute to perceived handoff quality.A cross-sectional study of community pharmacists in a Midwest State of the United States. Self-administered questionnaires were used to collect information on participant and practice setting characteristics. Data were analyzed using descriptive statistics and multivariate logistic regression.	A total of 445 completed surveys were returned (response rate, 82%). In almost half of the time, handoffs that occur in a community pharmacy setting were inaccurate or incomplete. Nearly half of the time handoffs occur in environments full of interruptions and distractions. More than 90% of the respondents indicated that they have undergone no formal training on proper ways of handing off information. Nearly 40% of respondents reported that their pharmacy dispensing technology does not have adequate functionality to support handing off information and that at least 50% of the time, poor handoffs result in additional work to the pharmacist because of the need for complete information before providing patient care. Multivariate analysis showed that being very familiar with patients, lower daily prescription volume, not having a 24-hour operation, and larger percentage of handoffs occurring in a synchronous fashion are all associated with better handoff quality.	Handoffs occur frequently and are problematic in community pharmacies. Current pharmacy environments offer limited support to conduct good handoffs, and as a result, pharmacists report loss of information. This could present as a significant patient safety hazard. Future interventions should target facilitating better communication during shift changes.	
28452605	Nurses and physicians work side-by-side in the intensive care unit (ICU). Effective exchanges of patient information are essential to safe patient care in the ICU. Nurses often rate nurse-physician communication lower than physicians and report that it is difficult to speak up, that disagreements are not resolved and that their input is not well received. Therefore, this study explored nurses' dialogue with physicians regarding patients' clinical status and the prerequisites for effective and accurate exchanges of information. We adopted a qualitative approach, conducting three focus group discussions with five to six nurses and physicians each (14 total). Two themes emerged. The first theme highlighted nurses' contributions to dialogues with physicians; nurses' ongoing observations of patients were essential to patient care discussions. The second theme addressed the prerequisites of accurate and effective dialogue regarding care options, comprising three subthemes: nurses' ability to speak up and present clinical changes, establishment of shared goal and clinical understanding, and open dialogue and willingness to listen to each other. Nurses should understand their essential role in conducting ongoing observations of patients and their right to be included in care-related decision-making processes. Physicians should be willing to listen to and include nurses' clinical observations and concerns.
28451947	Little is known about continuity, change and predictors of anxiety in ASD. This follow-up study investigated changes in caregiver-reported anxiety in 54 non-referred youth with ASD after 10-19 months. Earlier child predictors of later anxiety were also examined. Anxiety scores were generally stable. Time 1 ASD repetitive behavior symptoms, but not social/communication symptoms, predicted Time 2 total anxiety scores, over and above child age, gender and adaptive functioning scores, but this predictive relationship was fully mitigated by Time 1 anxiety scores when these were included as a covariate in the regression model. Exploring bi-directionality between autism and anxiety symptomatology, Time 1 anxiety scores did not predict Time 2 ASD symptoms. Preliminary clinical implications and possible future directions are discussed.
28451911	Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development.Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis.	Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions.	Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.	
28451890	Many gay, bisexual, and transgender (GBT) people of color (POC) join house and/or constructed family communities, which serve as support networks composed mostly of other non-biologically related GBT/POC. These networks can decrease or increase the risk of exposure to HIV via multiple mechanisms (e.g., providing informal sexual safety education versus stigmatizing family members with HIV, encouraging sexual safety practices versus unsafe escorting, teaching self-care versus substance use) but act to support family members in the face of social and economic hardship. Researchers interviewed ten members of these social networks in the Boston metro area of the US and produced a saturated grounded theory analysis to explore the role of gay family/house networks in HIV risk management. While network members utilized HIV prevention resources, interviewees described how their efficacy was related to the intentions of leadership and strength of kinship boundaries within their community, economic opportunities, and communication skills. Clinical and research implications are discussed.
28451693	Functional near-infrared spectroscopy (fNIRS) is currently one of the most promising tools in the neuroscientific research to study brain hemodynamics during naturalistic social communication. The application of fNIRS by studies in this field of knowledge has been widely justified by its strong resilience to motion artifacts, including those that might be generated by communicative head and facial movements. Previous studies have focused on the identification and correction of these artifacts, but a quantification of the differential contribution of common communicative movements on the quality of fNIRS signals is still missing. We assessed the impact of four movements (nodding head up and down, reading aloud, nodding head sideways, and raising eyebrows) performed during rest and task conditions on two metrics of signal quality control: an estimative of signal-to-noise performance and the negative correlation between oxygenated and deoxygenated hemoglobin (oxy-Hb and deoxy-Hb). Channel-wise group analysis confirmed the robustness of the fNIRS technique to head nodding movements but showed a large effect of raising eyebrows in both signal quality control metrics, both during task and rest conditions. Reading aloud did not disrupt the expected anticorrelation between oxy-Hb and deoxy-Hb but had a relatively large effect on signal-to-noise performance. These findings may have implications to the interpretation of fNIRS studies examining communicative processes.
28450841	The identification of non-verbal emotional signals, and especially of facial expressions, is essential for successful social communication among humans. Previous research has reported an age-related decline in facial emotion identification, and argued for socio-emotional or aging-brain model explanations. However, more perceptual differences in the gaze strategies that accompany facial emotional processing with advancing age have been under-explored yet. In this study, 22 young (22.2 years) and 22 older (70.4 years) adults were instructed to look at basic facial expressions while their gaze movements were recorded by an eye-tracker. Participants were then asked to identify each emotion, and the unbiased hit rate was applied as performance measure. Gaze data were first analyzed using traditional measures of fixations over two preferential regions of the face (upper and lower areas) for each emotion. Then, to better capture core gaze changes with advancing age, spatio-temporal gaze behaviors were deeper examined using data-driven analysis (dimension reduction, clustering). Results first confirmed that older adults performed worse than younger adults at identifying facial expressions, except for "joy" and "disgust," and this was accompanied by a gaze preference toward the lower-face. Interestingly, this phenomenon was maintained during the whole time course of stimulus presentation. More importantly, trials corresponding to older adults were more tightly clustered, suggesting that the gaze behavior patterns of older adults are more consistent than those of younger adults. This study demonstrates that, confronted to emotional faces, younger and older adults do not prioritize or ignore the same facial areas. Older adults mainly adopted a focused-gaze strategy, consisting in focusing only on the lower part of the face throughout the whole stimuli display time. This consistency may constitute a robust and distinctive "social signature" of emotional identification in aging. Younger adults, however, were more dispersed in terms of gaze behavior and used a more exploratory-gaze strategy, consisting in repeatedly visiting both facial areas.
28450217	In the U.S., palliative care programs improve access to hospice through enhanced communication and efficiencies in hospice eligibility review and enrollment. For community-based programs, this task may begin with telephone contact.To evaluate the incidence and predictors of hospice enrollment following telephonic outreach by a nurse after referral to a community-based, specialist palliative care program.	During 2012-2014, 299 consecutive patients who were referred to a palliative care program and subsequently enrolled in hospice provided electronic health record data for a retrospective cohort study. Those who elected hospice after telephonic outreach and before the first palliative care home visit, were compared with those who enrolled in hospice after palliative care visits began, using both bivariate and multivariate analyses.	Mean (SD) age was 74.1 (18.7) years; 60.2% were women, 44.4% were White, 22.5% were Hispanic, 20.9% were Black, and 9.6% were Asian. In total, 177 patients (59.2%) elected hospice following telephonic outreach and 122 (40.8%) enrolled after home visits began. The former group received a mean of 4.5 calls (median = 3.0) before hospice election. In multivariate analysis, hospice enrollment following telephonic outreach alone was associated with hospital or nursing home referral, not married status, and poor performance status (all P < 0.05).	More than half of patients electing hospice after referral to a palliative care program did so following telephonic outreach alone. Both sociodemographic and clinical characteristics predicted this outcome. Palliative care programs can improve hospice access through initial telephonic outreach by trained professionals.	
28449247	Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure.Children with ASD (N = 283; 82% boys; Mage  = 10.5 years) were drawn from a specialty ASD clinic. Parents and teachers provided ratings of the three core DSM-IV-TR domains of ASD symptoms (communication, social, and perseverative behavior) with the Child and Adolescent Symptom Inventory-4R (CASI-4R). External validators included child psychotropic medication status, frequency of ASD-relevant school-based services, and the Autism Diagnostic Observation Schedule (ADOS-2).	Four distinct subgroups emerged that ranged from large between-informant discrepancy (informant-specific) to relative lack of discrepancy (i.e. informant agreement; cross-situational): Moderate Parent/Low Teacher or Low Parent/Moderate Teacher Severity (Discrepancy), and Moderate or High Symptom Severity (Agreement). Subgroups were highly distinct (mean probability of group assignment = 94%). Relative to Discrepancy subgroups, Agreement subgroups were more likely to receive psychotropic medication, school-based special education services, and an ADOS-2 diagnosis. These differential associations would not have been identified based solely on CASI-4R scores from one informant.	The degree of parent-teacher discrepancy about ASD symptom severity appears to provide more clinically useful information than reliance on a specific symptom domain or informant, and thus yields an innovative, cost-effective approach to assessing functional impairment. This conclusion stands in contrast to existing symptom clustering approaches in ASD, which treat within-informant patterns of symptom severity as generalizable across settings. Within-child variability in symptom expression across settings may yield uniquely useful information for characterizing the ASD phenotype.	
28449047	In 2016, Singapore grappled with one of the largest Zika outbreaks in Southeast Asia. This study examines the use of Facebook for Zika-related outreach by the Ministry of Health (MOH) and the National Environmental Agency (NEA) from March 1, 2015, to September 1, 2016, and public response to this effort. Despite nearly equivalent outreach, MOH's Facebook posts received more likes (µ = 3.49) and shares (µ = 30.11), whereas NEA's posts received more comments (µ = 4.55), with NEA posting mostly on prevention (N = 30) and MOH on situational updates (N = 24). Thematic analyses identified prevention-related posts as garnering the most likes (N = 1277), while update-related posts were most shared (N = 1059) and commented upon (N = 220). Outreach ceased briefly for 2 months after Singapore's first imported case of Zika, but increased following the outbreak of locally transmitted cases in August 2016. Public engagement was significantly higher during Zika compared with prior haze and dengue outbreaks. The results indicate the value of Facebook as a tool for rapid outreach during infectious disease outbreaks, and as a "listening" platform for those managing the situation. We discuss implications for public health communication research and policy.
28449016	This paper critically explores the research approach undertaken by Māori and tauiwi researchers working alongside kaumātua within the context of physician-assisted dying. We critically explore the collaborative process we undertook in framing the research context and discuss the rewards and challenges that emerged.The research this critical discussion draws on undertook a qualitative Kaupapa Māori consistent research approach and drew on the principles of an Interface Research approach. The paper focuses on the collaborative approach taken between the 10 researchers involved in the study.	Challenges identified within the collaborative Kaupapa Māori consistent research process included: determining appropriate authority and representation of researchers and participants; maintaining clear communication; time and logistical management. The key strengths that emerged from this research design were: establishing a culturally safe and robust research process; an ability to build and maintain relationships between researchers and participants; and the opportunity to develop academic research skills between researchers and participants.	Collaborative Kaupapa Māori consistent research approaches to research can enable accountability, control and representation throughout the entire research process. Given the rich research results achieved and personal rewards gained from this study design, we would advocate for the application of such approaches within health research contexts.	
28448784	Diabetes mellitus (DM) patients with comorbid hypertension (HTN) are at a higher risk of developing microvascular and macrovascular DM complications. Through guideline-driven recommendations, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are highly recommended for these patients. Unfortunately, medication adherence to these products, though crucial to achieving therapeutic benefit, is frequently suboptimal. Motivational interviewing (MI) is a patient-centered collaborative communication style that is used to strengthen internal motivation for change that may prove effective in enhancing adherence.To examine the effect of an MI telephone intervention conducted by pharmacy students in improving adherence to ACEIs/ARBs among Medicare Advantage Plan (MAP) patients with both DM and HTN.	A prospective study was conducted among patients enrolled in a Texas MAP. Medical claims data were used to identify patients with DM and HTN, and pharmacy claims were observed to recognize those who filled either an ACEI or an ARB during June 2014. Patients with a 6-month proportion of days covered (PDC) < 0.80 in the previous 6 months were determined nonadherent, and 75% of those were randomly selected to serve as potential subjects for the intervention, while 25% were randomly selected to serve as potential subjects for the control group. The intervention was a telephone call by a pharmacy student on rotation at the health plan, and 5 monthly follow-up calls. Before implementing calls, participating students attended a 3-day MI training course, where their proficiency for MI skills was evaluated. Refill data during the 6-month postintervention were evaluated to examine the intervention effect measured on 3 outcomes: PDC; PDC ≥ 0.80 versus < 0.80; and discontinuation versus continuation. Multivariate linear and logistic regression models were constructed to adjust for any imbalances in baseline characteristics, including age, gender, number of other medications, regimen complexity, health low-income subsidy status, prescriber specialty, comorbidities, 6-month previous hospitalization, baseline 6-month PDC, and Centers for Medicare & Medicaid Services risk score.	A total of 11 students participated in the intervention implementation. Patients receiving calls were randomly selected from those potential subjects for the intervention arm until a target of 250 was reached; 500 controls were randomly selected from the potential subjects for the control arm. The final cohort included in multivariate models consisted of 743 patients. Patients completing the initial call and at least 2 follow-ups were less likely to discontinue (OR = 0.29; 95% CI = 0.15-0.54; P < 0.001) and more likely to be adherent in the linear regression model (β = 0.0604, P < 0.001) and the logistic regression model (OR = 1.53; 95% CI = 1.02-2.28; P = 0.009). Other factors significantly associated with better adherence included higher baseline PDC and number of medications. Depression status was significantly associated with lower adherence.	Patients receiving 2 or more calls had significantly better adherence and less discontinuation during the 6 months following initial calls compared with those who did not receive calls. This finding indicates that an MI-based telephone intervention by pharmacy students may be a promising intervention to improve adherence. Future research should examine the sustainability of the intervention effect for longer time periods and its influence on associated clinical outcomes.	This project was supported by the Pharmaceutical Research and Manufacturers of America Foundation (PhRMA). The content is solely the responsibility of the authors and does not necessarily represent the official views of PhRMA. The funding agency was not involved in research design, analysis, or reporting results. Funding was obtained by Abughosh. Holstad provided a consultation regarding the MI guide and provided the MI training. Study concept and design were contributed by Abughosh and Fleming, along with Serna, Esse, and Holstad. Serna, Esse, Mann, Holstad, and Masilamani collected the data, and data interpretation was performed by Abughosh, Wong, and Esse. The manuscript was written by Abughosh, Wong, and Esse and revised by Masilamani and Holstad, along with the other authors.	
28448681	It has been suggested that people with autism spectrum disorder (ASD) have an increased tendency to use explicit (or intentional) learning strategies. This altered learning may play a role in the development of the social communication difficulties characterizing ASD. In the current study, we investigated incidental and intentional sequence learning using a Serial Reaction Time (SRT) task in an adult ASD population. Response times and event related potentials (ERP) components (N2b and P3) were assessed as indicators of learning and knowledge. Findings showed that behaviorally, sequence learning and ensuing explicit knowledge were similar in ASD and typically developing (TD) controls. However, ERP findings showed that learning in the TD group was characterized by an enhanced N2b, while learning in the ASD group was characterized by an enhanced P3. These findings suggest that learning in the TD group might be more incidental in nature, whereas learning in the ASD group is more intentional or effortful. Increased intentional learning might serve as a strategy for individuals with ASD to control an overwhelming environment. Although this led to similar behavioral performances on the SRT task, it is very plausible that this intentional learning has adverse effects in more complex social situations, and hence contributes to the social impairments found in ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28448442	Background: Autism is characterized by difficulties in social interaction, communication, and repetitive behaviors; with different degrees of severity in each of the core areas. Haploinsufficiency and point mutations of RAI1 are associated with Smith-Magenis syndrome (SMS), a genetic condition that scores within the autism spectrum range for social responsiveness and communication, and is characterized by neurobehavioral abnormalities, intellectual disability, developmental delay, sleep disturbance, and self-injurious behaviors. Methods: To investigate the relationship between Rai1 and social impairment, we evaluated the Rai1+/- mice with a battery of tests to address social behavior in mice. Results: We found that the mutant mice showed diminished interest in social odors, abnormal submissive tendencies, and increased repetitive behaviors when compared to wild type littermates. Conclusions: These findings suggest that Rai1 contributes to social behavior in mice, and prompt it as a candidate gene for the social behaviors observed in Smith-Magenis Syndrome patients.
28448228	Little attention has been given to sociable/unsociable communication in persons with dementia despite the importance of these behaviors in maintaining engagement in marital relationships. An observational measure of verbal and nonverbal communication in persons with dementia (Verbal and Nonverbal Interaction Scale-CR) who were engaged in conversations with spouses was tested for reliability and validity. Married persons with dementia were video-recorded at home conversing with spouses over 10 weeks (N = 118 recordings). Reliability [inter-coder (.92), test-retest (r =.61-.77), internal consistency (α =.65 -.79)] were adequate. Following an intervention, the Verbal and Nonverbal Interaction Scale-CR predicted improved communication over 10 weeks. The ratio of sociable to unsociable communication improved by 4.46 points per session [β = 4.46, t(10) = 1.96, p =.039]. VNVIS-CR is recommended to describe sociable and unsociable communication in persons with dementia as they engage in conversations with spouses.
28448061	Although there is considerable research into the genetic background of autism spectrum disorders, environmental factors are likely to contribute to the variation in prevalence over time. Rodent experiments indicate that environmental exposures can have effects on subsequent generations, and human studies indicate that parental prenatal exposures may play a part in developmental variation. Here we use the Avon Longitudinal Study of Parents and Children (ALSPAC) to test the hypothesis that if the mother or father (F1) had been exposed to their own mother's (F0) smoking during pregnancy, the offspring (F2) would be at increased risk of autism. We find an association between maternal grandmother smoking in pregnancy and grand daughters having adverse scores in Social Communication and Repetitive Behaviour measures that are independently predictive of diagnosed autism. In line with this, we show an association with actual diagnosis of autism in her grandchildren. Paternal grandmothers smoking in pregnancy showed no associations.
28447854	To discuss healthy diet from a psychological perspective by considering definitions of healthy diet in terms of consumer understanding; the health effects of specific dietary elements in terms of overweight and (chronic) illness; the prevalence of healthy diet; the psychological and environmental determinants of healthy diet; and the psychological interventions that have been designed to promote healthy diet.A systematic review of the psychological literature on healthy diet.	Our findings suggest that consumers have a relatively poor understanding of a healthy diet. The literature also demonstrates that there is poor evidence on the health protective effects of single foods or nutrients. We further show that low SES is the single consistent risk factor for not adhering to a healthy diet. Our review of the literature on determinants demonstrates that intentions, habits, self-regulatory skills, and the social and physical environment are the most important determinants of a healthy diet, which are in turn amenable to change by intervention strategies with varying levels of effectiveness. Educational interventions generally show a limited effect on practising a healthy diet whereas interventions targeting habitual behaviour and/or the physical environment seem more promising.	In view of the large number of people who are concerned about their diets and make attempts to change their dietary patterns, we conclude that it is crucial to gain a better understanding of both the automatic and environmental influences that are responsible for people not acting upon their good intentions for diet change.	
28447824	Reports an error in "Similar Representations of Emotions Across Faces and Voices" by Lisa Katharina Kuhn, Taeko Wydell, Nadine Lavan, Carolyn McGettigan and Lúcia Garrido (Emotion, Advanced Online Publication, Mar 02, 2017, np). (The following abstract of the original article appeared in record 2017-09406-001.) Emotions are a vital component of social communication, carried across a range of modalities and via different perceptual signals such as specific muscle contractions in the face and in the upper respiratory system. Previous studies have found that emotion recognition impairments after brain damage depend on the modality of presentation: recognition from faces may be impaired whereas recognition from voices remains preserved, and vice versa. On the other hand, there is also evidence for shared neural activation during emotion processing in both modalities. In a behavioral study, we investigated whether there are shared representations in the recognition of emotions from faces and voices. We used a within-subjects design in which participants rated the intensity of facial expressions and nonverbal vocalizations for each of the 6 basic emotion labels. For each participant and each modality, we then computed a representation matrix with the intensity ratings of each emotion. These matrices allowed us to examine the patterns of confusions between emotions and to characterize the representations of emotions within each modality. We then compared the representations across modalities by computing the correlations of the representation matrices across faces and voices. We found highly correlated matrices across modalities, which suggest similar representations of emotions across faces and voices. We also showed that these results could not be explained by commonalities between low-level visual and acoustic properties of the stimuli. We thus propose that there are similar or shared coding mechanisms for emotions which may act independently of modality, despite their distinct perceptual inputs. (PsycINFO Database Record
28447544	Posed stimuli dominate the study of nonverbal communication of emotion, but concerns have been raised that the use of posed stimuli may inflate recognition accuracy relative to spontaneous expressions. Here, we compare recognition of emotions from spontaneous expressions with that of matched posed stimuli. Participants made forced-choice judgments about the expressed emotion and whether the expression was spontaneous, and rated expressions on intensity (Experiments 1 and 2) and prototypicality (Experiment 2). Listeners were able to accurately infer emotions from both posed and spontaneous expressions, from auditory, visual, and audiovisual cues. Furthermore, perceived intensity and prototypicality were found to play a role in the accurate recognition of emotion, particularly from spontaneous expressions. Our findings demonstrate that perceivers can reliably recognise emotions from spontaneous expressions, and that depending on the comparison set, recognition levels can even be equivalent to that of posed stimulus sets.
28447466	To evaluate an intervention promoting adoption of occupational sun protection policies by employers in a randomized trial.A randomized pretest-posttest controlled design with 2-year follow-up was conducted in 2010 to 2013.	Local government organizations in Colorado who had outdoor workers in public works, public safety, and/or parks and recreation.	Ninety-eight local government organizations (n = 51 municipalities, 10 counties, and 37 special districts).	Organizations were randomly assigned to receive a policy and education intervention comprised of personal contacts and theory-based training and materials or to an attention control group.	Occupational policy documents were coded for sun safety content by a trained research assistant blind to condition.	Policy scores were analyzed with logistic and Poisson regression models using imputation.	At posttest, more organizations in the intervention group had a sun protection policy than in the control group (odds ratio [OR] = 4.91, P < .05; intent to treat: OR = 5.95, P < .05) and policies were more extensive (χ2 = 31.29, P < .01; intent to treat: χ2 =73.79, P < .01) and stronger (χ2 = 24.50, P < .01; intent to treat: χ2 = 51.95, P < .01). Policy adoption was higher when the number of contacts and trainings increased ( P < .05).	The intervention had a large effect on adoption of formal sun protection policies, perhaps because of its fit with legal requirements to maintain safe workplaces. Personal contacts with managers were influential on adoption of occupational policy even in this age of communication technology and social media.	
28447202	Dietary behaviours may be influenced by perceptions of barriers to healthy eating. Using data from a large cross-European study (N = 5900), we explored associations between various perceived barriers to healthy eating and dietary behaviours among adults from urban regions in five European countries and examined whether associations differed across regions and socio-demographic backgrounds.Frequency of consumption of fruit, vegetables, fish, fast food, sugar-sweetened beverages, sweets, breakfast and home-cooked meals were split by the median into higher and lower consumption. We tested associations between barriers (irregular working hours; giving up preferred foods; busy lifestyle; lack of willpower; price of healthy food; taste preferences of family and friends; lack of healthy options and unappealing foods) and dietary variables using multilevel logistic regression models. We explored whether associations differed by age, sex, education, urban region, weight status, household composition or employment.	Respondents who perceived any barrier were less likely to report higher consumption of healthier foods and more likely to report higher consumption of fast food. 'Lack of willpower', 'time constraints' and 'taste preferences' were most consistently associated with consumption. For example, those perceiving lack of willpower ate less fruit [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.50-0.64], and those with a busy lifestyle ate less vegetables (OR 0.54; 95% CI 0.47-0.62). Many associations differed in size, but not in direction, by region, sex, age and household composition.	Perceived 'lack of willpower', 'time constraints' and 'taste preferences' were barriers most strongly related to dietary behaviours, but the association between various barriers and lower intake of fruit and vegetables was somewhat more pronounced among younger participants and women.	
28447017	In this "digital age," the model of healthcare is changing rapidly, primarily in the area of communication that is happening among the major stakeholders each minute. Patients, being the central point of the importance of all the work and development, are more empowered than ever with information from various sources, among which social media is leading from the front. This article reviews how social media engages healthcare service providers, service seekers, and regulatory authorities. If the gaps in the current regulations are filled, better healthcare outputs can be triggered. This article also briefly explores the popular healthcare applications launched by leading pharmaceutical companies, encompassing the big data advantage, in this evolving era of patient centricity.
28446699	Collective foraging confers benefits in terms of reduced predation risk and access to social information, but it heightens local competition when resources are limited. In social insects, resource limitation has been suggested as a possible cause for the typical decrease in per capita productivity observed with increasing colony size, a phenomenon known as Michener's paradox. Polydomy (distribution of a colony's brood and workers across multiple nests) is believed to help circumvent this paradox through its positive effect on foraging efficiency, but there is still little supporting evidence for this hypothesis. Here, we show experimentally that polydomy enhances the foraging performance of food-deprived Temnothorax nylanderi ant colonies via several mechanisms. First, polydomy influences task allocation within colonies, resulting in faster retrieval of protein resources. Second, communication between sister nests reduces search times for far away resources. Third, colonies move queens, brood and workers across available nest sites in response to spatial heterogeneities in protein and carbohydrate resources. This suggests that polydomy represents a flexible mechanism for space occupancy, helping ant colonies adjust to the environment.
28446695	Predators may eavesdrop on their prey using innate signals of varying nature. In regards to social prey, most of the prey signals are derived from social communication and may therefore be highly complex. The most efficient predators select signals that provide the highest benefits. Here, we showed the use of eusocial prey signals by the termite-raiding ant Odontoponera transversaO. transversa selected the trail pheromone of termites as kairomone in several species of fungus-growing termites (Termitidae: Macrotermitinae: Odontotermes yunnanensis, Macrotermes yunnanensis, Ancistrotermes dimorphus). The most commonly predated termite, O. yunnanensis, was able to regulate the trail pheromone component ratios during its foraging activity. The ratio of the two trail pheromone compounds was correlated with the number of termites in the foraging party. (3Z)-Dodec-3-en-1-ol (DOE) was the dominant trail pheromone component in the initial foraging stages when fewer termites were present. Once a trail was established, (3Z,6Z)-dodeca-3,6-dien-1-ol (DDE) became the major recruitment component in the trail pheromone and enabled mass recruitment of nest-mates to the food source. Although the ants could perceive both components, they revealed stronger behavioural responses to the recruitment component, DDE, than to the common major component, DOE. In other words, the ants use the trail pheromone information as an indication of suitable prey abundance, and regulate their behavioural responses based on the changing trail pheromone component. The eavesdropping behaviour in ants therefore leads to an arms race between predator and prey where the species specific production of trail pheromones in termites is targeted by predatory ant species.
28446524	Rehabilitation measures for patients in the working age primarily aim at maintaining employability, restoring fitness for work or timely return to work (RTW). To facilitate RTW after long sick leave in Germany, both rehabilitation physicians' knowledge about the patients' workplace and communication between the rehabilitation physician and the occupational physician need to be improved. This research will record the experiences and attitudes of occupational physicians, rehabilitation physicians and general practitioners, as well as of rehabilitation patients, to indicate barriers and possibilities for improvement concerning the intersection between workplace and rehabilitation institution. As a previous literature review has shown, insufficient data on the experiences and attitudes of the stakeholders are available. Therefore, an exploratory qualitative approach was chosen.8 focus group discussions will be conducted with occupational physicians, rehabilitation physicians, general practitioners and rehabilitation patients (2 focus groups with 6-8 interviewees per category). Qualitative content analysis will be used to evaluate the data, thus describing positive and negative experiences and attitudes, barriers and possibilities for improvement at the intersection of general and occupational medicine and rehabilitation with regard to the workplace. The data from the focus groups will be used to develop a standardised quantitative questionnaire for a survey of the medical groups and rehabilitation patients in a follow-up project.	The research will be undertaken with the approval of the Ethics Committee of the Medical Faculty and University Hospital of Tuebingen. The study participants' consent will be documented in written form. The names of all study participants and all other confidential information data fall under medical confidentiality. The results will be published in a peer-reviewed medical journal independent of the nature of the results.	
28446367	Depression is the leading cause of disability worldwide. The suggested association between social media use (SMU) and depression may be explained by the emerging maladaptive use pattern known as problematic social media use (PSMU), characterized by addictive components.We aimed to assess the association between PSMU and depressive symptoms-controlling for overall time and frequency of SMU-among a large sample of U.S. young adults.	In October 2014, participants aged 19-32 (N = 1749) were randomly selected from a nationally-representative U.S. probability-based panel and subsequently invited to participate in an online survey. We assessed depressive symptoms using the validated Patient-Reported Outcomes Measurement Information System (PROMIS) brief depression scale. We measured PSMU using an adapted version of the Bergen Facebook Addiction Scale to encompass broader SMU. Using logistic regression models, we tested the association between PSMU and depressive symptoms, controlling for time and frequency of SMU as well as a comprehensive set of socio-demographic covariates.	In the multivariable model, PSMU was significantly associated with a 9% increase in odds of depressive symptoms (AOR [adjusted odds ratio] = 1.09; 95% CI [confidence interval]: 1.05, 1.13; p < 0.001.) Increased frequency of SMU was also significantly associated with increased depressive symptoms, whereas SMU time was not (AOR = 1.01; 95% CI: 1.00, 1.01; p = 0.001 and AOR = 1.00; 95% CI: 0.999-1.001; p = 0.43, respectively).	PSMU was strongly and independently associated with increased depressive symptoms in this nationally-representative sample of young adults. PSMU largely explained the association between SMU and depressive symptom, suggesting that it may be how we use social media, not how much, that poses a risk. Intervention efforts aimed at reducing depressive symptoms, such as screenings for maladaptive SMU, may be most successful if they address addictive components and frequency-rather than time-of SMU.	
28446164	Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient. The aim of this paper is to describe 'core information sets' which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals.The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this 'core information'. We propose that such information addresses the 'reasonable patient' standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient.	The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice.	
28446098	Mentors are vital for supporting nursing students' learning in practice, but increasing demands on registered nurses can make this a challenging part of their role. This article describes how a new education team in Jersey used the World Café approach to working with mentors on a mentor update day. It explains how the café environment helped mentors to share ideas, develop opportunities to support students' learning in practice areas, increase interdepartmental working and increased communication between the education department and mentors.
28446056	Augmentative and alternative communication (AAC) systems were introduced into clinical practice by therapists to help compensate for persistent language deficits in people with aphasia. Although, there is currently a push towards an increased focus on compensatory approaches in an attempt to maximize communication function for social interaction, available studies including AAC systems, especially technologically advanced communication tools and systems, known as 'high-technology AAC', show key issues and obstacles for these tools to become utilized in mainstream clinical practice. Areas covered: The current review synthesizes communication intervention studies that involved the use of high-technology communication devices to enhance linguistic communication skills for adults with post-stroke aphasia. The review focuses on compensatory approaches that emphasized functional communication. It also summarizes recommendations for the report of studies evaluating high-technology devices that may be potentially relevant for other researchers working with adults with post-stroke aphasia. Expert commentary: Taken together with positive results in heterogeneous studies, high-technology devices represent a compensatory strategy to enhance communicative skills in individuals with post-stroke aphasia. Improvements in the design of studies and reporting of results may lead to better interpretation of the already existing scientific results from aphasia management.
28445476	A large-scale experiment during the 2010 U.S. Congressional Election demonstrated a positive effect of an online get-out-the-vote message on real world voting behavior. Here, we report results from a replication of the experiment conducted during the U.S. Presidential Election in 2012. In spite of the fact that get-out-the-vote messages typically yield smaller effects during high-stakes elections due to saturation of mobilization efforts from many sources, a significant increase in voting was again observed. Voting also increased significantly among the close friends of those who received the message to go to the polls, and the total effect on the friends was likely larger than the direct effect, suggesting that understanding social influence effects is potentially even more important than understanding the direct effects of messaging. These results replicate earlier work and they add to growing evidence that online social networks can be instrumental for spreading offline behaviors.
28444467	Making correct inferences regarding social and individual intentions may be crucial for successful interactions, especially when we are required to discriminate between cooperative and competitive behaviors. The results of previous studies indicate that reach-to-grasp kinematic parameters may be used to infer the social or individual outcome of a movement. However, the majority of the studies investigated this ability by presenting reach-to-grasp movements from a third-person perspective only. The aim of the present study was to assess whether the ability to recognize the intent associated to a reach-to-grasp movement varies as a function of perspective by manipulating the perspective of observation (second- and third-perspective) within participants. To this end, we presented participants with video clips of models performing a reach-to-grasp movement with different intents. The video clips were recorded both from a lateral view (third-person perspective) and from a frontal view (second-person perspective). After viewing the clips, in two subsequent tasks participants were asked to distinguish between social and non-social intentions by observing the initial phase of the same action recorded from the two different views. Results showed that, when a fast-speed movement was presented from a lateral view, participants were able to predict its social intention. In contrast, when the same movement was observed from a frontal view, performance was impaired. These results indicate that the ability to detect social intentions from motor cues can be biased by the visual perspective of the observer, specifically for fast-speed movements.
28444458	The use of modern information and communication technologies (ICT) in daily life has significantly increased during the last several years. These essential online technologies have also found their way into the healthcare system. The use of modern ICT for health reasons can be summarized by the term 'eHealth'. Despite the potential importance of eHealth in the field of otorhinolaryngology (ORL), there is little understanding of patients' attitudes towards the deeper integration of these technologies into intersectoral care. The aim of this study was to gain a better understanding of patients' attitudes towards the use of modern ICT for intersectoral communication and information transfer in the field of ORL. Therefore, a structured interview was developed by an interdisciplinary team of otorhinolaryngologists, public health researchers, and information technology (IT) specialists. Overall, 211 ORL patients were interviewed at the Department of Otorhinolaryngology-Head and Neck Surgery, Tuebingen University Hospital, Germany, and 203 of these patients completed the interview. This study revealed ORL patients' perspectives on the potential of eHealth, especially for appointment scheduling, appointment reminders, and intersectoral communication of personal medical information. Furthermore, this study provides evidence that data security and the impacts of eHealth on the physician-patient relationship and on treatment quality warrant special attention in future research.
28444316	Synchrony in social groups may confer significant evolutionary advantages by improving group cohesion and social interaction. However, the neurobiological mechanisms translating social synchrony into refined social information transmission between interacting individuals are still elusive. In two successively conducted experiments involving a total of 199 healthy volunteers, we explored the involvement of the neuropeptide oxytocin (OXT) in reciprocal social interaction. First, we show that synchronous social interactions evoke heightened endogenous OXT release in dyadic partners. In a second step, we examined the consequences of elevated OXT concentrations on emotion transmission by intranasally administering synthetic OXT before recording emotional expressions. Intriguingly, our data demonstrate that the subjects' facial and vocal expressiveness of fear and happiness is enhanced after OXT compared to placebo administration. Collectively, our findings point to a central role of social synchrony in facilitating reciprocal communication between individuals via heightened OXT signaling. Elevated OXT concentrations among synchronized individuals seem to augment the partners' emotional expressiveness, thereby contributing to improved transmission of emotional information in social communication.
28443647	The idea of a hierarchical spatial organization of society lies at the core of seminal theories in human geography that have strongly influenced our understanding of social organization. Along the same line, the recent availability of large-scale human mobility and communication data has offered novel quantitative insights hinting at a strong geographical confinement of human interactions within neighboring regions, extending to local levels within countries. However, models of human interaction largely ignore this effect. Here, we analyze several country-wide networks of telephone calls - both, mobile and landline - and in either case uncover a systematic decrease of communication induced by borders which we identify as the missing variable in state-of-the-art models. Using this empirical evidence, we propose an alternative modeling framework that naturally stylizes the damping effect of borders. We show that this new notion substantially improves the predictive power of widely used interaction models. This increases our ability to understand, model and predict social activities and to plan the development of infrastructures across multiple scales.
28443371	Cost-related nonadherence (CRN) to recommended self-management behaviors among adults with chronic conditions such as diabetes is prevalent. Few behavioral interventions to mitigate CRN have been tested and evaluated.We developed a financial burden resource tool and examined its acceptability and the preliminary effects on patient-centered outcomes among adults with diabetes or prediabetes seen in a clinical setting.	We report a pre-post one-group design pilot study. From an endocrinology clinic, we recruited 104 adults with diabetes who reported financial burdens with their diabetes management or engaged in CRN behaviors. We offered participants the financial burden resource tool we developed, which provided tailored, low-cost resource options for diabetes management and other social needs. Acceptability and self-reported outcomes were assessed 2 months after use of the tool.	Mean age of participants was 50.5 years ( SD = 15.3). Participants found the tool highly acceptable across 15 indicators (e.g., 93% "learned a lot," 98% "topics relevant" 95% "applicable to their lives," 98% "liked the information"). Significant improvements between baseline and 2-month follow-up were observed for discussion of cost concerns with nurses (19% to 29%, p < .05) and pharmacists (13% to 25.5%, p < .01), not skipping doses of medicines due to cost (11% to 4%, p < .03), and financial management (33.83 to 39.62, p < .007). There were no significant changes in perception of financial burden.	A financial burden resource tool is highly acceptable to patients, is easy to administer, and can prompt behavior change. This pilot study supports the need for well-powered trials with longer follow-up to further evaluate the effectiveness of such tools in improving CRN and key outcomes.	
28443038	Mother-infant interactions during feeding and play are pivotal experiences in the development of infants' early social abilities (Stern, 1985, 1995; Biringen, 2000). Stern indicated distinctive characteristics of mother-infant interactions, respectively, during feeding and play, suggesting to evaluate both to better describe the complexity of such early affective and social experiences (Stern, 1996). Moreover, during the first years of life, infants acquire cognitive and social skills that allow them to interact with new social partners in extra-dyadic interactions. However, the relations between mother-child interactions and infants' social skills in extra-dyadic interactions are still unknown. We investigated longitudinally the relations between mother-child interactions during feeding and play and child's pre-verbal communicative abilities in extra-dyadic interactions during play. 20 dyads were evaluated at T1 (infants aged between 9-22 months) and 6 months later, at T2. The interdyadic differences in mother-infant interactions during feeding and play were evaluated, respectively, with the "Feeding Scale" (Chatoor et al., 1997) and with the "Play Scale" (Chatoor, 2006) and the socio-communicative abilities of children with a new social partner during play were evaluated with the "Early Social Communication Scales" (Mundy et al., 2003). We distinguished the dyads into two categories: dyads with functional interactions (high dyadic reciprocity, low dyadic conflict) and dyads with dysfunctional interactions (lower dyadic reciprocity, higher dyadic conflict). At T1, infants belonging to dyads with dysfunctional interactions were significantly lower in "Initiating Joint Attention" and in "Responding to Joint Attention" in interaction with a new social partner compared to the infants belonging to dyads with functional interactions. At T2, infants belonging to dyads with dysfunctional interactions were significantly lower in "Initiating Social Interactions" with a new social partner compared to the infants belonging to dyads with functional interactions. There were significant correlations between the quality of mother-infant interactions during feeding and infants' social abilities in interaction with a stranger both at T1 and at T2. This study showed a stable relation over time between mother-child interactions and child's social communicative skills in extra-dyadic interactions.

28442609	Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety.Compare interns' and residents' experiences, attitudes and factors associated with speaking up about traditional versus professionalism-related safety threats.	Anonymous, cross-sectional survey.	Six US academic medical centres, 2013-2014.	1800 medical and surgical interns and residents (47% responded).	Attitudes about, barriers and facilitators for, and self-reported experience with speaking up. Likelihood of speaking up and the potential for patient harm in two vignettes. Safety Attitude Questionnaire (SAQ) teamwork and safety scales; and Speaking Up Climate for Patient Safety (SUC-Safe) and Speaking Up Climate for Professionalism (SUC-Prof) scales.	Respondents more commonly observed unprofessional behaviour (75%, 628/837) than traditional safety threats (49%, 410/837); p<0.001, but reported speaking up about unprofessional behaviour less commonly (46%, 287/628 vs 71%, 291/410; p<0.001). Respondents more commonly reported fear of conflict as a barrier to speaking up about unprofessional behaviour compared with traditional safety threats (58%, 482/837 vs 42%, 348/837; p<0.001). Respondents were also less likely to speak up to an attending physician in the professionalism vignette than the traditional safety vignette, even when they perceived high potential patient harm (20%, 49/251 vs 71%, 179/251; p<0.001). Positive perceptions of SAQ teamwork climate and SUC-Safe were independently associated with speaking up in the traditional safety vignette (OR 1.90, 99% CI 1.36 to 2.66 and 1.46, 1.02 to 2.09, respectively), while only a positive perception of SUC-Prof was associated with speaking up in the professionalism vignette (1.76, 1.23 to 2.50).	Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm. Measuring SUC-Safe, and particularly SUC-Prof, may fill an existing gap in safety culture assessment.	
28442455	Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking.This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio.	Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation.	A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for the zBMI (b=-0.03 [0.02], P=.04) and the healthy snack ratio (b=-0.84 [0.37], P=.03). Attitude to eat healthy for appearance mediated both the fitness app use frequency-zBMI (a × b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a × b=0.04 [0.01], P=.001) associations. No mediation was observed for the associations between the frequency of use of fitness or nutrition apps and the healthy snack or beverage ratio.	Commercial fitness and nutrition apps show some association with healthier eating behaviors and BMI in adolescents. However, effective behavior change techniques should be included to affect key determinants of healthy eating.	
28442175	International guidelines promote active investigation and treatment of incontinence; however, these guidelines do not fully accommodate the psychosocial aspects associated with providing continence care i.e. the caregiving dynamics. The author developed a new framework that aims to support nurses and care workers in their efforts to identify and meet the continence care needs of individuals with complex health conditions who are dependent on another person for assistance to manage incontinence or to maintain continence. The framework is underpinned by two core concepts: 'dignity' and 'care', and is characterized by a focus on: empathic continence care; personhood in dementia; therapeutic communication; authentic partnership in continence care; acknowledging stigma, social taboos and courtesy stigma; and the need for a foundational continence assessment. This paper describes the Dignity in Continence Care Framework and suggests strategies for its use in the future education of nurses and care workers about continence care.
28442055	This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-to-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and 'emotional touchpoints' relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants' use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.
28442021	Although successful communication is at the heart of the clinical consultation, communication between Aboriginal patients and practitioners such as doctors, nurses and allied health professionals, continues to be problematic and is arguably the biggest barrier to the delivery of successful health care to Aboriginal people. This paper presents an overarching framework for practitioners to help them reorientate their communication with Aboriginal patients using 'clinical yarning'. Clinical yarning is a patient-centred approach that marries Aboriginal cultural communication preferences with biomedical understandings of health and disease. Clinical yarning consists of three interrelated areas: the social yarn, in which the practitioner aims to find common ground and develop the interpersonal relationship; the diagnostic yarn, in which the practitioner facilitates the patient's health story while interpreting it through a biomedical or scientific lens; and the management yarn, that employs stories and metaphors as tools for patients to help them understand a health issue so a collaborative management approach can be adopted. There is cultural and research evidence that supports this approach. Clinical yarning has the potential to improve outcomes for patients and practitioners.
28441333	A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her rehabilitation process, and how this is integrated with existing rehabilitation. The case study has been developed based on a semi-structured interview. A Thematic Content analysis was used to reveal dominant patterns and categories. This study revealed a lack of communication and collaboration between public administration (social service), service dog providers, health rehabilitation services, and providers of psychological treatment. It also revealed limited access for the dog to public services, limited success in incorporating the dog into goal-directed treatment and rehabilitation procedures, a strongly felt emotional support from the dog, and a perceived stigma by having the dog wearing a vest with he words "mentally ill" printed on it.
28441097	Efforts are underway to educate consumers about the dangers of smoking at the point of sale (POS). Research is limited about the efficacy of POS antismoking ads to guide campaign development. This study experimentally tests whether the type of antismoking ad and the context in which ads are viewed influence people's reactions to the ads. A national convenience sample of 7,812 adult current smokers and recent quitters was randomized to 1 of 39 conditions. Participants viewed one of the four types of antismoking ads (negative health consequences-graphic, negative social consequences-intended emotive, benefits of quitting-informational, benefits of quitting-graphic) in one of the three contexts (alone, next to a cigarette ad, POS tobacco display). We assessed participants' reactions to the ads, including perceived effectiveness, negative emotion, affective dissonance, and motivational reaction. Graphic ads elicited more negative emotion and affective dissonance than benefits of quitting ads. Graphic ads elicited higher perceived effectiveness and more affective dissonance than intended emotive ads. Antismoking ads fared best when viewed alone, and graphic ads were least influenced by the context in which they were viewed. These results suggest that in developing POS campaigns, it is important to consider the competitive pro-tobacco context in which antismoking ads will be viewed.
28440809	Pheromones regulate social and reproductive behavior in most mammalian species. These effects are mediated by the vomeronasal and main olfactory systems. Effects of putative pheromones on human neuroendocrine activity, brain activity and attractiveness ratings suggest that humans may communicate via similar chemosignaling. Here we studied two samples of younger and older individuals, respectively, with respect to one nonsynonymous polymorphism in the gene encoding the human vomeronasal type-1 receptor 1, VN1R1, and one nonsynonymous polymorphism in the gene encoding the olfactory receptor OR7D4. Participants in both samples had self-reported their sociosexual behavior using the sociosexual orientation inventory, including questions regarding lifetime number of one-night stands, number of partners last year and expected number of partners the coming 5 years. In women, there was a significant association between the VN1R1 polymorphism and sociosexual behavior in both samples, driven specifically by the question regarding one-night stands. Our results support the hypothesis that human social interaction is modulated by communication via chemosignaling.
28439790	In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.
28439751	Obtaining genetic testing insurance authorizations for patients is a complex, time-involved process often requiring genetic counselor (GC) and physician involvement. In an effort to mitigate this complexity and meet the increasing number of genetic testing insurance authorization requests, GCs formed a novel partnership with an industrial engineer (IE) and a patient services associate (PSA) to develop a streamlined work flow. Eight genetics clinics and five specialty clinics at the University of Michigan were surveyed to obtain benchmarking data. Tasks needed for genetic testing insurance authorization were outlined and time-saving work flow changes were introduced including 1) creation of an Excel password-protected shared database between GCs and PSAs, used for initiating insurance authorization requests, tracking and follow-up 2) instituting the PSAs sending GCs a pre-clinic email noting each patients' genetic testing insurance coverage 3) inclusion of test medical necessity documentation in the clinic visit summary note instead of writing a separate insurance letter and 4) PSAs development of a manual with insurance providers and genetic testing laboratories information. These work flow changes made it more efficient to request and track genetic testing insurance authorizations for patients, enhanced GCs and PSAs communication, and reduced tasks done by clinicians.
28439543	Predators of highly defensive prey likely develop cost-reducing adaptations. The ant Megaponera analis is a specialized termite predator, solely raiding termites of the subfamily Macrotermitinae (in this study, mostly colonies of Pseudocanthotermes sp.) at their foraging sites. The evolutionary arms race between termites and ants led to various defensive mechanisms in termites (for example, a caste specialized in fighting predators). Because M. analis incurs high injury/mortality risks when preying on termites, some risk-mitigating adaptations seem likely to have evolved. We show that a unique rescue behavior in M. analis, consisting of injured nestmates being carried back to the nest, reduces combat mortality. After a fight, injured ants are carried back by their nestmates; these ants have usually lost an extremity or have termites clinging to them and are able to recover within the nest. Injured ants that are forced experimentally to return without help, die in 32% of the cases. Behavioral experiments show that two compounds, dimethyl disulfide and dimethyl trisulfide, present in the mandibular gland reservoirs, trigger the rescue behavior. A model accounting for this rescue behavior identifies the drivers favoring its evolution and estimates that rescuing enables maintenance of a 28.7% larger colony size. Our results are the first to explore experimentally the adaptive value of this form of rescue behavior focused on injured nestmates in social insects and help us to identify evolutionary drivers responsible for this type of behavior to evolve in animals.
28439332	Friends are considered an important source of advice and information about sex. Conversations about sex among young people tend to generate norms that influence positive or negative pressure on individuals to conform to group standards. The aim of the study was to explore peer communication on sex and sexual health.Grounded theory qualitative study design was employed using focus group discussions and participant observation. Participants were selected using criterion purposive sampling. Semi-structured guides and checklists were used as data collection tools. Information was audio-recorded and transcribed verbatim and uploaded to ATLAS.ti 7 software for coding. Data collection and analysis were undertaken simultaneously using constant comparative analysis.	Students talked with peers and sexual partners about sex more than sexual health issues. Common places of talk included dormitory, begtera (near dorm where students meet), and space (reading rooms). Whereas, time of talk, either in a group or with just their close friends or sex partners, included during training, evening and weekend time, during walking together, and break time. Students used verbal and non-verbal and formal and informal communication styles.	The content, place, and time for discussions about sex were influenced by gender, social-cultural norms (e.g. religion), rural vs urban living, and the occurrence of sexual health issues (e.g, sexually-transmitted infections or unwanted pregnancies). Priority should be given to designing audience-specific strategies and messages to promote discussions about sex and to encourage safe sexual practices. Primary target groups should include female and rural students, who are predisposed to risky sexual behavior.	
28439328	Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia.A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values <0.05 were considered statistically significant.	Three hundred and nighty one in-school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%.	Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.	
28438726	Individuals with type 2 diabetes have an increased risk for comorbidities such as heart disease, lower limb amputations, stroke, and renal failure. Multiple factors influence development of complications in a person living with type 2 diabetes; however, an individual's self-management behaviors may delay the onset of, or lessen the severity of, these complications. Social support provides personal, informal advice and knowledge that helps individuals initiate and sustain self-management and adherence.Our aim was to gain an understanding of type 2 diabetes social interaction in a virtual environment, one type of computer-mediated environment (CME), and the social support characteristics that increase and sustain self-management in adults living with chronic illness.	This study is a secondary analysis of longitudinal data collected in a CME study, Second Life Impacts Diabetes Education & Self-Management (1R21-LM010727-01). This virtual environment replicated a real-life community where 6 months of naturalistic synchronous voice conversations, emails, and text chats were recorded among participants and providers. This analysis uses a mixed-methods approach to explore and compare qualitative and quantitative findings. This analysis is guided by two theories: Strong/Weak Ties Theory and Social Penetration Theory. Qualitative data will be analyzed using content analysis, and we will complete descriptive statistics on the quantified variables (eg, average number of ties). Institutional review board approval was obtained in June 2016.	This study is in progress.	Interventions provided through virtual environments are a promising solution to increasing self-management practices. However, little is known of the depth, breadth, and quality of social support that is exchanged and how interaction supports self-management and relates to health outcomes. This study will provide knowledge that will help guide clinical practice and policy to enhance social support for chronic illness via the Internet.	
28438638	Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by abnormal social interactions, repetitive behaviors that impair social communication, and circumscribed interests. BTBR T+tf/J (BTBR) inbred mice are generally used as a model for ASD, as they show repetitive behaviors and social deficits that resemble signs of ADS in humans. Adenosine A2A receptors (A2ARs) are considered as potential targets in the treatment of immune, inflammatory, and neurodegenerative diseases. In this study, we investigated the potential effects of the A2A adenosine receptor (A2AR) antagonist SCH 5826 (SCH) and agonist CGS 21680 (CGS) on behavior (self-grooming), hot plate test results, and expression levels of IL-17A+, RORγt+, Foxp3+, and IL-10+ in CD4+ T spleen cells in BTBR and C57BL/6 (B6) mice. We also assessed IL-17A, RORγt, Stat3, pStat3, Foxp3, and IL-10 mRNA and protein expression levels in the brain tissue. The CGS-treated mice showed a significantly altered self-grooming score and a reduced response to the hot plate test. The results further revealed that the SCH efficiently increased the IL-17A+ and RORγt+ expression levels and decreased the Foxp3+ and IL-10+ expression levels in CD4+ cells. However, the treatment with CGS significantly reversed these effects. In addition, CGS significantly decreased the IL-17A, RORγt, Stat3, and pStat3 levels and increased the Foxp3 and IL-10 mRNA and protein expression levels as compared with the BTBR control and SCH treatments. Our results clearly indicate that the CGS A2AR agonist may represent a unique target for future therapeutic strategies for neuroimmune dysfunction.
28438584	Family members of critically ill patients who participate in research focused on palliative care issues have been found to be systematically different from those who do not. These differences threaten the validity of research and raise ethical questions about worsening disparities in care by failing to represent diverse perspectives.This study's aims were to explore: 1) barriers and facilitators influencing family members' decisions to participate in palliative care research; and 2) potential methods to enhance research participation.	Family members who were asked to participate in a randomized trial testing the efficacy of a facilitator to improve clinician-family communication in the intensive care unit (ICU). Family members who participated (n = 17) and those who declined participation (n = 7) in Family Communication Study were interviewed about their recruitment experiences. We also included family members of currently critically ill patients to assess current experiences (n = 4). Interviews were audio-recorded and transcribed. Investigators used thematic analysis to identify factors influencing family members' decisions. Transcripts were co-reviewed to synthesize codes and themes.	Three factors influencing participants' decisions were identified: Altruism, Research Experience, and Enhanced Resources. Altruism and Research Experience described intrinsic characteristics that are less amenable to strategies for improving participation rates. Enhanced Resources reflects families' desires for increased access to information and logistical and emotional support.	Family members found their recruitment experiences to be positive when staff were knowledgeable about the ICU, sensitive to the stressful circumstances, and conveyed a caring attitude. By training research staff to be supportive of families' emotional needs and need for logistical knowledge about the ICU, recruitment of a potentially more diverse sample of families may be enhanced.	
28438437	The extralinguistic and paralinguistic aspects of the language refer to higher-order language functions such as lexical-semantic processes, prosody, indirect speech acts or discourse comprehension and production. Studies suggest that these processes are mediated by the Right Hemisphere (RH) and there is also some evidence of RH dysfunctions in schizophrenia. The aim of the paper is to investigate the extralinguistic and paralinguistic processing mediated by Right Hemisphere in schizophrenia patients using a validated and standardized battery of tests.Two groups of participants were examined: a schizophrenia sample (40 participants) and a control group (39 participants). Extralinguistic and paralinguistic processing was assessed in all subjects by the Polish version of the Right Hemisphere Language Battery (RHLB-PL), which measures comprehension of implicit information, naming, understanding humor, inappropriate remarks and comments, explanation and understanding of metaphors, understanding emotional and language prosody and discourse understanding.	Schizophrenia patients scored significantly lower than controls in subtests measuring comprehension of implicit information, interpretation of humor, explanation of metaphors, inappropriate remarks and comments, discernment of emotional and language prosody and comprehension of discourse. No differences were observed in naming, understanding metaphors or in processing visuo-spatial information.	Extralinguistic and paralinguistic dysfunctions appear to be present in schizophrenia patients and they suggest that RH processing may be disturbed in that group of patients. As the disturbances of higher-order language processes mediated by the RH may cause serious impairments in the social communication of patients, it is worth evaluating them during clinical examination.	
28438103	Technological advances toward consumer-specific expectations require a sustained commitment and coordination across policy- and decision-makers. The present scenario-based study aimed at identifying prevailing perceptions regarding telehealth applications among Austrian healthcare experts. During a two-round online Delphi survey, panelists rated perceived benefits, obstacles, innovativeness, desirability, and estimated implementation date of 10 telehealth scenarios. Panelists (n = 73, 74% males) perceived that the implementation of telehealth scenarios could especially improve patients' knowledge, quality of social healthcare, and living standard. In contrast, the three top-ranked obstacles were costs, technical prerequisites, and data security. Survey participants rated innovativeness of the presented future scenarios as quite high, whereas perceived desirability was moderate. Overall, ratings suggested precautious attitudes toward technological innovations. The survey findings suggest building taskforces and enhancing communication between healthcare stakeholders to proactively shape the future of telehealth in Austria.
28438076	There is a relative lack of longitudinal studies investigating stroke-specific outcomes and quality of life (QOL). This study aimed to identify which factors (level of disability, cognitive functioning, depressive symptoms, physical activity, and work and social engagement) were independently associated with each stroke-specific domain of QOL, adjusting for age and gender, at 3 months and 12 months post-stroke in an Australian cohort.Survivors of ischemic stroke were recruited from 18 sites of the STroke imAging pRevention and Treatment (START) longitudinal cohort study. Survivors were assessed at 3 months (n = 185) and 12 months (n = 170) post-stroke using the Stroke Impact Scale (SIS), modified Rankin Scale (mRS), Montreal Cognitive Assessment (MoCA), Montgomery-Asberg Depression Rating Scale, Rapid Assessment of Physical Activity, and Work and Social Adjustment Scale (WSAS).	WSAS was independently associated with the SIS domains of: Physical Composite function; Participation; and Perceived Recovery at 3 months and 12 months and SIS domain of Emotion at 12 months post-stroke. The presence of depressive symptoms was independently associated with the SIS domains of: Memory and Thinking; and Emotion at 3 months. At 12 months post-stroke, mRS was independently associated with SIS domain of Physical Composite function and MoCA with SIS domain of Communication.	Engaging in work and social activities is an important factor associated with stroke-specific domains of QOL over time. It is recommended that services focus on improving work and social engagement given their importance related to QOL in the first year of recovery post-stroke. Identifying and treating those with depressive symptoms may enhance QOL in the early months post-stroke.	
28436545	This study investigated transfer effects of gaze-interactive attention training to more complex social and cognitive skills in infancy. Seventy 9-month-olds were assigned to a training group (n = 35) or an active control group (n = 35). Before, after, and at 6-week follow-up both groups completed an assessment battery assessing transfer to nontrained aspects of attention control, including table top tasks assessing social attention in seminaturalistic contexts. Transfer effects were found on nontrained screen-based tasks but importantly also on a structured observation task assessing the infants' likelihood to respond to an adult's social-communication cues. The results causally link basic attention skills and more complex social-communicative skills and provide a principle for studying causal mechanisms of early development.
28436388	The early diagnosis of dementia is of great clinical and social importance. A recent study using the qualitative methodology of conversation analysis (CA) demonstrated that language and communication problems are evident during interactions between patients and neurologists, and that interactional observations can be used to differentiate between cognitive difficulties due to neurodegenerative disorders (ND) or functional memory disorders (FMD).This study explores whether the differential diagnostic analysis of doctor-patient interactions in a memory clinic can be automated.	Verbatim transcripts of conversations between neurologists and patients initially presenting with memory problems to a specialist clinic were produced manually (15 with FMD, and 15 with ND). A range of automatically detectable features focusing on acoustic, lexical, semantic, and visual information contained in the transcripts were defined aiming to replicate the diagnostic qualitative observations. The features were used to train a set of five machine learning classifiers to distinguish between ND and FMD.	The mean rate of correct classification between ND and FMD was 93% ranging from 97% by the Perceptron classifier to 90% by the Random Forest classifier.Using only the ten best features, the mean correct classification score increased to 95%.	This pilot study provides proof-of-principle that a machine learning approach to analyzing transcripts of interactions between neurologists and patients describing memory problems can distinguish people with neurodegenerative dementia from people with FMD.	
28435420	The objective of this study was to assess a model for improving healthcare integration for patients with multiple chronic diseases in an integrated healthcare organisation in the Basque Country and to propose areas for improvement.We organised four nominal groups composed of representatives from different categories of clinicians involved in the development of an integrated healthcare organisation and in the integrated care of patients with multiple diseases, namely, internists, general practitioners, and primary care and hospital nurses.	The aspect rated most positively was the concept itself of an integrated care model, which is able to improve communication between levels of care, increase the quality of the care provided and enhance patient safety. Additionally, it was agreed that the role of assigned clinicians is a key element. The problems identified mostly concern its implementation in daily practice.	The results of this study made it possible to suggest at least 8 areas of improvement to be implemented. These are related to: nurses' roles; care and monitoring of stable patients; team work; communication with patients; coordination with social workers and between internists and family doctors; as well as the development of an office of medical services to lead the integration process.	
28435419	The article presents an analysis of the formulation and implementation of a social innovation: integrated home care (IHC) in post-soviet Lithuania. From 1998 a series of top-down orders to implement IHC were issued, however, home nursing did not start. In 2011 the Ministry of Social Security and Labour began a process to develop integrated home care using new, collaborative processes. The result was 21 pilot projects with well-conceptualized IHC services.Using data from focus groups, interviews, and recorded observations, the research team systematically documented the innovation process, including themes and deviations, employing Smale's Innovation Trinity framework to organize the larger picture.	In the Lithuanian post-totalitarian context, top-down communication was found to be prevalent. Not only IHC, but also openness to change and dialogue at high levels were innovations. Patient-centered practice at local levels could only occur when a new attitude of mind was reached through dialogue with officials at higher levels and between peers.	The enactment, rather than the mask of dialogue, participatory program development were critical in the success of IHC innovation. This is difficult to achieve in the light of antiquated public bureaucracies, but in this case, the Ministry team, rather than avoiding the expectation of top-down communication, made it into an asset through promotion of collaboration.	
28434427	Fish oil contains omega-3 fatty acids, which play a vital role in fetal growth and development. In utero exposure to omega-3 fatty acids is exclusively dependent on maternal nutrition. Previous studies have suggested that prenatal fish oil supplementation has positive impacts on child neurodevelopment later in life. This study examines the associations between fish oil supplementation both before pregnancy and throughout pregnancy and subsequent child development. Mother-child pairs from the Upstate KIDS Study, a birth cohort consisting of children born between 2008 and 2010, were included. Self-reported prenatal fish oil supplementation data were available for 5845 children (3807 singletons and 2038 twins). At multiple time points, from 4 months to 3 years of age, child development was reported by the parents on the Ages and Stages Questionnaire (ASQ). Five developmental domains were assessed: fine motor, gross motor, communication, personal-social functioning and problem solving. Generalized linear mixed models were used to estimate odds ratios (OR) while adjusting for covariates. Primary analyses showed that the risk of failing the ASQ problem-solving domain was significantly lower among children of women who took fish oil before pregnancy (OR 0.40, 95% confidence intervals (CI) 0.18-0.89) and during pregnancy (OR 0.43, 95% CI 0.22-0.83). Gender interaction was not statistically significant, although stratified results indicated stronger associations among girls. Similarly, associations were primarily among singletons. Prenatal fish oil supplementation may be beneficial in regards to neurodevelopment. Specifically, it is associated with a lower risk of failing the problem-solving domain up to 3 years of age.
28434402	Communication for Development (C4D) is a strategy promoted by the United Nations Children's Fund to foster positive and measurable changes at the individual, family, community, social, and policy levels of society. In western China, C4D activities have previously been conducted as part of province-level immunization programs. In this study, we evaluated the association of C4D with changes in parental knowledge of immunization services, measles disease, and measles vaccine, and changes in their children's measles vaccine coverage.From April 2013 to April 2014, C4D activities were implemented as part of provincial immunization programs in the Inner Mongolia, Guangxi, Chongqing, Guizhou, Tibet, Shaanxi, Gansu, Ningxia, and Qinghai provinces. We used a before-and-after study design and employed face-to-face interviews to assess changes in parental knowledge and vaccination coverage.	We surveyed 2 107 households at baseline and 2 070 households after 1 year of C4D activities. Following C4D, 95% of caregivers were aware of the vaccination record check requirement for entry into kindergarten and primary school; 80% of caregivers were aware that migrant children were eligible for free vaccination; more than 70% of caregivers knew that measles is a respiratory infectious disease; and 90% of caregivers knew the symptoms of measles. Caregivers' willingness to take their children to the clinic for vaccination increased from 51.3% at baseline to 67.4% in the post-C4D survey. Coverage of one-dose measles-containing vaccine (MCV) increased from 83.8% at baseline to 90.1% after C4D. One-dose MCV coverage was greater than 95% in the Guangxi, Shaanxi, and Gansu provinces. Two-dose MCV coverage increased from 68.5 to 77.6%. House-to-house communication was the most popular C4D activity among caregivers (91.6% favoring), followed by posters and educational talks (64.8 and 49.9% favoring).	C4D is associated with increased caregiver knowledge about measles, increased willingness to seek immunization services for their children, and increased measles vaccination coverage. Tailored communication strategies based on insights gained from these analyses may be able to increase vaccination coverage in hard-to-reach areas. C4D should be considered for larger scale implementation in China.	
28433857	Joint attention (JA) is hypothesized to have a close relationship with developing theory of mind (ToM) capabilities. We tested the co-occurrence of ToM and JA in social interactions between adults with no reported history of psychiatric illness or neurodevelopmental disorders. Participants engaged in an experimental task that encouraged nonverbal communication, including JA, and also ToM activity. We adapted an in-lab variant of experience sampling methods (Bryant et al., 2013) to measure ToM during JA based on participants' subjective reports of their thoughts while performing the task. This experiment successfully elicited instances of JA in 17/20 dyads. We compared participants' thought contents during episodes of JA and non-JA. Our results suggest that, in adults, JA and ToM may occur independently.
28433792	A common social impairment in individuals with ASD is difficulty interpreting and or predicting emotions of others. To date, several interventions targeting teaching emotion recognition and understanding have been utilized both by researchers and practitioners. The results suggest that teaching emotion recognition is possible, but that the results do not generalize to non-instructional contexts. This study sought to replicate earlier findings of a positive impact of teaching emotion recognition using a computer-based intervention and to extend it by testing for generalization on live models in the classroom setting.Two boys and one girl, four to eight years in age, educated in self-contained classrooms for students with communication and social skills deficits, participated in this study. A multiple probe across participants design was utilized. Measures of emotion recognition and understanding were assessed at baseline, intervention, and one month post-intervention to determine maintenance effects. Social validity was assessed through parent and teacher questionnaires.	All participants showed improvements in measures assessing their recognition of emotions in faces, generalized knowledge to live models, and maintained gains one month post intervention.	These preliminary results are encouraging and should be utilized to inform a group design, in order to test efficacy with a larger population.	
28433401	Fine-tuning communication is well documented in mammalian social play which relies on a large variety of specific and non-specific signals. Facial expressions are one of the most frequent patterns in play communication. The reciprocity of facial signals expressed by the players provides information on their reciprocal attentional state and on the correct perception/decoding of the signal itself. Here, for the first time, we explored the Relaxed Open Mouth (ROM), a widespread playful facial expression among mammals, in the South American sea lion (Otaria flavescens). In this species, like many others, ROM appears to be used as a playful signal as distinct from merely being a biting action. ROM was often reciprocated by players. Even though ROM did not vary in frequency of emission as a function of the number of players involved, it was reciprocated more often during dyadic encounters, in which the players had the highest probability to engage in a face-to-face interaction. Finally, we found that it was the reciprocation of ROMs, more than their frequency performance, that was effective in prolonging playful bouts. In conclusion, ROM is widespread in many social mammals and O. flavescens is not an exception. At least in those species for which quantitative data are available, ROM seems to be characterized by similar design features clearly indicating that the signal underwent to similar selective pressures.
28432920	Using stress process theory and structural equation modelling, this study investigated the complex relationship between health status, family strain, dependency, and the life satisfaction of rural older adults with reported functional impairments in India. Data were extracted from a large-scale study of 903 randomly selected adults aged 61 years and older from 30 rural clusters of India. The sample for this study was confined to 653 older adults who reported functional impairments. Structural equation modelling showed that poor health status indirectly lowered the life satisfaction of older adults through family strains. Moreover, poor health status also indirectly influenced life satisfaction through dependency and family strain (poor health→dependency→family strains→life satisfaction). The findings indicate that for professionals who deal with the health of older adults, exploring relationship strains and dependency is vital to the assessment and intervention of subjective wellbeing. Inter-sectoral coordination and communication between healthcare and social service agencies might facilitate effective management of health problems among older adults. Moreover, taking family strains and dependency into account when caring for older adults with health problems is critical to help improve their quality of life and maintain their wellbeing.
28432823	Twitter is a public microblogging platform that overcomes physical limitations and allows unrestricted participation beyond academic silos, enabling interactive discussions. Twitter-based journal clubs have demonstrated growth, sustainability, and worldwide communication, using a hashtag (#) to follow participation. This article describes the first year of #GeriMedJC, a monthly 1-hour live, 23-hour asynchronous Twitter-based complement to the traditional-format geriatric medicine journal club. The Twitter moderator tweets from the handle @GeriMedJC; encourages use of #GeriMedJC; and invites content experts, study authors, and followers to participate in critical appraisal of medical literature. Using the hashtag #GeriMedJC, tweets were categorized according to thematic content, relevance to the journal club, and authorship. Third-party analytical tools Symplur and Twitter Analytics were used for growth and effect metrics (number of followers, participants, tweets, retweets, replies, impressions). Qualitative analysis of follower and participant profiles was used to establish country of origin and occupation. A semistructured interview of postgraduate trainees was conducted to ascertain qualitative aspects of the experience. In the first year, @GeriMedJC has grown to 541 followers on six continents. Most followers were physicians (43%), two-thirds of which were geriatricians. Growth metrics increased over 12 months, with a mean of 121 tweets, 25 participants, and 105,831 impressions per journal club. Tweets were most often related to the article being appraised (87.5%) and ranged in thematic content from clinical practice (29%) to critical appraisal (24%) to medical education (20%). #GeriMedJC is a feasible example of using social media platforms such as Twitter to encourage international and interprofessional appraisal of medical literature.
28432211	Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21.We constructed an ABS frame, partially supplemented with auxiliary data, to recruit this hard-to-reach sample. Branded and tested mail-based recruitment materials were designed to bring respondents online for screening, consent and surveying. Once enrolled, respondents completed online surveys every 6 months via computer, tablet or smartphone. Numerous strategies were utilized to enhance retention and representativeness RESULTS: Results detail sample performance, representativeness and retention rates as well as device utilization trends for survey completion among youth and young adult respondents. Panel development efforts resulted in a large, nationally representative sample with high retention rates.	This study is among the first to employ this hybrid ABS-to-online methodology to recruit and retain youth and young adults in a probability-based online cohort panel. The approach is particularly valuable for conducting research among younger populations as it capitalizes on their increasing access to and comfort with digital communication. We discuss challenges and opportunities of panel recruitment and retention methods in an effort to provide valuable information for tobacco control researchers seeking to obtain representative, population-based samples of youth and young adults in the U.S. as well as across the globe.	
28432104	The function of the honey bee tremble dance and how it attracts signal receivers is poorly understood. We tested the hypothesis that tremble followers and waggle followers exhibit the same dance-following behavior. If correct, this could unify our understanding of dance following, provide insight into dance information transfer, and offer a way to identify the signal receivers of tremble dance information. Followers showed similar initial attraction to and tracking of dancers. However, waggle dancers were faster than tremble dancers, and follower-forward, -sideways, and -angular velocities were generally similar to the velocities of their respective dancers. Waggle dancers attracted followers from 1.3-fold greater distances away than tremble dancers. Both follower types were attracted to the lateral sides of dancers, but tremble followers were more attracted to the dancer's head, and waggle followers were more attracted to the dancer's abdomen. Tremble dancers engaged in 4-fold more brief food exchanges with their followers than waggle dancers. The behaviors of both follower types are therefore relatively conserved. Researchers can now take the next steps, observing tremble followers to determine their subsequent behaviors and testing the broader question of whether follower attraction and tracking is conserved in a wide range of social insects.
28431579	Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation.EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN implementation indicators from TSN program database.	EvaTSN is a challenging French national project for the production of evidenced-based information on HI technologies impact and on the context and conditions of their effectiveness and efficiency. We will be able to support health care management in order to implement HI technologies. We will also be able to produce an evaluation toolkit for HI technology evaluation.	
28431547	Home environment has an important influence on children's fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire's Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children's FV intake. This study's aims were to assess: 1) did asking behaviors at baseline predict home FV availability at baseline (T0) (RQ1); 2) were asking behaviors and home FV availability influenced by the intervention (RQ2); 3) did increases in asking behaviors predict increased home FV availability (RQ3); and 4) did increases in asking behaviors and increases in home FV availability mediate increases in FV intake among children (RQ4)?This is a secondary analysis of a study using a randomized controlled trial, with 4 groups (each n = 100 child-parent dyads). All groups were analyzed together for this paper since groups did not vary on components relevant to our analysis. All children and parents (n = 400 dyads) received a self-regulation serious game intervention and parent material. The intervention ran for three months. Measurements were taken at baseline, immediately after intervention and at 3-month follow-up. Asking behavior and home FV availability were measured using questionnaires; child FV intake was measured using 24-h dietary recalls. ANCOVA methods (research question 1), linear mixed-effect models (research question 2), and Structural Equation Modeling (research questions 3 and 4) were used.	Baseline child asking behaviors predicted baseline home FV availability. The intervention increased child asking behaviors and home FV availability. Increases in child asking behaviors, however, did not predict increased home FV availability. Increased child asking behaviors and home FV availability also did not mediate the increases in child FV intake.	Children influence their home FV environment through their asking behaviors, which can be enhanced via a serious game intervention. The obtained increases in asking behavior were, however, insufficient to affect home FV availability or intake. Other factors, such as child preferences, sample characteristics, intervention duration and parental direct involvement may play a role and warrant examination in future research.	
28431300	The aim of the study was to investigate how high math-anxious (HMA) individuals react to errors in an arithmetic task. Twenty HMA and 19 low math-anxious (LMA) individuals were presented with a multi-digit addition verification task and were given response feedback. Post-error adjustment measures (response time and accuracy) were analyzed in order to study differences between groups when faced with errors in an arithmetical task. Results showed that both HMA and LMA individuals were slower to respond following an error than following a correct answer. However, post-error accuracy effects emerged only for the HMA group, showing that they were also less accurate after having committed an error than after giving the right answer. Importantly, these differences were observed only when individuals needed to repeat the same response given in the previous trial. These results suggest that, for HMA individuals, errors caused reactive inhibition of the erroneous response, facilitating performance if the next problem required the alternative response but hampering it if the response was the same. This stronger reaction to errors could be a factor contributing to the difficulties that HMA individuals experience in learning math and doing math tasks.
28430377	To identify factors that influence lack of engagement of young adults with Type 1 diabetes (aged 13-21 years) with structured diabetes education (SDE) to inform and broaden the reach of future SDE.A quantitative, cross-sectional survey was undertaken of 227 young people with Type 1 diabetes drawn from 11 health trusts across Northern Ireland and England, deemed to be representative of the wider population. Participants were asked to complete a questionnaire exploring non-attendance, along with the Diabetes Care Profile, the Diabetes Empowerment Scale (Short Form), the Diabetes Knowledge Test and the 12-item General Health Questionnaire. Demographic, health and diabetes-specific variables including HbA1c were also collected.	The five most commonly cited reasons for non-attendance were 'Had other things to do' (68.3%), 'No time' (62.2%), 'Could not get time off school/college or work' (60.8%), 'Learnt about diabetes from other sources' (55.5%) and 'Feel able to cope on own' (52.9%).	Greater emphasis is required on communication with young people about the benefits of SDE. In addition, efforts need to be directed to making diabetes education more accessible without losing the quality of structured programmes.	
28429988	Objective Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment. Barriers to patient safety were described as lack of sufficient resources; lack of communication and negative attitudes to incident reporting. To a great extent, nurses' work for patient safety consists of efforts to compensate for defects and ensure good health care in their daily work, since work with patient safety is not a management priority. Conclusion Patient safety needs to be clarified and prioritized in nursing homes, and there is a need to understand nurses' role among other care givers and the need for shared routines among care givers.
28429958	This study examines the implications of a history of personal violence on health and health behaviors. A secondary analysis of cross-sectional data involving adults (n = 214) from a semirural area in southern Louisiana between October 2008 and December 2010 was conducted to ascertain the association between a personal history of violence victimization and indicators of sexual health behaviors and outcomes: communication with sexual partners about HIV status, consistent condom use, and sexually transmitted infection (STI). While violence victimization is widely accepted as a risk factor for high-risk sex behavior, the mechanisms underlying violence victimization's influence on sexual health outcomes remain unclear. Bivariate analyses demonstrated a significant positive association between experience of physical abuse and lifetime history of STI. Surprisingly, respondents reporting lifetime physical violence were more than two times more likely to ask sexual partners about HIV status [odds ratio (OR) for physical attack = 2.23, 95% confidence intervals (CI) = 1.00-4.97; OR for physical injury = 4.60, 95% CI = 1.79-11.85]. Consistent condom use was not significantly associated with violence exposure in adjusted models. There was no evidence that communication with sexual partners mediated the relationship between experiences of violence and condom use. The link between personal history of violence and condom use may be mediated through alternative pathways beyond communication.
28429816	Early language skills are critical for later academic success. Lower socioeconomic status (SES) children tend to start school with limited language skills compared to advantaged peers. We test the hypothesis that this is due in part to differences in caregiver contingent talk during infancy (how often the caregiver talks about what is in the focus of the infant's attention).In a randomised controlled trial with high and low SES families, 142 11-month olds and their caregivers were randomly allocated to either a contingent talk intervention or a dental health control. Families in the language intervention watched a video about contingent talk and were asked to practise it for 15 min a day for a month. Caregiver communication was assessed at baseline and after 1 month. Infant communication was assessed at baseline, 12, 15, 18 and 24 months.	At baseline, social gradients were observed in caregiver contingent talk to their 11-month olds (but not in infant communication). At posttest, when infants were 12 months old, caregivers across the SES spectrum who had been allocated to the language intervention group engaged in significantly more contingent talk. Lower SES caregivers in this intervention group also reported that their children produced significantly more words at 15 and 18 months. Effects of the intervention did not persist at 24 months. Instead expressive vocabulary at this age was best predicted by baseline infant communication, baseline contingent talk and SES.	A social gradient in children's communication emerges during the second year of life. A low-intensity intervention demonstrated that it is possible to increase caregiver contingent talk and that this is effective in promoting vocabulary growth for lower SES infants in the short term. However, these effects are not long-lasting, suggesting that follow-up interventions may be necessary to yield benefits lasting to school entry.	
28429620	Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents. Interviews were analyzed using directed qualitative content analysis. Physicians provided a variety of perspectives on decision making for treatment that fell into 3 overarching themes: approach to surgery and alternatives, communication and decision making with families, and sociocultural factors/barriers to care. Perspectives were moderately heterogeneous, suggesting that individual social and relational elements may significantly influence how physicians refer patients and recommend treatment, and how parents choose surgery for this prevalent condition. These findings will inform development of culturally competent communication strategies and support tools to enhance shared decision making for physicians treating children with SDB.
28429618	Research studies using existing samples of individuals with autism spectrum disorders have identified differences in symptoms between males and females. Differences are typically reported in school age and adolescence, with similarities in symptom presentation at earlier ages. However, existing studies on sex differences are significantly limited, making it challenging to discern if, how, and at what point in development females with autism spectrum disorder actually exhibit a different behavioral presentation than males. The purpose of this study was to gather impressions from a large group of clinicians to isolate specific areas for future study of sex differences. Clinicians were surveyed about their opinions and perceptions of symptom severity in females, as compared to males, at different points during development. They were also asked to provide open-ended responses about female symptom presentation. Consistent with previous literature, clinicians noted more sex-related differences in restricted and repetitive behaviors and fewer differences for social communication features. Differences were most commonly observed in school age and adolescence, suggesting this time period as a critical and particularly vulnerable window for females with autism spectrum disorder. The results are discussed in the context of other male/female differences across development so that more targeted investigations of autism spectrum disorder sex differences across development.
28429376	The study aims to evaluate the prevalence of nursing home (NH) resident crying and associated factors at the individual and NH levels.A regional retrospective study design has been used.	A total of 8875 residents, living in 105 NHs, were included.	The occurrence of an episode of crying on at least a daily basis in the last month was the dependent variable; independent variables were set at individual and at the NH levels as reported in the Val.Graf regional database.	A total of 1,443 (16.3%) residents reported daily episodes of crying over the last month. Several individual variables were significantly associated with crying; female gender (odds ratio [OR] 2.535, 95% confidence interval [CI] 2.069-3.107); sad, pained or worried facial expressions (OR 1.885, 95% CI 1.785-2.021); negative thoughts (OR 1.650, 95% CI 1.508-1.804); unrealistic fears (OR 1.410, 95% CI 1.295-1.534); anger with self or others (OR 1.141, 95% CI 1.043-1.248); repetitive anxious complaints/concerns (OR 1.136, 95% CI 1.045-1.235); clinical instability (OR 1.186, 95% CI 1.018-1.381); pain (OR 1.183, 95% CI 1.058-1.323); night restlessness (OR 1.180, 95% CI 1.100-1.267); communication problems (OR 1.169, 95% CI 1.051-1.300); and cognitive impairment (OR 1.086, 95% CI 1.019-1.156); all increased the likelihood of crying. Conversely, sociability (OR 0.866, 95% CI 0.805-0.932) and being involved in social based activities (OR 0.882, 95% CI 0.811-0.960) were protective against crying. However, the previously mentioned variables have explained only 35.9% of variance in daily crying.	Around one out of six residents living in NH cries on a daily basis, and the reasons are also at the individual level. Residents seem to cry for attachment and clinical needs and to express stress and unhappiness; more research is needed, aiming at discovering other factors associated with resident's daily crying. Copyright © 2017 John Wiley & Sons, Ltd.	
28428170	Mobile phone use and the adoption of healthy lifestyle software apps ("health apps") are rapidly proliferating. There is limited information on the users of health apps in terms of their social demographic and health characteristics, intentions to change, and actual health behaviors.The objectives of our study were to (1) to describe the sociodemographic characteristics associated with health app use in a recent US nationally representative sample; (2) to assess the attitudinal and behavioral predictors of the use of health apps for health promotion; and (3) to examine the association between the use of health-related apps and meeting the recommended guidelines for fruit and vegetable intake and physical activity.	Data on users of mobile devices and health apps were analyzed from the National Cancer Institute's 2015 Health Information National Trends Survey (HINTS), which was designed to provide nationally representative estimates for health information in the United States and is publicly available on the Internet. We used multivariable logistic regression models to assess sociodemographic predictors of mobile device and health app use and examine the associations between app use, intentions to change behavior, and actual behavioral change for fruit and vegetable consumption, physical activity, and weight loss.	From the 3677 total HINTS respondents, older individuals (45-64 years, odds ratio, OR 0.56, 95% CI 0.47-68; 65+ years, OR 0.19, 95% CI 0.14-0.24), males (OR 0.80, 95% CI 0.66-0.94), and having degree (OR 2.83, 95% CI 2.18-3.70) or less than high school education (OR 0.43, 95% CI 0.24-0.72) were all significantly associated with a reduced likelihood of having adopted health apps. Similarly, both age and education were significant variables for predicting whether a person had adopted a mobile device, especially if that person was a college graduate (OR 3.30). Individuals with apps were significantly more likely to report intentions to improve fruit (63.8% with apps vs 58.5% without apps, P=.01) and vegetable (74.9% vs 64.3%, P<.01) consumption, physical activity (83.0% vs 65.4%, P<.01), and weight loss (83.4% vs 71.8%, P<.01). Individuals with apps were also more likely to meet recommendations for physical activity compared with those without a device or health apps (56.2% with apps vs 47.8% without apps, P<.01).	The main users of health apps were individuals who were younger, had more education, reported excellent health, and had a higher income. Although differences persist for gender, age, and educational attainment, many individual sociodemographic factors are becoming less potent in influencing engagement with mobile devices and health app use. App use was associated with intentions to change diet and physical activity and meeting physical activity recommendations.	
28428164	The recent Zika outbreak witnessed the disease evolving from a regional health concern to a global epidemic. During this process, different communities across the globe became involved in Twitter, discussing the disease and key issues associated with it. This paper presents a study of this discussion in Twitter, at the nexus of location, actors, and concepts.Our objective in this study was to demonstrate the significance of 3 types of events: location related, actor related, and concept related, for understanding how a public health emergency of international concern plays out in social media, and Twitter in particular. Accordingly, the study contributes to research efforts toward gaining insights on the mechanisms that drive participation, contributions, and interaction in this social media platform during a disease outbreak.	We collected 6,249,626 tweets referring to the Zika outbreak over a period of 12 weeks early in the outbreak (December 2015 through March 2016). We analyzed this data corpus in terms of its geographical footprint, the actors participating in the discourse, and emerging concepts associated with the issue. Data were visualized and evaluated with spatiotemporal and network analysis tools to capture the evolution of interest on the topic and to reveal connections between locations, actors, and concepts in the form of interaction networks.	The spatiotemporal analysis of Twitter contributions reflects the spread of interest in Zika from its original hotspot in South America to North America and then across the globe. The Centers for Disease Control and World Health Organization had a prominent presence in social media discussions. Tweets about pregnancy and abortion increased as more information about this emerging infectious disease was presented to the public and public figures became involved in this.	The results of this study show the utility of analyzing temporal variations in the analytic triad of locations, actors, and concepts. This contributes to advancing our understanding of social media discourse during a public health emergency of international concern.	
28428158	Oral chemotherapy is increasingly used in place of traditional intravenous chemotherapy to treat patients with cancer. While oral chemotherapy includes benefits such as ease of administration, convenience, and minimization of invasive infusions, patients receive less oversight, support, and symptom monitoring from clinicians. Additionally, adherence is a well-documented challenge for patients with cancer prescribed oral chemotherapy regimens. With the ever-growing presence of smartphones and potential for efficacious behavioral intervention technology, we created a mobile health intervention for medication and symptom management.The objective of this study was to develop and evaluate the usability and acceptability of a smartphone app to support adherence to oral chemotherapy and symptom management in patients with cancer.	We used a 5-step development model to create a comprehensive mobile app with theoretically informed content. The research and technical development team worked together to develop and iteratively test the app. In addition to the research team, key stakeholders including patients and family members, oncology clinicians, health care representatives, and practice administrators contributed to the content refinement of the intervention. Patient and family members also participated in alpha and beta testing of the final prototype to assess usability and acceptability before we began the randomized controlled trial.	We incorporated app components based on the stakeholder feedback we received in focus groups and alpha and beta testing. App components included medication reminders, self-reporting of medication adherence and symptoms, an education library including nutritional information, Fitbit integration, social networking resources, and individually tailored symptom management feedback. We are conducting a randomized controlled trial to determine the effectiveness of the app in improving adherence to oral chemotherapy, quality of life, and burden of symptoms and side effects. At every stage in this trial, we are engaging stakeholders to solicit feedback on our progress and next steps.	To our knowledge, we are the first to describe the development of an app designed for people taking oral chemotherapy. The app addresses many concerns with oral chemotherapy, such as medication adherence and symptom management. Soliciting feedback from stakeholders with broad perspectives and expertise ensured that the app was acceptable and potentially beneficial for patients, caregivers, and clinicians. In our development process, we instantiated 7 of the 8 best practices proposed in a recent review of mobile health app development. Our process demonstrated the importance of effective communication between research groups and technical teams, as well as meticulous planning of technical specifications before development begins. Future efforts should consider incorporating other proven strategies in software, such as gamification, to bolster the impact of mobile health apps. Forthcoming results from our randomized controlled trial will provide key data on the effectiveness of this app in improving medication adherence and symptom management.	
28426999	To investigate the current state of knowledge about emotional intelligence and affective events that arise during nursing students' clinical placement experiences.Narrative literature review.	CINAHL, MEDLINE, PsycINFO, Scopus, Web of Science, ERIC and APAIS-Health databases published in English between 1990 and 2016.	Data extraction from and constant comparative analysis of ten (10) research articles.	We found four main themes: (1) emotional intelligence buffers stress; (2) emotional intelligence reduces anxiety associated with end of life care; (3) emotional intelligence promotes effective communication; and (4) emotional intelligence improves nursing performance.	The articles we analysed adopted a variety of emotional intelligence models. Using the Ashkanasy and Daus "three-stream" taxonomy (Stream 1: ability models; 2: self-report; 3: mixed models), we found that Stream 2 self-report measures were the most popular followed by Stream 3 mixed model measures. None of the studies we surveyed used the Stream 1 approach. Findings nonetheless indicated that emotional intelligence was important in maintaining physical and psychological well-being. We concluded that developing emotional intelligence should be a useful adjunct to improve academic and clinical performance and to reduce the risk of emotional distress during clinical placement experiences. We call for more consistency in the use of emotional intelligence tests as a means to create an empirical evidence base in the field of nurse education.	

28426356	Adolescence is associated with smoking initiation among men in China. The lack of qualitative studies using Chinese adolescent samples can pose challenges to enacting effective smoking prevention messages that resonate with male Chinese teenagers' thoughts, needs, and wishes.This focus group study was designed to obtain in-depth contextual information on early smoking among male teenagers in China.	Twenty focus groups of 7-10 male students from vocational and junior colleges (N = 165) were conducted, approximately half in Shanxi and half in Guangdong.	A large number of early smoking activities occurred in homes and schools, and teenagers considered school toilets and dorms safe havens for smoking. Many participants' first cigarettes were offered to them by peers, others first smoked during social interactions, and some started smoking of their own volition. Teenagers were curious about the attributes of cigarette products, smoking techniques, and physical reactions. More participants disclosed negative first smoking experiences than positive experiences. Negative first physical experiences motivated some participants to acquire better smoking techniques. Smoking experimentation was sustained in part by reciprocated cigarette offers. Heavy experimentation occurred before graduation from high school. Conclusions/Importance: The current findings provide an empirical basis for developing intervention strategies that are alternative or complementary to the current conventional health education. These strategies include cognitive response methods to enhance antismoking beliefs, smoke-free social interaction norms, and school-based (e.g., peer education) and home-based (e.g., involving family members) intervention programs.	
28426301	To evaluate the HOLA en Grupos intervention, a Spanish-language small-group behavioral HIV prevention intervention designed to increase condom use and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men.In 2012 to 2015, we recruited and randomized 304 Hispanic/Latino men who have sex with men, aged 18 to 55 years in North Carolina, to the 4-session HOLA en Grupos intervention or an attention-equivalent general health education comparison intervention. Participants completed structured assessments at baseline and 6-month follow-up. Follow-up retention was 100%.	At follow-up, relative to comparison participants, HOLA en Grupos participants reported increased consistent condom use during the past 3 months (adjusted odds ratio [AOR] = 4.1; 95% confidence interval [CI] = 2.2, 7.9; P < .001) and HIV testing during the past 6 months (AOR = 13.8; 95% CI = 7.6, 25.3; P < .001). HOLA en Grupos participants also reported increased knowledge of HIV (P < .001) and sexually transmitted infections (P < .001); condom use skills (P < .001), self-efficacy (P < .001), expectancies (P < .001), and intentions (P < .001); sexual communication skills (P < .01); and decreased fatalism (P < .001).	The HOLA en Grupos intervention is efficacious for reducing HIV risk behaviors among Hispanic/Latino men who have sex with men.	
28426166	Due to its attributes, characteristics, and technological resources, the mobile phone (MP) has become one of the most commonly used communication devices. Historically, ample evidence has ruled out the substantial short-term impact of radiofrequency electromagnetic field (RF-EMF) emitted by MP on human cognitive performance. However, more recent evidence suggests potential harmful effects associated with MP EMF exposure. The aim of this review is to readdress the question of whether the effect of MP EMF exposure on brain function should be reopened. We strengthen our argument focusing on recent neuroimaging and electroencephalography studies, in order to present a more specific analysis of effects of MP EMF exposure on neurocognitive function. Several studies indicate an increase in cortical excitability and/or efficiency with EMF exposure, which appears to be more prominent in fronto-temporal regions and has been associated with faster reaction time. Cortical excitability might also underpin disruption to sleep. However, several inconsistent findings exist, and conclusions regarding adverse effects of EMF exposure are currently limited. It also should be noted that the crucial scientific question of the effect of longer-term MP EMF exposure on brain function remains unanswered and essentially unaddressed. Bioelectromagnetics. 38:329-338, 2017. © 2017 Wiley Periodicals, Inc.
28426115	The number of migrants and refugees in Europe in the past few years has increased dramatically due to war, violence or prosecutions in their homeland. Migration may affect physical, mental and social health. The objective of this article is to assess migrants and refugees' health problems, and to recommend appropriate interventions.A PubMed search of published articles on health problems of newly arrived migrants and refugees was conducted from 2003 through 2016, focusing on the current refugee crisis in Europe.	In addition to communicable diseases, such as respiratory, gastrointestinal and dermatologic infections, non-communicable diseases, including chronic conditions, mental and social problems, account for a significant morbidity burden in newly arrived migrants and refugees. Vaccine-preventable diseases are also of outmost importance. The appropriate management of newly arrived refugees and migrants' health problems is affected by barriers to access to health care including legal, communication, cultural and bureaucratic difficulties. There is diversity and lack of integration regarding health care provision across Europe due to policy differences between health care systems and social services.	There is a notable burden of communicable and non-communicable diseases among newly arrived migrants and refugees. Provision of health care at reception and temporary centres should be integrated and provided by a multidisciplinary team Appropriate health care of migrants and refugees could greatly enhance their health and social status which will benefit also the host countries at large.	
28425776	Acquired communication disorders (ACD), following stroke and traumatic brain injury, may not be correctly identified in Aboriginal Australians due to a lack of linguistically and culturally appropriate assessment tools. Within this paper we explore key issues that were considered in the development of the Aboriginal Communication Assessment After Brain Injury (ACAABI) - a screening tool designed to assess the presence of ACD in Aboriginal populations.A literature review and consultation with key stakeholders were undertaken to explore directions needed to develop a new tool, based on existing tools and recommendations for future developments.	The literature searches revealed no existing screening tool for ACD in these populations, but identified tools in the areas of cognition and social-emotional wellbeing. Articles retrieved described details of the content and style of these tools, with recommendations for the development and administration of a new tool. The findings from the interview and focus group views were consistent with the approach recommended in the literature.	There is a need for a screening tool for ACD to be developed but any tool must be informed by knowledge of Aboriginal language, culture and community input in order to be acceptable and valid.	
28425022	Impairments in social interaction and communication are critical features of ASD but the underlying processes are poorly understood. An under-explored area is the social motor synchronization that happens when we coordinate our bodies with others. Here, we explored the relationships between dynamical measures of social motor synchronization and assessments of ASD traits. We found (a) spontaneous social motor synchronization was associated with responding to joint attention, cooperation, and theory of mind while intentional social motor synchronization was associated with initiating joint attention and theory of mind; and (b) social motor synchronization was associated with ASD severity but not fully explained by motor problems. Findings suggest that objective measures of social motor synchronization may provide insights into understanding ASD traits.
28424643	Teaching is reportedly rare in hunter-gatherer societies, raising the question of whether it is a species-typical trait in humans. A problem with past studies is that they tend to conceptualize teaching in terms of Western pedagogical practices. In contrast, this study proceeds from the premise that teaching requires the ostensive manifestation of generalizable knowledge: the teacher must signal intent to share information, indicate the intended recipient, and transmit knowledge that is applicable beyond the present context. Certain features of human communication appear to be ostensive in function (e.g., eye contact, pointing, contingency, prosodic variation), and collectively serve as "natural pedagogy." Tellingly, oral storytelling in forager societies typically employs these and other ostensive behaviors, and is widely reported to be an important source of generalizable ecological and social knowledge. Despite this, oral storytelling has been conspicuously overlooked in studies of teaching in preliterate societies. Accordingly, this study presents evidence that oral storytelling involves the use of ostension and the transmission of generic knowledge, thereby meeting the criteria of pedagogy.
28424194	Evidence has shown that, despite wide variation in models of care, community-based specialist palliative care teams can improve outcomes and reduce acute care use at end of life. The goal of this study was to explore similarities in care practices among effective and diverse specialist teams to inform the development of other community-based teams.Interviews with 78 providers and administrators from 11 distinct community-based specialist palliative care teams from Ontario, Canada were conducted. Interviews were audio-recorded, transcribed and analysed using an inductive approach to identify common themes.	3 key themes across all teams emerged. First, the distinct models of care were generally summarised into 3 models: primary care and specialist providers either collaborated by transferring, sharing or consulting in care. Second, teams explicitly or implicitly followed 7 common care practices related to: specialised expertise 24/7; intrateam communication; timeliness; physical symptom and psychosocial-spiritual management; education; peace and fulfilment; and advocacy for patient preferences. Third, all teams emphasised the importance of team building, even more than using clinical tools and processes.	Despite wide variation in models of care among community-based specialist palliative care teams, this large qualitative study identified several common themes in care practices that can guide the development of other teams.	
28423992	The release of World Health Organisation guidelines recommending the prophylactic use of daily Truvada® for all populations at high risk of acquiring HIV opens the way for implementation of oral pre-exposure prophylaxis (PrEP). The impact of new prevention technologies is, however, dependent on demand creation strategies such as user awareness, acceptability and access, which in turn are influenced by sociocultural and gender norms. This study was conducted in three locations in KwaZulu-Natal, urban, rural and peri-urban, with six participatory workshops. Knowledge, desirable features of a product and demand positioning for PrEP were assessed using a participatory action media research process which included art-based activities and group discussion using a semi-structured interview schedule. The data were analysed using thematic analysis. The key themes that emerged in relation to product adoption were: ability to maintain secrecy of product use; the need for agency with personal choices around HIV prevention; and an increased desire for HIV protection. Findings reaffirm the influence of user engagement in understanding the sociocultural dynamics that influence demand creation for PrEP adoption.
28423919	Joint attention - the ability to coordinate attention with a social partner - is critical for social communication, learning and the regulation of interpersonal relationships. Infants and young children with autism demonstrate impairments in both initiating and responding to joint attention bids in naturalistic settings. However, little is known about joint attention abilities in adults with autism. Here, we tested 17 autistic adults and 17 age- and nonverbal intelligence quotient-matched controls using an interactive eye-tracking paradigm in which participants initiated and responded to joint attention bids with an on-screen avatar. Compared to control participants, autistic adults completed fewer trials successfully. They were also slower to respond to joint attention bids in the first block of testing but performed as well as controls in the second block. There were no group differences in responding to spatial cues on a non-social task with similar attention and oculomotor demands. These experimental results were mirrored in the subjective reports given by participants, with some commenting that they initially found it challenging to communicate using eye gaze, but were able to develop strategies that allowed them to achieve joint attention. Our study indicates that for many autistic individuals, subtle difficulties using eye-gaze information persist well into adulthood.
28423823	Advanced health and social services paradigms are supported by a comprehensive set of domains managed by different scientific disciplines. Interoperability has to evolve beyond information and communication technology (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. So, the system must properly reflect the environment in front and around the computer as essential and even defining part of the health system. This paper introduces an ICT-independent system-theoretical, ontology-driven reference architecture model allowing the representation and harmonization of all domains involved including the transformation into an appropriate ICT design and implementation. The entire process is completely formalized and can therefore be fully automated.
28423820	Personal health records (PHRs) offer tantalising benefits for patients and healthcare providers, including improvements in patient-provider communication, patient empowerment, and access to data and information. A suspicion that disadvantaged patients are less likely to use or benefit from PHRs stimulated a research agenda that included: (a) a literature review; and (b) empirical analysis of eight years' hospital admission and discharge data linked to measures of patient social disadvantage. The results demonstrated an association between disadvantage, increased use of public hospital services and barriers to PHR use. These findings may appear self-evident, but dramatically highlight how disadvantaged patients continue to be overlooked in many e-health design processes, and are rarely a focus of user centred design. The paper concludes by briefly considering the implications of this invisibility.
28422986	The transition from single-cell to multicellular behavior is important in early development but rarely studied. The starvation-induced aggregation of the social amoeba Dictyostelium discoideum into a multicellular slug is known to result from single-cell chemotaxis towards emitted pulses of cyclic adenosine monophosphate (cAMP). However, how exactly do transient, short-range chemical gradients lead to coherent collective movement at a macroscopic scale? Here, we developed a multiscale model verified by quantitative microscopy to describe behaviors ranging widely from chemotaxis and excitability of individual cells to aggregation of thousands of cells. To better understand the mechanism of long-range cell-cell communication and hence aggregation, we analyzed cell-cell correlations, showing evidence of self-organization at the onset of aggregation (as opposed to following a leader cell). Surprisingly, cell collectives, despite their finite size, show features of criticality known from phase transitions in physical systems. By comparing wild-type and mutant cells with impaired aggregation, we found the longest cell-cell communication distance in wild-type cells, suggesting that criticality provides an adaptive advantage and optimally sized aggregates for the dispersal of spores.
28422898	To characterize Internet and social media use among adults with moderate to severe traumatic brain injury (TBI) and to compare demographic and socioeconomic factors associated with Internet use between those with and without TBI.Ten Traumatic Brain Injury Model Systems centers.	Persons with moderate to severe TBI (N = 337) enrolled in the TBI Model Systems National Database and eligible for follow-up from April 1, 2014, to March 31, 2015.	Prospective cross-sectional observational cohort study.	Internet usage survey.	The proportion of Internet users with TBI was high (74%) but significantly lower than those in the general population (84%). Smartphones were the most prevalent means of Internet access for persons with TBI. The majority of Internet users with TBI had a profile account on a social networking site (79%), with more than half of the sample reporting multiplatform use of 2 or more social networking sites.	Despite the prevalence of Internet use among persons with TBI, technological disparities remain in comparison with the general population. The extent of social media use among persons with TBI demonstrates the potential of these platforms for social engagement and other purposes. However, further research examining the quality of online activities and identifying potential risk factors of problematic use is recommended.	
28422613	A gap in childhood cancer outcomes remains between developed and developing countries. Persistence of this gap may be caused by financial, social, or educational disparities. Twinning and distance learning initiatives may improve such disparities. Integrating telemedicine into pediatric oncology twinning programs enhances education and facilitates patient-centered capacity building.We performed an analysis of Web-based meetings held from August 2005 through July 2009 between the International Outreach Program at St. Jude Children's Research Hospital and the Instituto Materno Infantil de Pernambuco (IMIP) in Recife, Brazil. We determined the effect of these online conferences on the development and implementation of an innovative protocol for children with acute lymphoblastic leukemia (ALL) at IMIP.	Meetings occurred in 45 months of the 48-month study period with an average of two meetings per month. A total of 163 new patients were discussed during the study period; we retrieved documentation of patient-related discussions for 147 of them, constituting 286 discussions. On average, each patient was discussed 1.9 times (range, 1-15 discussions/patient). Compared with that of the era predating the online meetings (1993-2005), overall mortality, early death, and relapse of patients with ALL decreased after the telemedicine program was instituted at IMIP.	Personal dedication and institutional support are essential for successful telemedicine initiatives. Documentation and archival of meetings are important for accurately measuring outcomes and developing methods for improved care.	Integration of telemedicine into twinning programs facilitates communication about interventions, leading to improved outcomes of pediatric patients with cancer.	
28422561	Discussing goals of care and advance care planning is beneficial, yet how to best integrate goals of care communication into clinical care remains unclear.To develop and determine the feasibility of a structured goals of care communication guide for nurses and social workers.	Developmental study with providers in an academic and Veterans Affairs (VA) health system (n = 42) and subsequent pilot testing with patients with chronic obstructive pulmonary disease or heart failure (n = 15) and informal caregivers (n = 4) in a VA health system. During pilot testing, the communication guide was administered, followed by semistructured, open-ended questions about the content and process of communication. Changes to the guide were made iteratively, and subsequent piloting occurred until no additional changes emerged.	Provider and patient feedback to the communication guide.	Iterative input resulted in the goals of care communication guide. The guide included questions to elicit patient understanding of and attitudes toward the future of illness, clarify values and goals, identify end-of-life preferences, and agree on a follow-up plan. Revisions to guide content and phrasing continued during development and pilot testing. In pilot testing, patients validated the importance of the topic; none said the goals of care discussion should not be conducted. Patients and informal caregivers liked the final guide length (∼30 minutes), felt it flowed well, and was clear.	In this developmental and pilot study, a structured goals of care communication guide was iteratively designed, implemented by nurses and social workers, and was feasible based on administration time and acceptability by patients and providers.	
28422519	Why is it so difficult to resist the desire to use social media? One possibility is that frequent social media users possess strong and spontaneous hedonic reactions to social media cues, which, in turn, makes it difficult to resist social media temptations. In two studies (total N = 200), we investigated less-frequent and frequent social media users' spontaneous hedonic reactions to social media cues using the Affect Misattribution Procedure-an implicit measure of affective reactions. Results demonstrated that frequent social media users showed more favorable affective reactions in response to social media (vs. control) cues, whereas less-frequent social media users' affective reactions did not differ between social media and control cues (Studies 1 and 2). Moreover, the spontaneous hedonic reactions to social media (vs. control) cues were related to self-reported cravings to use social media and partially accounted for the link between social media use and social media cravings (Study 2). These findings suggest that frequent social media users' spontaneous hedonic reactions in response to social media cues might contribute to their difficulties in resisting desires to use social media.
28422518	Based on the theory of normative social behavior (Rimal & Real, 2005), this study examined the effects of descriptive norms, close versus distal peer injunctive norms, and interdependent self-construal on college students' intentions to consume alcohol. Results of a cross-sectional study conducted among U.S. college students (N = 581) found that descriptive norms, close, and distal peer injunctive norms had independent effects on college students' intentions to consume alcohol. Furthermore, close peer injunctive norms moderated the effects of descriptive norms on college students' intentions to consume alcohol and the interaction showed different patterns among students with a strong and weak interdependent self-construal. High levels of close peer injunctive norms weakened the relationship between descriptive norms and intentions to consume alcohol among students with a strong interdependent self-construal but strengthened the relationship between descriptive norms and intentions to consume alcohol among students with a weak interdependent self-construal. Implications of the findings for norms-based research and college drinking interventions are discussed.
28422296	Sociologists have tended to frame medical gatekeeping as an exclusionary social practice, delineating how practitioners and clerical staff police the moral boundaries of medicine by keeping out patients who are categorised as 'bad', 'deviant', or otherwise problematic. Yet medical gatekeeping, understood more broadly, can include not only keeping patients out of particular clinical settings, but also redirecting them to alternative sources of care. In this article, I draw on qualitative analysis of audio-recorded patient-provider interactions in a United States emergency department (ED) to illustrate medical gatekeeping as a two-step process of, first, categorising certain patient complaints as unsuitable for treatment within a particular setting, and second, diverting patients to alternative sites for care. I refer to these as the restrictive and facilitative components of medical gatekeeping to denote how each relates to patients' access to care, recognising that both components of medical gatekeeping are part of a coordinated organisational strategy for managing resource scarcity. By illustrating how ED providers reveal intimate knowledge of structural vulnerabilities in diverting socioeconomically disadvantaged patients with chronic back pain to clinical sites that are better equipped to provide care, I suggest that we rethink the emphasis on restrictive practices in sociological accounts of medical gatekeeping.
28422169	A key element thought to have changed during domestication is dogs' propensity to communicate with humans, particularly their inclination to gaze at them. A classic test to measure this is the 'unsolvable task', where after repeated successes in obtaining a reward by object-manipulation, the animal is confronted with an unsolvable version of the task. 'Looking back' at humans has been considered an expression of dogs seeking help. While it occurs more in dogs than in socialized wolves, the level of exposure to human communication also appears to play a role. We tested similarly raised adult wolves and mixed breed dogs, pet dogs and free-ranging dogs. Unlike previous studies, as well as species and levels of socialization, we included 'persistence' in trying to solve the task as a potential explanatory factor. Wolves were more persistent than all dog groups. Regardless of socialization or species, less persistent animals looked back sooner and longer. Free-ranging dogs, despite little exposure to dog-human communication, behaved similarly to other dogs. Together, results suggest that basic wolf-dog differences in motivation and exploration may override differences in human-directed behaviour when animals are equally socialized, and that once the human is considered a social partner, looking behaviour occurs easily.
28422133	Autism spectrum disorder (ASD) is a heterogeneous group of disorders characterized by problems with social interaction, communication, and repetitive and restricted behavior. Despite its high heritability and the substantial progress made in elucidating genetic associations, the corresponding biological mechanisms are largely unknown. Our objective is to investigate the contribution of common genetic variation to biological pathways functionally involved in ASD. We conducted gene-set analyses to identify ASD-associated functional biological pathways using the statistical tools MAGMA and INRICH. Gene-set selection was based on previously reported associations with psychiatric disorders and resulted in testing of specific synaptic and glial sets, a glutamate pathway gene-set, mitochondrial gene-sets and gene-sets consisting of fragile X mental retardation protein (FMRP) targets. In total 32 gene-sets were tested. We used Psychiatric Genomics Consortium genome-wide association studies summary statistics of ASD. The study is based on the largest ASD sample to date (N=5305). We found one significantly associated gene-set consisting of FMRP-targeting transcripts (MAGMA: p corr.=0.014, INRICH: p corr.=0.031; all competitive P-values). The results indicate the involvement of FMRP-targeted transcripts in ASD in common genetic variation. This novel finding is in line with the literature as FMRP has been linked to fragile X syndrome, ASD and cognitive development in whole-exome sequencing and copy number variant studies. This gene-set has also been linked to Schizophrenia suggesting that FMRP-targeted transcripts might be involved in a general mechanism with shared genetic etiology between psychiatric disorders.
28422091	Gaining information about conspecifics via long-distance vocalizations is crucial for social and spatially flexible species such as the African elephant (Loxodonta africana). Female elephants are known to discriminate individuals and kin based on acoustic cues. Specifically, females approached the loudspeaker exclusively with playbacks of familiar individuals with high association indexes, intentionally fusing with their affiliates. For males, which are less bonded, gathering social information via vocalizations could still have important implications, but little is known about their vocal discrimination skills. We experimentally tested the ability of male African elephants to discriminate the social rumbles of familiar (from the same population) versus unfamiliar females. Male elephants discriminated and preferentially moved towards the rumbles of unfamiliar females, showing longer attentive reactions and significantly more orientating (facing and approaching the speaker) behavior. The increased orientating response of males towards playbacks of unfamiliar females is converse to the reaction of female subjects. Our results provide evidence that male elephants extract social information from vocalizations, yet with a different intention than females. Accordingly, males might use social cues in vocalizations to assess mating opportunities, which may involve selection to identify individuals or kin in order to avoid inbreeding.
28421695	We evaluated a structured intervention programme aimed at preparing adolescents with developmental language disorders for job interviews. Our primary outcome measures included change in ratings of verbal and non-verbal social communication behaviours evident during mock interviews.In study 1, 12 participants, aged 17-19 years, from a specialist sixth-form college completed the intervention and two mock interviews, one pre- and one post-intervention. In study 2, 34 participants, aged 17-19 years, completed a modified intervention programme and three mock interviews, one at baseline (included to control for possible practise effects), one pre- and one post-intervention. In both studies, interviews were video recorded and social communication behaviours were coded by independent assessors blind to interview time, participant diagnosis and therapy content. A repeated-measures design was employed to measure change in communication behaviours.	In study 1, a significant increase in the number of 'positive' verbal and non-verbal social communication behaviours was observed from pre- to post-intervention. However, there was no significant change in the number of 'negative' behaviours (i.e., fidgeting, irrelevant remarks). In study 2, there were no significant changes in verbal behaviours, but significant group differences (though wide individual variation) in both positive and negative non-verbal social communication behaviours.	Our findings suggest that training specific social communication skills that are important for interview success, and consistently reinforcing those behaviours during therapy practice, can increase the use of those skills in an interview setting, though in this heterogeneous population there was considerable variation in therapy outcome. The skills of the interviewer were identified as a potential source of variation in outcome, and a target for future research and practice.	
28421646	There is some evidence that vocabulary intervention is effective for children, although further research is needed to confirm the impact of intervention within contexts of social disadvantage. Very little is known about the effectiveness of interventions to increase adolescent knowledge of cross-curriculum words.To evaluate the effectiveness of an intervention programme designed to develop adolescents' knowledge of cross-curriculum words.	Participants were 35 adolescents aged between 12 and 14 years who were at risk of educational underachievement with low scores on a range of assessments. Participants received a 10-week intervention programme in small groups, targeting 10 cross-curriculum words (e.g., 'summarize'). This was evaluated using a bespoke outcome measure (the Word Knowledge Profile). The study involved an AABA design, with a repeated baseline, delayed intervention cohort and blind assessment. Intervention included both semantic and phonological information about the target words and involved the adolescents using the words in multiple contexts.	Results were promising and participants' knowledge of the targeted words significantly increased following intervention. Progress was demonstrated on the Word Knowledge Profile on the item requiring participants to define the word (for the summer intervention group only). This increase in depth of knowledge was seen on taught words but not on matched non-taught words.	Cross-curriculum words are not consistently understood by adolescents at risk of low educational attainment within a low socio-economic context. A 10-week intervention programme resulted in some increases to the depth of knowledge of targeted cross-curriculum words.	
28421566	Precision global health is an approach similar to precision medicine, which facilitates, through innovation and technology, better targeting of public health interventions on a global scale, for the purpose of maximising their effectiveness and relevance. Illustrative examples include: the use of remote sensing data to fight vector-borne diseases; large databases of genomic sequences of foodborne pathogens helping to identify origins of outbreaks; social networks and internet search engines for tracking communicable diseases; cell phone data in humanitarian actions; drones to deliver healthcare services in remote and secluded areas. Open science and data sharing platforms are proposed for fostering international research programmes under fair, ethical and respectful conditions. Innovative education, such as massive open online courses or serious games, can promote wider access to training in public health and improving health literacy. The world is moving towards learning healthcare systems. Professionals are equipped with data collection and decision support devices. They share information, which are complemented by external sources, and analysed in real time using machine learning techniques. They allow for the early detection of anomalies, and eventually guide appropriate public health interventions. This article shows how information-driven approaches, enabled by digital technologies, can help improving global health with greater equity.
28421471	In 2002, the U.S. Centers for Disease Control and Prevention (CDC) launched the VERB. It's what you do! campaign to increase physical activity among tweens and concomitantly respond to the rise in childhood obesity. This retrospective study summarizes the history of the VERB campaign's social marketing approach and its effectiveness in promoting behavior change in the targeted population.The legacy of VERB, which ended in 2006, is discussed, with an emphasis on examining initiatives over the last decade and the degree to which they followed (or did not follow) the structural and thematic lead of the campaign. The article ends with suggestions for how VERB still has the potential to inform other social marketing campaigns going forward.	
28421286	Studies with younger participants have shown that listening to music is used to achieve a multitude of positive effects that can be summarized by three fundamental dimensions: self-awareness, social relatedness and regulation of mood and arousal. For the elderly, these effects contain a high potential with respect to alleviation of affective symptoms and enhancement of social participation; however, it is still unclear if the elderly exhibit the same pattern of fundamental uses of listening to music as younger persons and how they evaluate their access to music in different housing situations.To answer these questions, 115 persons (aged 57-94 years) in different housing situations were asked for their motives for listening to music and their satisfaction with various aspects of access to music.	The elderly showed the same pattern of the three fundamental dimensions of the use of listening to music as younger respondents, although specific uses were more pronounced, such as relaxation, reminiscing, and compensation for loneliness; however, the general intensity of the use of listening to music was lower. Older people saw deficits in the frequency, coordination, and communication of musical arrangements in their residential environment.	Older people listen to music to obtain specific effects in the same way as younger people do; however, the decreasing intensity of the use of listening to music, together with the desires of the older respondents, demonstrate a need for more musical arrangements that should be better coordinated, communicated, and preferably personalized.	
28420600	Despite efforts made by public health organizations to improve consumption of fruits and vegetables, populations in developed countries usually eat less than the minimum recommended. Social media, such as blogs, represent a unique opportunity for improving knowledge translation in health care because they facilitate interactive communication between the public and health professionals. However, no studies have yet evaluated the effect of blogs to promote dietary behavior changes.Our study aims to conduct a preliminary assessment before undertaking a full randomized controlled trial (RCT) of the feasibility of using an evidence-based healthy eating blog promoting the consumption of fruits and vegetables among adult women.	A total of 80 women aged 18 years and older (mean 42, SD 13 years) eating less than five servings per day of fruit and vegetables (mean 2.75, SD 1.84 servings) were recruited. Participants were randomized to the healthy eating blog group (n=40), which included a weekly blog post over a 6-month period, or to a control group (n=40) that had no exposure to the healthy eating blog. Blog posts were written by a registered dietitian and focused on the improvement of fruit and vegetable consumption. We targeted four main determinants of the behavior that were identified as the best predictors for fruit and vegetable intake by two systematic reviews: (1) knowledge, (2) attitude, (3) self-efficacy, and (4) motivation. The intervention was considered feasible if (1) more than 70% of questionnaires were completed, (2) attendance rate was more than 90% for in-person appointments with the research coordinator, (3) participants accessed at least 75% of the blog posts, and (4) the attrition rate was less than 25%. Blog access was assessed by collecting the blog browsing history data for each participant.	During the intervention, 26 posts were published on the blog. Pre- (baseline) and postintervention (6 months) questionnaires were completed by mean 97% (SD 3%) of participants. All participants attended their in-person appointments. Women accessed mean 87% (SD 7%) of the posts published during the intervention. Only 3% (2/80) of participants dropped out of the study. Between the healthy eating blog and control groups, a difference of 1.0 servings of fruits and vegetables (P<.001) indicated moderate effects of the intervention (Cohen d=0.54).	These results suggest that an intervention using a healthy eating blog meets preestablished feasibility criteria. A larger-scale RCT using the same methodology will be conducted to assess the impact of a healthy eating blog on the dietary habits of women.	
28420401	Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process.Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment.	Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence.	There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful.	PROSPERO 2015: CRD42015020243.	
28419485	Mothers' interactions with their young children have predicted later child development, behavior, and health, but evidence has been developed mainly in at-risk clinical samples. An economically and racially diverse sample of pregnant women who were not experiencing a high-risk pregnancy were recruited to participate in a community-based, longitudinal study of factors associated with child cognitive and social-emotional development during the first 3 years. The purpose of the present analysis was to identify associations between the characteristics of 1125 mothers and their 1-year-olds and the mothers' and children's scores on the Nursing Child Assessment Teaching Scale (NCATS). A multivariable approach was used to identify maternal and child characteristics associated with NCATS scores and to develop prediction models for NCATS total and subscale scores of mothers and children. Child expressive and receptive communication and maternal IQ, marital status, age, and insurance predicted NCATS Mother total score, accounting for 28% of the score variance. Child expressive communication and birth weight predicted the NCATS Child total score, accounting for 4% of variance. Child's expressive communication and mother's IQ and marital status predicted NCATS mother-child total scores. While these findings were similar to reports of NCATS scores in at-risk populations, no previous teams examined all of the mother and child characteristics included in this analysis. These findings support the utility of the NCATS for assessing mother-child interaction and predicting child outcomes in community-based, non-clinical populations. © 2017 Wiley Periodicals, Inc.
28418746	In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of "One World, One Health."
28418398	Oxytocin may influence various human behaviors and the connectivity across subcortical and cortical networks. Previous oxytocin studies are male biased and often constrained by task-based inferences. Here, we investigate the impact of oxytocin on resting-state connectivity between subcortical and cortical networks in women. We collected resting-state functional magnetic resonance imaging (fMRI) data on 26 typically developing women 40 min following intranasal oxytocin administration using a double-blind placebo-controlled crossover design. Independent components analysis (ICA) was applied to examine connectivity between networks. An independent analysis of oxytocin receptor (OXTR) gene expression in human subcortical and cortical areas was carried out to determine plausibility of direct oxytocin effects on OXTR. In women, OXTR was highly expressed in striatal and other subcortical regions, but showed modest expression in cortical areas. Oxytocin increased connectivity between corticostriatal circuitry typically involved in reward, emotion, social communication, language and pain processing. This effect was 1.39 standard deviations above the null effect of no difference between oxytocin and placebo. This oxytocin-related effect on corticostriatal connectivity covaried with autistic traits, such that oxytocin-related increase in connectivity was stronger in individuals with higher autistic traits. In sum, oxytocin strengthened corticostriatal connectivity in women, particularly with cortical networks that are involved in social-communicative, motivational and affective processes. This effect may be important for future work on neurological and psychiatric conditions (for example, autism), particularly through highlighting how oxytocin may operate differently for subsets of individuals.
28418396	A questionnaire-based survey.To describe functional gains and health following upper-limb tetraplegia surgery using the International Classification of Functioning, Disability and Health (ICF) as a reference and to explore interconnections across different dimensions of functioning and health.	A specialized center for advanced reconstruction of extremities at Sahlgrenska University Hospital, Gothenburg, Sweden.	Fifty-seven individuals who participated in a satisfaction survey were included in the present study. Besides questions concerned with the respondents' satisfaction with different aspects of surgery, the measures included perceived overall health status (EQ-VAS) and achieved grip strength. Univariate analyses were used to explore interconnections between measures.	The gains could be subcategorized and linked to the ICF domains 'mobility', 'self-care', 'communication', 'domestic life', and 'community, social and civic life', with 'handling objects' and 'maneuvering a wheelchair' as the most frequently reported gains. The mean EQ-VAS score was 67±22. No significant correlation was shown between grip strength and activity gains, nor between grip strength and perceived overall health. The degree of satisfaction was, however, associated with self-reported overall health among participants.	The functional gains achieved after tetraplegia surgery could be applied to the ICF constructs' body functions/structures and activity with possible implications on participation. The overall health perception was relatively high and could be linked to the degree of satisfaction among participants. Muscle strength is not necessarily transferable to activity performance. This emphasizes the importance of addressing factors other than strength in the post-surgical rehabilitation and assessments.Spinal Cord advance online publication, 18 April 2017; doi:10.1038/sc.2017.36.	
28418261	During early childhood, it is important to identify which children require intervention before they face the increased demands of school. This study aimed to: (1) compare parents' and educators' concerns, (2) examine inter-rater reliability between parents' and educators' concerns and (3) determine the group difference between level of concern and children's performance on clinical testing.Parents and educators of 1205 4- to 5-year-old children in the Sound Start Study completed the Parents' Evaluation of Developmental Status. Children whose parents/educators were concerned about speech and language underwent direct assessment measuring speech accuracy (n = 275), receptive vocabulary (n = 131) and language (n = 274).	More parents/educators were concerned about children's speech and expressive language, than behaviour, social-emotional, school readiness, receptive language, self-help, fine motor and gross motor skills. Parents' and educators' responses were significantly correlated (except gross motor). Parents' and educators' level of concern about expressive speech and language was significantly correlated with speech accuracy on direct assessment. Educators' level of concern was significantly correlated with a screening measure of language. Scores on a test of receptive vocabulary significantly differed between those with concern and those without.	Children's communication skills concerned more parents and educators than other aspects of development and these concerns generally aligned with clinical testing.	
28417950	Altered immune functioning has been demonstrated in individuals with autism spectrum disorder (ASD). The current study explores the relationship between perceived immune functioning and experiencing ASD traits in healthy young adults. N = 410 students from Utrecht University completed a survey on immune functioning and autistic traits. In addition to a 1-item perceived immune functioning rating, the Immune Function Questionnaire (IFQ) was completed to assess perceived immune functioning. The Dutch translation of the Autism-Spectrum Quotient (AQ) was completed to examine variation in autistic traits, including the domains "social insights and behavior", "difficulties with change", "communication", "phantasy and imagination", and "detail orientation". The 1-item perceived immune functioning score did not significantly correlate with the total AQ score. However, a significant negative correlation was found between perceived immune functioning and the AQ subscale "difficulties with change" (r = -0.119, p = 0.019). In women, 1-item perceived immune functioning correlated significantly with the AQ subscales "difficulties with change" (r = -0.149, p = 0.029) and "communication" (r = -0.145, p = 0.032). In men, none of the AQ subscales significantly correlated with 1-item perceived immune functioning. In conclusion, a modest relationship between perceived immune functioning and several autistic traits was found.
28417462	To assess patient satisfaction, self-rated oral health and associated factors, including periodontal status and dental caries, among patients covered for dental insurance through a National Social Security Scheme in New Delhi, India.A total of 1,498 patients participated in the study. Satisfaction levels and self-rated oral-health scores were measured using a questionnaire comprising 12 closed-ended questions. Clinical data were collected using the Community Periodontal Index (CPI) and the decayed, missing and filled teeth (DMFT) index. Regression analysis was conducted to evaluate factors associated with dental caries, periodontal status and self-rated oral health.	Areas of concern included poor cleanliness within the hospital, extensive delays for appointments, waiting time in hospital and inadequate interpersonal and communication skills among health-care professionals. Approximately 51% of the respondents rated their oral health as fair to poor. Younger age, no tobacco usage, good periodontal status and absence of dental caries were significantly associated with higher oral health satisfaction, with odds ratios of 3.94, 2.38, 2.58 and 2.09, respectively (P ≤ 0.001).	The study indicates poor satisfaction levels with the current dental care system and a poor self-rated oral health status among the study population. Some specific areas of concern have been identified. These findings may facilitate restructuring of the existing dental services under the National Social Security Scheme towards creating a better patient care system.	
28417158	Internet use has global influences on all aspects of life and has become a growing concern. Cross-sectional studies on Internet addiction (IA) have been reported but causality is often unclear. More longitudinal studies are warranted.We investigated incidence and predictors of IA conversion among secondary school students. A 12-month longitudinal study was conducted among Hong Kong Chinese Secondary 1-4 students (N = 8286). Using the 26-item Chen Internet Addiction Scale (CIAS; cut-off >63), non-IA cases were identified at baseline. Conversion to IA during the follow-up period was detected, with incidence and predictors derived using multi-level models.	Prevalence of IA was 16.0% at baseline and incidence of IA was 11.81 per 100 person-years (13.74 for males and 9.78 for females). Risk background factors were male sex, higher school forms, and living with only one parent, while protective background factors were having a mother/father with university education. Adjusted for all background factors, higher baseline CIAS score (ORa = 1.07), longer hours spent online for entertainment and social communication (ORa = 1.92 and 1.63 respectively), and Health Belief Model (HBM) constructs (except perceived severity of IA and perceived self-efficacy to reduce use) were significant predictors of conversion to IA (ORa = 1.07-1.45).	Prevalence and incidence of IA conversion were high and need attention. Interventions should take into account risk predictors identified, such as those of the HBM, and time management skills should be enhanced. Screening is warranted to identify those at high risk (e.g. high CIAS score) and provide them with primary and secondary interventions.	
28417111	The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.
28417062	Promoting healthy eating and lifestyles among populations with limited resources is a complex undertaking that often requires strong partnerships between various agencies. In local communities, these agencies are typically located in different areas, serve diverse subgroups, and operate distinct programs, limiting their communication and interactions with each other. This study assessed the network of agencies in local communities that promote healthy eating and lifestyles among populations with limited resources. Network surveys were administered in 2016 among 89 agencies located in 4 rural counties in Michigan that served limited-resource audiences. The agencies were categorized into 8 types: K-12 schools, early childhood centers, emergency food providers, health-related agencies, social resource centers, low-income/subsidized housing complexes, continuing education organizations, and others. Network analysis was conducted to examine 4 network structures-communication, funding, cooperation, and collaboration networks between agencies within each county. Agencies had a moderate level of cooperation, but were only loosely connected in the other 3 networks, indicated by low network density. Agencies in a network were decentralized rather than centralized around a few influential agencies, indicated by low centralization. There was evidence regarding homophily in a network, indicated by some significant correlations within agencies of the same type. Agencies connected in any one network were considerably more likely to be connected in all the other networks as well. In conclusion, promoting healthy eating and lifestyles among populations with limited resources warrants strong partnership between agencies in communities. Network analysis serves as a useful tool to evaluate community partnerships and facilitate coalition building.
28416026	Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care.Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013.	Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Findings Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a 'safety net' they could fall back on in case of difficulties, whereas staff used the analogy of a 'bridge' to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient's care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient.	
28415860	Online fitness communities are a recent phenomenon experiencing growing user bases. They can be considered as online social networks in which recording, monitoring, and sharing of physical activity (PA) are the most prevalent practices. They have added a new dimension to the social experience of PA in which online peers function as virtual PA partners or supporters. However, research into seeking and receiving computer-mediated social support for PA is scarce. Our aim was to study to what extent using online fitness communities and sharing physical activities with online social networks results in receiving various types of online social support.Two databases, one containing physical activities logged with Strava and one containing physical activities logged with RunKeeper and shared on Twitter, were investigated for occurrence and type of social support, by means of a deductive content analysis.	Results indicate that social support delivered through Twitter is not particularly extensive. On Strava, social support is significantly more prevalent. Especially esteem support, expressed as compliments for the accomplishment of an activity, is provided on both Strava and Twitter.	The results demonstrate that social media have potential as a platform used for providing social support for PA, but differences among various social network sites can be substantial. Especially esteem support can be expected, in contrast to online health communities, where information support is more common.	
28414847	This work first analyzes the construction of a typology of the studies on collective health and its institutionalization process in Brazil, in which three stages are proposed: the preventive project, social medicine and collective health. Secondly, the work examines the phases of institutionalization, disciplinarization and professionalization of collective health in Brazil. Within the institutionalization phase, the study analyzes connectivity and communication, regularization of discourses and practices, the construction of a separate identity and political actions, and the incorporation and legitimation of these elements. It is concluded that the trajectory of the construction of collective health is marked by three dimensions: the theoretical-critical, the political-sanitary and the pedagogical-professional.
28414837	The objective of this paper is to analyze the representation of health services in Mexican television, considering that television plays an important role in the production and reproduction of the social meanings of health. A descriptive study analyzed the contents of 672 hours of continuous television (media flows) broadcast in Mexico in 2011, examining advertising, television shows and newscasts. The analysis of all these messages shows that the representation of private care services predominates. When public care services are mentioned, the communication is mainly regarding the Seguro Popular de Salud [Popular Health Insurance, for those with low incomes], while the social security model of care is underrepresented. We therefore conclude that television favors the two first models of health care. This kind of representation could hold potential consequences for health subjectivities.
28414618	Spanish-speaking Latinos account for 13% of the U.S. population yet are chronically under-represented in national surveys; additionally, the response quality suffers from low literacy rates and translation challenges. These are the same issues that health communicators face when understanding how best to communicate important health information to Latinos. The Health Information National Trends Survey (HINTS) offers a unique opportunity to understand the health communication landscape and information needs of the U.S.We describe the challenges in recruiting Spanish-speaking HINTS respondents and strategies used to improve rates and quality of responses among Spanish-speaking Latinos. Cognitive interviewing techniques helped to better understand how Spanish-speaking Latinos were interpreting the survey questions, and the extent to which these interpretations matched English-speaking respondents' interpretations. Some Spanish-speaking respondents had difficulty with the questions because of a lack of access to health care. Additionally, Spanish-speaking respondents had a particularly hard time answering questions that were presented in a grid format. We describe the cognitive interview process, and consider the impact of format changes on Spanish-speaking people's responses and response quality. We discuss challenges that remain in understanding health information needs of non-English-speakers.	
28414570	Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate cancer-related stigma, weak-tie support preference, and online community use for social support in a survey of online prostate cancer community participants (n = 149). Findings revealed a positive relationship between stigma and perceived stress. This relationship, however, was moderated by weak-tie support preference and online community use for social support. Specifically, stigma was positively related to perceived stress when weak-tie support was preferred. Analyses also showed a positive relationship between stigma and perceived stress in those who used their online community for advice or emotional support. Health communication scholars should work collaboratively with diagnosed men, clinicians, and online community administrators to develop online interventions that optimally match social support needs.
28413687	This paper sets out a recent transition in our thinking in relation to psychopathology associated with personality disorder, in an approach that integrates our thinking about attachment, mentalizing (understanding ourselves and others in terms of intentional mental states) and epistemic trust (openness to the reception of social communication that is personally relevant and of generalizable significance) with recent findings on the structure of both adult and child psychopathology and resilience. In this paper - the first of two parts - we review evidence suggesting that a general psychopathology or p factor underlies vulnerability for psychopathology. We link this p factor to a lack of resilience using Kalisch and colleagues' positive appraisal style theory of resilience (PASTOR). We argue that vulnerability for (severe) psychopathology results from impairments in three central mechanisms underlying resilience - positive situation classification, retrospective reappraisal of threat, and inhibition of retraumatizing triggers - which in turn result from a lack of flexibility in terms of social communicative processes. We suggest that, from this perspective, personality disorders, and borderline personality disorder (BPD) in particular, can be considered to be the prototype of disorders characterized by a lack of resilience. Part 2 proposes an evolutionary developmental psychopathology account linking this inflexibility in social communication to problems with the development of epistemic trust - that is, an evolutionary pre-wired social communication system that normally facilitates resilience through salutogenesis, that is, the capacity to learn and derive benefit from the (social) environment.
28412556	Cooperating with other people is a key achievement in child development and is essential for human culture. We examined whether we could induce 4-year-old children to increase their cooperation with an unfamiliar peer by providing the peers with synchronized motion experience prior to the tasks. Children were randomly assigned to independent treatment and control groups. The treatment of synchronous motion caused children to enhance their cooperation, as measured by the speed of joint task completion, compared with control groups that underwent asynchronous motion or no motion at all. Further analysis suggested that synchronization experience increased intentional communication between peer partners, resulting in increased coordination and cooperation.
28412153	Poor medication adherence is an ongoing issue, and contributes to increased hospitalizations and healthcare costs. Although most adverse effects are rare, the perceived risk of adverse effects may contribute to low adherence rates.The objective of this study was to determine how adverse effect likelihood and pharmacist counseling on adverse effect prevention affects individuals': (1) willingness to use a hypothetical medication and (2) perceptions of medication safety.	This study used a 3 × 3 experimental design. Participants (n = 601) viewed a hypothetical scenario asking them to imagine being prescribed an anti-asthma medication that could cause fungal infections of the throat. Participants were randomized to 1 of 9 scenarios that differed on: probability of developing an infection (5%, 20%, no probability mentioned) and whether they were told how to reduce the risk of infection (no prevention strategy discussed, prevention strategy discussed, prevention strategy discussed with explanation for how it works). Participants were recruited through Amazon Mechanical Turk.	Participants were less willing to take the medication (F = 12.86, p < 0.0001) and considered it less safe (F = 13.11, p < 0.0001) when the probability of fungal infection was presented as 20% compared to 5% or when no probability information was given. Participants were more willing to take the medication (F = 11.78, p < 0.0001) and considered it safer (F = 11.17, p < 0.0001) when a prevention strategy was given. Finally, there was a non-statistically significant interaction between the probability and prevention strategy information such that provision of prevention information reduced the effect of variation in the probability of infection on both willingness to use the medication and perceived medication safety.	Optimal risk communication involves more than informing patients about possible adverse effects. Pharmacists could potentially improve patient acceptance of therapeutic recommendations, and allay medication safety concerns, by counseling about strategies patients can implement to reduce the perceived risk of adverse effects.	
28411523	Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in this region. This paper analyses the level of clinical coordination between PC and SC experienced by doctors and explores influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was carried out based on a survey of doctors working in the study networks (348 doctors per country). The COORDENA questionnaire was applied to measure their experiences of clinical management and information coordination, and their related factors. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between general perception of care coordination and associated factors. With some differences between countries, doctors generally reported limited care coordination, mainly in the transfer of information and communication for the follow-up of patients and access to SC for referred patients, especially in the case of PC doctors and, to a lesser degree, inappropriate clinical referrals and disagreement over treatments, in the case of SC doctors. Factors associated with a better general perception of coordination were: being a SC doctor, considering that there is enough time for coordination within consultation hours, job and salary satisfaction, identifying the PC doctor as the coordinator of patient care across levels, knowing the doctors of the other care level and trusting in their clinical skills. These results provide evidence of problems in the implementation of a primary care-based model that require changes in aspects of employment, organization and interaction between doctors, all key factors for coordination.
28411449	Perfluoroalkyl substances (PFAS), found in many household products and classed as endocrine disrupting chemicals, can be transferred through the placenta and are associated with multiple developmental deficits in offspring. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the association between intrauterine exposure to PFAS and early communication development in 432 mother-daughter dyads at 15 and 38months of age. Concentrations of perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA) were measured in maternal serum collected during pregnancy. Early communication development was measured with the ALSPAC-adapted MacArthur Communicative Development Inventories for Infants and Toddlers. The infant questionnaire measured verbal comprehension, vocabulary comprehension and production, nonverbal communication, and social development. The toddler questionnaire measured language, intelligibility, and communicative sub-scores. Multivariable linear regression was used to examine associations between each PFAS exposure and each communication sub-scale score. The association between maternal PFAS concentrations and early communication development at 15 and 38months of age varied by maternal age at delivery. In daughters of younger mothers (<25years of age), every 1ng/mL of PFOS was associated with a 3.82 point (95% confidence interval (CI): -6.18, -1.47) lower vocabulary score at 15months and a 0.80 point (95% CI: -1.74, 0.14) lower language score at 38months. Prenatal exposure to select PFAS was positively and negatively associated with communication development among girls, with inconsistent pattern of association across all measured PFAS and endpoints.
28411030	Standardised pain assessment i.e. the McGill Pain Questionnaire provide an elicited pain language. Midwives observe spontaneous non-elicited pain language to guide their assessment of how a woman is coping with labour. This paper examined the labour pain experience using the questions: What type of pain language do women use? Do any of the words match the descriptors of standardised pain assessments? What type of information doverbal and non-verbal cues provide to the midwife?A literature search was conducted in 2013. Studies were included if they had pain as the primary outcome and examined non-elicited pain language from the maternal perspective. A total of 12 articles were included.	The analysis revealed six categories in which labour pain can be viewed: 'positive', 'negative', 'physical', 'emotional', 'transcendent' and 'natural'. Women's language comprised i.e. prefixes and suffixes, which indicate the qualities of pain, and figurative language. Language indicated location of pain, gave insight into other life phenomena i.e. death, and shared similarities with standardised pain assessmentdescriptors. Labour cues were 'functional', 'dysfunctional,' or 'neutral' (part of the physiological childbirth process), and were verbal, non-verbal, emotional, psychological, physical behaviour or reactions, or tactile.	Labour can bring about a spectrum of sensations and therefore emotions from happiness and pleasure to suffering and grief. Spontaneous pain language comprises verbal language and non-verbal behaviour. Narratives are an effective form of pain communication in that they provide details regarding the quality, nature and dimensions of pain, and details notcaptured in quantitative data.	
28410385	From work contracts and group buying platforms to political coalitions and international climate and economical summits, often individuals assemble in groups that must collectively reach decisions that may favor each part unequally. Here we quantify to which extent our network ties promote the evolution of collective fairness in group interactions, modeled by means of Multiplayer Ultimatum Games (MUG). We show that a single topological feature of social networks-which we call structural power-has a profound impact on the tendency of individuals to take decisions that favor each part equally. Increased fair outcomes are attained whenever structural power is high, such that the networks that tie individuals allow them to meet the same partners in different groups, thus providing the opportunity to strongly influence each other. On the other hand, the absence of such close peer-influence relationships dismisses any positive effect created by the network. Interestingly, we show that increasing the structural power of a network leads to the appearance of well-defined modules-as found in human social networks that often exhibit community structure-providing an interaction environment that maximizes collective fairness.
28410188	An increasing number of patients are raising their voices in online forums to exchange health-related information. Facebook is the leading social media platform with more than 1 billion international daily users recorded in the summer of 2015. Facebook has a dynamic audience and is utilized in a number of ways, discussing medical issues being one of them. Ewing sarcoma mainly affects teenagers and young adults. Additionally, many individuals within this age group are regular users of Facebook. However, little is known about the impact of this modern way of communication via Web-based platforms on patients with Ewing sarcoma and their social environment.The aim of this study was to analyze and compare Ewing sarcoma patients' and relatives' behavior on Facebook to draw conclusions regarding the impact of Facebook on Ewing sarcoma treatment.	We examined a Facebook group named "Ewing Sarcoma Awareness" that is used to exchange information for both patients and relatives regarding Ewing sarcoma. A self-designed questionnaire was used to compare patients' and relatives' answers. Additionally, we analyzed all processes (posts, likes, threads, links) in the group for 6 consecutive months. A total of 65 members of the Facebook group (26 patients, 39 relatives) out of 2227 international group members participated in our study.	More than 70% (46/65) of all participants reported that they use the group Ewing Sarcoma Awareness as a source of information about Ewing sarcoma. Of the participants, 89% (58/65) agreed on our scale from a little to a lot that being in contact with other affected people through the group makes it easier to handle the diagnosis. In this study, 20% (13/65) of all participants reported that the group affected their choice of treatment and 15% (10/65) of participants were influenced in the selection of their specialist. Regarding the recommendation of the Facebook group toward other people, significant differences (P=.003) were found comparing patients' and relatives' results. During the last 6 months most activities in the group concerned sharing destiny and handling the diagnosis.	The Facebook group Ewing Sarcoma Awareness has a relevant impact on group members regarding their choice of treatment. Moreover, participants turn toward the group to receive mental and emotional support in everyday life. Statements made within the group are in part questionable from a medical point of view and the impact made by these statements on patients' care requires further evaluation.	
28410177	The digital divide is a recognized public health problem caused by social determinants that exacerbate health disparities. Despite the "tectonic shift" in how most of the public obtains cancer information, underserved communities are at increased risk of being digitally marginalized. However, research that examines factors underlying eHealth information seeking in diverse health contexts is lacking.The aim of this paper is to explore preferences and use of eHealth cancer prevention information (CPI) among patients and caregivers attending a minority-serving oncology clinic using the comprehensive model of information seeking as a theoretical framework. Specifically, the study examined the role of social determinants and prevention orientation in differences in preference and use of the Internet for CPI seeking among this diverse sample.	Survey methodology was used to identify social determinants and behavioral factors, including prevention orientation as correlates and predictors of respondents' (n=252) preferences and use of eHealth for CPI seeking.	Less than half (112/252, 44.4%) of respondents said that if faced with the need to seek CPI, they would seek this information online. In the final logistic regression model, education, ethnicity, age, and prevention orientation made significant contributions to the model (P<.05). Specifically, for each year increase in age, participants were 3% less likely to use the Internet for CPI seeking (P=.011). Compared to college graduates, respondents who did not complete high school were 11.75 times less likely to cite the Internet as a CPI carrier (P<.001) and those with a high school education were 3 times (2.99, P=.015) less likely. In addition, the odds that a Spanish speaker would cite the Internet as a CPI carrier were one-fifth (22%) of non-Hispanic whites (P=.032) and about one-quarter (26%) of English-speaking Latinos (P=.036). Finally, with each one point increase on the prevention orientation scale, respondents were 1.83 times less likely to cite online CPI seeking (P=.05).	Social determinants to health have profound influence on eHealth CPI seeking. Providers and policy makers should focus on meeting patients and family members' CPI needs following diagnosis and increase eHealth accessibility and availability of evidence-based CPI to diverse populations. Future research is needed to unravel further differences in eHealth CPI seeking, including those among Native Americans that emerged as an additional digitally underserved racial/ethnic group. Finally, additional factors underlying these differences should be explored to better tailor CPI eHealth information to diverse communities' information needs.	
28408725	Developmental delay is a delay in areas of speech, language, motor, social and cognitive development. Because of the negative impact of intellectual and learning disabilities, early identification of children with developmental and behavioral problems using appropriate screening tests is crucial.Utilization of parent-completed Ages and Stages Questionnaires (ASQs) for detecting the developmental delay in preschool age children and clarification of possible associated risk factors.	This cross-sectional study was conducted on 1012 children aged 24-60 months enrolled from six centers (n=608) and six villages (n=404) located in Menoufia Governorate, Egypt. All children were screened by nine age-based questionnaires in the first stage of assessment. Children whose scores were ≤ cut-off points in one or more of the screened developmental areas were considered to have suspected developmental delay (SDD) and underwent further evaluation in the second stage assessment.	Among the 1012 studied children aged 24-60 months, 978 (96.4%) had normal development. SDD had an overall prevalence of 3.4%, with the highest rates of SDD in problem-solving (3%), followed by communication (2.4%), fine motor skills (2.2%) and social-personal domain (1%), with no SDD in gross motor skills. SDD was more commonly observed in boys, with a significant association with both parental education and consanguinity. Problems with learning (32.3%) was the most commonly observed provisional diagnosis, followed by language disorders (29.4%). Children with SDD in more than one area of ASQ skills also had mild to borderline IQ scores.	The use of of parent-completed ASQs showed an overall prevalence of developmental delay in children aged 24-60 months of3.4%. Male gender, consanguinity and parental education were identified as risk factors for developmental delay. Family counselling about the child's developmental state is needed.	
28408364	The capacity to advertise via the Internet continues to contribute to the shifting dynamics in adult commercial sex work. eHealth interventions have shown promise to promote Internet-based sex workers' health and safety internationally, yet minimal attention has been paid in Canada to developing such interventions. Understanding the information communicated in Internet-based sex work advertisements is a critical step in knowledge development to inform such interventions.The purpose of this content analysis was to increase our understanding of the health and safety information within the Internet advertisements among women, men, and transgender sex workers and to describe how this information may be utilized to inform eHealth service development for this population.	A total of 75 Internet-based sex worker advertisements (45 women, 24 men, and 6 transgender persons) were purposefully selected from 226 advertisements collected as part of a larger study in Western Canada. Content analysis was employed to guide data extraction about demographic characteristics, sexual services provided, service restrictions, health practices and concerns, safety and security, and business practices. Frequencies for each variable were calculated and further classified by gender. Thematic analysis was then undertaken to situate the communications within the social and commercialized contexts of the sex industry.	Four communications themes were identified: (1) demographic characteristics; (2) sexual services; (3) health; and (4) safety and security. White was the most common ethnicity (46/75, 61%) of advertisements. It was found that 20-29 years of age accounted for 32 of the 51 advertisements that provided age. Escort, the only legal business title, was the most common role title used (48/75, 64%). In total, 85% (64/75) of advertisements detailed lists of sexual services provided and 41% (31/75) of advertisements noted never offering uncovered services (ie, no condom). Gender and the type of Web-based platform mattered for information communicated. It was found that 35 of the 45 women's advertisements were situated in personal websites and hosted details about nonsexual aspects of an appointment. Men and transworkers used Internet classified advertisement platforms with predetermined categories. Communications about sexually transmitted infections (STIs) occurred in only 16% (12/75) of advertisements with men accounting for 7. Women's advertisements accounted for 26 of the 37 advertisements noting safety restrictions. Zero men or transpersons restricted alcohol or drug use. In total, 75% (56/75) of advertisements offered out-call services and the average minimal hourly rate ranged from Can $140/h to Can $200/h.	The study findings contribute to understandings about the diverse platforms used in commercial sex advertisements, and how sex workers frame information for potential clients. This information affords health care providers and policy makers insights to how they might assist with promoting the health of Internet-based sex workers and their clients.	
28408094	Good communication skills are essential for pharmacy students to help patients with their medicines. Students' attitudes towards communication skills learning will influence their willingness to engage in communication training, and their skills when dealing with patients later on in their professional life.The aim of this study was to explore Nordic pharmacy students' attitudes to communication skills learning, and the associations between those attitudes and various student characteristics.	A cross-sectional questionnaire-based study was conducted in 11 Nordic pharmacy schools between April 2015 and January 2016. The overall response rate for the final study population was 77% (367 out of 479 students). Pharmacy students who had fulfilled all mandatory communication training and most of their pharmacy practical experience periods were included. The communication skills attitudes scale was the main outcome. Linear regression models were fitted with the outcome variable and various student characteristics as the predictors, using generalized estimating equations to account for clustering within pharmacy schools.	Nordic pharmacy students in general have moderately positive attitudes towards learning communication skills. Positive attitudes towards learning communication skills among pharmacy students were associated with being female (βadjusted 0.42, 95% CI 0.20 to 0.63, p < 0.001), following a newer pharmacy training program (βadjusted 0.81, 95% CI 0.63 to 0.98, p < 0.001), having higher self-rated need for communication skills improvement (βadjusted 0.50, 95% CI 0.30 to 0.71, p<0.001) and believing one's communication skills are not the result of personality (βadjusted -0.24, 95% CI -0.44 to -0.04, p=0.017).	The study provides important information for faculty members responsible for curriculum improvements and teachers to refine their teaching of communication skills. From this, the teaching can be better tailored to suit different students. The students' chances of being able to effectively help patients in the future will be increased by that.	
28407233	Despite emerging evidence for an association between communication disorders and maltreatment, little research has examined sexual abuse characteristics or disclosure experiences among individuals with language disorder (LD). Given that communication difficulties may constitute a barrier to disclosure, the disclosure experiences among individuals with and without communication difficulties may also differ.Five-year-old children identified with a language and/or speech disorder from a nonclinical community sample and a control group were followed to adulthood in a prospective longitudinal study. At age 31, participants completed a behaviorally specific questionnaire on experiences of sexual abuse and questionnaires on disclosure experiences and social reactions to disclosure. Due to low endorsement of sexual victimization among male participants and low sample size, results are reported for women only and exclude nine participants with speech disorder without LD. Participation rates were 28 of 40 in the LD cohort and 45 of 51 controls. Sexual victimization severity was defined using an index combining five indicators (duration, invasiveness, relationship to perpetrator, coercive tactics used, and number of perpetrators). Subthreshold sexual victimization was defined as a single, noncontact incident with a perpetrator unknown to the child; experiences with greater severity were classified as child sexual abuse.	Among women who reported sexual victimization by age 18, invasiveness and overall severity were greater in the LD cohort than in the control cohort. Women in the LD cohort (43%) were more likely than controls (16%) to report child sexual abuse, excluding subthreshold experiences. There were no differences between cohorts in probability of disclosure, latency to disclosure, or social reactions.	Women with a history of child LD in a nonclinical sample reported substantial child sexual abuse experiences. Implications for understanding associations between LD and mental health and for prevention and early intervention are discussed.	
28406884	Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis and is spread from person to person through the air. TB can be spread in congregate settings, such as school environments, to varying degrees, based on factors including duration of contact and air ventilation (1); therefore, evaluating potential contacts and exposures can be challenging. In February 2015, a student at a Kansas high school received a diagnosis of active pulmonary TB disease. Screening of 385 (91%) school contacts, four (100%) household contacts, and 19 (90%) social contacts resulted in the identification of 50 persons with latent TB infection. Johnson County Department of Health and Environment (JCDHE) Public Health Emergency Preparedness personnel used their experience with points of distribution logistics to optimize testing clinic layouts and implement the incident command structure. Open communication with students, school staff members, the public, and the media about the investigation from the outset was imperative to reduce rumors and unease that can accompany a large communicable disease investigation. The large number of persons needing treatment for latent TB overwhelmed JCDHE's two TB nurses. As a result, JCDHE developed a policy and procedure to allow persons who met eligibility requirements to complete 12 weekly doses of isoniazid and rifapentine treatment using video directly observed therapy (VDOT) rather than traditional in-person directly observed therapy (DOT). This procedure facilitated treatment compliance and completion; among the eligible 15 persons who chose the 12-week VDOT option, 14 (93%) completed treatment. State and local health departments might consider use of VDOT to monitor treatment of persons with latent TB infection.
28406786	Health care costs have increasingly shifted to patients, and financial distress caused by medical care has increased. Patients may wish to discuss costs with their clinicians.Describe patient preferences for communication about cost in the clinical setting.	Cross-sectional, self-administered survey of a stratified random sample of the population insured in an integrated health care system in Washington State. Our sampling frame was the entire membership aged 21 years or older. Sampling was stratified by sex and group practice enrollment.	Preference for discussing health care costs with one's physician. We conducted regression analyses to determine predictors of communication preference; potential predictors included demographic characteristics, financial burden, delay in seeking care because of cost, and socioeconomic variables. Survey responses were weighted to adjust for nonresponse and sampling.	Of 7200 invitations sent, 2200 survey responses were returned. Ninety-two percent wished to know their out-of-pocket costs before beginning treatment. Most respondents preferred their physician talk with them about out-of-pocket costs (81.4%) and expressed comfort with discussing costs with their physician (75.6%). Overall, 43.7% reported any delay in seeking care in the previous 12 months. One in 5 respondents (21.6%) reported family medical debt. Delay in seeking care was positively and independently associated with preferring to discuss costs with one's physician; current medical financial burden was not.	Patient preferences for communication about costs with physicians are high, and medical debt and delay in care-seeking are prevalent. Delay in care-seeking independently predicts cost communication preferences.	
28406387	Transgender-inclusive behaviors are actions and communication supporting transgender individuals. Examples include using language not reinforcing the gender binary, asking for and using correct pronouns, creation of spaces that welcome members of the transgender community, and acknowledging cisgender (non-transgender) privilege. A survey was developed measuring this behavior in individuals to examine the impact of transgender-inclusive behavior and the potential effect of interventions on promoting inclusive behavior. Data were collected utilizing an online survey (N = 1,051). The sample was split in half to run two sets of cases in a principal components analysis. Analysis of the full sample showed Cronbach's alpha to be .93 (n = 918). Findings suggest that the Transgender Inclusive Behavior Scale (TIBS) may be a useful instrument for identifying behaviors related to being inclusive of transgender individuals, groups, and communities. It may also be used to measure behavior change before and after transgender-specific educational and behavioral interventions.
28406382	Human eyes convey a remarkable variety of complex social and emotional information. However, it is unknown which physical eye features convey mental states and how that came about. In the current experiments, we tested the hypothesis that the receiver's perception of mental states is grounded in expressive eye appearance that serves an optical function for the sender. Specifically, opposing features of eye widening versus eye narrowing that regulate sensitivity versus discrimination not only conveyed their associated basic emotions (e.g., fear vs. disgust, respectively) but also conveyed opposing clusters of complex mental states that communicate sensitivity versus discrimination (e.g., awe vs. suspicion). This sensitivity-discrimination dimension accounted for the majority of variance in perceived mental states (61.7%). Further, these eye features remained diagnostic of these complex mental states even in the context of competing information from the lower face. These results demonstrate that how humans read complex mental states may be derived from a basic optical principle of how people see.
28406381	Processing fluency is used as a basis for various types of judgment. For example, previous research has shown that people judge food additives with names that are more difficult to pronounce (i.e., that are disfluent) to be more harmful. We explored the possibility that the association between disfluency and perceived harmfulness might be in the opposite direction for some categories of stimuli. Although we found some support for this hypothesis, an improved analysis and further studies indicated that the effect was strongly dependent on the stimuli used. We then used stimulus sampling and showed that the original association between fluency and perceived safety was not replicable with the newly constructed stimuli. We found the association between fluency and perceived safety using the newly constructed stimuli in a final study, but only when pronounceability was confounded with word length. The results cast doubt on generalizability of the association between pronounceability and perceived safety and underscore the importance of treating stimulus as a random factor.
28406317	Street's ecological model has shaped the research-examining communication during medical encounters for over a decade. Although the model accounts for the variety of contexts that shape the conversations in which patients and health-care providers engage, the model does not adequately address the way that everyday conversations about health carry over into patient-provider interactions. In this essay, we propose an extension of Street's model that adds the context of everyday communication about health as a contributing factor in the medical encounter. We support the need for this extension by discussing research that points to the ways these conversations with our social network influence communication during the medical encounter and propose new areas for research based on this extension.
28406275	Globally adolescents and young adults account for more than 40% of new HIV infections, and HIV-related deaths amongst adolescents increased by 50% from 2005 to 2012. Adherence to antiretroviral therapy (ART) is critical to control viral replication and preserve health; however, there is a paucity of research on adherence amongst the growing population of adolescents living with HIV/AIDS (ALHIV) in Southern Africa. We examined levels of self-reported ART adherence, barriers to adherence, and factors associated with non-adherence amongst ALHIV in Malawi.Cross-sectional study of 519 ALHIV (12-18 years) attending two large HIV clinics in central and south-eastern Malawi. Participants self-reported missed doses (past week/month), barriers to adherence, and completed questionnaires on past traumatic events/stressors, disclosure, depression, substance use, treatment self-efficacy, and social support. Biomedical data were retrieved from existing medical records. Multivariate logistic regression was performed to identify factors independently associated with self-reported ART adherence (7 day recall).	The mean age of participants (SD) was 14.5 (2) years and 290 (56%) were female. Of the 519 participants, 153 (30%) reported having missed ART doses within the past week, and 234 (45%) in the past month. Commonly reported barriers to adherence included forgetting (39%), travel from home (14%), busy with other things (11%), feeling depressed/overwhelmed (6%), feeling stigmatized by people outside (5%) and within the home (3%). Factors found to be independently associated with missing a dose in the past week were drinking alcohol in the past month (OR 4.96, 95% CI [1.41-17.4]), missed clinic appointment in the past 6 months (OR 2.23, 95% CI [1.43-3.49]), witnessed or experienced violence in the home (OR 1.86, 95% CI [1.08-3.21]), and poor treatment self-efficacy (OR 1.55 95% CI [1.02-2.34]). Sex and age were not associated with adherence.	In our study, nearly half of all ALHIV reported non-adherence to ART in the past month. Violence in the home or alcohol use in the past year as well as poor treatment self-efficacy were associated with worse adherence. Sub-optimal adherence is a major issue for ALHIV and compromise treatment outcomes. Programmes specifically tailored to address those challenges most pertinent to ALHIV may help improve adherence to ART.	
28406248	This study investigated the features of developmental difficulties combined with sensory defects in children with congenital rubella syndrome (CRS). Following a large rubella outbreak in Khanh Hoa Province, Vietnam, in 2011, we enrolled 41 children with CRS from September 2011 through May 2013. Fourteen participants died and six became untraceable by October 2013; the remaining 21 children were followed up from 2013 to 2015. Thirteen and seven participants had hearing and functional ophthalmological impairment, respectively. Developmental difficulties were suspected in 19 (95%) children who failed in at least one area of the Ages and Stages Questionnaire (ASQ) and/or Denver II in 2013 and/or 2015. Developmental difficulties were frequently identified in the ASQ communication domain (n = 14 in 2013) and Denver II language area (n = 13 in 2013). Seven (41%) participants were suspected of having autism spectrum disorder (ASD) in 2013 by the Modified Checklist for Autism in Toddlers. In 2015, proportions of children failing the problem-solving (62%) and personal-social (62%) domains had increased and two of 13 were diagnosed with ASD by the Childhood Autism Rating Scale, Second Edition. Developmental difficulties were suspected in most children with CRS, including autism largely combined with sensory dysfunction.
28405898	The purpose of this study was to identify current smokers' communication format preferences for receiving smoking cessation information in a lung cancer screening setting. A cross-sectional correlational design using survey methodology with 159 screening-eligible current smokers was the method used. Data was dichotomized (digital versus traditional preference) and analyzed using Pearson's chi-squared test, Mann-Whitney U test, and logistic regression. Race was a statistically significant predictor with White participants having four times greater odds of reporting preference for a digital format for receiving smoking cessation information such as social media and/or supportive text messages (OR: 4.06; p = 0.004). Lung cancer screening is a new venue where current long-term smokers can be offered information about smoking cessation while they are engaging in a health-promoting behavior and potentially more likely to contemplate quitting. It is important to consider the communication format preference of current smokers to support cessation uptake. This study is the first to examine communication format preference of current smokers in the context of the lung cancer screening venue. Key differences noted by race support the need for further research examining multiple formats of communication with efforts to maximize options in the cancer screening setting.
28405894	This paper reviews the empirical literature on psychosocial factors relating to children with disabilities in the context of disaster or terrorism.Research indicates adults with disabilities experience increased exposure to hazards due to existing social disparities and barriers associated with disability status. However, studies on the psychological effects of disaster/terrorism on children with pre-existing disabilities are exceedingly few and empirical evidence of the effectiveness of trauma-focused therapies for this population is limited. Secondary adversities, including social stigma and health concerns, also compromise the recovery of these children post-disaster/terrorism. Schools and teachers appear to be particularly important in the recovery of children with disabilities from disaster. Disasters, terrorism, and war all contribute to increased incidence of disability, as well as disproportionately affect children with pre-existing disabilities. Disaster preparedness interventions and societal changes are needed to decrease the disproportionate environmental and social vulnerability of children with disabilities to disaster and terrorism.	
28405338	In Part 1 of this paper, we discussed emerging evidence suggesting that a general psychopathology or 'p' factor underlying the various forms of psychopathology should be conceptualized in terms of the absence of resilience, that is, the absence of positive reappraisal mechanisms when faced with adversity. These impairments in the capacity for positive reappraisal seem to provide a comprehensive explanation for the association between the p factor and comorbidity, future caseness, and the 'hard-to-reach' character of many patients with severe personality pathology, most notably borderline personality disorder (BPD). In this, the second part of the paper, we trace the development of the absence of resilience to disruptions in the emergence of human social communication, based on recent evolutionary and developmental psychopathology accounts. We argue that BPD and related disorders may be reconceptualized as a form of social understanding in which epistemic hypervigilance, distrust or outright epistemic freezing is an adaptive consequence of the social learning environment. Negative appraisal mechanisms become overriding, particularly in situations of attachment stress. This constitutes a shift towards a more socially oriented perspective on personality psychopathology in which the absence of psychological resilience is seen as a learned response to the transmission of social knowledge. This shift in our views has also forced us to reconsider the role of attachment in BPD. The implications for prevention and intervention of this novel approach are discussed.
28405159	Medicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose.This study validated the LMQ in a sample of adults using regular prescription medicines in the UK.	Questionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media. A total of 1,177 were returned: 507 (43.1%) from pharmacy distribution and 670 (56.9%) online. Construct validity was assessed by principal components analysis and item reduction undertaken on the original 60-item pool. Known-groups analysis assessed differences in mean total scores between participants using different numbers of medicines and between those who did or did not require assistance with medicine use. Internal consistency was assessed by Cronbach's alpha. Free-text comments were analyzed thematically to substantiate underlying dimensions.	A 42-item, eight-factor structure comprising intercorrelated dimensions (patient-doctor relationships and communication about medicines, patient-pharmacist communication about medicines, interferences with daily life, practical difficulties, effectiveness, acceptance of medicine use, autonomy/control over medicines and concerns about medicine use) was derived, which explained 57.4% of the total variation. Six of the eight subscales had acceptable internal consistency (α>0.7). More positive experiences were observed among patients using eight or fewer medicines compared to nine or more, and those independent with managing/using their medicines versus those requiring assistance. Free-text comments, provided by almost a third of the respondents, supported the domains identified.	The resultant LMQ-2 is a valid and reliable multidimensional measure of prescription medicine use experiences, which covers more diverse domains than existing questionnaires. However, further validation work is necessary.	
28403207	The increasing focus of marine biosecurity agencies on transferring management responsibilities to citizens and industry begs the question whether devolved responsibility is a viable option for creating biosecurity outcomes. We examined recreational marine users' self-declared awareness of non-indigenous marine species (NIMS) at six locations in Tasmania, Australia and evaluated the accuracy of their awareness through recognition of four well-known NIMS with active awareness campaigns. We also investigated whether the activities of recreational marine users influence the accuracy of their NIMS recognition skills. We generally found that respondents declare NIMS awareness (70.45%), yet we found their recognition accuracy was variable ranging from low to fair (<10% to 54.95%) and recreational activity did not influence accuracy. Based on our results, we conclude that marine users' awareness does not predict accuracy and therefore devolved management of biosecurity without additional resources may pose a risky biosecurity management strategy.
28403158	Organizations are increasingly using sustainability reports to inform their stakeholders and the public about their sustainability practices. We apply topic modelling to 9,514 sustainability reports published between 1999 and 2015 in order to identify common topics and, thus, the most common practices described in these reports. In particular, we identify forty-two topics that reflect sustainability and focus on the coverage and trends of economic, environmental, and social sustainability topics. Among the first to analyse such a large amount of data on organizations' sustainability reporting, the paper serves as an example of how to apply natural language processing as a strategy of inquiry in sustainability research. The paper also derives from the data analysis ten propositions for future research and practice that are of immediate value for organizations and researchers.
28402748	Purpose Genetic testing for breast cancer risk is evolving rapidly, with growing use of multiple-gene panels that can yield uncertain results. However, little is known about the context of such testing or its impact on treatment. Methods A population-based sample of patients with breast cancer diagnosed in 2014 to 2015 and identified by two SEER registries (Georgia and Los Angeles) were surveyed about genetic testing experiences (N = 3,672; response rate, 68%). Responses were merged with SEER data. A patient subgroup at higher pretest risk of pathogenic mutation carriage was defined according to genetic testing guidelines. Patients' attending surgeons were surveyed about genetic testing and results management. We examined patterns and correlates of genetic counseling and testing and the impact of results on bilateral mastectomy (BLM) use. Results Six hundred sixty-six patients reported genetic testing. Although two thirds of patients were tested before surgical treatment, patients without private insurance more often experienced delays. Approximately half of patients (57% at higher pretest risk, 42% at average risk) discussed results with a genetic counselor. Patients with pathogenic mutations in BRCA1/2 or another gene had the highest rates of BLM (higher risk, 80%; average risk, 85%); however, BLM was also common among patients with genetic variants of uncertain significance (VUS; higher risk, 43%; average risk, 51%). Surgeons' confidence in discussing testing increased with volume of patients with breast cancer, but many surgeons (higher volume, 24%; lower volume, 50%) managed patients with BRCA1/2 VUS the same as patients with BRCA1/2 pathogenic mutations. Conclusion Many patients with breast cancer are tested without ever seeing a genetic counselor. Half of average-risk patients with VUS undergo BLM, suggesting a limited understanding of results that some surgeons share. These findings emphasize the need to address challenges in personalized communication about genetic testing.
28402479	The recent call to move from focus on one brain's functioning to two-brain communication initiated a search for mechanisms that enable two humans to coordinate brain response during social interactions. Here, we utilized the mother-child context as a developmentally salient setting to study two-brain coupling. Mothers and their 9-year-old children were videotaped at home in positive and conflictual interactions. Positive interactions were microcoded for social synchrony and conflicts for overall dialogical style. Following, mother and child underwent magnetoencephalography while observing the positive vignettes. Episodes of behavioral synchrony, compared to non-synchrony, increased gamma-band power in the superior temporal sulcus (STS), hub of social cognition, mirroring and mentalizing. This neural pattern was coupled between mother and child. Brain-to-brain coordination was anchored in behavioral synchrony; only during episodes of behavioral synchrony, but not during non-synchronous moments, mother's and child's STS gamma power was coupled. Importantly, neural synchrony was not found during observation of unfamiliar mother-child interaction Maternal empathic/dialogical conflict style predicted mothers' STS activations whereas child withdrawal predicted attenuated STS response in both partners. Results define a novel neural marker for brain-to-brain synchrony, highlight the role of rapid bottom-up oscillatory mechanisms for neural coupling and indicate that behavior-based processes may drive synchrony between two brains during social interactions.
28402422	Orthognathic treatment is routine practice to rehabilitate severe malocclusions and dentofacial deformities. Because orthognathic treatment is elective, patient's involvement in deciding whether to proceed with treatment is vital. Interaction and communication between patient and treating team plays a key role in achieving post-treatment satisfaction. To achieve satisfaction, an orthognathic 'information clinic' for prospective orthognathic patients was established at Oral and Maxillofacial Unit, Tampere University Hospital, Finland. 'Information clinic' includes short talks with power-point presentation given by orthodontist, oral hygienist, oral and maxillofacial surgeon, psychologist, and previous patient. Aim of the study was to set up an 'information clinic' and, more specifically, 1. to assess patients' opinions on the 'clinic' during pilot phase (2013-14) and 2. to analyse general statistics during the first 3 years (2013-16).During the pilot phase, patient opinions, based on voluntary questionnaire, were obtained from 85 people. General data were collected for the clinics run in 2013-16.	Seventy-two per cent of respondents reported the information provided to help in their decision-making to proceed/not proceed with treatment. Majority considered the information about the surgical aspects and meeting patient who had undergone orthognathic treatment to be the most important part of the clinic. Between March 2013 and 2016, 290 prospective orthognathic patients were invited to 29 'information clinics'. One hundred and ninety-four patients attended, of whom 137 were female and 57 male (age range 15-67 years).	The questionnaire and verbal feedback from the patients was positive; hence, the 'information clinic' is now offered as a routine process to all prospective orthognathic patients in our clinic.	
28402405	The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis.

28402150	Research on the influence of media on youths' sexual behavior in sub-Saharan Africa has focused almost entirely on the effects of multimedia health communication campaigns and edutainment programming. Scholarly literature is nearly silent about the influence of the multiple hours that young people in many sub-Saharan nations spend immersed in increasingly sex-heavy entertainment programming. We surveyed a stratified cluster sample of 437 Nairobi public high school students about motivational and parental mediation factors associated with their exposure to sexual radio and TV content. Watching sexual content in the bedroom predicted higher intake of both sexual radio and TV content. Believing that parents were successful in their efforts to limit media use predicted lower intake of both sexual radio and TV content. A friend/companion motive for watching was associated with taking in higher levels of sexual TV content. For day school students, watching sexual content in the sitting room also predicted higher levels of exposure to sexual TV content.
28402137	We advance a new theoretical approach for interpreting health communication from an embodied, intersubjective perspective. We propose individuals experience the world as bodied beings and must make sense of their embodied experiences by managing meanings of who they are in the world (being), the actions they perform (doing), and who they want to become (directed becoming). We call this theory managing meanings of embodied experiences (MMEE). Guided by the philosophies of phenomenology, pragmatism, and feminism, we provide a three-fold framework for exploring individuals' management of health meanings during interactions with others in society. The first layer-being-demonstrates a mutually constituting, intersubjective presence with others, whereby we attend to our own and another's embodied expressions accomplished communicatively. The second layer-doing-appreciates experiences directed by personal and social values both perceived and conceived during the unfolding of coordinated communicative events. The third layer-directed becoming-highlights our ability to mindfully direct changes to our identity and actions through critical reflection; it is the transformative potential of our reflective synthesis of being and doing.
28402013	Conceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences.To describe individuals' experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations.	A longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS-EU-47-Item Questionnaire. Findings are presented from the first round of data collection.	Twenty-six participants purposefully selected from a CVD risk reduction programme at three separate time points.	Four key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health-care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health-care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side-effects.	Findings are relevant for health-care providers in order to enhance the patient-provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels.	
28401739	Autism spectrum disorder (ASD) frequently co-occurs with intellectual disability (ID) and often remains undiagnosed until adulthood. The Social Communication Questionnaire (SCQ) is a widely used measure to screen for ASD. To improve the utility of the SCQ for adults with ID, the aim of this study was to develop an ID-specific and adult appropriate algorithm for the SCQ using a core set of valid items. These items were identified in one sample (N = 226) and further cross-validated in a second, independent sample (N = 225) from Germany, England and the U.S. The newly developed algorithm has 24 items compared with the 40 items in the original instrument. The reduced item core set yielded similar diagnostic validity as the original algorithm with good sensitivity values (0.81-0.89) and low specificity values (0.62-0.72). Overall, these results suggest that the removed items may not carry diagnostically relevant information in adults with ID; thus, excluding these items may result in a more efficient and age-appropriate screening measure for this population. However, due to the low specificity values, a comprehensive assessment is essential for a final diagnostic assignment. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28401613	To describe the perspectives of healthcare professionals caring for intubated patients on implementing augmentative and alternative communication (AAC) in critical care settings.Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalisation and rehabilitation. Little is known about the use of AAC in critical care settings.	The design was informed by interpretive descriptive methodology along with the theoretical framework symbolic interactionism, which guided the study of healthcare professionals (n = 48) in five different intensive care units. Data were generated through participant observations and 10 focus group interviews.	The findings represent an understanding of the healthcare professionals' perspectives on implementing AAC in critical care settings and revealed three themes. Caring Ontology was the foundation of the healthcare professionals' profession. Cultural Belief represented the actual premise in the interactions during the healthcare professionals' work, saving lives in a biomedical setting whilst appearing competent and efficient, leading to Triggered Conduct and giving low priority to psychosocial issues like communication.	Lack of the ability to communicate puts patients at greater risk of receiving poorer treatment, which supports the pressuring need to implement and use AAC in critical care. It is documented that culture in biomedical paradigms can have consequences that are the opposite of the staffs' ideals. The findings may guide staff in implementing AAC strategies in their communication with patients and at the same time preserve their caring ontology and professional pride.	Improving communication strategies may improve patient safety and make a difference in patient outcomes. Increased knowledge of and familiarity with AAC strategies may provide healthcare professionals with an enhanced feeling of competence.	
28401440	Understanding one's own emotions is an important part of social-emotional development in early childhood. Few studies have looked at the ability of children with autism spectrum disorder (ASD) to relate their own emotions to previous life events. Our previous study showed that the description of events that elicited specific emotions is qualitatively and quantitatively different in ASD in comparison to typically developing (TD) pre-adolescents. The current study evaluated differences in coherence and content of responses to questions on emotions in ASD and TD in two age groups. The evaluation was based on the section on Emotions of the Autism Diagnostic Observation Schedule Module 3 test. The study included 96 boys, 48 diagnosed with ASD (IQ≥85) and 48 TD children, divided into younger (6:0-8:0y) and older (8:2-11:0y) groups. Young TD children were able to give coherent responses to questions on experiences that evoked basic emotions. Children with ASD gave fewer coherent responses and more 'no response' and 'odd' responses across the examined age range. Only in the TD group was the level of vocabulary associated with the number of coherent statements. TD children gave more responses with content related to interpersonal relationships, self-awareness and social events than children with ASD. Deficits in coherence and content of responses to questions on emotions related to previous life events derive from the core deficits of ASD. The significant quantitative and qualitative gap that exists between ASD and TD may be useful during the diagnostic process of ASD in childhood.

28400892	Information and Communication Technology (ICT) opens up new possibilities for introducing innovative teaching and learning methods to deliver education in different educational areas. Use of internet and social media has grown rapidly and is a key way in how nurses and nurse educator students find information. However, the evidence is still lacking how nurse educator students use social media.The aim of this study is to describe nurse educator students' use of social media and the ways in which their educational needs are related to social media.	The data were collected using a structured questionnaire that included one open question. Altogether, 49 nurse educator students completed and returned the questionnaire (response rate 96%). The quantitative data were analysed using statistical programme SPPS and content analysis.	While many nurse educator students reported using the tools of social media, others claimed that they do not use social media at all. Facebook was most common (53% use it every day) and YouTube (17%) the second most common form of social media used to support daily living. The participants reported using YouTube (6% use it every day) and Facebook (4%) most often as support in their studies. They reported using Second life as virtual reality form of social media, the least. The most common educational needs of nurse educator students include receiving more in-depth information about how to use social media, as well as more practice in using it.	In the future, the education of the nurse educator students should include even more in-depth information about the forms of social media and about the advantages of using it in teaching. The education should encourage nurse educator students and provide them with more possibilities to train and make use of the benefits of social media as support in their daily lives and studies. There is need for more robust evidence of social media use in nurse educator students education.	
28400356	The eHealth Literacy Scale (eHEALS) is a tool to assess consumers' comfort and skills in using information technologies for health. Although evidence exists of reliability and construct validity of the scale, less agreement exists on structural validity.The aim of this study was to validate the Italian version of the eHealth Literacy Scale (I-eHEALS) in a community sample with a focus on its structural validity, by applying psychometric techniques that account for item difficulty.	Two Web-based surveys were conducted among a total of 296 people living in the Italian-speaking region of Switzerland (Ticino). After examining the latent variables underlying the observed variables of the Italian scale via principal component analysis (PCA), fit indices for two alternative models were calculated using confirmatory factor analysis (CFA). The scale structure was examined via parametric and nonparametric item response theory (IRT) analyses accounting for differences between items regarding the proportion of answers indicating high ability. Convergent validity was assessed by correlations with theoretically related constructs.	CFA showed a suboptimal model fit for both models. IRT analyses confirmed all items measure a single dimension as intended. Reliability and construct validity of the final scale were also confirmed. The contrasting results of factor analysis (FA) and IRT analyses highlight the importance of considering differences in item difficulty when examining health literacy scales.	The findings support the reliability and validity of the translated scale and its use for assessing Italian-speaking consumers' eHealth literacy.	
28399881	The family is an important social context where children learn and adopt eating behaviors. Specifically, parents play the role of health promoters, role models, and educators in the lives of children, influencing their food cognitions and choices. This study attempts to systematically review empirical studies examining the influence of parents on child food consumption behavior in two contexts: one promotive in nature (e.g., healthy food), and the other preventive in nature (e.g., unhealthy food).From a total of 6,448 titles extracted from Web of Science, ERIC, PsycINFO and PubMED, seventy eight studies met the inclusion criteria for a systematic review, while thirty seven articles contained requisite statistical information for meta-analysis. The parental variables extracted include active guidance/education, restrictive guidance/rule-making, availability, accessibility, modeling, pressure to eat, rewarding food consumption, rewarding with verbal praise, and using food as reward. The food consumption behaviors examined include fruits and vegetables consumption, sugar-sweetened beverages, and snack consumption.	Results indicate that availability (Healthy: r = .24, p < .001; Unhealthy: r = .34, p < .001) and parental modeling effects (Healthy: r = .32, p < .001; Unhealthy: r = .35, p < .001) show the strongest associations with both healthy and unhealthy food consumption. In addition, the efficacy of some parenting practices might be dependent on the food consumption context and the age of the child. For healthy foods, active guidance/education might be more effective (r = .15, p < .001). For unhealthy foods, restrictive guidance/rule-making might be more effective (r = -.11, p < .01). For children 7 and older, restrictive guidance/rule-making could be more effective in preventing unhealthy eating (r = - .20, p < .05). For children 6 and younger, rewarding with verbal praise can be more effective in promoting healthy eating (r = .26, p < .001) and in preventing unhealthy eating (r = - .08, p < .01).	This study illustrates that a number of parental behaviors are strong correlates of child food consumption behavior. More importantly, this study highlights 3 main areas in parental influence of child food consumption that are understudied: (1) active guidance/education, (2) psychosocial mediators, and (3) moderating influence of general parenting styles.	
28399829	Public health mass media campaigns may contribute to reducing the health and social burden attributed to alcohol consumption, but little is known about which advertising characteristics have been used, or have been effective, in alcohol harm reduction campaigns to date. As a first step towards encouraging further research to identify the impact of various advertising characteristics, this study aimed to systematically identify and examine the content of alcohol harm reduction advertisements (ads).Ads were identified through an exhaustive internet search of Google, YouTube, Vimeo, and relevant government and health agency websites. Eligible ads were: English language, produced between 2006 and 2014, not primarily focused on drink-driving or alcohol in pregnancy, and not alcohol industry funded. Systematic content analysis of all ads was performed; each ad was double-coded.	In total, 110 individual ads from 72 different alcohol harm reduction campaigns were identified, with the main source countries being Australia (40%) and the United Kingdom (26%). The dominant topic for 52% of ads was short-term harms, while 10% addressed long-term harms, 18% addressed underage drinking, 17% communicated a how-to-change message, and 3% advocated for policy change. The behavioural objective of most ads was to motivate audiences to reduce their alcohol consumption (38%) or to behave responsibly and/or not get drunk when drinking (33%). Only 10% of all ads mentioned low-risk drinking guidelines. Eighty-seven percent of ads used a dramatisation execution style and 74% had a negative emotional tone. Ninety percent of ads contained messages or content that appeared to target adults, and 36% specifically targeted young adults.	Some message attributes have been employed more frequently than others, suggesting several promising avenues for future audience or population-based research to compare the relative effectiveness of different characteristics of alcohol harm reduction ads. Given most alcohol-attributable harm is due to long-term disease, these findings suggest future campaigns may fill a potentially important gap if they were to focus on long-term harms. There is scope for such long-term harm campaigns to place greater emphasis on encouraging reduced personal consumption of alcohol, potentially through more frequent communication of low-risk drinking guidelines.	
28399676	The U.S. Dietary Guidelines recommend low-fat milk consumption, and Supplemental Nutrition Assistance Program Education (SNAP-Ed) programs follow these guidelines to develop health education programs for SNAP recipients. This study evaluated a multilevel media intervention promoting low-fat milk use among Oklahoma SNAP recipients, a population often missed. Behavior change was measured with pre- and postintervention telephone interviews with SNAP recipients ( n = 860). Immediately following the intervention, self-reported purchases of 1% milk, the focus of behavior change, significantly increased to 7.9% from 4.1%-a relative improvement of 92.7%, χ2(1, n = 824) = 5.8, p = .02. Milk nutrition knowledge scores significantly improved as well, t(846) = 2.9, p = .004, and low-fat milk users exhibited more milk nutrition knowledge than high-fat milk users, t(437) = 4.0, p = .000. The intervention, which resonated with the priority audience, was well received ( Mdn = 6, 1, 7). Factors contributing to its success included a gain-based message strategy and clearly articulating the desired behavior. Salient messages personalized the issues and concerns raised by the priority audience-all the vitamins and minerals without the fat. Findings suggest that matching gender and ethnicity mediated the effect among those most resistant to substituting low-fat for high-fat milk.
28399351	The aim of this study is to monitor and analyze the influence of chosen family indicators related to alcohol consumption and experience of drunkenness in a representative sample of Czech children.Data for our work were obtained from the Health Behaviour in School Aged Children (HBSC) study - a World Health Organization (WHO) cross national study. The sample consisted of 4,293 children aged 11, 13 and 15 years. Data collection was conducted in June 2010 in 88 randomly selected schools in the Czech Republic using standardized questionnaires. Statistical analysis was performed in the program NCSS 9, methods of descriptive statistics, χ2 test of independence in the contingency tables and logistic regression analysis were used.	Regular alcohol consumption (at least weekly) was reported by 7.4% of children aged eleven, 19.3% of children aged thirteen and 38.4% of children aged fifteen years. Drunkenness at least twice in their life was admitted by 3% of children aged eleven, 15% of children aged thirteen and 43% of children aged fifteen years. Both alcohol consumption and drunkenness were significantly associated (p<0.001) with age and gender. Formal structure of family was found to have significant effect on the experience of drunkenness, but no effect on alcohol consumption was recorded. Based on our results, neither the amount of time spent together, nor the children communication with parents had a statistically significant influence on alcohol consumption or drunkenness experience within each family type. However, statistically significant differences were observed between different family types (p<0.001).	These findings indicate a high degree of liberalism of Czech society towards alcohol. It appears that alcohol consumption will remain a serious problem in Czech society, therefore, more attention should be paid to this phenomenon in the future.	
28398967	This review synthesized physical activity and exercise intervention literature for the past 10 yrs for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes. Systematic searches yielded 132 eligible studies. The major disability groups were multiple sclerosis (41%), stroke (15%), and spinal cord injury (12%). Research designs primarily involved randomized controlled trials (61%) versus quasi-experimental designs (39%). Approximately 20% of the interventions used some form of the following technology: information and communication technology (48%), interactive technology (37%), or electronic gauges (30%). Eighteen percent of studies used intervention strategies based on behavioral theory, which was typically combined with technology to promote activity and increase adherence in generally larger study samples. The three prevailing theories included social cognitive theory (58%), social accountability theory (21%), and transtheoretical model (21%). Upon completing the intervention, studies reported primarily significant outcomes (80%). Exercise research for PWD has grown in both quantity and quality, but several gaps remain. Study findings provide a roadmap for future exercise trials on understudied populations and highlight technology and behavior change theory as drivers of future intervention research.
28398663	Male genital anomalies often require surgery in early life to address functional and cosmetic consequences. However, there has been little assessment of developmental outcomes of affected boys.We conducted a population-based cohort study of all boys born in New South Wales, Australia, and undergoing school-entry developmental assessment in 2009 or 2012. Health and developmental information was obtained by means of record-linkage of birth, hospital and Australian Early Development Census data. Boys with hypospadias or undescended testis (UDT) were compared with those without. Developmental outcomes were assessed in five domains (physical health, emotional maturity, communication, cognitive skills, and social competence), and boys were categorized as vulnerable (<10th centile of national scores), developmentally high risk (DHR; vulnerable in 2+ domains), and special needs.	We included 420 boys with hypospadias, 873 with UDT, and 77,176 unaffected boys. There was no difference in the proportion of boys developmentally vulnerable in any domain or DHR between boys with hypospadias (DHR: n = 49; 13.1%; p = 0.9), UDT (n = 116; 15.2%; p = 0.06), and unaffected boys (n = 9278; 12.9%). Compared with unaffected boys (n = 4826; 6.3%), boys with hypospadias (n = 43; 10.2%; p < 0.001) or UDT (n = 105; 12.0%; p < 0.001) were more likely to have special needs. Stratified analyses revealed that only boys with UDT and coexisting anomalies had increased risk of being DHR (odds ratio: 2.65; 95% confidence interval, 1.61-4.36) or special needs (odds ratio: 2.91; 95% confidence interval, 2.00-4.22).	We found no increased risk of poor development among boys with hypospadias or UDT. However, boys with UDT and coexisting anomalies were more likely to have poorer development and special needs. Birth Defects Research 109:535-542, 2017. © 2017 Wiley Periodicals, Inc.	
28398403	Biomedical globalization is a reality in the presence of local worlds with growing human sufferance and inequalities. In this structural and cultural context, characterised by the new communication by Internet and social media, polarisation of medical and scientific debate is enhancing. Based on episodes related to public health issues like vaccines, the quest for better access of Italian professionals and public opinion to an open scientific debate on health research and practice is discussed.
28398134	Despite the important role of social relationships for health and wellbeing, little is known about how primary partners affect adherence to HIV care and treatment. We qualitatively explored how relationship dynamics and partner support influence adherence among couples from KwaZulu-Natal, South Africa. Twenty-four heterosexual couples with at least one HIV-positive partner completed semi-structured interviews on topics including relationship dynamics (intimacy or emotional closeness, communication, violence), experiences with HIV care and treatment and HIV-related social support. The majority of couples were seroconcordant HIV-positive (92%) and both on antiretroviral therapy (ART) (63%). Participants described how primary partners both interfered with and supported adherence. Negative forms of influence included relationship conflict, which resulted in forgetfulness to take pills, and men's attempt to control use of ART. However, participants were more likely to highlight positive forms of influence on adherence, which included social support (instrumental, informational and emotional), intimacy and commitment. The findings also suggest a reciprocal relationship between ART and relationships such that couple ART use may enhance relationship quality. Primary partners are important pillars of support for ART adherence, especially in contexts of high unemployment and poverty. Future interventions that encourage and leverage these supportive relationships could improve ART adherence among heterosexual couples in similar settings.
28397314	To evaluate the effectiveness of an action learning set to enhance clinical leadership and extend their scope and confidence more strategically.As the most senior clinical role in most healthcare systems, the consultant nurse role is a solitary one. They are required to develop personal resilience, commitment and a belief in their ability to lead, with new consultants needing a strong support network to succeed.	Following a 2-year action learning set, four nurse consultants, one therapy consultant, and a university educationalist engaged in a cooperative inquiry approach using four cycles of discussion, reflection, analysis and action over an 18-month period from March 2015-July 2016, to learn how to change and enhance their working practices. Data were analysed thematically.	Four themes emerged where the action learning set (i) offered structure and support, (ii) enabled a wider influence and (iii) empowered them to lead. The cooperative inquiry helped them realise how much they had gained from their collective learning and they felt empowered to lead.	Their motivation to "make a difference" remains palpable. The outcomes of the cooperative inquiry included an enhanced understanding of the importance of openness and trust and a willingness to share and learn from each other in a respectful and confidential environment with a receptiveness to change. Self-leadership has clearly been accepted and embraced, and their collaboration has improved communication across the organisation, enhanced their strategic leadership capability and given confidence to disseminate externally.	The action learning set offered structure to support these clinical leaders to keep them focused across the breadth of their role. Additionally, peer review with external facilitation has enabled these clinical leaders to gain a wider influence and empowered them to lead.	
28397306	Nearly half of children with intellectual disability (ID) have comorbid affective disorders. These problems are chronic if left untreated and can significantly impact upon future vocational, educational, and social opportunities. Despite this, there is a paucity of research into effective treatments for this population. Notably, one of the most supported of psychological therapies, cognitive behaviour therapy (CBT), remains largely uninvestigated in children with ID. The current review considers the neuropsychological profile of children and adolescents with mild to moderate ID, with a view to informing how CBT might best be adapted for children and adolescents with ID.Narrative review of literature considering the neuropsychological profiles of children and adolescents with ID, with specific focus upon attention, memory, learning, executive functioning, and communication. Studies were identified through SCOPUS, PsycINFO, and PubMed databases, using combinations of the key words 'intellectual disability', 'learning disability', 'neuropsychology', 'attention', 'learning', 'memory', 'executive function', 'language', and 'reading'.	Children with ID have significant deficits in attention, learning, memory, executive functions, and language. These deficits are likely to have a negative impact upon engagement in CBT. Suggestions for adapting therapy to accommodate these wide ranging deficits are proposed.	There are multiple cognitive factors which need to be considered when modifying CBT for children who have ID. Furthermore, research is required to test whether CBT so modified is effective in this population.	Clinical implications Effective ways of providing cognitive behavioural therapy (CBT) to children with intellectual disability (ID) is unclear. This study provides a framework of potential adaptations for clinical practice As rates of mental illness for children with intellectual disability are high, and rates of treatment provision low, it is hoped that the recommendations provided in this study will encourage more mental health practitioners to provide CBT to children with ID. Limitations These recommendations are based only upon neuropsychological literature. Trialling the effectiveness of an adapted form of CBT for children and adolescents with ID is required. There are varying causes of intellectual disability, with differences in cognitive profiles. The utility of the recommendations made here may vary according to specific aetiologies.	
28396007	The intrinsic value of an action refers to the inherent sense that experiencing a behavior is enjoyable even if it has no explicit outcome. Previous research has suggested that a common valuation mechanism within the reward network may be responsible for processing the intrinsic value of achieving both the outcome and external rewards. However, how the intrinsic value of action is neurally represented remains unknown. We hypothesized that the intrinsic value of action is determined by an action-outcome contingency indicating the behavior is controllable and that the outcome of the action can be evaluated by this feedback. Consequently, the reward network should be activated, reflecting the generation of the intrinsic value of action. To test this hypothesis, we conducted a functional magnetic resonance imaging (fMRI) investigation of a stopwatch game in which the action-outcome contingency was manipulated. This experiment involved 36 healthy volunteers and four versions of a stopwatch game that manipulated controllability (the feeling that participants were controlling the stopwatch themselves) and outcome (a signal allowing participants to see the result of their action). A free-choice experiment was administered after the fMRI to explore preference levels for each game. The results showed that the stopwatch game with the action-outcome contingency evoked a greater degree of enjoyment because the participants chose this condition over those that lacked such a contingency. The ventral striatum and midbrain were activated only when action-outcome contingency was present. Thus, the intrinsic value of action was represented by an increase in ventral striatal and midbrain activation.
28395590	Sharing memories in conversations with close others is posited to be part of the social function of autobiographical memory. The present research focused on the sharing of a particular type of memory: Specific memories about one-time co-experienced events, which we termed Specific We memories. Two studies with 595 total participants examined the factors that lead to and/or are influenced by the sharing of Specific We memories. In Study 1, participants reported on their most recent conversation. Specific We memories were reportedly discussed most often in conversations with others who were close and with whom the participant had frequent communication. In Study 2, participants were randomly assigned either to increase or to simply record the frequency of communication with a close other (parent). Increases in the frequency of reported sharing of Specific We memories as well as closeness to the parent resulted. Mediation analyses of both studies revealed causal relationships among reported sharing of Specific We memories and closeness. We discuss the relevance of these results for understanding the social function of autobiographical memory.
28395297	This study investigated whether measures of early social communication vary among young children of diverse racial/ethnic status with and without autism spectrum disorder (ASD).Participants were 364 toddlers between ages 18 and 36 months with a diagnosis of ASD confirmed (n = 195) or ruled out (n = 169), from 3 racial/ethnic categories: non-Hispanic White (n = 226), non-Hispanic Black (n = 74), and Hispanic (n = 64). Group differences in social communication were examined using an observational measure-the Communication and Symbolic Behavior Scales Behavior Sample (CSBS-BS; Wetherby & Prizant, 2002)-and a parent-report measure, the Early Screening for Autism and Communication Disorders (Wetherby, Woods, & Lord, 2007).	Controlling for maternal education, children with ASD scored significantly lower on the CSBS-BS than children without, indicating poorer social communication skills, and higher on the Early Screening for Autism and Communication Disorders, indicating more ASD features. Racial/ethnic groups did not differ on 6 CSBS-BS clusters, but Non-Hispanic White toddlers scored significantly higher than both other groups on the Understanding cluster. There were no significant Diagnosis × Race/Ethnicity interactions.	These findings indicate good agreement between observed and parent-report measures in this sample. Results suggest that the CSBS-BS and Early Screening for Autism and Communication Disorders could be viable tools in the detection process for toddlers with ASD in these racial/ethnic groups.	
28394752	Patients with a history of substance use are more likely than those without substance use to experience chronic noncancer pain (CNCP), to be prescribed opioids, and to experience opioid misuse or overdose. Primary care practitioners (PCPs) in safety-net settings care for low-income patients with CNCP and substance use, usually without specialist consultation. To inform communication related to opioid risk, we explored PCPs' and patients' perceptions of the risks of chronic opioid therapy.We conducted semistructured interviews with 23 PCPs and 46 of their patients, who had a history of CNCP and substance use. We recruited from 6 safety-net health care settings in the San Francisco Bay Area. We transcribed interviews verbatim and analyzed transcripts using grounded theory methodology.	(1) PCPs feared harming patients and the community by opioid prescribing. PCPs emphasized fear of opioid overdose. (2) Patients did not highlight concerns about the adverse health consequences of opioids, except for addiction. (3) Both patients and PCPs were concerned about PCPs' medicolegal risks related to opioid prescribing. (4) Patients reported feeling stigmatized by policies aimed at reducing opioid misuse.	We identified differences in how clinicians and patients perceive opioid risk. To improve the informed consent process for opioid therapy, patients and PCPs need to have a shared understanding of the risks of opioids and engage in discussions that promote patient autonomy and safety. As clinics implement opioid prescribing policies, clinicians must develop effective communication strategies in order to educate patients about opioid risks and decrease patients' experiences of stigma and discrimination.	
28394216	Research into the seasonality of mood has long been stymied by a lack of data, in part due to the prohibitive cost of traditional data collection and the tendency for data to be highly localized. Recent work using social media data has evinced the utility of psycholinguistic features in tracking mood and mental illness, but Twitter data, which are nonanonymous and short-form by design, have almost exclusively been the subject of analysis. In this article, we present a novel corpus within this field of study, comments from the social network Reddit, which does not suffer from these potential limitations. We find that although there are no notable changes in mood in the entire population over the course of a year, a small cohort is acutely sensitive to changes in the relative day length (i.e., the relative photoperiod). Our findings corroborate the phase shift hypothesis, which is the prevailing theory for the seasonality of mood. We also demonstrate the viability of the Reddit comments corpus for studies in mood and, more broadly, mental health.
28394207	Social anxiety (SA) and online privacy concerns (OPCs) are conceptually distinct fears, but both may be activated by Internet-based social contexts. Whereas SA is focused on being the object of interpersonal evaluation, OPC is focused on preventing others from gaining unauthorized access to private personal information. No research to date has investigated how SA and OPCs may uniquely or interactively predict individual differences in online interaction anxiety or attitudes and preferences about online communication. Participants (N = 374) completed the Social Phobia Inventory and measures of OPCs, online interaction anxiety, and attitudes related to online communication. The results revealed that SA and OPCs were not correlated with one another; however, they each uniquely predicted significant variance in particular outcomes, with no interactive effects. Findings help to illuminate the ways in which online communication preferences may be differentially shaped by people's levels of SA and OPCs, respectively. Theoretical implications and applications are discussed.
28393745	Recent studies have detected similarities between autism spectrum disorder and schizophrenia. We investigated structural abnormalities associated with autistic-like traits in patients with schizophrenia by voxel-based morphometry.Patients with schizophrenia and healthy subjects were evaluated by the adult version of the social responsiveness scale (SRS-A), which is sensitive to autistic traits and symptoms even under subthreshold conditions, and magnetic resonance imaging.	There were significant decreases in the anterior cingulate cortex, bilateral hippocampi, cerebellums, and right insula of patients with schizophrenia, compared with healthy subjects. We found significant negative correlations of the social communication and interaction (SCI) score, a subscale of SRS-A, with grey matter volume in the left posterior superior temporal region of schizophrenia patients. When subscales of SCI were examined separately in schizophrenic patients, negative correlations were observed between the social cognition score and the volumes of the left posterior superior temporal region, and between social motivation and the posterior cingulate cortex.	We found significant negative correlation between the SCI score and the grey matter volume in the left posterior superior temporal region of schizophrenia patients. This area was the region affected in previous studies of autistic spectrum disorders. Further, this area was associated with the theory of mind. Schizophrenia patients not necessarily show the impairment of SCI, nor this correlated region was not always the point with schizophrenia-specific change. However, we reveal the relationship between the left posterior superior temporal gyrus and the severity of the SCI in schizophrenia by using with SRS-A.	
28393350	There has been increasing interest in the potential for pre-emptive interventions in the prodrome of autism, but little investigation as to their effect.A two-site, two-arm assessor-blinded randomised controlled trial (RCT) of a 12-session parent-mediated social communication intervention delivered between 9 and 14 months of age (Intervention in the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting), against no intervention. Fifty-four infants (28 intervention, 26 nonintervention) at familial risk of autism but not otherwise selected for developmental atypicality were assessed at 9-month baseline, 15-month treatment endpoint, and 27- and 39-month follow-up.	severity of autism prodromal symptoms, blind-rated on Autism Observation Schedule for Infants or Autism Diagnostic Observation Schedule 2nd Edition across the four assessment points.	blind-rated parent-child interaction and child language; nonblind parent-rated communication and socialisation. Prespecified intention-to-treat analysis combined estimates from repeated measures within correlated regressions to estimate the overall effect of the infancy intervention over time.	Effect estimates in favour of intervention on autism prodromal symptoms, maximal at 27 months, had confidence intervals (CIs) at each separate time point including the null, but showed a significant overall effect over the course of the intervention and follow-up period (effect size [ES] = 0.32; 95% CI 0.04, 0.60; p = .026). Effects on proximal intervention targets of parent nondirectiveness/synchrony (ES = 0.33; CI 0.04, 0.63; p = .013) and child attentiveness/communication initiation (ES = 0.36; 95% CI 0.04, 0.68; p = .015) showed similar results. There was no effect on categorical diagnostic outcome or formal language measures.	Follow-up to 3 years of the first RCT of a very early social communication intervention for infants at familial risk of developing autism has shown a treatment effect, extending 24 months after intervention end, to reduce the overall severity of autism prodromal symptoms and enhance parent-child dyadic social communication over this period. We highlight the value of extended follow-up and repeat assessment for early intervention trials.	
28393082	This pilot study explored psychosocial influences of e-cigarette use among dual users.Two focus groups among adult current smokers who had ever used e-cigarettes were conducted in Georgia. Discussions were audio-recorded. Principles of grounded theory and thematic analysis were employed.	Reasons for initial use included curiosity and social influence. Themes related to regular use included enjoyment of sensory experiences and perception of reduced harm. Nicotine craving, social image, and convenience were reasons for initial and regular dual use. Two patterns of use emerged - (1) using e-cigarettes to supplement combustible cigarettes; and (2) to replace combustible cigarettes.	Reasons for dual use were related to nicotine dependence, social influence, product appeal, and perception of reduced harm. Understanding contextual nuances of dual use can inform policy and communication.	
28392908	Shared genetic influences between attention-deficit/hyperactivity disorder (ADHD) symptoms and autism spectrum disorder (ASD) symptoms have been reported. Cross-trait genetic relationships are, however, subject to dynamic changes during development. We investigated the continuity of genetic overlap between ASD and ADHD symptoms in a general population sample during childhood and adolescence. We also studied uni- and cross-dimensional trait-disorder links with respect to genetic ADHD and ASD risk.Social-communication difficulties (N ≤ 5551, Social and Communication Disorders Checklist, SCDC) and combined hyperactive-impulsive/inattentive ADHD symptoms (N ≤ 5678, Strengths and Difficulties Questionnaire, SDQ-ADHD) were repeatedly measured in a UK birth cohort (ALSPAC, age 7 to 17 years). Genome-wide summary statistics on clinical ASD (5305 cases; 5305 pseudo-controls) and ADHD (4163 cases; 12,040 controls/pseudo-controls) were available from the Psychiatric Genomics Consortium. Genetic trait variances and genetic overlap between phenotypes were estimated using genome-wide data.	In the general population, genetic influences for SCDC and SDQ-ADHD scores were shared throughout development. Genetic correlations across traits reached a similar strength and magnitude (cross-trait rg ≤ 1, pmin  = 3 × 10-4) as those between repeated measures of the same trait (within-trait rg ≤ 0.94, pmin  = 7 × 10-4). Shared genetic influences between traits, especially during later adolescence, may implicate variants in K-RAS signalling upregulated genes (p-meta = 6.4 × 10-4). Uni-dimensionally, each population-based trait mapped to the expected behavioural continuum: risk-increasing alleles for clinical ADHD were persistently associated with SDQ-ADHD scores throughout development (marginal regression R2 = 0.084%). An age-specific genetic overlap between clinical ASD and social-communication difficulties during childhood was also shown, as per previous reports. Cross-dimensionally, however, neither SCDC nor SDQ-ADHD scores were linked to genetic risk for disorder.	In the general population, genetic aetiologies between social-communication difficulties and ADHD symptoms are shared throughout child and adolescent development and may implicate similar biological pathways that co-vary during development. Within both the ASD and the ADHD dimension, population-based traits are also linked to clinical disorder, although much larger clinical discovery samples are required to reliably detect cross-dimensional trait-disorder relationships.	
28392702	Hepatic encephalopathy (HE) is a complex disease requiring a multidisciplinary approach among specialists, primary care team, family, and caregivers. HE is currently a diagnosis of exclusion, requiring an extensive workup to exclude other possible etiologies, including mental status changes, metabolic, infectious, traumatic, and iatrogenic causes. The categorization of HE encompasses a continuum, varying from the clinically silent minimal HE (MHE), which is only detectable using psychometric tests, to overt HE, which is further divided into four grades of severity. While there has been an increased effort to create fast and reliable methods for the detection of MHE, screening is still underperformed due to the lack of standardization and efficient methods of diagnosis. The management of HE requires consultation from various disciplines, including hepatology, primary care physicians, neurology, psychiatry, dietician/nutritionist, social workers, and other medical and surgical subspecialties based on clinical presentation and clear communication among these disciplines to best manage patients with HE throughout their course. The first-line therapy for HE is lactulose with or without rifaximin. Following the initial episode of overt HE, secondary prophylaxis with lactulose and/or rifaximin is indicated with the goal to prevent recurrent episodes and improve quality of life. Recent studies have demonstrated the negative impact of MHE on quality of life and clinical outcomes. In light of all this, we emphasize the importance of screening and treating MHE in patients with liver cirrhosis, particularly through a multidisciplinary team approach.
28392473	Mucolipidosis type IV (ML-IV) is a rare autosomal recessive lysosomal storage disorder which presents with nonspecific developmental delay. Nowadays with the use of new tools such as next generation sequencing, more ML-IV affected patients are diagnosed. Still, identifying the behavioral phenotype might be of help for early diagnosis and anticipatory guidance, as well as for counseling of the families.Identification of the behavioral characteristics of 12 ML-IV patients, aged from 2.5 to 34 years, based on their caregivers' observations.	The information was gathered from the patients' parents using an extensive semi-structured interview especially designed for this study. Each interview lasted approximately three hours.	Patients were uniformly described as friendly and show explicit pleasure from both social interactions and music. They all presented delays in psychomotor development, while their general health was reported as good. Parents reported that the patients present deterioration of motor and communication skills over the years. Episodes of ocular pain, with ipsilateral flushing of the face and tearing were frequently reported, as was shortening of the Achilles tendon. Since the identification of the ML-IV gene, diagnosis is made earlier in life.	We suggest that ML-IV be considered in the differential diagnosis of patients with developmental delay, who present the behavioral phenotype reported here. This pattern could also be useful for the ancitipatory guidance in the care of ML-IV affected patients. Further clinical research is warranted to confirm these preliminary findings.	
28392323	Autism spectrum disorders (ASD) are neurodevelopmental disabilities characterized by severe impairment in social communication skills and restricted, repetitive behaviors. We have previously shown that a single transplantation of mesenchymal stem cells (MSC) into the cerebral lateral ventricles of BTBR autistic-like mice resulted in an improvement across all diagnostic criteria of ASD. We suggested that brain-derived neurotrophic factor (BDNF), a protein which supports the survival and regeneration of neurons secreted by MSC, largely contributed to the beneficial behavioral effect. In this study, we investigated the behavioral effects of transplanted MSC induced to secrete higher amounts of neurotrophic factors (NurOwn®), on various ASD-related behavioral domains using the BTBR mouse model of ASD. We demonstrate that NurOwn® transplantation had significant advantages over MSC transplantation in terms of improving communication skills, one and six months following treatment, as compared to sham-treated BTBR mice. Furthermore, NurOwn® transplantation resulted in reduced stereotypic behavior for as long as six months post treatment, compared to the one month improvement observed in the MSC treated mice. Notably, NurOwn® treatment resulted in improved cognitive flexibility, an improvement that was not observed by MSC treatment. Both MSC and NurOwn® transplantation induced an improvement in social behavior that lasted for six months. In conclusion, the present study demonstrates that a single transplantation of MSC or NurOwn® have long-lasting benefits, while NurOwn® may be superior to MSC treatment.
28392086	An important domain in health-related quality of life evaluations is quality of life perceptions due to having a voice disorder. The purpose of the current study was (1) to examine the correlation of the Iranian Voice Quality of Life Profile (IVQLP) with the Voice-Related Quality of Life (VRQOL) and Voice Handicap Index-30 (VHI-30) for establishing the construct convergent validity of the IVQLP, and (2) to examine the correlation between VRQOL and VHI-30.Study sample consisted of 150 patients, 91 male and 59 female, diagnosed with muscle tension dysphonia, benign organic disorders such as polyps and nodules, and unilateral vocal fold paralysis. In total, 150 patients aged 46.53 ± 13.84 years completed the IVQLP and Persian versions of the VHI and VRQOL.	The results showed that Spearman rank-order correlation coefficient between the results of the VHI and IVQLP questionnaires was 0.90 (P < 0.001). The correlation coefficient between VRQOL and IVQLP was -0.88. (P < 0.001) The Spearman correlation between VHI and VRQOL was -0.94. (P < 0.001) CONCLUSIONS: The current study showed that the IVQLP has good construct validity, and it can evaluate quality of life in Iranian dysphonic patients based on their culture. Also, the VHI-30 and VRQOL correlation was very high.	
28391742	Background Leftover samples obtained during autopsies are extremely important basic materials for forensic research. However, there are no established practices for research-related use of obtained samples. Objective This study discusses good practice for the secondary use of samples collected during medicolegal autopsies. Methods A questionnaire was posted to all 76 departments of forensic medicine performing medicolegal autopsies in Japan, and 48 responses were received (response rate: 63.2%). As a secondary analysis, we surveyed information provided on department websites. Results Ethical reviews conducted when samples were to be used for research varied greatly among departments, with 21 (43.8%) departments reporting 'fundamentally, all cases are subject to review', eight (16.7%) reporting 'only some are subject to review' and 17 (39.6%) reporting 'none are subject to review'. Information made available on websites indicated that 11 departments had a statement of some type to bereaved families about the potential research use of human samples obtained during autopsies. Nine of these included a notice stating that bereaved families may revoke their consent for use. Several departments used an opt-out system. Conclusion There is no common practice in the field of legal medicine on the ethical use for medical research of leftover samples from medicolegal autopsies. The trust of not only bereaved families but also society in general is required for the scientific validity and social benefits of medical studies using leftover samples from medicolegal autopsies through the use of opt-out consenting and offline and online dissemination and public-relations activities.
28391128	This paper draws on interview data to examine how international health care workers navigated risk during the unprecedented Ebola outbreak in West Africa. It identifies the importance of place in risk perception, including how different spatial localities give rise to different feelings of threat or safety, some from the construction of physical boundaries, and others mediated through aspects of social relations, such as trust, communication and team dynamics. Referring to these spatial localities as 'riskscapes', the paper calls for greater recognition of the role of place in understanding risk perception, and how people navigate risk.
28390620	Since the pragmatic skills of hearing-impaired Persian-speaking children have not yet been investigated particularly through story retelling, this study aimed to evaluate some pragmatic abilities of normal-hearing and hearing-impaired children using a story retelling test.15 normal-hearing and 15 profound hearing-impaired 7-year-old children were evaluated using the story retelling test with the content validity of 89%, construct validity of 85%, and reliability of 83%. Three macro structure criteria including topic maintenance, event sequencing, explicitness, and four macro structure criteria including referencing, conjunctive cohesion, syntax complexity, and utterance length were assessed. The test was performed with live voice in a quiet room where children were then asked to retell the story. The tasks of the children were recorded on a tape, transcribed, scored and analyzed.	In the macro structure criteria, utterances of hearing-impaired students were less consistent, enough information was not given to listeners to have a full understanding of the subject, and the story events were less frequently expressed in a rational order than those of normal-hearing group (P < 0.0001). Regarding the macro structure criteria of the test, unlike the normal-hearing students who obtained high scores, hearing-impaired students failed to gain any scores on the items of this section.	These results suggest that Hearing-impaired children were not able to use language as effectively as their hearing peers, and they utilized quite different pragmatic functions.	
28390232	Addiction beliefs about tobacco use are associated with intentions to use and use of tobacco products. Exposure to information about tobacco products in media sources may affect addiction beliefs.To examine the relationship between media exposure and tobacco product addiction beliefs.	A nationally representative sample of US adults (n=3738) from the 2015 National Cancer Institute's Health Information National Trends Survey was used to examine addiction beliefs about cigarettes, cigars, smokeless tobacco, electronic cigarettes, hookah/waterpipe tobacco, and roll-your-own cigarettes. We used logistic regression to examine the relationship between media exposure and addiction beliefs. We defined media exposure by hours exposed, as well as exposure to tobacco use health effects information through media sources including social media. We categorized media sources by whether respondents actively or passively engaged with the source.	A majority (60.6% to 87.3%) of respondents believed that cigarettes, cigars, roll-your-own cigarettes and smokeless tobacco are addictive. Less than half of respondents believed that electronic cigarettes or hookah/waterpipes are addictive (45.2% and 49.8%, respectively). Respondents exposed to messages about tobacco use health effects on active media channels (e.g., social media) had greater odds of believing that smokeless tobacco (adjusted odds ratio [AOR]=1.48), hookah/waterpipe (AOR=1.69), and roll-your-own cigarettes (AOR=1.61) are addictive. Respondents exposed to tobacco use health effects messages on passive media channels (e.g., television), had greater odds of believing that cigarettes (AOR=2.76) and electronic cigarettes (AOR=2.12) are addictive.	US adult exposure to information about the health effects of tobacco use was associated with addiction beliefs about tobacco products.	
28390033	Substantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood.This early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention. In this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection 'Fingerprint Model', suggesting one possible approach to accurately and early identify neurodevelopmental disorders.	
28389756	High levels of stress and anxiety are common in children with Autism Spectrum Disorder (ASD). Within this study of school-aged children (20 male, 6 female) we hypothesised that functional hearing deficits (also pervasive in ASD) could be ameliorated by auditory interventions and that, as a consequence, stress levels would be reduced. The use of Ear-Level Remote Microphone devices and Classroom Amplification systems resulted in significantly improved listening, communication and social interaction and a reduction in physiologic stress levels (salivary cortisol) in both one-on-one and group listening situations.
28389418	Health care social media used for health information exchange and emotional communication involves different types of users, including patients, caregivers, and health professionals. However, it is difficult to identify different stakeholders because user identification data are lacking due to privacy protection and proprietary interests. Therefore, identifying the concerns of different stakeholders and how they use health care social media when confronted with huge amounts of health-related messages posted by users is a critical problem.We aimed to develop a new content analysis method using text mining techniques applied in health care social media to (1) identify different health care stakeholders, (2) determine hot topics of concern, and (3) measure sentiment expression by different stakeholders.	We collected 138,161 messages posted by 39,606 members in lung cancer, diabetes, and breast cancer forums in the online community MedHelp.org over 10 years (January 2007 to October 2016) as experimental data. We used text mining techniques to process text data to identify different stakeholders and determine health-related hot topics, and then analyzed sentiment expression.	We identified 3 significantly different stakeholder groups using expectation maximization clustering (3 performance metrics: Rand=0.802, Jaccard=0.393, Fowlkes-Mallows=0.537; P<.001), in which patients (24,429/39,606, 61.68%) and caregivers (12,232/39,606, 30.88%) represented the majority of the population, in contrast to specialists (2945/39,606, 7.43%). We identified 5 significantly different health-related topics: symptom, examination, drug, procedure, and complication (Rand=0.783, Jaccard=0.369, Fowlkes-Mallows=0.495; P<.001). Patients were concerned most about symptom topics related to lung cancer (536/1657, 32.34%), drug topics related to diabetes (1883/5904, 31.89%), and examination topics related to breast cancer (8728/23,934, 36.47%). By comparison, caregivers were more concerned about drug topics related to lung cancer (300/2721, 11.03% vs 109/1657, 6.58%), procedure topics related to breast cancer (3952/13,954, 28.32% vs 5822/23,934, 24.33%), and complication topics (4449/25,701, 17.31% vs 4070/31,495, 12.92%). In addition, patients (9040/36,081, 25.05%) were more likely than caregivers (2659/18,470, 14.39%) and specialists (17,943/83,610, 21.46%) to express their emotions. However, patients' sentiment intensity score (2.46) was lower than those of caregivers (4.66) and specialists (5.14). In particular, for caregivers, negative sentiment scores were higher than positive scores (2.56 vs 2.18), with the opposite among specialists (2.62 vs 2.46). Overall, the proportion of negative messages was greater than that of positive messages related to symptom, complication, and examination. The pattern was opposite for drug and procedure topics. A trend analysis showed that patients and caregivers gradually changed their emotional state in a positive direction.	The hot topics of interest and sentiment expression differed significantly among different stakeholders in different disease forums. These findings could help improve social media services to facilitate diverse stakeholder engagement for health information sharing and social interaction more effectively.	
28389328	In the Netherlands, HPV-vaccination uptake among 12-year-old girls remains to be lower (61% in 2016) than expected. The present study is about 1) replicating the extent to which social-psychological determinants found in earlier cross-sectional studies explain HPV-vaccination intention, and 2) testing whether HPV-vaccination intention, as well as other social-psychological determinants, are good predictors of future HPV-vaccination uptake in a longitudinal design.A random sample of mothers of girls invited for the vaccination in 2015 was drawn from the Dutch vaccination register (Praeventis) (N=36,000) and from three online panels (N=2483). Two months prior to the vaccination of girls, their mothers were requested to complete a web-based questionnaire by letter (Praeventis sample) or by e-mail (panel samples). HPV-vaccination uptake was derived from Praeventis. Backward linear and logistic regression analyses were conducted to examine most dominant predictors of HPV-vaccination intention and uptake, respectively. The total sample used for data analyses consisted of 8062 mothers. Response rates were 18% for the Praeventis sample and 47% for the panel samples.	HPV-vaccination intention was best explained by attitude, beliefs, subjective norms, habit, and perceived relative effectiveness of the vaccination; they explained 83% of the variance in HPV-vaccination intention. Intention appeared to be the only stable predictor of HPV-vaccination uptake and explained 43% of the variance in HPV-vaccination uptake.	These results confirm what was found by earlier cross-sectional studies, and provide strong leads for selecting relevant targets in the planning of future communication strategies aiming to improve HPV-vaccination uptake.	
28388661	The most effective type of social participation against psychological distress in older adults is not well documented. The aim of this study was to examine whether different types of social participation are associated with changes in psychological distress level in older men and women in Japan.Two thousand seven hundred community-dwelling older adults (aged 65-74 years, 50% women) were randomly selected from the resident registry of three cities. Of these, participants who reported social participation and psychological distress level in the baseline survey in 2010 were followed up. Psychological distress was evaluated based on K6 scales at baseline and follow-up (in 2015). Social participation level was examined using question items from the National Health and Nutrition Survey in Japan. Exploratory factor analysis was used to derive the underlying factor structure. Multiple linear regression analysis was used to examine the association between social participation and changes in psychological distress level after adjusting for covariates stratified by both gender and age group or living arrangement.	Data from 825 community-dwelling older adults (45.3% women) were analyzed. Social participation was categorized into two types using factor analysis: community involvement (volunteer activities, community events, clubs for the elderly) and individual relationship (friendship, communication with family and friends, hobbies). During the 5-year follow-up, 29.5% of participants reported a deterioration in psychological distress. Higher community involvement was independently associated with lower risk of psychological distress for older women (β = 0.099, p = 0.047), whereas there were no associations with individual relationship for either gender. Furthermore, in older women living with others, higher community involvement was also associated with lower risk of psychological distress (β = 0.110, p = 0.048).	Community involvement provides older women with mental health benefits regardless of individual relationship level. Promoting community involvement may be an effective strategy for healthy mental aging.	
28388310	Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants.To identify service providers' views on the barriers to migrant healthcare.	Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare.	Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population.	The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.	
28387794	To explore the success of community-based participatory research [CBPR] in engaging African American women to achieve health equity by elucidating community, trust, communication and impact. Recommendations helpful for researchers interested in engaging communities to achieve health equity in the USA are included.African American women experience health disparities of multifactorial etiology and are underrepresented in research. CBPR is a collaborative approach that incorporates perspectives, which address the intricate determinants of health and has been reported as an effective means to address health disparities. Yet, the science of CBPR seems elusive to researchers in the medical field. The opportunity exists to better understand and expand the use of the principles of engagement, replication, and sustainability in engaging African American women in health research.	A variety of literature regarding engaging African American women in community-based participatory research was reviewed.	CBPR focused on robust engagement of marginalized groups continues to be validated as a vital approach to the elimination of disparities and improved health for all, especially ethnic and racial minority populations. However, limited evidence of focused engagement of African American women was found. Making specific outreach to African American women must be a community and patient engagement priority to achieve health equity.	Continued research is needed which specifically focuses on building and sustaining engagement with African American women and their communities. This research can transform healthcare access, experiences and outcomes by yielding actionable information about what African American women need and want to promote wellness for themselves and their communities.	
28386983	Most staff working in intellectual disability services will be confronted with people with intellectual disabilities who need support around death, dying and bereavement. Previous studies suggest that intellectual disability staff tend to protect clients from knowing about death and avoid communication about death. The aims of this study were to gain further insight into the individual, organisational and contextual factors that affect the communication of death-related bad news to people with intellectual disabilities by intellectual disability staff and to develop guidelines for services to enable appropriate communication with clients about death and dying.Semi-structured interviews were held with 20 social care staff working in intellectual disability residential or supported living services in London, who had supported a client affected by death-related bad news in the past 6 months.	Staff found supporting people with intellectual disabilities around death and dying extremely difficult and tended to avoid communication about death. The following factors had a particularly strong influence on staff practice around communicating death-related bad news: fear and distress around death; life and work experience; and organisational culture. Staff attitudes to death communication had a stronger influence than their client's level of cognitive or communicative abilities. Managers were important role models.	Service managers should ensure not only that all their staff receive training in death, loss and communication but also that staff are enabled to reflect on their practice, through emotional support, supervision and team discussions. Future work should focus on the development and testing of strategies to enable intellectual disability staff to support their clients in the areas of dying, death and bereavement.	
28386948	There has been limited epidemiological research describing population-based samples regarding developmental pathways throughout infancy, and the research that exists has revealed substantial diversity. Identifying predictors for developmental pathways can inform early intervention services.The Ages and Stages Questionnaire was used to measure communication, gross motor, fine motor, problem-solving and personal-social skills longitudinally in a large, population-based sample of 1555 infants recruited from well-baby clinics in five municipalities in southeast Norway. We conducted latent class analyses to identify common pathways within the five developmental areas.	Our results indicated that most classes of infants showed generally positive and stable normative developmental pathways. However, for communication and gross motor areas, more heterogeneity was found. For gross motor development, a class of 10% followed a U-shaped curve. A class of 8% had a declining communication pathway and did not reach the level of the high stable communication class at 24 months. Low gestational age, low Apgar score, male sex, maternal depression symptoms, non-Scandinavian maternal ethnicity and high maternal education significantly predict less beneficial communication pathways.	The results suggest that infants with low gestational age, low Apgar score, male sex and a mother with depression symptoms or non-Scandinavian ethnicity may be at risk of developing less beneficial developmental pathways, especially within the communication area. Targeting these infants for surveillance and support might be protective against delayed development in several areas during a critical window of development.	
28386800	Stingless bees (Hymenoptera, Apidae: Meliponini) represent a highly diverse group of social bees confined to the world's tropics and subtropics. They show a striking diversity of structural and behavioral adaptations and are important pollinators of tropical plants. Despite their diversity and functional importance, their ecology, and especially chemical ecology, has received relatively little attention, particularly compared to their relative the honeybee, Apis mellifera. Here, I review various aspects of the chemical ecology of stingless bees, from communication over resource allocation to defense. I list examples in which functions of specific compounds (or compound groups) have been demonstrated by behavioral experiments, and show that many aspects (e.g., queen-worker interactions, host-parasite interactions, neuronal processing etc.) remain little studied. This review further reveals that the vast majority of studies on the chemical ecology of stingless bees have been conducted in the New World, whereas studies on Old World stingless bees are still comparatively rare. Given the diversity of species, behaviors and, apparently, chemical compounds used, I suggest that stingless bees provide an ideal subject for studying how functional context and the need for species specificity may interact to shape pheromone diversification in social insects.
28386658	Social relations among Muslim elders in the U.S. were examined to investigate diversity within an ethnic group whose members share a common religious belief system. Data included a web-based survey (N = 264) and semi-structured interviews (N = 18). A social constructionist perspective was used recognizing that ethnicity is fluid, not static and culture was highlighted as a way of seeing as opposed to a way of being. Regression analysis was conducted using survey data to investigate diversity among Muslims elders concerning social contact and activities. Social contact was predominantly with older adults for both African American and European compared to South Asian Muslims. Concerning social activities, the U.S. born was less likely than immigrants to be satisfied with activities for elders. Grounded analysis of semi-structured data uncovered two themes: social connectedness and communication. Each theme provided in-depth understandings of how culture, as ways of seeing the world, shape social relations in diverse ways, leading to the proposition that though family may be necessary for well-being in old age, it is not sufficient. By focusing on one religious group that included both immigrants and those born in the U.S., with various ancestral origins, findings advance a systematic and critical approach to challenge essentialist assumptions in the study of ethnic aging.
28386429	The sentinel behaviour of 38 Arabian babbler adult floaters, who lived alone within a territory belonging to a foreign group, was studied and compared with their own sentinel behaviour in the past, when they were group members. All floaters acted as sentinels and uttered 'alarm calls'. This suggests that sentinel activity is due at least, in part, to selfish motives. Floaters sentinelled less than they did as group members, with the decrease in sentinel activity sharper for ex-dominants than for ex-subordinates. One possible explanation for these differences is that sentinel activity is aimed not only at detecting predators, but also at detecting foreign conspecifics. Within a group, the latter incentive is stronger for breeding dominants than for subordinates, whereas all floaters alike may be trying to detect the owners of the territory in which they were roaming but also to avoid being detected by them. Other possible explanations are that floaters have less time and energy for sentinel activity because they are weaker or because foraging is more difficult in a foreign territory. This may be especially so for dominants who used to enjoy privileged access to food in their group. No significant difference was found in the rate of sentinels' 'alarm calls' between floaters and group members, suggesting that their main purpose is predator-prey communication, of which warning groupmates may be a side benefit.
28386412	When identifying other individuals, animals may match current cues with stored information about that individual from the same sensory modality. Animals may also be able to combine current information with previously acquired information from other sensory modalities, indicating that they possess complex cognitive templates of individuals that are independent of modality. We investigated whether goats (Capra hircus) possess cross-modal representations (auditory-visual) of conspecifics. We presented subjects with recorded conspecific calls broadcast equidistant between two individuals, one of which was the caller. We found that, when presented with a stablemate and another herd member, goats looked towards the caller sooner and for longer than the non-caller, regardless of caller identity. By contrast, when choosing between two herd members, other than their stablemate, goats did not show a preference to look towards the caller. Goats show cross-modal recognition of close social partners, but not of less familiar herd members. Goats may employ inferential reasoning when identifying conspecifics, potentially facilitating individual identification based on incomplete information. Understanding the prevalence of cross-modal recognition and the degree to which different sensory modalities are integrated provides insight into how animals learn about other individuals, and the evolution of animal communication.
28385680	Health care portals have the potential to provide consumers with timely, transparent access to health care information and engage them in the care process.The objective was to examine the use, utility, and impact on engagement in care and caregiver-provider communication of a client/family portal providing access to electronic health records (EHRs) and secure, 2-way e-messaging with care providers.	We conducted a prospective, mixed-methods study involving collection of caregivers' portal usage information over a 14-month period (from portal introduction in January 2015 to the end of the study period in March 2016), a Web-based survey for caregivers administered after a minimum of 2 months' exposure to the portal and repeated 2 months later, and focus groups or individual interviews held with caregivers and service providers at the same points in time. The survey assessed caregivers' perceptions of the utility of and satisfaction with the EHR and e-messaging, and the portal's impact on client engagement and perceptions of caregiver-provider communication. A total of 18 caregivers (parents) completed surveys and 6 also took part in focus groups or interviews. In addition, 5 service providers from different disciplines took part in focus groups or interviews.	Although usage patterns varied, the typical pattern was a steady level of use (2.5 times a month over an average of 9 months), which is higher than typically reported use. The portal pages most frequently accessed were the home page, health record main page, appointment main page, and reports main page. The Web-based survey captured caregivers' perceptions of usefulness of and satisfaction with the EHR and portal messaging, as well as the portal's impact on their engagement in care and perceptions of caregiver-provider communication. The surveys indicated a moderate degree of utility of and satisfaction with the portal features, and a low but emerging impact on engagement in care and caregiver-provider communication (survey scales measuring these outcomes displayed excellent internal consistency, with Cronbach alpha ranging from .89 to .95). Qualitative themes from focus groups and interviews supported and extended the survey findings. Caregivers and service providers saw appreciable information benefits and provided recommendations to increase portal use and utility. Caregivers focused on the scope of organizational adoption of the portal system and indicated their hopes for the future of the portal, whereas service providers were concerned about how to best manage their investment of time and effort in preparing client-friendly reports and messaging clients via the portal.	Overall, the findings show the promise of the portal and the need for ongoing evaluation to show the portal's ultimate potential in enhancing engagement in care and communication with care providers.	
28385465	The 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea was a serious threat to public health, and was exacerbated by the inappropriate responses of major institutions and the public. This study examined the sources of confusion during the MERS outbreak and identified the factors that can affect people's behavior.An online survey of the risk perception of university students in South Korea was performed after the epidemic had peaked. The questionnaire addressed the major social determinants in South Korea during the MERS epidemic. The analysis included data from 1,470 subjects who provided complete answers.	The students had 53.5% of the essential knowledge about MERS. Women showed higher risk perception than men, and trust in the media was positively associated with risk perception (P < .001). Additionally, risk perception was positively associated with overreaction by the public (odds ratio, 2.80; 95% confidence interval, 2.17-3.60; P < .001). These findings suggest that media content affected the public's perception of MERS risk and that perception of a high level of risk led to overreaction.	Risk perception was associated with most of the social factors examined and overreaction by the public. Therefore, providing accurate information and data to the public, establishing trust, and facilitating the development of an attitude will all be important in future crises.	
28385363	To investigate BRCA-positive, unaffected patients' - referred to as previvors - information needs after testing positive for a deleterious BRCA genetic mutation.25 qualitative interviews were conducted with previvors. Data were analyzed using the constant comparison method of grounded theory.	Analysis revealed a theoretical model of previvors' information needs related to the stage of their health journey. Specifically, a four-stage model was developed based on the data: (1) pre-testing information needs, (2) post-testing information needs, (3) pre-management information needs, and (4) post-management information needs. Two recurring dimensions of desired knowledge also emerged within the stages-personal/social knowledge and medical knowledge.	While previvors may be genetically predisposed to develop cancer, they have not been diagnosed with cancer, and therefore have different information needs than cancer patients and cancer survivors.	This model can serve as a framework for assisting healthcare providers in meeting the specific information needs of cancer previvors.	
28384509	Autism Spectrum Disorder (ASD) is characterized by remarkable heterogeneity in social, communication, and behavioral deficits, creating a major barrier in identifying effective treatments for a given individual with ASD. To facilitate precision medicine in ASD, we utilized a well-validated biological motion neuroimaging task to identify pretreatment biomarkers that can accurately forecast the response to an evidence-based behavioral treatment, Virtual Reality-Social Cognition Training (VR-SCT). In a preliminary sample of 17 young adults with high-functioning ASD, we identified neural predictors of change in emotion recognition after VR-SCT. The predictors were characterized by the pretreatment brain activations to biological vs. scrambled motion in the neural circuits that support (a) language comprehension and interpretation of incongruent auditory emotions and prosody, and (b) processing socio-emotional experience and interpersonal affective information, as well as emotional regulation. The predictive value of the findings for individual adults with ASD was supported by regression-based multivariate pattern analyses with cross validation. To our knowledge, this is the first pilot study that shows neuroimaging-based predictive biomarkers for treatment effectiveness in adults with ASD. The findings have potentially far-reaching implications for developing more precise and effective treatments for ASD.
28384145	Enduring power of attorney (EPA) is a simple and easy-to-set-up legal document which protects the wishes of the donor, as well as preventing significant psychological and social cost for the patient and their family when long-term residential care needs to be arranged due to the patient's increasing care requirements. It also reduces the significant cost in hospital beds days for the district health board involved while awaiting the Protection of Personal and Property Rights order. However, the prevalence of EPA is low in the geriatric population who arguably need it the most. This study aims to identify the barriers in obtaining an EPA in this population.Using a cross-sectional design, 100 individuals seen in community geriatric clinics or home visits in Counties Manukau Health between June to September 2015 were surveyed.	There was no significant difference in prevalence of EPA between those with cognitive impairment and those without (40.4% and 35% respectively with difference in proportion 5% (95% CI: -14% to 24%, p 0.61)). New Zealand Europeans were more likely than other ethnic groups to have EPA (63.5% vs 10.4%, with difference in proportion of 53% (95% CI: 37% to 69%, p<0.001)). Forty-three participants without EPA gave lack of information as their reason for not having obtained one. The majority of those without EPA (49 participants) felt that their doctor or lawyer would be the best person to convey such information to them, as opposed to mass media such as TV or internet.	EPA has not been widely acknowledged as an important aspect of health and legal planning by the participants of this survey, predominantly due to the lack of knowledge in the general public and financial barriers. Increased efforts to educate and support uptake could have positive personal and social outcomes.	
28383173	The Childhood Autism Spectrum Test (CAST; Scott, Baron-Cohen, Bolton & Brayne, 2002) has proved to be a good test for screening autism spectrum disorders (ASD) and social communication problems. This study provides evidence on its psychometric properties, describe its validity for screening and provides data on its discriminative capabilities in a Spanish sample of 4-12 year-old children from community and clinical settings (N = 1460 and 36, respectively). Factorial and convergent validity is also assessed. The full Spanish version with a cut-off score of 15 presented a high sensitivity (83.9%) and specificity (92.5%), a positive predictive value (PPV) of .63 and an internal consistency (α) of .826. Some items showed low discriminating power and these results led us to propose a reduced version with 28 items and a cut-off score of 13, which presented a high sensitivity (85.7%) and specificity (91.16%), a PPV of .61 and an α of .839. Correlations were high between the Spanish full and reduced versions of the CAST, and ADI-R (Autism Diagnostic Interview Revised) and ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition). Like previous adaptation studies, a two-factor structure was found. The data show that the CAST can be a valid and reliable questionnaire for ASD screening in Spanish clinical and community populations. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28382893	Adolescents' snack choices could be altered by increasing the reinforcing value (RV) of healthy snacks compared with unhealthy snacks. This study assessed whether the RV of fruit increased by linking it to a reward and if this increased RV was comparable with the RV of unhealthy snacks alone. Moderation effects of sex, hunger, BMI z-scores and sensitivity to reward were also explored. The RV of snacks was assessed in a sample of 165 adolescents (15·1 (sd 1·5) years, 39·4 % boys and 17·4 % overweight) using a computerised food reinforcement task. Adolescents obtained points for snacks through mouse clicks (responses) following progressive ratio schedules of increasing response requirements. Participants were (computer) randomised to three experimental groups (1:1:1): fruit (n 53), fruit+reward (n 60) or unhealthy snacks (n 69). The RV was evaluated as total number of responses and breakpoint (schedule of terminating food reinforcement task). Multilevel regression analyses (total number of responses) and Cox's proportional hazard regression models (breakpoint) were used. The total number of responses made were not different between fruit+reward and fruit (b -473; 95 % CI -1152, 205, P=0·17) or unhealthy snacks (b410; 95 % CI -222, 1043, P=0·20). The breakpoint was slightly higher for fruit than fruit+reward (HR 1·34; 95 % CI 1·00, 1·79, P=0·050), whereas no difference between unhealthy snacks and fruit+reward (HR 0·86; 95 % CI 0·62, 1·18, P=0·34) was observed. No indication of moderation was found. Offering rewards slightly increases the RV of fruit and may be a promising strategy to increase healthy food choices. Future studies should however, explore if other rewards, could reach larger effect sizes.
28382758	Team sports settings are challenging, dynamic environments in which coaches often benefit from proactive players who take initiative in providing valuable suggestions and feedback. Based on self-determination theory and achievement goal theory, this study examined the mediating role of a mastery and performance motivational climate in the positive relation between coaches' psychological need-supportive behavior and team athletes' proactivity. The study sample consisted of 75 male and 105 female volleyball players (Mage =21.92, SDage =4.92), whose level ranged from the highest national level in Belgium to the regional levels. They completed a questionnaire assessing coach need support, motivational climate and three primary types of proactivity (voice, taking charge, and upward communication). Multilevel structural equation modeling yielded a good fit for the hypothesized model. Consistent with our hypotheses, need support related positively to a mastery climate (β=0.74, P<.001), which, in turn, positively predicted proactivity (β=0.72, P<.001). Need-supportive coaching behavior negatively predicted a performance climate (β=-0.39, P<.001). Rejecting our hypothesis, a performance climate positively predicted proactivity, albeit to a smaller extent than a mastery climate (β=0.21, P<.001). These findings suggest that a need-supportive coaching style enables coaches to create a mastery climate. Such a climate seems to encourage athletes to be proactive, which enables teams to effectively tackle encountered challenges. The weaker but significant positive relation between a performance climate and proactivity will be discussed within the framework of social interdependence theory.
28382582	Insufficient capacity to use evidence-based programs (EBPs) limits the impact of community-based organizations (CBOs) to improve population health and address health disparities. PLANET MassCONECT was a community-based participatory research (CBPR) project conducted in three Massachusetts communities. Researchers and practitioners co-created an intervention to build capacity among CBO staff members to systematically find, adapt, and evaluate EBPs. The project supported development of trainee social networks and this cross-sectional study examines the association between network engagement and EBP usage, an important goal of the capacity-building program. Trainee cohorts were enrolled from June 2010 to April 2012 and we collected community-specific network data in late 2013. The relationship of interest was communication among network members regarding the systematic approach to program planning presented in the intervention. For Communities A, B, and C, 39/59, 36/61, and 50/59 trainees responded to our survey, respectively. We conducted the full network analysis in Community C. The average degree, or number of connections with other trainees, is a useful marker of engagement; respondents averaged 6.6 reported connections. Degree was associated with recent use of EBPs, in a linear regression, adjusting for important covariates. The results call for further attention to practitioner networks that support the use of research evidence in community settings. Consideration of key contextual factors, including resource levels, turnover rates, and community complexity will be vital for success.
28382571	Many women fail to meet recommended levels of physical activity (PA). Limited research has examined women's barriers to PA adoption during attempts to increase PA-in particular, how often they experience PA lapses (i.e., failure to meet PA goals), their cognitive-affective responses to lapses, and the role of social support in preventing or responding to lapses. The present study assessed weekly variability in PA lapses, cognitive-affective responses to lapses, and social support related to PA among women participating in a partner-based PA program (n = 20). Multilevel modeling showed that greater PA self-efficacy and more frequent partner communication predicted fewer lapses during the concurrent or subsequent week (ps < 0.02). Interestingly, greater self-forgiveness for lapsing also predicted more lapses the subsequent week (p = 0.04), though greater perceived partner support appeared to buffer the negative effect of self-forgiveness on future lapses (p = 0.04). These findings demonstrate the importance of cognitive-affective responses to PA lapses for future PA, as well as the potential benefit of social support for preventing PA lapses among women.
28382416	Scholarship on newborn screening, dried bloodspot retention, and large population biobanking call consistently for improved public engagement. Communication with participants likely occurs only in the context of collection, consent, or notification, if at all. We ran an 11-week advertising campaign to inform Michigan Facebook users unlikely to know that their or their children's dried bloodspots (DBSs) were stored in a state biobank. We investigated the pattern and content of comments posted during the campaign, focusing on users' questions, attitudes and concerns, and the role the moderator played in addressing them. We used Facebook data to quantitatively assess engagement and employed conventional content analysis to investigate themes, attitudes, and social dynamics among user and moderator comments. Five ad sets elicited comments during campaign weeks 4-8, reaching ∼800,000 Facebook users ($6000). Gravitating around broad, underlying ethical, legal, and social issues, 180 posts from 129 unique users related to newborn screening or biobanking. Thirty six conveyed negative attitudes and 33 conveyed positive attitudes; 53 posed questions. The most prevalent themes identified were consent, privacy, bloodspot use, identifiability, inclusion criteria, research benefits, (mis)trust, genetics, DBS destruction, awareness, and the role of government. The moderator's 81 posts were responsive-answering questions, correcting or clarifying information, or providing information about opting out. Facebook ad campaigns can improve engagement by pushing out relevant content and creating dynamic, responsive, visible forums for discussion. Reduced control over messaging may be worth the trade-off for creating accessible, transparent, people-centered engagement on public health issues that are sensitive and complex.
28382123	Introduction Parental support is important in the habilitation/rehabilitation of children using cochlear implant devices. Hence, it is important for families to know the realistic expectations regarding outcomes from CIs. Objective The objective of the present study is to know the parents' expectation from children using CIs. Methods For this study, we recruited 23 parents of children using CIs. We administered 15 questions translated in to Hindi related to communication abilities, social skills, academic achievement, change in future life, rehabilitation demand, and stress due to hearing impairment. Results The response of the questions (5-point rating scale) related to communication abilities showed that parents were expecting children using CIs to use the telephone (95%), to be able to detect soft sounds (99%), to listen in crowds (86%), to be able to easily understand others (76%), and to show improvement in communication skills (78%). Similarly, for questions related to social skills showed 90% of the parents expecting that their children with CIs should be able to easily make friends with normal hearing peers, and 80% of the parents were expecting the children to achieve high standards in their reading and writing skills. Questions related to change in future life showed 86% of the parents expecting their children with CIs to act like normal hearing children. Further, 78% parents showed positive response regarding importance of intensive training. However, 70% of the parents reported stress in the family due to the existence of the hearing impaired child. Conclusion Overall, the existing questionnaire-based study showed that parents have high expectations from their children with cochlear implant.
28381719	 The practice of regulatory science (RS) for drug development is described. In the course material for education in pharmaceutical sciences drafted by the RS Division of the Pharmaceutical Society of Japan, RS for pharmaceuticals is defined as the science of predicting, assessing, and judging the quality, efficacy, and safety of pharmaceutical products throughout their lifespan. RS is also described as an integrated science based on basic and applied biomedical sciences, including analytical chemistry, biochemistry, pharmacology, toxicology, genetics, biostatistics, epidemiology, and clinical trial methodology, and social sciences such as decision science, risk assessment, and communication science. The involvement of RS in drug development generally starts after the optimization of lead compounds. RS plays important roles governing pharmaceuticals during their entire life cycle management phase as well as the drug development phase.
28381714	 In 2006, a model core curriculum in pharmaceutical studies was developed prior to the outset of the 6-year pharmacy degree. In the 10 years that followed, medical care and life science technology has progressed, pharmaceutical laws have been revised, and the responsibilities of pharmacists have increased. In response to such social changes and needs, the Model Core Curriculum for Pharmacy Education was revised in December 2013. In order to play an active role as a pharmacist in any medical workplace, it is important for pharmacy students to develop their communication skills and attitudes in order to foster the trust of their patients and other medical professionals. In the new Model Core Curriculum, education in the humanities is clearly described as a foundation to pharmaceutical education, which pertains to the clinical role of a pharmacist; hence, each pharmacy school has outlined strategies for students to learn bioethics and medical ethics, and to develop communication skills. Today, although the importance of humanities education is rapidly increasing, it is difficult to immediately evaluate the outcome of learning humanities subjects and communication. Such an evaluation requires a longer-term perspective. This paper describes the status and problems of humanities education as a component of pharmacy education, and considers future directions of research in humanities education with respect to pharmacy education.
28381331	This study examined the extent to which health related aspect, health outcome, behaviour outcomes and social connectedness may predict adolescents' wellbeing at the schools of Jordan.Using a two-stage cluster sampling technique 1166 adolescents completed the Health Behaviour of School Children survey.	Stepwise Regression Analysis showed that the adolescents' wellbeing was predicted by academic achievements, bullying behaviour, eating habits, psycho-somatization, parent support and ease of communication with parents. These predictors explained 40% of the variance in the emotional wellbeing scores.	This study provides baseline information to build the evidence base for surveillance of health behaviors among adolescents in Jordan. Students' experiences of secondary school and their relationships at school continue to predict their emotional wellbeing.	
28379351	Due to the limited power of small-scale genome-wide association studies (GWAS), researchers tend to collaborate and establish a larger consortium in order to perform large-scale GWAS. Genome-wide association meta-analysis (GWAMA) is a statistical tool that aims to synthesize results from multiple independent studies to increase the statistical power and reduce false-positive findings of GWAS. However, it has been demonstrated that the aggregate data of individual studies are subject to inference attacks, hence privacy concerns arise when researchers share study data in GWAMA.In this article, we propose a secure quality control (SQC) protocol, which enables checking the quality of data in a privacy-preserving way without revealing sensitive information to a potential adversary. SQC employs state-of-the-art cryptographic and statistical techniques for privacy protection. We implement the solution in a meta-analysis pipeline with real data to demonstrate the efficiency and scalability on commodity machines. The distributed execution of SQC on a cluster of 128 cores for one million genetic variants takes less than one hour, which is a modest cost considering the 10-month time span usually observed for the completion of the QC procedure that includes timing of logistics.	SQC is implemented in Java and is publicly available at https://github.com/acs6610987/secureqc.	jean-pierre.hubaux@epfl.ch.	Supplementary data are available at Bioinformatics online.	
28378499	Despite advances in early diagnosis and behavioral therapies, more effective treatments for children with autism spectrum disorder (ASD) are needed. We hypothesized that umbilical cord blood-derived cell therapies may have potential in alleviating ASD symptoms by modulating inflammatory processes in the brain. Accordingly, we conducted a phase I, open-label trial to assess the safety and feasibility of a single intravenous infusion of autologous umbilical cord blood, as well as sensitivity to change in several ASD assessment tools, to determine suitable endpoints for future trials. Twenty-five children, median age 4.6 years (range 2.26-5.97), with a confirmed diagnosis of ASD and a qualified banked autologous umbilical cord blood unit, were enrolled. Children were evaluated with a battery of behavioral and functional tests immediately prior to cord blood infusion (baseline) and 6 and 12 months later. Assessment of adverse events across the 12-month period indicated that the treatment was safe and well tolerated. Significant improvements in children's behavior were observed on parent-report measures of social communication skills and autism symptoms, clinician ratings of overall autism symptom severity and degree of improvement, standardized measures of expressive vocabulary, and objective eye-tracking measures of children's attention to social stimuli, indicating that these measures may be useful endpoints in future studies. Behavioral improvements were observed during the first 6 months after infusion and were greater in children with higher baseline nonverbal intelligence quotients. These data will serve as the basis for future studies to determine the efficacy of umbilical cord blood infusions in children with ASD. Stem Cells Translational Medicine 2017;6:1332-1339.
28378133	Involvement of palliative care is so far not common practice for critically ill patients on surgical intensive care units (ICUs) in Germany. The objectives of palliative care concepts are improvement of patient quality of life by relief of disease-related symptoms using an interdisciplinary approach and support of patients and their relatives considering their current physical, psychological, social and spiritual needs. The need for palliative care can be identified via defined screening criteria. Integration of palliative care can either be realized using a consultative model which focusses on involvement of palliative care consultants or an integrative model which embeds palliative care principles into the routine daily practice by the ICU team. Early integration of palliative care in terms of advance care planning (ACP) can lead to an increase in goals of care discussions and quality of life as well as a decrease of mortality and length of stay on the ICU. Moreover, stress reactions of relatives and ICU staff can be reduced and higher satisfaction with therapy can be achieved. The core of goal of care discussions is professional and well-structured communication between patients, relatives and staff. Consideration of palliative care principles by model-based integration into ICU practice can improve complex intensive care courses of disease in a productive but dignified way without neglecting curative attempts.
28377367	Online health information-seeking behavior (OHISB) is currently a widespread and common behavior that has been described as an important prerequisite of empowerment and health literacy. Although demographic factors such as socioeconomic status (SES), age, and gender have been identified as important determinants of OHISB, research is limited regarding the gender-specific motivational determinants of OHISB and differences between women and men in the use of online resources for health information purposes.The aim of this study was to identify gender-specific determinants and patterns of OHISB by analyzing data from a representative German sample of adults (N=1728) with special attention to access and frequency of use as well as topics and sources of OHISB.	We employed a 2-step analysis, that is, after exploring differences between users and nonusers of online health information using logistic regression models, we highlighted gender-specific determinants of the frequency of OHISB by applying zero-truncated negative binomial models.	Age (odds ratio, OR for females=0.97, 95% CI 0.96-0.99) and degree of satisfaction with one's general practitioner (GP) (OR for males=0.73, 95% CI 0.57-0.92) were gender-specific determinants of access to OHISB. Regarding the frequency of OHISB, daily Internet use (incidence rate ratio, IRR=1.67, 95% CI 1.19-2.33) and a strong interest in health topics (IRR=1.45, 95% CI 1.19-1.77) were revealed to be more important predictors than SES (IRR for high SES=1.25, 95% CI 0.91-1.73).	Users indicate that the Internet seems to be capable of providing a valuable source of informational support and patient empowerment. Increasing the potential value of the Internet as a source for health literacy and patient empowerment requires need-oriented and gender-specific health communication efforts, media, and information strategies.	
28376917	This study focused on decision-making on terminating pregnancy for Arab Muslim women in Israel who were pregnant with fetuses diagnosed with congenital anomalies. It examined the impact of the doctor-patient interaction on the women's decision, especially in light of social and religious pressures not to terminate under any circumstances. Our goal was to identify perceptions and attitudes of Muslim Arab women who choose to continue their pregnancy following the detection of congenital anomalies in prenatal tests. Specific objectives included (1) To examine the Muslim Arab women's perceptions on genetic testing, and ascertain the reasons for their decision to continue the pregnancy following the detection of a congenital anomaly in the fetus; and (2) To examine risk communication of gynecologists regarding genetic testing and abortions, and regarding the decision of continuing or terminating a pregnancy following detection of a congenital anomaly.The research framework used the constructivist classical qualitative method to understand the experience of women at high risk for congenital anomalies and their experience of how doctors communicate the risk.	It showed that the emotional element is no less dominant than religious and social elements. The findings emphasized the disparities between doctors and women regarding emotional involvement (non-directive counselling). The women interviewees (N = 24) felt that this expressed insensitivity. As far as we know, the emotional component has not been raised in previous studies of Muslim women at high risk for congenital defects in their fetus, and therefore comprises a significant contribution of the present study.	To mitigate gaps, doctors should take affect into consideration in their communication with patients. It is important for doctors to understand the emotional element in risk communication, both in how they respect women's emotions and in creating an emotional interaction between themselves and the women.	
28376872	Evidence indicates that suboptimal clinical handover from the intensive care unit (ICU) to general wards leads to unnecessary ICU readmissions and increased mortality. We aimed to gain insight into barriers and facilitators to implement and use ICU discharge practices.A mixed methods approach was conducted, using 1) 23 individual and four focus group interviews, with post-ICU patients, ICU managers, and nurses and physicians working in the ICU or general ward of ten Dutch hospitals, and 2) a questionnaire survey, which contained 27 statements derived from the interviews, and was completed by 166 ICU physicians (21.8%) from 64 Dutch hospitals (71.1% of the total of 90 Dutch hospitals).	The interviews resulted in 66 barriers and facilitators related to: the intervention (e.g., feasibility); the professional (e.g., attitude towards checklists); social factors (e.g., presence or absence of a culture of feedback); and the organisation (e.g., financial resources). A facilitator considered important by ICU physicians was a checklist to structure discharge communication (92.2%). Barriers deemed important were lack of a culture of feedback (55.4%), an absence of discharge criteria (23.5%), and an overestimation of the capabilities of general wards to care for complex patients by ICU physicians (74.7%).	Based on the barriers and facilitators found in this study, improving handover communication, formulating specific discharge criteria, stimulating a culture of feedback, and preventing overestimation of the general ward are important to effectively improve the ICU discharge process.	
28376851	Chronic pain patients often use complementary medicine (CM) to alleviate their pain; however, little is known about the use of CM by chronic low back pain (cLBP) patients. We investigated the frequency of use of CM by cLBP patients, the perceived effects of these therapies, patients' knowledge regarding CM, and patient-physician communication regarding CM.A cross-sectional survey was conducted from November 2014 to February 2015. A questionnaire was distributed by physicians to 238 consecutive patients consulting for cLBP at the Pain Center of Lausanne University Hospital, Switzerland. Poisson regression model was used to analyze patients' level of knowledge regarding various CMs, and the logistic regression model was used to assess CM use for cLBP.	The questionnaire was returned by 168 cLBP patients (response rate: 70.6%). Lifetime prevalence of CM use for cLBP was 77.3%. The most commonly used therapies were osteopathy (48.8%), massage (45.2%) and acupuncture (31.6%), rated for their usefulness on a 0-10 scale as a mean ± SD of 5.4 ± 2.7, 5.9 ± 2.5 and 3.8 ± 3.2, respectively. The CM treatment best known by patients was osteopathy, followed by massage and acupuncture. If their doctors proposed CM as a treatment for cLBP, 78% of participants reported being very or somewhat likely to try CM. Respondents with CM health insurance were more likely to use CM (OR = 2.26; 95%CI: 1.07-4.78; p = 0.031) for cLBP. Respondents having experienced cLBP for more than five years were more likely to use CM to treat their cLBP than respondents having experienced cLBP for one year or less (OR = 2.84; 95%CI: 1.02-7.88; p = 0.044).	More than three-quarters of cLBP patients in our sample did use CM to treat their cLBP. The results showed that the most commonly used therapies were not necessarily the highest rated in terms of perceived usefulness. These results highlight the importance of developing integrative pain centers in which patients may obtain advice regarding CM treatments.	
28376776	Because no single person or group holds knowledge about all aspects of research, mechanisms are needed to support knowledge exchange and engagement. Expertise in the research setting necessarily includes scientific and methodological expertise, but also expertise gained through the experience of participating in research and/or being a recipient of research outcomes (as a patient or member of the public). Engagement is, by its nature, reciprocal and relational: the process of engaging research participants, patients, citizens and others (the many 'publics' of engagement) brings them closer to the research but also brings the research closer to them. When translating research into practice, engaging the public and other stakeholders is explicitly intended to make the outcomes of translation relevant to its constituency of users.In practice, engagement faces numerous challenges and is often time-consuming, expensive and 'thorny' work. We explore the epistemic and ontological considerations and implications of four common critiques of engagement methodologies that contest: representativeness, communication and articulation, impacts and outcome, and democracy. The ECOUTER (Employing COnceptUal schema for policy and Translation Engagement in Research) methodology addresses problems of representation and epistemic foundationalism using a methodology that asks, "How could it be otherwise?" ECOUTER affords the possibility of engagement where spatial and temporal constraints are present, relying on saturation as a method of 'keeping open' the possible considerations that might emerge and including reflexive use of qualitative analytic methods.	This paper describes the ECOUTER process, focusing on one worked example and detailing lessons learned from four other pilots. ECOUTER uses mind-mapping techniques to 'open up' engagement, iteratively and organically. ECOUTER aims to balance the breadth, accessibility and user-determination of the scope of engagement. An ECOUTER exercise comprises four stages: (1) engagement and knowledge exchange; (2) analysis of mindmap contributions; (3) development of a conceptual schema (i.e. a map of concepts and their relationship); and (4) feedback, refinement and development of recommendations.	ECOUTER refuses fixed truths but also refuses a fixed nature. Its promise lies in its flexibility, adaptability and openness. ECOUTER will be formed and re-formed by the needs and creativity of those who use it.	
28375592	Bowel cancer screening reduces cancer-specific mortality. There is a socioeconomic gradient in the uptake of the English NHS Bowel Cancer Screening Programme (BCSP), which may lead to inequalities in cancer outcomes.To reduce socioeconomic inequalities in uptake of the NHS BCSP’s guaiac faecal occult blood test (gFOBt) without compromising uptake in any socioeconomic group.	Workstream 1 explored psychosocial determinants of non-uptake of gFOBt in focus groups and interviews. Workstream 2 developed and tested four theoretically based interventions: (1) ‘gist’ information, (2) a ‘narrative’ leaflet, (3) ‘general practice endorsement’ (GPE) and (4) an ‘enhanced reminder’ (ER). Workstream 3 comprised four national cluster randomised controlled trials (RCTs) of the cost-effectiveness of each intervention.	Interventions were co-designed with user panels, user tested using interviews and focus groups, and piloted with postal questionnaires. RCTs compared ‘usual care’ (existing NHS BCSP invitations) with usual care plus each intervention. The four trials tested: (1) ‘gist’ leaflet (n = 163,525), (2) ‘narrative’ leaflet (n = 150,417), (3) GPE on the invitation letter (n = 265,434) and (4) ER (n = 168,480). Randomisation was based on day of mailing of the screening invitation. The Index of Multiple Deprivation (IMD) score associated with each individual’s home address was used as the marker of socioeconomic circumstances (SECs). Change in the socioeconomic gradient in uptake (interaction between treatment group and IMD quintile) was the primary outcome. Screening uptake was defined as the return of a gFOBt kit within 18 weeks of the invitation that led to a ‘definitive’ test result of either ‘normal’ (i.e. no further investigation required) or ‘abnormal’ (i.e. requiring referral for further testing). Difference in overall uptake was the secondary outcome.	The gist and narrative trials showed no effect on the SECs gradient or overall uptake (57.6% and 56.7%, respectively, compared with 57.3% and 58.5%, respectively, for usual care; all p-values > 0.05). GPE showed no effect on the gradient (p = 0.5) but increased overall uptake [58.2% vs. 57.5% in usual care, odds ratio (OR) = 1.07, 95% confidence interval (CI) 1.04 to 1.10; p < 0.0001]. ER showed a significant interaction with SECs (p = 0.005), with a stronger effect in the most deprived IMD quintile (14.1% vs. 13.3% in usual care, OR = 1.11, 95% CI 1.04 to 1.20; p = 0.003) than the least deprived (34.7% vs. 34.9% in usual care OR = 1.00, 95% CI 0.94 to 1.06; p = 0.98), and higher overall uptake (25.8% vs. 25.1% in usual care, OR = 1.07, 95% CI 1.03 to 1.11; p = 0.001). All interventions were inexpensive to provide.	In line with NHS policy, the gist and narrative leaflets supplemented rather than replaced existing NHS BCSP information. This may have undermined their effect.	Enhanced reminder reduced the gradient and modestly increased overall uptake, whereas GPE increased overall uptake but did not reduce the gradient. Therefore, given their effectiveness and very low cost, the findings suggest that implementation of both by the NHS BCSP would be beneficial. The gist and narrative results highlight the challenge of achieving equitable delivery of the screening offer when all communication is written; the format is universal and informed decision-making mandates extensive medical information.	Socioculturally tailored research to promote communication about screening with family and friends should be developed and evaluated.	Current Controlled Trials ISRCTN74121020.	This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 5, No. 8. See the NIHR Journals Library website for further project information.	
28375826	Social isolation is a problem facing many older women. Isolation can contribute to poor health as adults age without social support. Increased and tailored communication offers service organizations more opportunities to provide social support to these adults. This research examines perceptions of aging to explore communication behaviors, barriers, and opportunities for improved communication and service provision for aging women. Using data from focus groups and interviews, this study finds that participants from community organizations rely on word of mouth and traditional media to communicate with their aging constituents, despite opportunities to use digital communication and to develop communication plans for this population.
28375542	Jamaica, along with the Americas, experienced major epidemics of arboviral diseases transmitted by the Aedes aegypti mosquito in recent years. These include dengue fever in 2012, Chikungunya fever in 2014 and Zika virus infection (ZIKV) in 2016. We present the emergence of the ZIKV epidemic in Jamaica and outline the national response.The Ministry of Health's preparedness included: heightened surveillance, clinical management guidance, vector control and management, laboratory capacity strengthening, training and staffing, risk communication and public education, social mobilization, inter-sectoral collaboration, resource mobilization and international cooperation.	The first case of ZIKV was confirmed on January 29, 2016 with date of onset of January 17, 2016. From January 3 to July 30, 2016 (Epidemiological Week (EW) 1-30), 4648 cases of ZIKV were recorded (4576 suspected, 72 laboratory-confirmed). Leading symptoms were similar among suspected and confirmed cases: rash (71% and 88%), fever (65% and 53%) and joint pains (47% and 38%). There were 17 suspected cases of Guillain Barre syndrome; 383 were reported in pregnant women, with no reports of microcephaly to date. Zika and dengue viruses were circulating predominantly in 2016. At EW30, 1744 cases of dengue were recorded (1661 suspected and 83 confirmed). Dengue serotypes 3 and 4 were circulating with 121 reports of dengue haemorrhagic fever.	The possibility exists for endemicity of ZIKV similar to dengue and chikungunya in Jamaica. A ZIKV vaccine, similar to the dengue and chikungunya vaccines, is needed to be fast-tracked into clinical trials to mitigate the effects of this disease.	
28375501	Ethical discussions around health care reform typically focus on problems of social justice and health care equity. This review, in contrast, focuses on ethical issues of particular importance to neurosurgeons, especially with respect to potential changes in the physician-patient relationship that may occur in the context of health care reform.The Patient Protection and Affordable Care Act (ACA) of 2010 (H.R. 3590) was not the first attempt at health care reform in the United States but it is the one currently in force. Its ambitions include universal access to health care, a focus on population health, payment reform, and cost control. Each of these aims is complicated by a number of ethical challenges, of which 7 stand out because of their potential influence on patient care: the accountability of physicians and surgeons to individual patients; the effects of financial incentives on clinical judgment; the definition and management of conflicting interests; the duty to preserve patient autonomy in the face of protocolized care; problems in information exchange and communication; issues related to electronic health records and data security; and the appropriate use of "Big Data."Systematic social and economic reforms inevitably raise ethical concerns. While the ACA may have driven these 7 to particular prominence, they are actually generic. Nevertheless, they are immediately relevant to the practice of neurosurgery and likely to reflect the realities the profession will be obliged to confront in the pursuit of more efficient and more effective health care.
28375071	The primary purpose of this study was to compare two methods for assessing student communication skills: a labor-intensive review of video-recorded interactions and global communications assessment using a comprehensive rotation-assessment tool. Secondary goals of the study were to evaluate student strengths and weaknesses to inform the pre-clinical communications curriculum and to evaluate for consistency between types of reviewers. Video recordings of 43 student encounters with clients presenting their animals for wellness or diagnostic appointments to the primary care service at a veterinary teaching hospital were reviewed by one of three primary care clinicians, a social worker, and a clinical communications instructor, using a common rubric. Scores using the rubric were compared with overall scores for verbal communications on a comprehensive rotation-assessment tool, both for the primary care rotation and for other small-animal rotations. Duration did not vary significantly between wellness and diagnostic appointments, or between dog and cat appointments. Scores achieved by students on video review varied by evaluator, with the clinical communications instructor scoring students the lowest and the social worker scoring students the highest. Strengths identified included greeting the client appropriately, gathering initial information about the reason for the visit, and using lay terminology appropriately. Weaknesses included summarizing information for the client, talking to clients about money, and making strong recommendations.
28374957	Sperm competition theory predicts that males should use cues indicating the risk and intensity of sperm competition to tailor their sperm investment accordingly. Rival males are an important source of social information regarding sperm competition risk. However, revealing such information may not be in the rival males' interest. Here, we use a theoretical approach based on informed and uninformed games to investigate when information transfer about sperm competition risk to competitors is beneficial for a male, and when it is not. The results show that signalling to potential future mates that a female has already mated is beneficial when the signalling male has a sperm competition disadvantage, whereas it is unfavourable when the signaller has an advantage. The reason for this counterintuitive result is that the rival males' optimal response is to reduce sperm investment when the signaller has a disadvantage and, conversely, to increase investment when the signaller has an advantage. Furthermore, we analysed scenarios where males use alternative reproductive tactics. In this situation, signalling the awareness of sperm competition risk rarely pays; instead, it is beneficial to maintain an information advantage. Thus, it may be beneficial for bourgeois males to accept cuckoldry instead of revealing their sperm competition awareness to reproductive parasites. These results provide new insight into the evolution of communication between rivals in the context of sperm competition.
28374929	Dysregulation of the mitogen activated protein kinase (MAPK) pathway in Costello syndrome (CS) may contribute to increased risk for autism-spectrum disorder (ASD). We examined prevalence of ASD symptoms in 14 individuals (six females) age 1-18 years with molecularly confirmed CS. Caregivers completed the Modified Checklist for Autism in Toddlers (M-CHAT) for ages 0-4 years (n = 7), and the Social Communication Questionnaire (SCQ) for ages 4 and older (n = 7). Age was associated with meeting ASD criteria: 5/7 (71.4%) younger children met the ASD cut-off on the MCHAT, compared to 0/7 older children on the SCQ. The following medical and developmental factors were strongly associated with ASD criteria on the M-CHAT: having a gastrostomy tube at time of assessment, not eating solid food, not walking, and not being toilet trained. Two children who met stricter ASD criteria had significantly lower adaptive functioning and were physically much more impaired. Among older participants, SCQ subscale scores in communication, socialization, and repetitive behavior domains were comparable to the typically-developing normative sample. ASD symptoms were highly elevated in younger CS individuals. Older children did not differ from typically developing samples in prevalence of ASD symptoms. CS individuals may appear to fall on the autism spectrum in early childhood due to severe feeding and orthopedic problems that improve by age four, suggesting many of these children may eventually emerge out of an ASD presentation.
28374161	Families often bear the burden of communication about cancer risk, as well as support during and after treatment for cancer in family members. These activities are left up to survivors and their families, with little support or knowledge of useful methods. We present data on aspects of family that are most relevant to risk of cancer-related communication and health promotion among family members. Families (a survivor, one first-degree relative and one parent; n = 313 families) were enrolled in the survey-based study. We assessed multiple aspects of family communication about risk for melanoma among family participants. Families communicate less frequently than desired about cancer risk. Most families do identify a "family health provider" who keeps family data and serves a resource for family members. The reasons given for lack of family communication are diverse but many can be addressed as part of a family communication intervention. Families are poised to improve their family communication about cancer risk and so can play a role in increasing the health of their members.
28373956	Intentional facial expression of emotion is critical to healthy social interactions. Patients with neurodegenerative disease, particularly those with right temporal or prefrontal atrophy, show dramatic socioemotional impairment. This was an exploratory study examining the neural and behavioral correlates of intentional facial expression of emotion in neurodegenerative disease patients and healthy controls. One hundred and thirty three participants (45 Alzheimer's disease, 16 behavioral variant frontotemporal dementia, 8 non-fluent primary progressive aphasia, 10 progressive supranuclear palsy, 11 right-temporal frontotemporal dementia, 9 semantic variant primary progressive aphasia patients and 34 healthy controls) were video recorded while imitating static images of emotional faces and producing emotional expressions based on verbal command; the accuracy of their expression was rated by blinded raters. Participants also underwent face-to-face socioemotional testing and informants described participants' typical socioemotional behavior. Patients' performance on emotion expression tasks was correlated with gray matter volume using voxel-based morphometry (VBM) across the entire sample. We found that intentional emotional imitation scores were related to fundamental socioemotional deficits; patients with known socioemotional deficits performed worse than controls on intentional emotion imitation; and intentional emotional expression predicted caregiver ratings of empathy and interpersonal warmth. Whole brain VBMs revealed a rightward cortical atrophy pattern homologous to the left lateralized speech production network was associated with intentional emotional imitation deficits. Results point to a possible neural mechanisms underlying complex socioemotional communication deficits in neurodegenerative disease patients.
28373270	Consumer-reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative US adult population with established atherosclerotic cardiovascular disease.The study population consisted of a nationally representative sample of 6810 individuals (aged ≥18 years), representing 18.3 million adults with established atherosclerotic cardiovascular disease (self-reported or International Classification of Diseases, Ninth Edition diagnosis) reporting a usual source of care in the 2010 to 2013 pooled Medical Expenditure Panel Survey cohort. Participants responded to questions from Consumer Assessment of Health Plans Survey that assessed PPC, and we developed a weighted PPC composite score using their responses, categorized as 1 (poor), 2 (average), and 3 (optimal). Outcomes of interest were (1) patient-reported outcomes: 12-item Short Form physical/mental health status, (2) quality of care measures: statin and ASA use, (3) healthcare resource utilization: emergency room visits and hospital stays, and (4) total annual and out-of-pocket healthcare expenditures. Atherosclerotic cardiovascular disease patients reporting poor versus optimal were over 2-fold more likely to report poor outcomes; 52% and 26% more likely to report that they are not on statin and aspirin, respectively, had a significantly greater utilization of health resources (odds ratio≥2 emergency room visit, 1.41 [95% confidence interval, 1.09-1.81]; odds ratio≥2 hospitalization, 1.36 [95% confidence interval, 1.04-1.79]), as well as an estimated $1243 ($127-$2359) higher annual healthcare expenditure.	This study reveals a strong relationship between PPC and patient-reported outcomes, utilization of evidence-based therapies, healthcare resource utilization, and expenditures among those with established atherosclerotic cardiovascular disease.	
28372878	A common finding in human functional brain-imaging studies is that damage to neural systems paradoxically results in enhanced functional connectivity between network regions, a phenomenon commonly referred to as 'hyperconnectivity'. Here, we describe the various ways that hyperconnectivity operates to benefit a neural network following injury while simultaneously negotiating the trade-off between metabolic cost and communication efficiency. Hyperconnectivity may be optimally expressed by increasing connections through the most central and metabolically efficient regions (i.e., hubs). While adaptive in the short term, we propose that chronic hyperconnectivity may leave network hubs vulnerable to secondary pathological processes over the life span due to chronically elevated metabolic stress. We conclude by offering novel, testable hypotheses for advancing our understanding of the role of hyperconnectivity in systems-level brain plasticity in neurological disorders.
28372560	Foodborne trematodiasis (FBT) is a significant global health problem, with the liver flukes Opisthorchis viverrini, O. felineus, and Clonorchis sinensis contributing to half of the global burden of FBT. North-eastern Thailand where O. viverrini is endemic and un-cooked fish dishes remain an integral part of the food culture has the highest reported incidence of opisthorchiasis, including associated cholangiocarcinoma. Both food sharing and eating practices are potentially important factors in FTB, suggesting an important role for the social ecology of disease transmission in these rural communities.Two rural Thai-Lao villages that were part of a 12-village project in Northeastern Thailand were selected for detailed investigation of O. viverrini infection risk associated with sharing of raw fish dishes among households. The project included screening individuals for infection and cholangiocarcinoma, a household questionnaire, and offering treatment options for positive individuals. Social network mapping was used to construct raw fish dish-sharing networks and create a proxy variable capturing variability in the degree of food sharing (DFS), measured as the number of different households with which each household shared fish dishes. Measures of associations between DFS, O. viverrini infection, the frequency of raw fish consumption, and the number of raw fish dishes consumed were generated using binary logistic regression, proportional odds ordinal logistic regression, and Poisson regression.	The results showed that the probability that a household has members infected with O. viverrini increased by ~7% (P < 0.01) for each additional household included in its network. Moreover, the frequency and number of types of raw fish dishes consumed increased significantly as the DFS increased. Of the two villages, that with the highest infection prevalence (48% versus 34.6%) had significantly higher social connectivity overall (P < 0.001).	Our findings suggest that the social ecology of human settlements may be key to understanding the transmission dynamics of some FBT. In the case of O. viverrini in Thai-Lao communities, for which food sharing is a traditional practice supporting social cohesion, food sharing network mapping should be incorporated into community-based interventions. These should encourage fish dish preparation methods that minimize infection risk by targeting households with high DFS values.	
28372553	There is little evidence on how professionals communicate to assess suicide risk. This study analysed how professionals interview patients about suicidal ideation in clinical practice.Three hundred nineteen video-recorded outpatient visits in U.K. secondary mental health care were screened. 83 exchanges about suicidal ideation were identified in 77 visits. A convenience sample of 6 cases in 46 primary care visits was also analysed. Depressive symptoms were assessed. Questions and responses were qualitatively analysed using conversation analysis. χ 2 tested whether questions were influenced by severity of depression or influenced patients' responses.	A gateway closed question was always asked inviting a yes/no response. 75% of questions were negatively phrased, communicating an expectation of no suicidal ideation, e.g., "No thoughts of harming yourself?". 25% were positively phrased, communicating an expectation of suicidal ideation, e.g., "Do you feel life is not worth living?". Comparing these two question types, patients were significantly more likely to say they were not suicidal when the question was negatively phrased but were not more likely to say they were suicidal when positively phrased (χ 2 = 7.2, df = 1, p = 0.016). 25% patients responded with a narrative rather than a yes/no, conveying ambivalence. Here, psychiatrists tended to pursue a yes/no response. When the patient responded no to the gateway question, the psychiatrist moved on to the next topic. A similar pattern was identified in primary care.	Psychiatrists tend to ask patients to confirm they are not suicidal using negative questions. Negatively phrased questions bias patients' responses towards reporting no suicidal ideation.	
28372356	The purpose of this study was to describe the source, length, number of views, and content of the most widely viewed Zika virus (ZIKV)-related YouTube videos. We hypothesized that ZIKV-related videos uploaded by different sources contained different content.The 100 most viewed English ZIKV-related videos were manually coded and analyzed statistically.	Among the 100 videos, there were 43 consumer-generated videos, 38 Internet-based news videos, 15 TV-based news videos, and 4 professional videos. Internet news sources captured over two-thirds of the total of 8 894 505 views. Compared with consumer-generated videos, Internet-based news videos were more likely to mention the impact of ZIKV on babies (odds ratio [OR], 6.25; 95% confidence interval [CI], 1.64 to 23.76), the number of cases in Latin America (OR, 5.63; 95% CI, 1.47 to 21.52); and ZIKV in Africa (OR, 2.56; 95% CI, 1.04 to 6.31). Compared with consumer-generated videos, TV-based news videos were more likely to express anxiety or fear of catching ZIKV (OR, 6.67; 95% CI, 1.36 to 32.70); to highlight fear of ZIKV among members of the public (OR, 7.45; 95% CI, 1.20 to 46.16); and to discuss avoiding pregnancy (OR, 3.88; 95% CI, 1.13 to 13.25).	Public health agencies should establish a larger presence on YouTube to reach more people with evidence-based information about ZIKV.	
28371669	Veterans' Treatment Courts (VTCs) are posited as a solution to offer rehabilitation for veterans involved in the criminal justice system. Despite the pervasive implementation of VTCs, there is little research focused specifically on VTC implementation and outcomes, which are based on other problem-solving court models such as drug court. The current study presents qualitative process evaluation data from key stakeholders (n=21) and veteran participants (n=4) to show accomplishments, challenges, and lessons learned during first-year implementation at two VTC sites. Quantitative performance data is also presented on veteran participants (n=19) served during the first year to show: types of services, monitoring, judicial interaction, sanctions/therapeutic responses, and rewards, as well as preliminary data on recidivism. Qualitative data, from both key stakeholders and veteran participants, suggests that offering rehabilitation via various program components, services/referrals, and accountability are critical to the success of the VTC. Data also provides valuable lessons learned for VTC implementation including communication, collaboration, information/protocols, and resources. Performance data shows that a variety of services are utilized and that frequent judicial interaction, drug testing, and sanctions are cornerstones of the VTC. Implications and future directions for research are discussed.
28371492	This study examined whether individuals with autism spectrum disorder (ASD) produce co-speech gestures similarly to typically developing (TD) peers. Participants were 20 youth ages 10-18 years with high-functioning ASD and 21 TD controls matched on age, gender, verbal IQ, and handedness. Gestures were elicited using a classic narrative-retelling task, in which participants watched a Tweety and Sylvester cartoon and retold the cartoon to a confederate. Analyses compared gesture rate, type, and viewpoint (character, observer, dual) across groups. Communicative utility of gestures was measured via naïve coder ratings of whether a movement was a gesture, and the clarity of a gesture's meaning. The ASD group produced shorter narratives and fewer total gestures than the TD group. Accounting for narrative length, the ASD group produced fewer gestures per clause than the TD group; however, proportions of gesture types (iconic, deictic, beat, metaphoric, emblems) did not differ. Most notably, the ASD group's gestures were rated as less clearly gestures in terms of timing and well formedness, with lower certainty ratings for gesture meaning. Gesture clarity and gesture meaning scores were related to diagnostic measures of gesture competence in ASD. Findings suggest that although fluent children and adolescents with ASD use the same type of gestures as controls, their gestures are more difficult to understand, which has significant implications for their communicative abilities more broadly. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28371046	Recognizing expectations and concerns of patients leads to more specialized management plans and greater adherence to treatment, and improves outcomes. Little is known about how age impacts on expectations or concerns regarding pain in patients attending a chronic pain clinic.We prospectively assessed the expectations and concerns of 100 adult patients at their first visit to a pain clinic. Patients reported their expectations and concerns for the clinic visit using a self-completed questionnaire. Categories of concerns and expectations were compared across age groups (≤65 years, >65 years) using the chi-square test and Fishers exact test.	Thirty-nine patients (39%) were over 65 years of age (older patients). The most frequently stated site of pain was the lumbar spine for all patients regardless of age. Common concerns of all patients related to sleep and mobility, and the most common expectation related to analgesia. Younger patients were more concerned about employment (23% vs. 3% of older patients, P = 0.005) and social participation (21% vs. 5%, P = 0.03), whereas older patients were more likely to be concerned about mobility (46% vs. 15% of younger patients, P = 0.001). More younger patients expected education on the source of pain than did older patients (23% vs. 3%, P = 0.005), whereas older patients were more likely to be unsure or have no expectations (26% vs. 3%, P = 0.005).	We found differences in patient expectations and concerns by age of those attending a chronic pain clinic. These differences can inform the communication process between physician and patient on treatment plans and outcomes. This article is protected by copyright. All rights reserved.	
28370414	The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation.We evaluated a full-day simulation-based team training course in neonatal resuscitation, by administering a questionnaire to 110 physicians, nurses and midwives before and after the training period. The questionnaire focused on four important domains: communication, leadership, confidence and technical skills. The study was carried out in Sweden from 2005 to 2007.	The response rate was 84%. Improvements in the participants' self-assessed ability to perform neonatal resuscitation were seen in all four domains after training (p < 0.001). Professionally inexperienced personnel showed a significant improvement in the technical skills domain compared to experienced personnel (p = 0.001). No differences were seen between professions or time since training in any of the four domains. Personnel with less previous experience with neonatal resuscitation showed improved confidence (p = 0.007) and technical skills (p = 0.003).	A full-day course on simulation-based team training with video-supported debriefing improved the participants' self-assessed ability to perform neonatal resuscitation.	
28370260	To synthesize evidence on the use of social media in nursing and midwifery education.Social media is one type of online platform that is being explored to determine if there is value in using interactive, digital communication tools to support how nurses and midwives learn in a variety of settings.	A sequential explanatory synthesis approach will be used for this mixed study review.	Five bibliographic databases; PubMed, MEDLINE, CINAHL, Scopus, and ERIC will be searched using a combination of keywords relevant to social networking and social media, nursing and midwifery, and education. The search will not be limited by year of publication. Titles, abstracts, and full papers will be screened by two independent reviewers against inclusion and exclusion criteria, with any disagreements resolved via a third reviewer. Selected studies will undergo quality assessment and data extraction. Data synthesis will occur in three sequential phases, with quantitative and qualitative data analysed separately and then integrated where possible to provide a conceptual framework illustrating learning via social media. Funding for this review was confirmed in May 2016 by Sigma Theta Tau International and the National League for Nursing.	The mixed study systematic review will produce the first rigorous synthesis on the use of social media in nursing and midwifery education and will have important implications for educators as well as students. It will also highlight knowledge gaps and make recommendations on the use of this novel technology in higher and continuing education.	
28370174	Parents undergo multiple transitions following the birth of an ill infant: their infant's illness-health trajectory, neonatal intensive care unit hospitalization and transfers from one healthcare setting to another, while also transitioning to parenthood. The objective of this review was to map and synthesize evidence on the experiences and needs of parents of preterm or ill infants as they transition within and between healthcare settings following birth.The scoping review followed Arskey and O'Malley's () framework, enhanced by Levac et al. (). Relevant studies were identified through a comprehensive search strategy of scientific and grey literature databases, online networks, Web of Science and citation lists of relevant articles. Inclusion criteria encompassed a focus on infants undergoing a healthcare transition, and the experiences and needs of parents during transition. Studies were appraised for design quality, and data relevant to parent experiences were extracted and underwent thematic analysis.	A total of 7773 records were retrieved, 90 full texts reviewed and 11 articles synthesized that represented a total sample of 435 parents of preterm or ill infants. Parents reported on their experiences in response to their infant's transition within and between hospitals and across levels of neonatal intensive care unit, intermediate and community hospital care. Ten studies used qualitative research methods, while one employed quantitative survey methods. Four key themes were identified: that of parent distress throughout transition, parenting at a distance, sources of stress and sources of support. Parents' stress resulted from not being informed or involved in the transition decision, inadequate communication and perceived differences in cultures of care across healthcare settings.	Opportunities to improve parents' early transition experiences include enhanced engagement, communication, information-sharing and shared decision-making between health care providers and parents. Future areas of research should focus on early transition interventions to advance parent capacity, confidence and closeness as the primary nurturer.	
28369410	Social accountability is increasingly invoked as a way of improving health services. This article presents a theory-driven qualitative study of the context, mechanisms and outcomes of a social accountability program, Citizen Voice and Action (CVA), implemented by World Vision (WV) in Zambia. Primary data were collected between November 2013 and January 2014. It included in-depth interviews and focus group discussions with program stakeholders. Secondary data were used iteratively-to inform the process for primary data collection, to guide primary data analysis and to contextualize findings from the primary data. CVA positively impacted the state, society, state-society relations and development coordination at the local level. Specifically, sustained improvements in some aspects of health system responsiveness, empowered citizens, the improved provision of public goods (health services) and increased consensus on development issues appeared to flow from CVA. The central challenge described by interviewees and FGD participants was the inability of CVA to address problems that required central level input. The mechanisms that generated these outcomes included productive state-society communication, enhanced trust, and state-society co-production of priorities and the provision of services. These mechanisms were activated in the context of existing structures for state-society interaction, willing political leaders, buy-in by traditional leaders, and WV's strong reputation and access to resources. Prospective observational research in multiple contexts would shed more light on the context, mechanisms and outcomes of CVA programs. In addition to findings that are intuitive and well supported in the literature we identified new areas that are promising areas for future research. These include (1) the context of organizational reputation by the organization(s) spearheading social accountability efforts; (2) the potential relationship between social accountability efforts and making ambitious national programs operational at the frontlines of the health system and (3) the feasibility of scale up for certain types of local level responsiveness.
28368272	Autism Spectrum Disorder (ASD) is a clinically heterogenous condition with a wide range of etiological factors and causing significant public health burden. ASD poses a serious developmental disadvantage to the child in the form of poor schooling, social function and adult productivity. Thus, framing evidence-based national guidelines is a pressing need.The meeting on formulation of national consensus guidelines on neurodevelopmental disorders was organized by Indian Academy of Paediatrics in Mumbai on 18th and 19th December 2015. The invited experts included Pediatricians, Developmental Pediatricians, Psychiatrists, Remedial Educators, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. Thereafter, a committee was established to review the points discussed in the meeting.	To provide consensus guidelines on evaluation and management of ASD in children in India.	Intervention should begin as early as possible. A definitive diagnosis is not necessary for commencing intervention. Intervention should target core features of autism i.e. deficits in social communication and interaction, and restricted repetitive patterns of behavior, activities and/ or interests. Intervention should be specific, evidence-based, structured and appropriate to the developmental needs of the child. Management of children should be provided through interdisciplinary teams, coordinated by the Pediatrician. Management of co-morbidities is critical to effectiveness of treatment. Pharmacotherapy may be offered to children when there is a specific target symptom or co-morbid condition.	
28367432	The threat posed by Meticillin-resistant Staphylococcus aureus (MRSA) has taken on an increasingly pan-European dimension. This article aims to provide an overview of the different approaches to the control of MRSA adopted in five European countries (Austria, Germany, Netherlands, Spain, and the UK) and discusses data and reporting mechanisms, regulations, guidelines, and health policy approaches with a focus on risk communication. Our hypothesis is that current infection control practices in different European countries are implicit messages that contribute to the health-related risk communication and subsequently to the public perception of risk posed by MRSA. A reporting template was used to systematically collect information from each country.Large variation in approaches was observed between countries. However, there were a number of consistent themes relevant to the communication of key information regarding MRSA, including misleading messages, inconsistencies in content and application of published guidelines, and frictions between the official communication and their adoption on provider level.	The variability of recommendations within, and across, countries could be contributing to the perception of inconsistency. Having inconsistent guidelines and practices in place may also be affecting the level at which recommended behaviors are adopted. The discrepancy between the official, explicit health messages around MRSA and the implicit messages stemming from the performance of infection control measures should, therefore, be a key target for those wishing to improve risk communication.	
28367385	While healthcare expenditure continues to increase overall health outcomes in the United States continue to be submarginal. The changes we make in our healthcare system need to be informed by a comprehensive and actionable definition of health that can unite patients, healthcare professionals, and policymakers.A literature review across multiple disciplines was conducted to assess a broad range of factors associated with health and well-being and based on this literature review a novel definition of health was developed.	Development of a definition of health as the ability to dynamically recognize and resolve dissonance in one's physical, mental, social and spiritual worlds via cooperation with social and spiritual connections, the medical community and with the natural world in a way that fosters and promotes harmony, resilience, and relief from suffering. This definition is then expanded into six domains (connection, communication, creativity, cooperation, cost-consciousness, and computerization) which are applicable to individuals, society and the healthcare system and which form the basis for actionable guidelines to promote measurable and sustained change on a public health scale.	Healthcare in the United States is changing and in order to move forward in an evidence-based and compassionate way, we need to understand what we mean by 'health' and how that definition can be operational at individual, societal, and public policy levels.	
28367068	In this article, we follow the approach taken by Riesch and Spiegalhalter in "Careless pork costs lives': Risk stories from science to press release to media' published in this journal, and offer an assessment of one example of a 'risk story'. Using content and thematic qualitative analysis, we consider how the findings of an article 'Fetal Alcohol Exposure and IQ at Age 8: Evidence from a Population-Based Birth-Cohort Study' were framed in the article itself, the associated press release, and the subsequent extensive media coverage. We contextualise this consideration of a risk story by discussing a body of work that critically engages with the development and global proliferation of efforts to advocate for alcohol abstinence to pregnant (and pre-pregnant) women. This work considers the 'democratisation' of risk, a term used to draw attention to the expansion of the definition of the problem of drinking in pregnancy to include any drinking and all women. We show here how this risk story contributed a new dimension to the democratisation of risk through claims that were made about uncertainty and certainty. A central argument we make concerns the contribution of the researchers themselves (not just lobby groups or journalists) to this outcome. We conclude that the democratisation of risk was advanced in this case not simply through journalists exaggerating and misrepresenting research findings, but that communication to the press and the initial interpretation of findings played their part. We suggest that this risk story raises concerns about the accuracy of reporting of research findings, and about the communication of unwarrantedly worrying messages to pregnant women about drinking alcohol.
28367052	To become language users, infants must embrace the integrality of speech perception and production. That they do so, and quite rapidly, is implied by the native-language attunement they achieve in each domain by 6-12 months. Yet research has most often addressed one or the other domain, rarely how they interrelate. Moreover, mainstream assumptions that perception relies on acoustic patterns whereas production involves motor patterns entail that the infant would have to translate incommensurable information to grasp the perception-production relationship. We posit the more parsimonious view that both domains depend on commensurate articulatory information. Our proposed framework combines principles of the Perceptual Assimilation Model (PAM) and Articulatory Phonology (AP). According to PAM, infants attune to articulatory information in native speech and detect similarities of nonnative phones to native articulatory patterns. The AP premise that gestures of the speech organs are the basic elements of phonology offers articulatory similarity metrics while satisfying the requirement that phonological information be discrete and contrastive: (a) distinct articulatory organs produce vocal tract constrictions and (b) phonological contrasts recruit different articulators and/or constrictions of a given articulator that differ in degree or location. Various lines of research suggest young children perceive articulatory information, which guides their productions: discrimination of between- versus within-organ contrasts, simulations of attunement to language-specific articulatory distributions, multimodal speech perception, oral/vocal imitation, and perceptual effects of articulator activation or suppression. We conclude that articulatory gesture information serves as the foundation for developmental integrality of speech perception and production.
28366828	Infectious diseases are the leading cause of death of children worldwide, causing a tenacious and major public-health burden. The dynamic interplay between pathogens and their host is one of the most complicated themes of the disease progression. Pathogens excel in developing different means to facilitate cell-cell communication via secreted vesicles, among others. The released vesicles are involved in the transfer of biologically active molecules that induce phenotypic changes in the recipient cells. The messages within the vesicles are delivered to coordinate diverse processes, including virulence factor expression, differentiation state and control of their population density. Importantly, production of such vesicles promotes pathogen survival, as it provides a secure means of pathogen-pathogen communication and an ability to manipulate host responses for their own benefits. This review highlights intriguing findings, which show the important role of EVs in the social activity of pathogens, within and in between their communities. We further present examples of how pathogens use EVs to alter host immune and non-immune responses. Advancing our understanding of cell-cell communication in infectious diseases will be particularly useful to decipher the complexity of the cross-talk between pathogens themselves and their hosts, leading to the development of therapeutic strategies for fighting infectious agents.
28366529	Family-centered care (FCC), including shared decision making (SDM), has become increasingly emphasized in pediatric health care delivery. Past studies using national surveys have used different FCC measurement approaches without determining their validity. We, therefore, sought to develop an FCC measurement model with Medical Expenditure Panel Survey (MEPS) items previously used to assess FCC or SDM; and to determine temporal associations of FCC with unmet health care need.Four longitudinal MEPS data files (2007-2011) were combined. The study sample included 15,764 US children aged 0 to 17 years. Eight items assessed FCC, and 5 items assessed unmet health care need. We performed exploratory factor analyses to develop an FCC measurement model and fit a cross-lagged structural equation model to determine temporal associations between FCC and unmet health care need.	Results supported a 2-factor FCC model including family-provider communication and SDM. The family-provider communication factor was indicated by items reflecting general communication between the child's doctor and family. The SDM factor was indicated by items reflecting decision-making about the child's health care. Adjusted cross-lagged structural equation model results showed family-provider communication and SDM were associated with a reduced likelihood of unmet health care need the following year. Unmet health care need was not significantly associated with family-provider communication or SDM the subsequent year.	Study results support differentiating between family-provider communication and SDM as interrelated aspects of FCC in future pediatric health care quality measurement and improvement. Family-provider communication and SDM may reduce the likelihood of unmet health care need the following year among US children.	
28365826	Many babies with trisomy 13 and 18 die in the first year of life. Survivors all have severe cognitive impairment. There has been a debate among both professionals and parents about whether it is appropriate to provide life-sustaining interventions to babies with these serious conditions. On one side of the debate are those who argue that there is no point in providing invasive, painful, and expensive procedures when the only outcomes are either early death or survival with severe cognitive impairment. Others suggest that, although mortality is high and cognitive impairment universal, babies with these conditions have an acceptable quality of life. In this paper, we will discuss both points of view. We will review the ways in which these conditions are portrayed in pediatrics textbooks and on social media sites that offer support to parents. We will then suggest an appropriate way to deal with clinical decisions for babies with these trisomies.
28365309	This article reviews the available evidence and guidance on methods to identify reports of quasi-experimental (QE) studies to inform systematic reviews of health care, public health, international development, education, crime and justice, and social welfare.Research, guidance, and examples of search strategies were identified by searching a range of databases, key guidance documents, selected reviews, conference proceedings, and personal communication. Current practice and research evidence were summarized.	Four thousand nine hundred twenty-four records were retrieved by database searches, and additional documents were obtained by other searches. QE studies are challenging to identify efficiently because they have no standardized nomenclature and may be indexed in various ways. Reliable search filters are not available. There is a lack of specific resources devoted to collecting QE studies and little evidence on where best to search.	Searches to identify QE studies should search a range of resources and, until indexing improves, use strategies that focus on the topic rather than the study design. Better definitions, better indexing in databases, prospective registers, and reporting guidance are required to improve the retrieval of QE studies and promote systematic reviews of what works based on the evidence from such studies.	
28364933	Before 2013, Senegal public health supply system was pull-based and fully public-run. Lengthy and recurrent stockouts of essential health products (incl. contraceptives) were the rule, not the exception as they used to strike more than 80% of public service delivery points (SDPs). Following a successful pilot in two districts in 2012, the Senegalese Ministry of Health and Social Action (MSAS) implemented the Informed Push Model (IPM) Project (2013-2016). In its first two years, IPM bridged key gaps and expanded the distribution of contraceptives by private third party logistics operators to all public SDPs in Senegal and nearly eliminated stockouts. However, the MSAS was slow to take ownership of the project. Understanding the roots of this reluctance, executing a range of targeted communication and advocacy efforts and preparing a strong transition plan are succeeding to push Government toward full ownership to enable the National Supply Pharmacy to distribute all health products going to SDPs, including vaccines, consistently with their Strategic Plan 2014-2018.
28364569	Introduction: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale. The objective of this review is to summarize the recommendations of clinical, research, and public health experts for scalable ART adherence interventions in resource-limited settings. Methods: In July 2015, the Bill and Melinda Gates Foundation convened a meeting to discuss the most promising ART adherence interventions for use at scale in resource-limited settings. This article summarizes that discussion with recent updates. It is not a systematic review, but rather provides practical considerations for programme implementation based on evidence from individual studies, systematic reviews, meta-analyses, and the World Health Organization Consolidated Guidelines for HIV, which include evidence from randomized controlled trials in low- and middle-income countries. Interventions are categorized broadly as education and counselling; information and communication technology-enhanced solutions; healthcare delivery restructuring; and economic incentives and social protection interventions. Each category is discussed, including descriptions of interventions, current evidence for effectiveness, and what appears promising for the near future. Approaches to intervention implementation and impact assessment are then described. Results and discussion: The evidence base is promising for currently available, effective, and scalable ART adherence interventions for resource-limited settings. Numerous interventions build on existing health care infrastructure and leverage available resources. Those most widely studied and implemented to date involve peer counselling, adherence clubs, and short message service (SMS). Many additional interventions could have an important impact on ART adherence with further development, including standardized counselling through multi-media technology, electronic dose monitoring, decentralized and differentiated models of care, and livelihood interventions. Optimal targeting and tailoring of interventions will require improved adherence measurement. Conclusions: The opportunity exists today to address and resolve many of the challenges to effective ART adherence, so that they do not limit the potential of ART to help bring about the end of AIDS.
28364283	The use of emoticons and emoji is increasingly popular across a variety of new platforms of online communication. They have also become popular as stimulus materials in scientific research. However, the assumption that emoji/emoticon users' interpretations always correspond to the developers'/researchers' intended meanings might be misleading. This article presents subjective norms of emoji and emoticons provided by everyday users. The Lisbon Emoji and Emoticon Database (LEED) comprises 238 stimuli: 85 emoticons and 153 emoji (collected from iOS, Android, Facebook, and Emojipedia). The sample included 505 Portuguese participants recruited online. Each participant evaluated a random subset of 20 stimuli for seven dimensions: aesthetic appeal, familiarity, visual complexity, concreteness, valence, arousal, and meaningfulness. Participants were additionally asked to attribute a meaning to each stimulus. The norms obtained include quantitative descriptive results (means, standard deviations, and confidence intervals) and a meaning analysis for each stimulus. We also examined the correlations between the dimensions and tested for differences between emoticons and emoji, as well as between the two major operating systems-Android and iOS. The LEED constitutes a readily available normative database (available at www.osf.io/nua4x ) with potential applications to different research domains.
28364263	This study aimed to develop and examine the acceptability, feasibility, and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer.Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative three-stage process. In stage 1, a focus group (n = 4) addressed acceptability; in stage 2, key informant interviews (n = 10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n = 23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes.	The final system includes programmed reminders to schedule and attend late effect screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system.	The text messaging system may assist AYA survivors by coordinating late effect screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources.	The text messaging system has the potential to improve the receipt of survivorship care.	
28364258	Dementia is one of the most prevalent diseases in the older population. Various dementia care models have been developed to address patient's healthcare needs. They can be described as "collaborative care" or "person-centered care". Referring to the needs of the workforce working with persons with dementia, a key element is the use of interprofessional education (IPE).The purpose of this article is to describe different international collaborative care models to define a minimum standard of healthcare professions for collaborative dementia care in primary care. This helps to identify requirements for IPE to optimize care of people with dementia and to support informal caregivers in the future.	In this article six dementia care models from 4 different countries (Germany, USA, UK and Netherlands) are described and compared regarding aims, interventions and healthcare professionals involved.	Care teams are minimally comprised of general practitioners or primary care providers, nurses, and social workers. Additional healthcare disciplines may be involved for specific interventions. Mostly, care team members received specific training but such training did not necessarily incorporate the IPE approach. To ensure successful collaboration of professions, IPE training programs should at least consist of the following core topics: (1) early diagnosis, (2) postdiagnostic support, (3) advanced care planning for patients and caregivers and (4) effective collaborative care.	The IPE programs for dementia should be expanded and must be widely implemented in order to assess the impact on collaborative practice. This study will provide the knowledge base for structuring IPE trainings developing educational agendas and adapting existing guidelines to improve collaborative dementia care in the future.	
28363883	As Twitter has grown in popularity to 313 million monthly active users, researchers have increasingly been using it as a data source for tobacco-related research.The objective of this systematic review was to assess the methodological approaches of categorically coded tobacco Twitter data and make recommendations for future studies.	Data sources included PsycINFO, Web of Science, PubMed, ABI/INFORM, Communication Source, and Tobacco Regulatory Science. Searches were limited to peer-reviewed journals and conference proceedings in English from January 2006 to July 2016. The initial search identified 274 articles using a Twitter keyword and a tobacco keyword. One coder reviewed all abstracts and identified 27 articles that met the following inclusion criteria: (1) original research, (2) focused on tobacco or a tobacco product, (3) analyzed Twitter data, and (4) coded Twitter data categorically. One coder extracted data collection and coding methods.	E-cigarettes were the most common type of Twitter data analyzed, followed by specific tobacco campaigns. The most prevalent data sources were Gnip and Twitter's Streaming application programming interface (API). The primary methods of coding were hand-coding and machine learning. The studies predominantly coded for relevance, sentiment, theme, user or account, and location of user.	Standards for data collection and coding should be developed to be able to more easily compare and replicate tobacco-related Twitter results. Additional recommendations include the following: sample Twitter's databases multiple times, make a distinction between message attitude and emotional tone for sentiment, code images and URLs, and analyze user profiles. Being relatively novel and widely used among adolescents and black and Hispanic individuals, Twitter could provide a rich source of tobacco surveillance data among vulnerable populations.	
28363390	The purpose of this study was to explore the (a) associations between students' personal and group resilience to their utilization of social networking platforms and formally taught communication skills, (b) students' personal and clinical characteristics that are related to personal and group resilience and the perceived helpfulness of communication course, and (c) factors that contribute to students' satisfaction with their clinical placement. Data were collected from 149 second year nursing students learning in a major university in the country of Israel with the use of a self-administered structured questionnaire. Students' satisfaction from their clinical placement was measured using 1 open-ended question, analyzed through qualitative methods. Results demonstrated positive correlations between students' use of social networking to their personal and group resilience (P<.05). Moreover, social media use, religion, and clinical placement characteristics were related to resilience and to the perceived helpfulness of the communication course (P<.01). Students' satisfaction with their clinical placement was based primarily on the clinical instructors' personal and professional skills. In conclusion, social networking can and should be used as a learning tool to promote resilience among nursing students. Faculty and nurse managers should be aware of the central role of the clinical instructor and initiate collaborative and supporting initiatives.
28363381	Pharmacy students start to develop their professional values through engagement with the course, practice exposure, staff and fellow students. Group working is an element of pedagogy which draws on the social aspects of learning to facilitate knowledge and skills development, but its potential role in facilitating professional identity formation has as yet been under researched.This study aimed to explore the potential of mutual learning through group work to contribute not only to academic knowledge and understanding, but also to the development of students' professional values and selves.	Semi-structured interviews were conducted with 17 home and international first year undergraduate pharmacy students in a UK School of Pharmacy, to explore their experiences of interacting for learning with other students on the course.	Thematic analysis of the interview data highlighted four main benefits of mutual learning, which are that it: promotes friendly interactions; aids learning about the subject and the profession; opens the mind through different opinions and ways of thinking; and enables learning about other people. Through working together students developed their communication skills and confidence; reflectively considered their own stance in the light of others' experiences and healthcare perspectives; and started to gain a wider worldview, potentially informing their future interactions with patients and colleagues. Some difficulties arose when group interactions functioned less well.	Opportunity for collaboration and exchange can positively influence development of students' professional outlook and values. However, careful management of group working is required, in order to create a mutually supportive environment wherein students feel able to interact, share and develop together.	
28363033	Internet-based cancer risk assessment tools might serve as a strategy for translating epidemiological risk prediction research into public health practice. Understanding how such tools affect key social-cognitive precursors of behavior change is crucial for leveraging their potential into effective interventions.To test the effects of a publicly available, Internet-based, breast cancer risk assessment tool on social-cognitive precursors of physical activity.	Women (N = 132) aged 40-78 with no personal cancer history indicated their perceived risk of breast cancer and were randomly assigned to receive personalized ( www.yourdiseaserisk.wustl.edu ) or nonpersonalized breast cancer risk information. Immediately thereafter, breast cancer risk perceptions and physical activity-related behavioral intentions, self-efficacy, and response efficacy were assessed.	Personalized information elicited higher intentions, self-efficacy, and response efficacy than nonpersonalized information, P values < 0.05. Self-efficacy and response efficacy mediated the effect of personalizing information on intentions. Women who received personalized information corrected their inaccurate risk perceptions to some extent, P values < 0.05, but few fully accepted the information.	Internet-based risk assessment tools can produce beneficial effects on important social-cognitive precursors of behavior change, but lingering skepticism, possibly due to defensive processing, needs to be addressed before the effects can be maximized.	
28362544	The suspension of compulsory scheduling of some pediatric vaccines has been discussed for a long time by health authorities in Italy but the current decrease of vaccination rates is a matter of concern. YouTube is the most popular video-based social media website. Considering the demonstrated impact of internet on vaccination decision-making and the increasing use of social media to share and disseminate health information, the aim of this study was to explore the message available on YouTube videos about vaccination.An observational study was conducted searching for YouTube videos in September 2015 and updated in January 2016, by using the keyword "vaccinations." We included recently posted videos in Italian on child vaccination (2014-2015). Videos were classified according to the message tone.	A total of 123 videos were selected. Pro-vaccination videos were 62 (50%), anti-vaccination 28 (23%), neutral or without a clear position in favor or against vaccination 33 (27%). Focusing on the first 2 groups, pro-vaccination videos had a higher number of views compared with those unfavorable (1602 ± 6544 vs 1482 ± 2735) (p < 0.001). However, anti-vaccination videos were liked more by viewers (17.8 ± 31.3) than positive ones (13.2 ± 44.7) (p < 0.001) in addition to being more shared (23 ± 22.6 vs 3.8 ± 5.5, p < 0.001).	Most of the videos were positive in tone, but those that disapproved of immunization were the most liked and shared. Considering the growing number of viewers, it is important to monitor the web to understand audience characteristics and what influences public opinions to use communication strategies more effectively.	
28362169	The Edinburgh Handedness Inventory (EHI) is persistently the most used inventory to evaluate handedness, being neuropsychological investigation and clinical practice. Despite this, there is no information on how this instrument functions in a Portuguese population. The objective of this study was therefore to examine the sociodemographic influences on handedness and establish psychometric properties of the EHI in a Portuguese sample. The sample consisted of 342 adults (157 men and 185 women), assessed with a battery of neuropsychological tests. The mean EHI Laterality Quotient was 63.52 (SD = 38.00). A much high percentage of ambiguous-handedness compared to left-handedness was detected. An inconsistency was found between the preference for formal education activities (writing-drawing-using scissors) and the remaining EHI activities. From sociodemographic variables, only age, area, and regions of residence showed significant influence on EHI scores. The reliability and temporal reliability of EHI were adequate. Confirmatory factor analysis indicated a one-factor model (χ2/df = 2.141; TLI = 0.972; CFI = 0.979; RMSEA = 0.058). The inconsistency between formal education and nonformal activities could be an indicator of social pressure. The present data give support for the notion that handedness measured by EHI is potentially sensitive to sociodemographic and cultural influences.
28361729	The electronic medical record provides an exciting opportunity to support the coordination of care by medical and social providers. Many of these systems include patient portals that allow providers to share clinical information with patients in real time. These "patient portals" provide a unique opportunity for clients and patients to access and use HIV and sexually transmitted infection information for communication with healthcare providers, with potential or actual sex partners, and for tracking their own clinical course and progress. A concerted effort to develop these should include a high level of transparency and adequate support for both patient and provider.
28361502	The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies) and skills (e.g. adhering to antiretroviral therapy or pre-exposure prophylaxis) are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV-serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV-serodiscordant couples.
28360492	The main objective of this study was to identify the prevalence of social media and Internet usage of orthopaedists and to determine its effects on patient-physician communication.Data were collected by e-mail from 321 orthopaedists who filled out the questionnaire. The questionnaire consists of a total 25 items pertaining to personal information, which social media tool they use, their overall views of and expectations from social media, the effects of social media on patient-physician relationship and communication.	The rates of keeping in contact with patients and "often" helping patients to manage their treatments over social media increased with age (p < 0.05). It was found that the rate of helping patients to manage their treatments over social media was significantly higher in academicians compared to that in specialist physicians (p = 0.040). The rates of having a personal website and being a member of online physician platform and social-networking sites were higher in participants working in the private sector than participants working in the public sector (p = 0.001). It was found that the rate of finding it useful to be in contact with patients over social media was higher in physicians working in the private sector compared to that in those working in the public sector (p < 0.01).	Social media tools and Internet are commonly used by orthopaedists to communicate with their patients. Even though there are beneficial effects in patient-physician relationship, effective standards and regulations should be developed to enable a safe communication and to resolve ethical and legal uncertainties.	
28360022	Growing evidence that patient engagement improves health outcomes and reduces health care costs has fueled health providers' focus on patient portals as the primary access point for personal health information and patient-provider communication. Whereas much attention has been given to identifying characteristics of older adults who do and do not adopt patient portals and necessary adaptions to portal design, little is known about their attitudes and perceptions regarding patient portal use as a tool for engagement in their health care within the context of health literacy, experience navigating Web-based health information, and previous patient portal use.The specific aims of this study were to explore attitudes toward portal adoption and its perceived usefulness as a tool for health care engagement among adults (65 years and older) who have varying levels of health literacy and degrees of prior patient portal use.	A phone survey of 100 community dwelling adults gathered sociodemographic, health, and technology related information. Older adults were purposefully selected for 4 follow-up focus groups based on survey responses to health literacy and previous patient portal use. A mixed-method approach was used to integrate phone survey data with thematic analysis of 4 focus groups. Due to variability in attitudes between focus group participants, an individual case analysis was performed and thematic patterns were used as the basis for subgroup formation.	Differences in health literacy, comfort navigating health information on the Web, and previous portal experience explained some but not all differences related to the 7 themes that emerged in the focus groups analysis. Individual cases who shared attitudes were arranged into 5 subgroups from least to most able and willing to engage in health care via a patient portal. The subgroups' overall portal adoption attitudes were: (1) Don't want to feel pushed into anything, (2) Will only adopt if required, (3) Somebody needs to help me, (4) See general convenience of the portal for simple tasks and medical history, but prefer human contact for questions, and (5) Appreciates current features and excited about new possibilities .	Most of the older adults are interested in using a patient portal regardless of health literacy level, previous patient portal adoption, or experience navigating health information on the Web. Research targeting informal caregivers of older adults who are unable or unwilling to engage with information technology in health care on their own is warranted. Health care organizations should consider tailored strategies to meet the needs of older adults (and their informal caregivers) and explore alternative workflows that integrate patient portal information into phone conversations and face-to-face contact with health care providers.	
28359781	In the Netherlands, the prevalence of dietary supplement use has doubled (from 17 to 40 per cent) since the 1980s. Yet, limited data is available on which socio-cognitive factors are associated with dietary supplement use. Therefore, the purpose of the study is to explain dietary supplement use with determinants deriving from the Integrated Change Model (ICM) and from formative research.Socio-cognitive and psychosocial factors were measured among users and non-users of dietary supplements in a longitudinal survey study, with measurements at baseline (N = 1448) and at one-month follow-up (N = 1161). Negative binomial regression analysis was applied to de data.	Intention emerged as the main predictor of dietary supplement use (OR = 1.99). Further predictors of dietary supplement use with smaller effect-sizes were: health regulatory focus (promotion, OR = 1.46), social modelling (OR = 1.44), attitude (pros, OR = 1.37), attitude (cons, OR = 0.87), health locus of control (OR = 0.77), and risk perception (chance of getting ill, OR = 1.22).	Individuals tend to use dietary supplements if they are promotion oriented, notice dietary supplement users in their social environment, estimate their chances of getting ill higher, and have positive attitudes towards dietary supplements. In contrast, non-users believe that external factors affect their health, and hold negative attitudes towards dietary supplements.	Mapping out individuals' socio-cognitive profile may contribute to the development of online health communication. Based on socio-cognitive and demographical factors, personalised advice can be given about dietary supplement use.	
28359728	The widely known vocabulary gap between health consumers and healthcare professionals hinders information seeking and health dialogue of consumers on end-user health applications. The Open Access and Collaborative Consumer Health Vocabulary (OAC CHV), which contains health-related terms used by lay consumers, has been created to bridge such a gap. Specifically, the OAC CHV facilitates consumers' health information retrieval by enabling consumer-facing health applications to translate between professional language and consumer friendly language. To keep up with the constantly evolving medical knowledge and language use, new terms need to be identified and added to the OAC CHV. User-generated content on social media, including social question and answer (social Q&A) sites, afford us an enormous opportunity in mining consumer health terms. Existing methods of identifying new consumer terms from text typically use ad-hoc lexical syntactic patterns and human review. Our study extends an existing method by extracting n-grams from a social Q&A textual corpus and representing them with a rich set of contextual and syntactic features. Using K-means clustering, our method, simiTerm, was able to identify terms that are both contextually and syntactically similar to the existing OAC CHV terms. We tested our method on social Q&A corpora on two disease domains: diabetes and cancer. Our method outperformed three baseline ranking methods. A post-hoc qualitative evaluation by human experts further validated that our method can effectively identify meaningful new consumer terms on social Q&A.
28359276	Labour market participation among young adults is essential for their future socioeconomic status and health. The aim of this study was to investigate the association between perceived stress among 20-21 year-olds and their labour market participation 8 years later as well as investigate any potential gender differences.A cohort of 1640 young adults born in 1983 completed a questionnaire in 2004 in which perceived stress was measured. The cohort was followed in a register of social benefits for 12 months in 2011-2012 and was categorized into active and passive labour market participation. Logistic regression was used to analyse the association between perceived stress and future labour market participation, taking into account effects of potential confounders. The analyses were stratified by gender.	The effects of perceived stress on future labour market participation differed significantly among young women and young men (p = 0.029). For young men, higher levels of perceived stress reduced the risk of future passive labour market participation, when adjusting for socioeconomic factors, self-rated health and copings strategies (p = 0.045). For young women, higher levels of perceived stress increased the risk of future passive labour market participation, when adjusting for the same potential confounding factors, although unlike the men, this association was not statistically significant (p = 0.335).	The observed gender difference has important implications from a public health point of view. Healthcare professionals might need to differentiate between the genders in terms of health communication, research and when developing preventive strategies.	
28359111	In the German Health system there is an increasing competition in the recruitment of specialised staff, especially for rehabilitation centres, which are deemed less attractive. Therefore, this study examines the attractiveness of the field of medical rehabilitation from the point of view of medical professionals. We conducted 16 semi-structured interviews with doctors from 7 rehabilitation centres with different medical specialisations. The interviews were digitized and transcribed. A structured content analysis was carried out using the software MAXQDA 11. 745 codes were identified and assigned to the categories "attractiveness", "unfavourable aspects" and "special features" of rehabilitation. Regarding medical rehabilitation, the interviewees appreciated especially the predictable, flexible working environment with little time pressure. Other than working with rehabilitative patients working as part of an interdisciplinary team was of high importance for the interviewees. Among the special features of rehabilitation in comparison with acute care were the higher relevance of the bio-psycho-social model of health and illness as well as the higher proportion of communication and organisation. Medical rehabilitation in Germany is an attractive field of work for medical doctors. This fact should be considered more with regards to rehabilitation's public image.
28358558	Emotional communication regulates the behaviors of social partners. Research on individuals' responding to others' emotions typically compares responses to a single negative emotion compared with responses to a neutral or positive emotion. Furthermore, coding of such responses routinely measure surface level features of the behavior (e.g., approach vs. avoidance) rather than its underlying function (e.g., the goal of the approach or avoidant behavior). This investigation examined infants' responding to others' emotional displays across 5 discrete emotions: joy, sadness, fear, anger, and disgust. Specifically, 16-, 19-, and 24-month-old infants observed an adult communicate a discrete emotion toward a stimulus during a naturalistic interaction. Infants' responses were coded to capture the function of their behaviors (e.g., exploration, prosocial behavior, and security seeking). The results revealed a number of instances indicating that infants use different functional behaviors in response to discrete emotions. Differences in behaviors across emotions were clearest in the 24-month-old infants, though younger infants also demonstrated some differential use of behaviors in response to discrete emotions. This is the first comprehensive study to identify differences in how infants respond with goal-directed behaviors to discrete emotions. Additionally, the inclusion of a function-based coding scheme and interpersonal paradigms may be informative for future emotion research with children and adults. Possible developmental accounts for the observed behaviors and the benefits of coding techniques emphasizing the function of social behavior over their form are discussed. (PsycINFO Database Record
28358269	This systematic review of the literature explores the perspectives and experiences of homecare workers providing care for people with dementia living at home up to the end of life. A search of major English language databases in 2016 identified 378 studies on the topic, of which 12 met the inclusion criteria. No empirical research was identified that specifically addressed the research question. However, synthesis of the findings from the broader literature revealed three overarching themes: value of job role, emotional labour and poor information and communication. The role of homecare workers supporting a person with dementia up to the end of life remains under-researched, with unmet needs for informational, technical and emotional support reported. The effective components of training and support are yet to be identified.
28358241	Cancer survivors often experience both short- and long-term challenges as a result of their cancer treatment. Many patients report feeling "lost in transition" following cancer treatment. The oncologist plays a key role in helping the patient to transition to survivorship. The purpose of this paper is to provide a descriptive understanding of the clinical care delivered during follow-up visits for lymphoma patients transitioning from active therapy into survivorship. We used thematic text analysis to identify themes in transcripts of audio recordings of 21 physicians and their patients in follow-up visits within 3 years of completing lymphoma treatment. Conversations between oncologists and patients during follow-up visits addressed a variety of themes, including specific health concerns, follow-up care, health promotion, prior treatment and test results, overall health status, emotional communication and affective tone, post-treatment rehabilitation, discussions occurring in the patient's physical examination, and social issues. However, the frequency with which these themes were discussed varied. In addition, there did not appear to be a consistent framework for these visits. The varied nature of the follow-up visits analyzed in this study suggests the need for increased structure in survivorship-care consultations.
28357785	Categorization of the needs of AYA cancer survivors is primarily based on quantitative analyses of epidemiological and observational research. The present study classified the phenomenological experiences of AYA survivors based on their own language.A systematic approach for selecting qualitative studies of unmet needs in AYA cancer survivors was used. Following selection based on quality, survivor statements were entered verbatim and thematic analysis was conducted using NVivo qualitative research software.	A total of 1993 AYA cancer survivors (post-treatment) were included in 58 studies (78% individual interviews). Mean age was 27.6 with an average of 8.6 years post-primary treatment. The organizational framework reported in this study was based on a heterogeneous group of cancer types. Thirteen themes including symptoms, function, reproductive health, emotional well-being, health management, health care system, social interaction, romantic relationships, cancer disclosure, normalcy, career development and employment, and school and fiscal concerns were identified. Forty-eight subthemes were also identified covering such areas as fertility, integrative health services, advice for cancer disclosure, family interaction, and insurance challenges.	Direct analysis of text identified many common unmet needs similarly reported in the quantitative literature. The phenomenological data also provided a breakdown of unmet needs into subthemes or elements of unmet needs.	This information can help form the basis for a personalized, valid, and reliable evaluation tool of the range of unmet needs in AYA survivors.	
28357154	This paper reports the findings of a national online survey to parents of children aged 5 and younger. The objectives of the study were to assess parental understanding of childhood immunizations, identify sources of information that they trust for vaccine-related content, assess where parents with young children stand on the key issues in the public debate about vaccination, and identify which risk communication messages are most effective for influencing the behaviours of vaccine hesitant parents.A total of 1,000 surveys (closed and open-ended questions) were administered in November 2015 using the Angus Reid Forum Panel, a key consumer panel consisting of approximately 150,000 Canadian adults aged 18 and older, spread across all geographic regions of Canada.	Approximately 92% of the Canadian parents surveyed consider vaccines safe and effective, and trust doctors and public health officials to provide timely and credible vaccine-related information. However, a concerning number of them either believe or are uncertain whether there is a link between vaccines and autism (28%), worry that vaccines might seriously harm their children (27%), or believe the pharmaceutical industry is behind the push for mandatory immunization (33%). Moreover, despite the common assumption that social media are becoming the go-to source of health news and information, most parents still rely on traditional media and official government websites for timely and credible information about vaccines and vaccine preventable diseases, particularly during community-based disease outbreaks. Finally, parents reported high levels of support for pro-vaccine messaging that has been demonstrated in previous research to have little to no positive impact on behaviour change, and may even be counterproductive.	The study's results are highly relevant in a context where public health officials are expending significant resources to increase rates of childhood immunization and combat vaccine hesitancy. The data offer insight into where parents stand on the political and public debate about mandatory vaccination, what aspects of vaccine science remain uncertain to them, which media and institutional sources they use and trust to navigate the health information environment, how they look for information and whom they trust during periods of health emergency or crisis, and which communication strategies are considered most effective in persuading vaccine hesitant parents to immunize their children.	
28356145	This study examined how mental health clinic administrators decided whether or not to adopt evidence-based and other innovative practices by exploring their views of implementation barriers and facilitators and operation of these views in assessment of implementation costs and benefits.Semi-structured interviews were conducted with 75 agency chief executive officers and program directors of 34 New York State-licensed mental health clinics serving children and adolescents.	Three interconnected themes relating to barriers and facilitators were identified, namely costs and benefits associated with adoption, capacity for adoption, and acceptability of new practices. The highest percentage of participants (86.7%) mentioned costs as a barrier, followed by limited capacity (55.9%) and lack of acceptability (52.9%). The highest percentage (82.3%) of participants identified available capacity as a facilitator, followed by acceptability (41.2%) and benefits or limited costs (24.0%). Assessment of costs and benefits exhibited several principles of behavioural economics, including loss aversion, temporal discounting use of heuristics, sensitivity to monetary incentives, decision fatigue, framing, and environmental influences.	The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents.	
28355616	Businesses increasingly conduct operations in remote areas where medical evacuation [Medevac(s)] carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of Medevacs of Shell International employees [i.e. expatriate employees (EEs) and frequent business travellers (FBTs)] was undertaken.A retrospective review of Medevac data (period 2008-12) that were similar in operational constraints and population profile was conducted. Employee records and Human Resource data were used as a denominator for the population. Analogous Medevac data from specific locations were used to compare patterns of diagnoses.	A total of 130 Medevacs were conducted during the study period, resulting in a Medevac rate of 4 per 1000 of population with 16 per 1000 for females and 3 per 1000 for males, respectively. The youngest and oldest age-groups required Medevacs in larger proportions. The evacuation rates were highest for countries classified as 'high' or 'extreme risk'. The most frequent diagnostic categories for Medevac were: trauma, digestive, musculoskeletal, cardiac and neurological. In 9% of the total, a strong to moderate link could be made between the pre-existing medical condition and diagnosis leading to Medevac.	This study uniquely provides a benchmark Medevac rate (4 per 1000) for EEs and FBTs and demonstrates that Medevac rates are highest from countries identified as 'high risk'; there is an age and gender bias, and pre-existing medical conditions are of notable relevance. It confirms a change in the trend from injury to illness as a reason for Medevac in the oil and gas industry and demonstrates that diagnoses of a digestive and traumatic nature are the most frequent. A holistic approach to health (as opposed to a predominant focus on fitness to work), more attention to female travellers, and the application of modern technology and communication will reduce the need for Medevacs.	
28355338	Long-lasting insecticide-treated nets and/or indoor residual spraying, associated with case management, are key interventions in the control of malaria in Africa. The objective of this study is to comment on the role of social and behavior change communication as a potential key intervention in the control of malaria in Mozambique. RESUMO As redes mosquiteiras impregnadas com insecticidade de longa duração e/ou pulverização intra-domiciliária, associada ao manejo de casos são intervenções-chave no controlo da malária em África. O objetivo deste estudo foi comentar o papel da comunicação para a mudança social e de comportamento como intervenção potencialmente chave no controlo da malária em Moçambique.
28353403	Electronic waste (e-waste) is a growing health and environmental concern in developing countries. In the sub-Saharan African region e-waste is considered a crisis with no end in sight yet; there is lack of structures and regulations to manage the problem. In this article, we discuss the potential of Health Impact Assessment (HIA) in addressing the health, environmental, and social impacts of e-waste in sub-Saharan Africa. We draw from environmental policy, environmental communication, global health policy, and health communication to argue that managing e-waste could be framed as ongoing HIA where all the steps of HIA are performed on a rolling basis with input from local communities. Further, we suggest that HIA should be infused into recycling legislation to help streamline the practice in order to make it safe for health and the environment and to maximize the economic benefits.
28353393	Since the key to effective health communication lies in its ability to communicate well, some of its core problems are those that relate to the sharing of meaning between communicators. In elaborating on these problems, this paper offers two key propositions: one, health communication has to pass through the filter of a particular world view that creates a discrepancy between expected and actual message reception and response. Two, the assumption of a rational human actor made implicitly by most health psychological models is a contestable issue, as many times message recipients do not follow a cognitive judgment process. The phenomenon of resisting health messages by reasonable people asks the question whether we ought to rethink our adherence to a particular vision of human health as many times the adverse reaction to behaviour modification occurs as the result of a particular dialogical or discursive situation. At the same time, most motivational decisions in people's daily routines are automatic and use a concept known as self-identity to give stability to their behaviour patterns. Finally, health communication as part of organised government practices adheres to predominant value perspectives within health promotion practice that affect the manner in which health issues become problematised. This paper proposes a humanistic model that aims to pay attention to the intricacies of human communication by addressing all of the above problems in turn. It interprets the sharing of meaning element in human communication and addresses the question of how the idea of health is created through discourse. As such, it offers a complementary and constructive paradigm and set of approaches to understand health, its meanings and communication.
28351003	Borderline personality disorder (BPD) is characterized by affective instability and interpersonal problems. In the context of social interaction, impairments in empathy are proposed to result in inadequate social behavior. In contrast to findings of reduced cognitive empathy, some authors suggested enhanced emotional empathy in BPD. It was investigated whether ambiguity leads to decreased cognitive or emotional empathy in BPD. Thirty-four patients with BPD and thirty-two healthy controls were presented with video clips, which were presented through prosody, facial expression, and speech content. Experimental conditions were designed to induce ambiguity by presenting neutral valence in one of these communication channels. Subjects were asked to indicate the actors' emotional valence, their decision confidence, and their own emotional state. BPD patients showed increased emotional empathy when neutral stories comprised nonverbally expressed emotions. In contrast, when all channels were emotional, patients showed lower emotional empathy than healthy controls. Regarding cognitive empathy, there were no significant differences between BPD patients and healthy control subjects in recognition accuracy, but reduced decision confidence in BPD. These results suggest that patients with BPD show altered emotional empathy, experiencing higher rates of emotional contagion when emotions are expressed nonverbally. The latter may contribute to misunderstandings and inadequate social behavior.
28350809	To conduct a randomized controlled trial assessing the impact of a family-based intervention delivered to Burmese migrant families displaced in Thailand on parenting and family functioning.Participants included 479 Burmese migrant families from 20 communities in Thailand. Families, including 513 caregivers and 479 children aged 7 to 15 years, were randomized to treatment and waitlist control groups. The treatment group received a 12-session family-based intervention delivered to groups of families by lay facilitators. Adapted standardized and locally derived measures were administered before and after the intervention to assess parent-child relationship quality, discipline practices, and family functioning.	Compared with controls, intervention families demonstrated improved quality of parent-child interactions on scales of parental warmth and affection (Effect size (ES) = 0.25 caregivers; 0.26 children, both p < 0.05) and negative relationship quality (ES = -0.37, p < 0.001 caregivers; -0.22 children, p < 0.05). Both children and caregivers also reported an effect on relationship quality based on a locally derived measure (ES = 0.40 caregivers, p < .001; 0.43 children, p < .05). Family functioning was improved, including family cohesion (ES = 0.46 caregivers; 0.36 children; both p < 0.001) and decreased negative interactions (ES = -0.30 caregivers, p < 0.01; -0.24 children, p < 0.05). Family communication also improved according to children only (ES = 0.29, p < 0.01). Caregivers, but not children, reported decreased harsh discipline (ES = -0.39, p < 0.001), and no effects were observed on use of positive discipline strategies. Treatment attendance was high, with participants attending a mean of 9.7 out of 12 sessions.	The intervention increased protective aspects of family well-being for migrant children and caregivers in a middle-income country. The strongest effects were on parent-child relationship quality and family functioning, while results were mixed on changes in discipline practices. Results suggest that a behavioral family-based approach implemented by lay providers in community settings is a promising intervention approach for strengthening families in highly stressed contexts.	
28350223	Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favourable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.
28350182	This article approaches care from a different angle by looking ethnographically at how it is shaped by structural differences in the power to control the circulation of knowledge. I focus on an investigation conducted by people classified as "indigenous", of an epidemic that killed 38 children and young adults in a Venezuelan rainforest. I trace how health/communicative inequities structured clinical interactions, documents, epidemiological investigations, news stories, and dialogues with healers, thwarting the identification of the epidemic, clinically identified as rabies. Although the Bolivarian socialist government provided access to care, professionals denigrated parents' contributions to care and communication and reduced complex, unequal relations between languages to practical problems of translation. Pointing to parallels with US social movements, I suggest that responding to demands for communicative justice in health requires seeing how health inequities are entangled with health/communicative inequities. The typographical slash points to importance of challenging the subdisciplinary boundary-work that relegates their study to non-overlapping conversations in medical and linguistic anthropology.
28349640	Copy number variation at 16p11.2 is associated with diverse phenotypes but little is known about the early developmental trajectories and emergence of the phenotype. This longitudinal study followed 56 children with the 16p11.2 BP4-BP5 deletion or duplication between the ages of 6 months and 8 years with diagnostic characterization and dimensional assessment across cognitive, adaptive, and behavioral domains. Linear mixed modeling revealed distinct developmental trajectories with deletions showing VIQ gains but declines in motor and social abilities while duplications showed VIQ gains and steady development across other domains. Nonparametric analyses suggest distinct trajectories and early cognitive abilities for deletion carriers who are ultimately diagnosed with intellectual disability and developmental coordination disorder as well as distinct trajectories and early social communication and cognitive abilities for duplication carriers diagnosed with ASD and intellectual disability. Findings provide predictions for patient developmental trajectories, insight into mean functioning of individuals with 16p11.2 at early ages, and highlight the need for ongoing monitoring of social and motor functioning and behavioral symptomatology to improve treatment planning. © 2017 Wiley Periodicals, Inc.
28349220	Big data can be used to assess perceptions about public health issues. This study assessed social media data from Twitter to inform communication campaigns to promote HIV testing and reduce discrimination related to HIV/AIDS or towards key populations to the HIV epidemic, and its potential utility to evaluate such campaigns through HIV testing uptake. Tweets from Brazil were collected from January 2014 to March 2015 and filtered by four categories of keywords including discrimination, HIV prevention, HIV testing, and HIV campaigns. In total over 100,000 geo-located tweets were extracted and analyzed. A dynamic online dashboard updated daily allowed mapping trends, anomalies and influencers, and enabled its use for feedback to campaigns, including correcting misconceptions. These results encourage the use of social networking data for improved messaging in campaigns. Clinical HIV test data was collected monthly from the city of Curitiba and compared to the number of tweets mapped to the city showing a moderate positive correlation (r = 0.39). Results are limited due to the availability of the HIV testing data. The potential of social media as a proxy for HIV testing uptake needs further validation, which can only be done with higher frequency and higher spatial granularity of service delivery data, enabling comparisons with the social media data. Such timely information could empower early response immediate media messaging to support programmatic efforts, such as HIV prevention, testing, and treatment scale up.
28348886	This study uses data from the European Social Survey in order to test the Prinstein-Dodge hypothesis that posits that peer effects may be larger in collectivistic than in individualistic societies. When defining individualism and collectivism at the country level, our results show that peer effects on obesity are indeed larger in collectivistic than in individualistic societies. However, when defining individualism and collectivism with individual values based on the Shalom Schwartz universal values theory, we find little support for this hypothesis.
28347450	mHealth (mobile health) services are becoming an increasingly important form of information and communication technology (ICT) enabled delivery for healthcare, especially in low-resource environments such as developing countries like Bangladesh. Despite widespread adoption of mobile phones and the acknowledged potential of using them to improve healthcare services, the adoption and acceptance of this technology among the elderly is significantly low. However, little research has been done to draw any systematic study of the elderly's intention to adopt mHealth services.The aim of this study was to develop a theoretical model based on the Unified Theory of Acceptance and Use of Technology (UTAUT) and then empirically test it for determining the key factors influencing elderly users' intention to adopt and use the mHealth services.	A face-to-face structured questionnaire survey method was used to collect data from nearly 300 participants of age 60 years and above from the capital city of Bangladesh. The data were analyzed using the Partial Least Squares (PLS) method, a statistical analysis technique based upon Structural Equation Modeling (SEM).	The study determined that performance expectancy, effort expectancy, social influence, technology anxiety, and resistance to change (p<0.05) had a significant impact on the users' behavioral intention to adopt mHealth services. The study, however, revealed no significant relation between the facilitating condition and the users' behavioral intention to use the mHealth services (p>0.05).	This study confirms the applicability of UTAUT model in the context of mHealth services among the elderly in developing countries like Bangladesh. It provides valuable information for mHealth service providers and policy makers in understanding the adoption challenges and the issues and also provides practical guidance for the successful implementation of mHealth services. Additionally the empirical findings identify implications related to the design and development of mHealth services that influence potential users. Furthermore, due to a generic approach, the findings of this study could be easily modified to assist other developing countries in the planning and up-take of mHealth services.	
28347439	Worldwide, the number of obese persons continues to grow. Online-mediated self-help groups represent an opportunity for obese persons to support each other. The aim of our study was to evaluate whether and how the use of and active participation in online self-help groups is associated with perceived informational and emotional support among obese adults.We conducted an online-based questionnaire (N=230) with users of online self-help groups for obese adults in Germany.	Findings revealed that forum activity is significantly correlated with perceived informational and emotional support. While asking questions was strongly correlated with both types of social support, sharing opinions and answering posts were more strongly correlated with perceived emotional support.	The level of social support in online communities depends on an individual's forum activity. Our findings offer a foundation for professionals in the health care sector to enhance their understanding, make recommendations, and further develop online self-help groups.	
28346923	In the last 5 years, interest in the interactions among the gut microbiome, brain, and behavior has exploded. Preclinical evidence supports a role of the gut microbiome in behavioral responses associated with pain, emotion, social interactions, and food intake. Limited, but growing, clinical evidence comes primarily from associations of gut microbial composition and function to behavioral and clinical features and brain structure and function. Converging evidence suggests that the brain and the gut microbiota are in bidirectional communication. Observed dysbiotic states in depression, chronic stress, and autism may reflect altered brain signaling to the gut, while altered gut microbial signaling to the brain may play a role in reinforcing brain alterations. On the other hand, primary dysbiotic states due to Western diets may signal to the brain, altering ingestive behavior. While studies performed in patients with depression and rodent models generated by fecal microbial transfer from such patients suggest causation, evidence for an influence of acute gut microbial alterations on human behavioral and clinical parameters is lacking. Only recently has an open-label microbial transfer therapy in children with autism tentatively validated the gut microbiota as a therapeutic target. The translational potential of preclinical findings remains unclear without further clinical investigation.
28346605	Interprofessional education (IPE) creates dynamic experiential learning that can address social determinants of health that influence health outcomes.To examine the effects of including public health students on IPE teams on the interprofessional practice domain constructs (values/ethics, roles/responsibilities, interprofessional communication, and teams and teamwork).	This single-case, mixed-methods study was performed using a grounded theory approach. Students from 8 graduate health sciences programs participated in an asynchronous, 6-week, online IPE learning activity. Three of the 4 interprofessional practice domain constructs were examined as outcome variables: participants' biomedical vs biopsychosocial patient approach (values/ethics); reported change in attitudes, beliefs, or values about other health professions (roles/responsibilities); and anticipated changes in future professional behaviors/interactions/approaches (teams and teamwork). Predictor variables were having an MPH participant on the IPE team, participants' enrollment in a clinical or nonclinical program, and student perception of the online format (interprofessional communication).	Three hundred nineteen students were included, 261 from clinical and 58 from nonclinical programs. A significant association was found between having an MPH participant on the IPE teams and participants' awareness of the influence of social determinants of health (OR, 2.04; 95% CI, 1.13-3.66; P<.05). Program type was also significantly associated with awareness of the influence of social determinants of health, such that participants in nonclinical programs were significantly more likely to report the importance of social determinants of health in the care plan (OR, 3.68; 95% CI, 1.38-9.84; P<.01). Participants were significantly less likely to report future behavior change if they were in clinical programs (OR, 0.44; 95% CI, 0.23-0.86; P<.05) or if they disliked the online format (OR, 0.25; 95% CI, 0.14-0.42; P<.01). The model fit the data well (χ23=30.80; P<.001).	Inclusion of MPH students on IPE teams has the potential to increase clinical participants' awareness of the influence of social determinants of health and interest in incorporating a biopsychosocial approach to health care.	
28346117	Humans use multiple senses to navigate the social world, and the sense of smell is arguably the most underestimated one. An intriguing aspect of the sense of smell is its social communicative function. Research has shown that human odors convey information about a range of states (e.g., emotions, sickness) and traits (e.g., individuality, gender). Yet, what underlies the communicability of these states and traits via smell? We fill this explanatory gap with a framework that highlights the dynamic and flexible aspects of human olfactory communication. In particular, we explain how chemical profiles, associative learning (i.e., the systematic co-occurrence of chemical profiles with state- or trait-related information), and top-down contextual influences could interact to shape human odor perception. Our model not only helps to integrate past research on human olfactory communication but it also opens new avenues for future research on this fascinating, yet to date poorly understood, field.
28345749	As public safety communication evolved, each disaster or emergency presented unique challenges for emergency managers and others response to disasters. Yet, a foundational focus is the timely dissemination of accurate information to keep communities informed and able to prepare, mitigate, respond, and recover. For the campus community, the increase in bomb threats, active shooter incidents, and geographic-based natural disasters call for the discovery of reliable and cost-effective solutions for emergency information management. Social media is becoming a critical asset in this endeavor. This article examines the evolution of public safety communication, the unique setting of the campus community, and social media's role in campus disaster resilience. In addition, an exploratory study was done to better understand the perception of social media use for public safety within the campus community. The findings provide practical recommendations for campus emergency management professions; however, future research is needed to provide specific, actionable ways to achieve these goals as well as understand how diverse universities utilize a variety of platforms.
28345209	The present study shows that the olfactory potency of intestinal and bile fluids taken from dominant male chameleon cichlids Australoheros facetus is greater than those from subordinate males. Thus, dominant status may be communicated by odorants released in the intestinal fluid and bile acids may contribute towards this.
28344699	There is no accepted best practice for optimizing tertiary student knowledge, perceptions, and skills to care for sexual and gender diverse groups. The objective of this research was to synthesize the relevant literature regarding effective curricular initiatives designed to enhance tertiary level student knowledge, perceptions, and skills to care for sexual and gender diverse populations.A modified Critical Interpretive Synthesis using a systematic search strategy was conducted in 2015. This method was chosen to synthesize the relevant qualitative and quantitative literature as it allows for the depth and breadth of information to be captured and new constructs to be illuminated. Databases searched include AMED, CINAHL EBM Reviews, ERIC, Ovid MEDLINE, Ovid Nursing Database, PsychInfo, and Google Scholar.	Thirty-one articles were included in this review. Curricular initiatives ranging from discrete to multimodal approaches have been implemented. Successful initiatives included discrete sessions with time for processing, and multi-modal strategies. Multi-modal approaches that encouraged awareness of one's lens and privilege in conjunction with facilitated communication seemed the most effective.	The literature is limited to the evaluation of explicit curricula. The wider cultural competence literature offers further insight by highlighting the importance of broad and embedded forces including social influences, the institutional climate, and the implicit, or hidden, curriculum. A combined interpretation of the complementary cultural competence and sexual and gender diversity literature provides a novel understanding of the optimal content and context for the delivery of a successful curricular initiative.	
28344564	Compared to typically developing children, children with autism (ASD) show delayed production of wh-questions. It is currently controversial the degree to which such deficits derive from social-pragmatic requirements and/or because these are complex grammatical structures. The current study employed the intermodal preferential looking (IPL) paradigm, which reduces social-pragmatic demands. The IPL paradigm can help distinguish these proposals, as successful comprehension promotes the "pragmatics-origins" argument whereas comprehension difficulties would implicate a "grammatical-origins" argument. Additionally, we tested both the linguistic and social explanations by assessing the contributions of children's early grammatical knowledge (i.e., SVO word order) and their social-pragmatic scores on the Vineland to their later wh-question comprehension. Fourteen children with ASD and 17 TD children, matched on language level, were visited in their homes at 4-month intervals. Comprehension of wh-questions and SVO word order were tested via IPL: the wh-question video showed a costumed horse and bird serving as agents or patients of familiar transitive actions. During the test trials, they were displayed side by side with directing audios (e.g., "What did the horse tickle?", "What hugged the bird?", "Where is the horse/bird?"). Children's eye movements were coded offline; the DV was their percent looking to the named item during test. To show comprehension, children should look longer at the named item during a where-question than during a subject-wh or object-wh question. Results indicated that TD children comprehended both subject and object wh-questions at 32 months of age. Comprehension of object-wh questions emerged chronologically later in children with ASD compared to their TD peers, but at similar levels of language. Moreover, performance on word order and social-pragmatic scores independently predicted both groups' later performance on wh-question comprehension. Our findings indicate that both grammar and social-pragmatics are implicated in the comprehension of wh-questions. The "grammatical-origins" argument is supported because the ASD group did not reveal earlier and stable comprehension of wh-questions; furthermore, their performance on SVO word order predicted their later success in linguistic processing of wh-questions. The "pragmatic-origins" argument is also supported because children's earlier socialization and communication scores strongly predicted their successful performance on wh-question comprehension.
28342674	The aim of this study was to compare student nurses' communication self-efficacy, empathy, and mindfulness across two countries, and to analyse the relationship between these qualities.The study had a cross-sectional design. Data was collected from final year student nurses in Norway and Sweden. Communication self-efficacy, empathy, and mindfulness were reported by questionnaires; Clear-cut communication with patients, Jefferson Scale of Empathy, and Langer 14 items mindfulness scale.	The study included 156 student nurses, 94 (60%) were Swedish. The mean communication self-efficacy score was 119 (95% CI 116-122), empathy score 115 (95% CI 113-117) and mindfulness score 79 (95% CI 78-81). A Mann-Whitney test showed that Swedish students scored significantly higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. When adjusted for age, gender, and country in a multiple linear regression, mindfulness was the only independent predictor of communication self-efficacy.	The Swedish student nurses in this study scored higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. Student nurses scoring high on mindfulness rated their communication self-efficacy higher.	A mindful learning approach may improve communication self-efficacy and possibly the effect of communication skills training.	
28342270	Breast cancer (BC) diagnosis and subsequent treatments present significant challenges and distress for both patients and their partners. This can lead to difficulties in marital relationships and, consequently, decreases in marital adjustment and psychosocial adaptation to BC for both partners. Our objective was to systematically review studies assessing marital adjustment in the context of female BC to understand which factors are associated with marital adjustment in both patients and partners and characterize the measures used to assess marital adjustment within these studies.This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English, peer-reviewed articles exploring factors associated with marital adjustment in the context of female BC were considered for inclusion.	Fourteen studies were included. Results evidenced that psychosocial variables play an important role on marital adjustment. Specifically, open and constructive communication, more social support, and supportive dyadic coping were found to be associated with higher levels of marital adjustment. Other variables such as self-efficacy, sexual functioning, and psychological adjustment were also positively associated with marital adjustment.	Most studies evidenced an association between psychosocial variables and marital adjustment for both women and their partners. Some important dimensions such as communication patterns, coping strategies, and social support dynamics were identified as potential targets for psychological interventions. Some variables, however, were explored only in a few studies, which limit our conclusions. Future studies should explore the role these variables and other relational and emotional variables play in promoting marital adjustment after BC.	
28342166	Parents and professionals are concerned that second language exposure may delay communication in children with ASD. In this study 174 youth (6-16 years) with and without ASD, exposed to a second language, were compared on executive function (EF) and functional communication (FC) with their peers without exposure. There were no significant differences between groups on age, IQ, and socioeconomic status. Parents reported on language exposure and rated EF and FC skills within everyday social contexts. The findings indicated that second language exposure in children with ASD is not associated with delay in cognitive and functional communication skills rather there was evidence of a reduced clinical impact as indexed by a lower percentage of children whose FC and EF ratings fell within the clinical range.
28342025	Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians.Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.	
28341897	Participating in community-engaged dissemination and implementation (CEDI) research is challenging for a variety of reasons. Currently, there is not specific guidance or a tool available for researchers to assess their readiness to conduct CEDI research. We propose a conceptual framework that identifies detailed competencies for researchers participating in CEDI and maps these competencies to domains. The framework is a necessary step toward developing a CEDI research readiness survey that measures a researcher's attitudes, willingness, and self-reported ability for acquiring the knowledge and performing the behaviors necessary for effective community engagement. The conceptual framework for CEDI competencies was developed by a team of eight faculty and staff affiliated with a university's Clinical and Translational Science Award (CTSA). The authors developed CEDI competencies by identifying the attitudes, knowledge, and behaviors necessary for carrying out commonly accepted CE principles. After collectively developing an initial list of competencies, team members individually mapped each competency to a single domain that provided the best fit. Following the individual mapping, the group held two sessions in which the sorting preferences were shared and discrepancies were discussed until consensus was reached. During this discussion, modifications to wording of competencies and domains were made as needed. The team then engaged five community stakeholders to review and modify the competencies and domains. The CEDI framework consists of 40 competencies organized into nine domains: perceived value of CE in D&I research, introspection and openness, knowledge of community characteristics, appreciation for stakeholder's experience with and attitudes toward research, preparing the partnership for collaborative decision-making, collaborative planning for the research design and goals, communication effectiveness, equitable distribution of resources and credit, and sustaining the partnership. Delineation of CEDI competencies advances the broader CE principles and D&I research goals found in the literature and facilitates development of readiness assessments tied to specific training resources for researchers interested in conducting CEDI research.
28341768	In May 2016, the Food and Drug Administration (FDA) issued a final rule that deemed e-cigarettes to be within their regulatory authority as a tobacco product. News and opinions about the regulation were shared on social media platforms, such as Twitter, which can play an important role in shaping the public's attitudes. We analysed information shared on Twitter for insights into initial public reactions.A text mining approach was used to uncover important topics among reactions to the e-cigarette regulations on Twitter. SAS Text Miner V. 12.1 software was used for descriptive text mining to uncover the primary topics from tweets collected from May 1 to May 17 2016 using NUVI software to gather the data.	A total of nine topics were generated. These topics reveal initial reactions to whether the FDA's e-cigarette regulations will benefit or harm public health, how the regulations will impact the emerging e-cigarette market and efforts to share the news. The topics were dominated by negative or mixed reactions.	In the days following the FDA's announcement of the new deeming regulations, the public reaction on Twitter was largely negative. Public health advocates should consider using social media outlets to better communicate the policy's intentions, reach and potential impact for public good to create a more balanced conversation.	
28341723	This qualitative study investigated the qualities of veterinary student performance that inform a supervisor's impression of their competency. Semi-structured interviews were conducted with a purposive sample of 15 supervisors from different veterinary subdisciplines, to elicit descriptions of excellent, weak and marginal students. Thematic analysis of transcriptions revealed 12 themes, of which engagement was frequently discussed and of stated importance, and trustworthiness was a differentiator of weak and marginal students from excellent students. Other themes were knowledge, application of knowledge, technical and animal handling skills, communication, social interaction, personal functioning, caring for animals, impact, prospects and the difficulty in judging competency. Patterns of association of themes were found, however themes were also used independently in unique combinations for most students described. The findings show the range of abilities, behaviours, attitudes and personal characteristics of students that are considered by supervisors and how these are weighted and balanced. The key contribution of engagement and trustworthiness to the overall impression aligns with research indicating their importance for success in clinical practice, as both contributors to competency and indicators of it. The findings may inform future design and investigation of workplace-based learning and in-training evaluation, as well as conceptions of veterinary competency.
28341692	More women with learning disability (LD) are becoming mothers. Women with LD have rights to equal access to maternity care that meets their needs, however, many have poor pregnancy and birth outcomes compared to other women in the UK. Research is limited in this area.The aim of the study was to explore the lived experiences of pregnancy, childbirth, prenatal and postnatal care and services received by this group of women in the UK, including their expressed information and support needs relating to maternity care.	A qualitative study in which data were generated using in-depth semistructured interviews with learning disabled women who were pregnant or had given birth within the last 3 years in the UK; data were analysed using interpretative phenomenological analysis.	9 women with varying levels of cognitive impairment took part. 4 super-ordinate themes were identified: 'I hate being treated differently', 'I find it harder to understand than other people', 'We've had to prove ourselves' and 'Make sure you've got very good support around you'. Subthemes included: 'Negative attitudes and denial of choice', 'Understanding of normal care', 'Written information' and 'Being judged by professionals'.	With support from family and services, learning disabled women can become confident and successful parents. Maternity services should make reasonable adjustments when providing care to this group, including adapting to their individual communication and learning needs: allowing sufficient time in appointments, offering clear explanations of each aspect of care and sensitive support for autonomy and fully informed choice. Mothers who will be subject to a social care assessment of their parenting skills need clear information about the process, their choices and the level of skill they must demonstrate, as well as access to sufficient antenatal and postnatal support to give them the best possible chance of passing the assessment.	
28340390	Nursing home residents with dementia experience increased risk for compromised eating performance due to intrapersonal, interpersonal, and environmental factors. Environmental stimulation is physical, social, and/or sensory stimulation present in the environment that can potentially trigger individuals' emotion or motivate physical reactions. Beyond the personal factors, there is a lack of evidence on how environmental stimulation influences individuals' eating performance at mealtimes.This study examined the association between environmental stimulation and eating performance among nursing home residents with dementia.	This study was a secondary analysis using baseline videos selected from a communication intervention study, where videos were recorded to capture staff-resident interactions during care activities for nursing home residents with dementia. Videos were included in this study only if residents demonstrated eating activities at mealtimes.	A total of 36 videos were selected (mean length=4min). The sample included 15 residents with dementia (mean age=86), and 19 certified nursing assistants (mean age=36) in 8 nursing homes.	The dependent variable was eating performance as measured by the Level of Eating Independence scale (range: 15-36, with higher scores indicating better eating performance). The independent variables were characteristics of environmental stimulation measured by the Person-Environment Apathy Rating-Environment subscale (stimulation clarity, stimulation strength, stimulation specificity, interaction involvement, physical accessibility, and environmental feedback). Each characteristic was rated on a 1-4 scale with higher scores indicating more desirable environmental stimulation. Multilevel models were used to examine the association between eating performance and environmental stimulation, adjusting for resident characteristics (i.e., age, gender, dementia stage, function, comorbidity, psychoactive medication use) and nesting effects of residents and staff.	Resident participants demonstrated moderate levels of eating performance (M=27.08, SD=5.16). Eating performance was significantly lower among older residents, those with more advanced dementia, and higher comorbidity. After controlling for resident characteristics, eating performance was significantly associated with stimulation specificity (how the stimulation is delivered and tailored to the resident), and was not associated with other environmental stimulation characteristics. For each 1 point increase in stimulation specificity, eating performance increased by 8.78 points (95% CI=0.59, 16.97).	Environmental stimulation that is personally tailored to a resident' needs and preferences and directly offered to a resident contributed to better eating performance among residents with dementia. The findings will direct future development and implementation of person-directed mealtime care programs and dining environment arrangements for residents with dementia in nursing homes.	
28340321	This study aims to determine the association between cognitive impairment and functional verbal reasoning in adults with severe traumatic brain injury (TBI), at six months post-injury.38 participants with severe TBI were assessed using the four tasks on the Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES) [1] and a battery of neuropsychological tests at 6 months post injury in a cross-sectional observational study.	Overall performance on the FAVRES [1] was strongly associated with overall performance on the neuropsychological battery (rho = 0.60). FAVRES Task 2 and FAVRES Task 4 had the most significant positive associations with the cognitive indices of Attention and speed of processing, Memory and Executive functions. There was one weak significant association between the Task 1 Accuracy score and the Total Cognitive index (rho = 0.46).	Performance on the FAVRES [1] is positively associated with cognitive processes. Participants with stronger verbal reasoning skills which may be required for activities in work, home and social contexts also had higher scores on tests of cognitive functioning. These findings may inform clinical practices for speech pathologists and other health professionals, in the assessment and treatment of cognitive communication disorders during early stages of recovery in people with severe TBI.	
28339324	Despite the growing popularity of mHealth applications, their usage outcomes have received limited empirical attention. Drawing on server-level user activity data and an online survey (N = 384), this study examines the use of an mHealth application for weight loss to elucidate the ways in which it can help individuals harness the power of self-efficacy and group support to enact behavior change and accomplish their health goals. The results of structural equation modeling based on 6-month user activity data demonstrated that (a) self-efficacy had a positive impact on persistent food logging in an mHealth application; (b) social support received from a mobile group was positively associated with food logging and group participation; and (c) both food logging and group participation predicted weight loss success. Extending these findings, this study suggests theoretical and practical implications for designing individually tailored and evidence-based health intervention strategies using advanced mHealth technologies.
28339177	Speech perception in noisy environments is boosted when a listener can see the speaker's mouth and integrate the auditory and visual speech information. Autistic children have a diminished capacity to integrate sensory information across modalities, which contributes to core symptoms of autism, such as impairments in social communication. We investigated the abilities of autistic and typically-developing (TD) children to integrate auditory and visual speech stimuli in various signal-to-noise ratios (SNR). Measurements of both whole-word and phoneme recognition were recorded. At the level of whole-word recognition, autistic children exhibited reduced performance in both the auditory and audiovisual modalities. Importantly, autistic children showed reduced behavioral benefit from multisensory integration with whole-word recognition, specifically at low SNRs. At the level of phoneme recognition, autistic children exhibited reduced performance relative to their TD peers in auditory, visual, and audiovisual modalities. However, and in contrast to their performance at the level of whole-word recognition, both autistic and TD children showed benefits from multisensory integration for phoneme recognition. In accordance with the principle of inverse effectiveness, both groups exhibited greater benefit at low SNRs relative to high SNRs. Thus, while autistic children showed typical multisensory benefits during phoneme recognition, these benefits did not translate to typical multisensory benefit of whole-word recognition in noisy environments. We hypothesize that sensory impairments in autistic children raise the SNR threshold needed to extract meaningful information from a given sensory input, resulting in subsequent failure to exhibit behavioral benefits from additional sensory information at the level of whole-word recognition. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1280-1290. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28338892	In recent decades, embodiment has become an influential concept in psychology and cognitive neuroscience. Embodiment denotes the study of the reciprocal (causal) relationships between mind and body, with the mind not only affecting the body but also vice versa. Embodied cognition comes to the fore in sensorimotor coupling, predictive coding, and nonverbal behavior. Additionally, the embodiment of the mind constitutes the basis of social interaction and communication, as evident in research on nonverbal synchrony and mimicry. These theoretical and empirical developments portend a range of implications for schizophrenia research and treatment. Sensorimotor dysfunctions are closely associated with affective and psychotic psychopathology, leading to altered timing in the processing of stimuli and to disordered appraisals of the environment. Problems of social cognition may be newly viewed as disordered embodied communication. The embodiment perspective suggests novel treatment strategies through psychotherapy and body-oriented interventions, and may ultimately provide biomarkers for diagnosis.
28338791	In dialogue, language processing is adapted to the conversational partner. We hypothesize that the brain facilitates partner-adapted language processing through preparatory neural configurations (task sets) that are tailored to the conversational partner. In this experiment, we measured neural activity with functional magnetic resonance imaging (fMRI) while healthy participants in the scanner (a) engaged in a verbal communication task with a conversational partner outside of the scanner, or (b) spoke outside of a conversational context (to test the microphone). Using multivariate searchlight analysis, we identify cortical regions that represent information on whether speakers plan to speak to a conversational partner or without having a partner. Most notably a region that has been associated with processing social-affective information and perspective taking, the ventromedial prefrontal cortex, as well as regions that have been associated with prospective task representation, the bilateral ventral prefrontal cortex, are involved in encoding the speaking condition. Our results suggest that speakers prepare, in advance of speaking, for the social context in which they will speak.
28338631	The death of a loved one is an emotional-laden experience, and while grief and mourning rituals are less formal today in many communities, there remain some social norms for individuals to process loss. The death of an ex-family member, such as a former spouse, is more complicated and expectations for how to respond are fraught with uncertainty. While grief has been studied and is primarily understood as an individual cognitive process, scholars in sociology and communication are considering the ways in which grief and mourning are social and take place in dialogue with others. This manuscript explores Kenneth Doka's concept of disenfranchised grief, which is "grief that is experienced when loss cannot be openly acknowledged, socially sanctioned, or publicly mourned" through the author's experience of the death of her ex-husband. The narrative will recount how the author learned about her ex-husband's death (via text message), and will challenge definitions of family and family communication about death and grief, particularly the communication strategies used to cope with this unique type of loss.
28337668	The increasing relevance of Information and Communication Technologies (ICTs) in medical care is indisputable. This evidence makes it necessary to start studies that analyse the scope these new forms of access to information and understanding of medicine have on the professional activity of the physician, on the attitude and on the knowledge of patients or, on the doctor-patient relationship. The purpose of this study is to explore some of these aspects in a group of physicians whose clinical activity is related to one of the greatest social impact health problems which is the treatment of chronic pain. Starting with the completion of a questionnaire, in the study group it is observed that the interaction between social structure, increase of information flows and ICTs generate transformations in social practices and behaviour of the actors of the health system. Internet is confirmed as an information space on the subject, but is shown as an underutilized space of interaction between the doctor and his patient.
28337487	Measuring gender inequality and women's empowerment is essential to understand the determinants of gender gaps, evaluate policies and monitor countries' progress. With this aim, over the past two decades, research has mainly been directed towards the development of composite indices. The purpose of this paper is to introduce a new and interdisciplinary perspective to the current debate on measuring gender inequality in human development. As a starting point, we develop a simple macroeconomic model of the interdependence between human development and gender inequality. We then introduce a biometric indicator, based on the ratio of female to male body mass index, to measure women's empowerment at the country level. Finally, by using the latest available data, we examine the ability of this biometric indicator to capture countries' performance in achieving gender equality. We obtain five main results: 1) we provide a theoretical framework to explain the joint determination of human development and gender inequality; 2) we show how to use this framework to simulate the impact of exogenous shocks or policy changes; 3) we demonstrate that exogenous changes have a direct and a multiplier effect on human development and gender inequality; 4) we find that the distribution of obesity between the female and male populations represents a useful proxy variable for measuring gender equality at the country level; 5) finally, we use these results to integrate and develop existing knowledge on the 'ecological' approach to the overweight and obesity pandemic.
28337431	Teaching in the field of public health needs to employ a global perspective to account for the fact that public health problems and solutions have global determinants and implications as well. International university partnerships can promote such a perspective through the strengthening of cooperation, exchange, and communication between academic institutions across national boundaries. As an example for such an academic network in the field of public health, we introduce the International Public Health Partnership-a collaboration between a university in Germany and universities in India, Turkey, and Nigeria. Formed in 2005, it facilitated the exchange of information, fostered discussion about the transferability of public health concepts, contributed to the structural development of the universities involved, and promoted an intercultural dialog through a combination of local and distance learning activities. Although well accepted by students and staff, different obstacles were encountered; these included limited external funding, scarce own financial, time and personnel resources, and diverging regulations and structures of degree programs at the partnership sites. In the present article, we share several lessons that we learned during our joint collaboration and provide recommendations for other universities that are involved in partnerships with institutions of higher education or are interested to initiate such collaborations.
28337167	Background: Despite the steadily escalating psychological and economic burden of depression, there is a lack of evidence for the effectiveness of available interventions on functioning areas beyond symptomatology. Therefore, the main objective of this study was to give an insight into the current measurement of treatment effectiveness in depression and to provide recommendations for its improvement. Materials and Methods: The study was based on a multi-informant approach, comparing data from a systematic literature review, an expert survey with representatives from clinical practice (130), and qualitative interviews with patients (11) experiencing depression. Results: Current literature places emphasis on symptomatic outcomes and neglects other domains of functioning, whereas clinicians and depressed patients highlight the importance of both. Interpersonal relationships, recreation and daily activities, communication, social participation, work difficulties were identified as being crucial for recovery. Personal factors, neglected by the literature, such as self-efficacy were introduced by experts and patients. Furthermore, clinicians and patients identified a number of differences regarding the areas improved by psychotherapeutic or pharmacological interventions that were not addressed by the pertinent literature. Conclusion: Creation of a new cross-nationally applicable measure of psychosocial functioning, broader remission criteria, report of domain-specific information, and a personalized approach in treatment decision-making are the first crucial steps needed for the improvement of the measurement of treatment effectiveness in depression. A better measurement will facilitate the clinical decision making and answer the escalating burden of depression.
28336503	Social media public health campaigns have the advantage of tailored messaging at low cost and large reach, but little is known about what would determine their feasibility as tools for inducing attitude and behavior change.The aim of this study was to test the feasibility of designing, implementing, and evaluating a social media-enabled intervention for skin cancer prevention.	A quasi-experimental feasibility study used social media (Twitter) to disseminate different message "frames" related to care in the sun and cancer prevention. Phase 1 utilized the Northern Ireland cancer charity's Twitter platform (May 1 to July 14, 2015). Following a 2-week "washout" period, Phase 2 commenced (August 1 to September 30, 2015) using a bespoke Twitter platform. Phase 2 also included a Thunderclap, whereby users allowed their social media accounts to automatically post a bespoke message on their behalf. Message frames were categorized into 5 broad categories: humor, shock or disgust, informative, personal stories, and opportunistic. Seed users with a notable following were contacted to be "influencers" in retweeting campaign content. A pre- and postintervention Web-based survey recorded skin cancer prevention knowledge and attitudes in Northern Ireland (population 1.8 million).	There were a total of 417,678 tweet impressions, 11,213 engagements, and 1211 retweets related to our campaign. Shocking messages generated the greatest impressions (shock, n=2369; informative, n=2258; humorous, n=1458; story, n=1680), whereas humorous messages generated greater engagement (humorous, n=148; shock, n=147; story, n=117; informative, n=100) and greater engagement rates compared with story tweets. Informative messages, resulted in the greatest number of shares (informative, n=17; humorous, n=10; shock, n=9; story, n=7). The study findings included improved knowledge of skin cancer severity in a pre- and postintervention Web-based survey, with greater awareness that skin cancer is the most common form of cancer (preintervention: 28.4% [95/335] vs postintervention: 39.3% [168/428] answered "True") and that melanoma is most serious (49.1% [165/336] vs 55.5% [238/429]). The results also show improved attitudes toward ultraviolet (UV) exposure and skin cancer with a reduction in agreement that respondents "like to tan" (60.5% [202/334] vs 55.6% [238/428]).	Social media-disseminated public health messages reached more than 23% of the Northern Ireland population. A Web-based survey suggested that the campaign might have contributed to improved knowledge and attitudes toward skin cancer among the target population. Findings suggested that shocking and humorous messages generated greatest impressions and engagement, but information-based messages were likely to be shared most. The extent of behavioral change as a result of the campaign remains to be explored, however, the change of attitudes and knowledge is promising. Social media is an inexpensive, effective method for delivering public health messages. However, existing and traditional process evaluation methods may not be suitable for social media.	
28335879	Social anxiety (SA) is a common condition associated with social and communication (SC) difficulties in typically developing young people, as well as those with autism spectrum disorder (ASD). Whether SC difficulties place children at risk for developing SA is unclear. Using a longitudinal design, the present study aimed to disentangle the relationship between SA symptoms and SC difficulties using a population-based sample of 9,491 children from the Avon Longitudinal Study of Parents and Children (ALSPAC).Parent-reported data on SC difficulties and SA symptoms were collected at ages 7, 10, and 13 years. A cross-lagged panel model was used to investigate the longitudinal stability and directional relationship between latent SC difficulties and SA constructs over time.	More SC difficulties were associated with greater SA symptoms at all ages. Earlier SC difficulties predicted a small but significant amount of variance in later SA symptoms. The reverse relationship from SA to SC difficulties was not observed. The relationship from SC difficulties to SA was strongest from age 7 to 10 years. No sex differences were observed.	The evidence suggests that SC difficulties may be an important risk factor for the development of SA. These findings suggest the potential usefulness of incorporating social skills training alongside effective interventions to prevent or alleviate symptoms of SA in childhood.	
28334943	Humans are highly social beings that interact with each other on a daily basis. In these complex interactions, we get along by being able to identify others' actions and infer their intentions, thoughts and feelings. One of the major theories accounting for this critical ability assumes that the understanding of social signals is based on a primordial tendency to simulate observed actions by activating a mirror neuron system. If mirror neuron regions are important for action and emotion recognition, damage to regions in this network should lead to deficits in these domains. In the current behavioural and EEG study, we focused on the lateral prefrontal cortex including dorsal and ventral prefrontal cortex and utilized a series of task paradigms, each measuring a different aspect of recognizing others' actions or emotions from body cues. We examined 17 patients with lesions including (n = 8) or not including (n = 9) the inferior frontal gyrus, a core mirror neuron system region, and compared their performance to matched healthy control subjects (n = 18), in behavioural tasks and in an EEG observation-execution task measuring mu suppression. Our results provide support for the role of the lateral prefrontal cortex in understanding others' emotions, by showing that even unilateral lesions result in deficits in both accuracy and reaction time in tasks involving the recognition of others' emotions. In tasks involving the recognition of actions, patients showed a general increase in reaction time, but not a reduction in accuracy. Deficits in emotion recognition can be seen by either direct damage to the inferior frontal gyrus, or via damage to dorsal lateral prefrontal cortex regions, resulting in deteriorated performance and less EEG mu suppression over sensorimotor cortex.
28334848	The use of social media (SM) as a surveillance tool of global illicit drug use is limited. To address this limitation, a systematic review of literature focused on the ability of SM to better recognize illicit drug use trends was addressed.A search was conducted in databases: PubMed, CINAHL via Ebsco, PsychINFO via Ebsco, Medline via Ebsco, ERIC, Cochrane Library, Science Direct, ABI/INFORM Complete and Communication and Mass Media Complete. Included studies were original research published in peer-reviewed journals between January 2005 and June 2015 that primarily focused on collecting data from SM platforms to track trends in illicit drug use. Excluded were studies focused on purchasing prescription drugs from illicit online pharmacies.	Selected studies used a range of SM tools/applications, including message boards, Twitter and blog/forums/platform discussions. Limitations included relevance, a lack of standardized surveillance systems and a lack of efficient algorithms to isolate relevant items.	Illicit drug use is a worldwide problem, and the rise of global social networking sites has led to the evolution of a readily accessible surveillance tool. Systematic approaches need to be developed to efficiently extract and analyze illicit drug content from social networks to supplement effective prevention programs.	
28334795	The current mixed-methods study examined everyday problems among deaf and hard of hearing (DHH) adolescents across various life domains. To better understand the factors influencing levels of perceived stress, the impact of DHH adolescents' coping and pragmatic abilities was also examined. Thirty DHH adolescents completed questionnaires about everyday stressors and coping, and 13 of these respondents were interviewed regarding their everyday problems. All participants used spoken language and attended mainstream high schools. Teachers evaluated the pragmatic skills of each participant through a communication assessment tool. The quantitative-based results showed that DHH adolescents perceived greatest stress related to the future, peers, and school, in that order. Considerably less stress was experienced with regard to parents, leisure, and romantic relationships. The qualitative data reflected the context-specific everyday stressors experienced by DHH adolescents and suggested they have been generated by problems related to having a hearing loss, experiences in social interactions, classroom environment, and academic challenges. Importantly, lower pragmatic abilities and increased level of withdrawal coping style were found to be associated with higher perceived stress. The conclusions focused on ways in which schools, teachers, and professionals can implement prevention and intervention efforts to adequately support DHH adolescents in facing everyday challenges.
28334519	To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves.The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals.	Descriptive qualitative design.	This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis.	Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons.	The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research.	Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing.	
28334381	Action and speech may take different forms, being expressed, for example, gently or rudely. These aspects of social communication, named vitality forms, have been little studied in neuroscience. In the present functional magnetic resonance imaging study, we investigated the role of insula in processing action and speech vitality forms. In speech runs, participants were asked to listen or imaging themselves to pronounce action verbs gently or rudely. In action runs, they were asked to observe or imaging themselves to perform actions gently or rudely. The results showed that, relative to controls, there was an activation of the dorso-central insula in both tasks of speech and action runs. The insula sector specific for action vitality form was located slightly more dorsally than that of speech with a large overlap of their activations. The psycho-physiological interaction analysis showed that the insular sector involved in action vitality forms processing is connected with the left hemisphere areas controlling arm actions, whereas the sector involved in speech vitality forms processing is linked with right hemisphere areas related to speech prosody. We conclude that the central part of the insula is a key region for vitality forms processing regardless of the modality by which they are conveyed or expressed.
28334080	Neuroimaging studies in autism spectrum disorders (ASDs) have provided inconsistent evidence of cortical abnormality. This is probably due to the small sample sizes used in most studies, and important differences in sample characteristics, particularly age, as well as to the heterogeneity of the disorder. To address these issues, we assessed abnormalities in ASD within the Autism Brain Imaging Data Exchange data set, which comprises data from approximately 1100 individuals (~6-55 years). A subset of these data that met stringent quality control and inclusion criteria (560 male subjects; 266 ASD; age = 6-35 years) were used to compute age-specific differences in cortical thickness in ASD and the relationship of any such differences to symptom severity of ASD. Our results show widespread increased cortical thickness in ASD, primarily left lateralized, from 6 years onwards, with differences diminishing during adulthood. The severity of symptoms related to social affect and communication correlated with these cortical abnormalities. These results are consistent with the conjecture that developmental patterns of cortical thickness abnormalities reflect delayed cortical maturation and highlight the dynamic nature of morphological abnormalities in ASD.
28333973	Breakdown of marriage and cohabitation is common in Western countries and is costly for individuals and society. Most research on reasons for breakdown has focused on marriages ending in divorce and/or have used data unrepresentative of the population. We present prevalence estimates of, and differences in, reported reasons for recent breakdown of marriages and cohabitations in Britain.Descriptive analyses of data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability sample survey (15,162 people aged 16-74 years) undertaken 2010-2012, using computer-assisted personal interviewing. We examined participants' reported reasons for live-in partnership breakdown in the past 5 years and how these varied by gender and partnership type (married vs. cohabitation).	Overall, 10.9% (95% CI: 9.9-11.9%) of men and 14.1% (13.2-15.0%) of women reported live-in partnership breakdown in the past 5 years. Mean duration of men's marriages was 14.2 years (95% CI: 12.8-15.7) vs. cohabitations; 3.5 years (3.0-4.0), and for women: 14.6 years (13.5-15.8) vs. 4.2 years (3.7-4.8). Among 706 men and 1254 women reporting experience of recent breakdown, the reasons 'grew apart' (men 39%, women 36%), 'arguments' (27%, 30%), 'unfaithfulness/adultery' (18%, 24%, p<0.05), and 'lack of respect/appreciation' (17%, 25%, p<0.05) were the most common, irrespective of partnership type. A total of 16% of women vs. 4% of men cited domestic violence. After adjusting for age at interview and duration of partnership, there were no significant differences in reasons given for breakup by partnership type, except that men more commonly cited 'moving due to changing circumstances' as a reason for a cohabitation ending than for a marriage (AOR = 3.78, 95% CI: 1.08-13.21); and among women, 'not sharing housework' (0.54, 0.35-0.83) and 'sexual difficulties' (0.45, 0.25-0.84) were less commonly cited as reasons for cohabitation ending than marriage.	These representative data on recently ended marriages and cohabitations among men and women in Britain show that there were more similarities than differences in the reasons reported for breakdown across partnership type. For both marriages and cohabitations, cited reasons relating to communication and relationship quality issues were most common, followed by unfaithfulness/adultery. Our findings support a focus on relationship quality, including communication and conflict resolution, in preventive and therapeutic interventions addressing breakdown of live-in partnerships.	
28333849	Neurodevelopmental concerns in males with sex chromosome aneuploidy (SCA) (XXY/Klinefelter syndrome, XYY, XXYY) include symptoms seen in autism spectrum disorder (ASD), such as language impairments and social difficulties. We aimed to: (1) evaluate ASD characteristics in research cohorts of SCA males under DSM-IV compared to DSM-5 criteria, and (2) analyze factors associated with ASD diagnoses in SCA.Evaluation of participants with XXY/KS (n=20), XYY (n=57) and XXYY (n=21) included medical history, cognitive/adaptive testing, Social Communication Questionnaire, Social Responsiveness Scale, Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, and DSM ASD criteria. Clinical impressions of ASD diagnostic category using the ADOS and DSM-IV criteria were compared to ADOS-2 and DSM-5 criteria. T-tests compared cognitive, adaptive, SES and prenatal vs. postnatal diagnoses between ASD and no ASD groups.	ASD rates in these research cohorts were 10% in XXY/KS, 38% in XYY, and 52% in XXYY using ADOS-2/DSM-5, and were not statistically different compared to DSM-IV criteria. In XYY and XXYY, the ASD group had lower verbal IQ and adaptive functioning compared to those without ASD. Many children without ASD still showed some social difficulties.	ASD rates in males with SCA are higher than reported for the general population. Males with Y chromosome aneuploidy (XYY and XXYY) were 4.8 times more likely to have a diagnosis of ASD than the XXY/KS group, and 20 times more likely than males in the general population (1 in 42 males, CDC 2010). ASD should be considered when evaluating social difficulties in SCA. Studies of SCA and Y-chromosome genes may provide insight into male predominance in idiopathic ASD.	
28333495	The last 2 decades witnessed a surge in empirical studies on the variables associated with achievement in higher education. A number of meta-analyses synthesized these findings. In our systematic literature review, we included 38 meta-analyses investigating 105 correlates of achievement, based on 3,330 effect sizes from almost 2 million students. We provide a list of the 105 variables, ordered by the effect size, and summary statistics for central research topics. The results highlight the close relation between social interaction in courses and achievement. Achievement is also strongly associated with the stimulation of meaningful learning by presenting information in a clear way, relating it to the students, and using conceptually demanding learning tasks. Instruction and communication technology has comparably weak effect sizes, which did not increase over time. Strong moderator effects are found for almost all instructional methods, indicating that how a method is implemented in detail strongly affects achievement. Teachers with high-achieving students invest time and effort in designing the microstructure of their courses, establish clear learning goals, and employ feedback practices. This emphasizes the importance of teacher training in higher education. Students with high achievement are characterized by high self-efficacy, high prior achievement and intelligence, conscientiousness, and the goal-directed use of learning strategies. Barring the paucity of controlled experiments and the lack of meta-analyses on recent educational innovations, the variables associated with achievement in higher education are generally well investigated and well understood. By using these findings, teachers, university administrators, and policymakers can increase the effectivity of higher education. (PsycINFO Database Record
28332918	Nineteen years after Lisa Timmons and Andy Fire first described RNA transfer from bacteria to C. elegans in an experimental setting 48 the biologic role of this trans-kingdom RNA-based communication remains unknown. Here we summarize our current understanding on the mechanism and potential role of such social RNA.
28332223	Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers.As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services.	Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services.	Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully.	
28332193	Three experiments (N = 100) examine the influence of causal information on overimitation. In Experiment 1, a transparent reward location reveals that the reward is unaffected by nonfunctional actions. When 5-year-olds observe an inefficient and subsequently an efficient strategy to retrieve a reward, they show overimitation in both phases-even though the reward is visible. In Experiment 2, children observe first the efficient then the inefficient strategy. The latter is always demonstrated communicatively, whereas the efficient strategy is presented communicatively (2a) or noncommunicatively (2b). Regardless of whether the efficient strategy is emphasized through communication or not, most children do not switch from the efficient to the inefficient strategy. Depending on the situation, children base their behavior on social motivations or causal information.
28330514	Pinterest (San Francisco, CA) and Instagram (Menlo Park, CA) are 2 popular photo-sharing social media platforms among young individuals. We assessed differences between Instagram and Pinterest in relaying photographic information regarding Zika virus. Specifically, we investigated whether the percentage of Zika-virus-related photos with Spanish or Portuguese texts embedded therein was higher for Instagram than for Pinterest and whether the contents of Zika-virus-related photos shared on Pinterest were different from those shared on Instagram.We retrieved and manually coded 616 Pinterest (key words: "zika" AND "virus") and 616 Instagram (hashtag: #zikavirus) photos.	Among the manually coded samples, 47% (290/616) of Pinterest photos and 23% (144/616) of Instagram photos were relevant to Zika virus. Words were embedded in 57% (164/290) of relevant Pinterest photos and all 144 relevant Instagram photos. Among the photos with embedded words, photos in Spanish or Portuguese were more prevalent on Instagram (77/144, 53%) than on Pinterest (14/164, 9%). There were more Zika-virus-related photos on Instagram than on Pinterest pertinent to Zika virus prevention (59/144, 41%, versus 41/290, 14%; P<0.0001), the effects of Zika virus on pregnancy (27/144, 19%, versus 32/290, 11%; P=0.04), and Zika-virus-associated deaths (4/144, 2%, versus 0/290, 0%; P=0.01).	Pinterest and Instagram are similar platforms for Zika virus prevention communication. (Disaster Med Public Health Preparedness. 2017;page 1 of 4).	
28330407	After the March 2011 Fukushima Daiichi Nuclear Power Plant accident, overseas experts and representatives of international organizations visited Japan to provide advice, technical support, and resources. Several international meetings on radiological protection and health issues have since been held in Fukushima to provide further advice. The content discussed has changed alongside local developments in health-related issues from radiation health effects and radiological protection to risk communication and psychological, public health, and social issues. The support of international organizations and experts has been valuable in implementing public health and support programs in Fukushima. The Fukushima accident showed that after a nuclear accident, authorities need to balance the risks of radiation with other health effects and develop programs to mitigate the overall effects on health (whole-health management), but there was little evidence of the importance of this at the time. Future research should examine international collaboration to assess this.
28330400	Since radiation accidents, particularly nuclear disasters, are rarer than other types of disasters, a comprehensive radiation disaster medical curriculum for them is currently unavailable. The Fukushima compound disaster has urged the establishment of a new medical curriculum in preparation for any future complex disaster. The medical education will aim to aid decision making on various health risks for workers, vulnerable people, and residents addressing each phase in the disaster. Herein, we introduce 3 novel educational programs that have been initiated to provide students, professionals, and leaders with the knowledge of and skills to elude the social consequences of complex nuclear disasters. The first program concentrates on radiation disaster medicine for medical students at the Fukushima Medical University, together with a science, technology, and society module comprising various topics, such as public risk communication, psychosocial consequences of radiation anxiety, and decision making for radiation disaster. The second program is a Phoenix Leader PhD degree at the Hiroshima University, which aims to develop future leaders who can address the associated scientific, environmental, and social issues. The third program is a Joint Graduate School of Master's degree in the Division of Disaster and Radiation Medical Sciences at the Nagasaki University and Fukushima Medical University.
28330396	A thyroid ultrasound examination program has been conducted in the aftermath of the Fukushima Daiichi Nuclear Power Plant accident to address concerns about the increased risk of thyroid cancer similar to those experienced by local residents after the 1986 Chernobyl accident. This is the second-largest thyroid cancer screening in younger age ever, following only that conducted after Chernobyl. As the natural history of thyroid cancer in younger populations is not well characterized, large-scale screening using thyroid ultrasound could result in overdiagnosis, even with careful planning, as has been experienced in South Korea. Awareness regarding the thyroid gland is generally low among residents, who tend to directly associate examination results with radiation exposure and are likely to develop newfound anxiety and feelings of self-condemnation and guilt. We reviewed the dilemma surrounding cancer screening and particularly underscored the need to address psychosocial issues associated with possible overdiagnosis. We modified our approach to address individual and social anxiety induced by results of screening conducted after the Fukushima accident. These findings and our experiences regarding the psychosocial issues related to thyroid examination should assist residents in their lifelong decision making and help them prepare for future disasters.
28330388	Social ecological models of health often describe multiple levels of influence that interact to influence health. However, it is still common for interventions to target only one or two of these levels, perhaps owing in part to a lack of guidance on how to design multilevel interventions to achieve optimal impact. The convergence strategy emphasizes that interventions at different levels mutually reinforce each other by changing patterns of interaction among two or more intervention audiences; this strategy is one approach for combining interventions at different levels to produce synergistic effects. We used semistructured interviews with 65 representatives in a cross-site national initiative that enhanced health and outcomes for patients with diabetes to examine whether the convergence strategy was a useful conceptual model for multilevel interventions. Using a framework analysis approach to analyze qualitative interview data, we found three synergistic themes that match the convergence strategy and support how multilevel interventions can be successful. These three themes were (1) enhancing engagement between patient and provider and access to quality care; (2) supporting communication, information sharing, and coordination among providers, community stakeholders, and systems; and (3) building relationships and fostering alignment among providers, community stakeholders, and systems. These results support the convergence strategy as a testable conceptual model and provide examples of successful intervention strategies for combining multilevel interventions to produce synergies across levels and promote diabetes self-management and that may extend to management of other chronic illnesses as well.
28329916	Transgender people face a range of personal and social conflicts that strongly influence their well-being. In many cases, the Internet can become the main resource in terms of finding support. The aim of this study was to understand how transgender people give and receive help online. Between 2013 and 2015, 122 online community conversations were collected on Italian forums and Facebook groups involving transgender people, and online interviews were conducted with 16 users of these communities. A qualitative content analysis was conducted by using the software package, NVivo10. The main categories that emerged were: motivations to join an online community, online help, differences between online and offline interactions, status, conflicts and professional help. Results indicate that participation in online communities often derives from the users' need for help. This help can be given by peers who have had similar experiences, and by professionals who participate in the discussions as moderator. The need to test one's own identity, to compare oneself with others and to share one's personal experiences made online communities at risk of exposing users to invalidation and transphobic messages. Administrators and moderators try to ensure the safety of users, and suggest that they ask for professional help offline and/or online when over-specific medical advice was sought. This study confirms that transgender people might find benefit from an online platform of help and support and might minimise distance problems, increase financial convenience and foster disinhibition.
28329852	This study identifies genres of communication that avoid the features of elderspeak and successfully engage cognitively or physically affected older adults in rich communicative interaction.The study examined 100 hr of audio- and video-recorded interaction between older Catholic nuns and their caregivers. The data were collected as part of a 7-year study on the linguistic and communicative factors that contribute to successful aging in a Catholic convent infirmary. Data analyzed in this article were selected from the corpus based on 2 criteria: (a) the interaction was absent of elderspeak and (b) the interaction was between a communicatively or cognitively impaired older adult and a caregiver.	Linguistic analysis of the interactions revealed 3 alternatives to elderspeak that maintain lexically and grammatically rich communication while maintaining minimal opportunity for communicative failure or breakdown. These include: (a) offered and requested blessings, (b) jokes, and (c) narratives.	These 3 communicative strategies offer examples of lexically and grammatically complex ways to communicate with older adults who have little other opportunity for similarly complex interaction and may reduce resistiveness to care, and linguistic isolation, which has been linked to cognitive decline.	
28329829	Between 2000 and 2012, the incident dialysis population in the United States increased by nearly 60%, most sharply among adults 75 years and older. End-of-life (EOL) conversations among dialysis patients are associated with better patient-centered outcomes and lower use of aggressive interventions in the last month of life. This study examined how health literacy may affect engagement, comprehension, and satisfaction with EOL conversations among elderly dialysis patients.Qualitative/descriptive study with semi-structured interviews about health literacy, EOL conversations, and goals of care with 31 elderly dialysis patients at 2 centers in Boston. Themes were interpreted in the context of Nutbeam's health literacy framework.	Despite high mortality risk in this population, only 13% of patients had discussed EOL preferences with physicians, half had discussed EOL with their social network, and 25% of participants explicitly stated that they had never considered EOL preferences. Less than 30% of participants could correctly define terminology commonly used in EOL conversations. Analyses yielded 5 themes: (1) Misunderstanding EOL terminology; (2) Nephrologists reluctant to discuss EOL; (3) Patients conforming to socially constructed roles; (4) Discordant expectations and dialysis experiences; and (5) Reconciling EOL values and future care. Patients had limited understanding of EOL terminology, lacked of opportunities for meaningful EOL discussion with providers and family, resulting in uncertainty about future care.	Limited health literacy presents a substantial barrier to communication and could lead to older adults committing to an intensive pattern of care without adequate information. Clinicians should consider health literacy when discussing dialysis initiation.	
28329823	Social network typologies have been used to classify the general population but have not previously been applied to the stroke population. This study investigated whether social network types remain stable following a stroke, and if not, why some people shift network type.We used a mixed methods design. Participants were recruited from two acute stroke units. They completed the Stroke Social Network Scale (SSNS) two weeks and six months post stroke and in-depth interviews 8-15 months following the stroke. Qualitative data was analysed using Framework Analysis; k-means cluster analysis was applied to the six-month data set.	Eighty-seven participants were recruited, 71 were followed up at six months, and 29 completed in-depth interviews. It was possible to classify all 29 participants into one of the following network types both prestroke and post stroke: diverse; friends-based; family-based; restricted-supported; restricted-unsupported. The main shift that took place post stroke was participants moving out of a diverse network into a family-based one. The friends-based network type was relatively stable. Two network types became more populated post stroke: restricted-unsupported and family-based. Triangulatory evidence was provided by k-means cluster analysis, which produced a cluster solution (for n = 71) with comparable characteristics to the network types derived from qualitative analysis.	Following a stroke, a person's social network is vulnerable to change. Explanatory factors for shifting network type included the physical and also psychological impact of having a stroke, as well as the tendency to lose contact with friends rather than family.	
28329800	Advance care planning (ACP) involves reflection on health care preferences and communication of the person's wishes in case of future incapacity. ACP is particularly pertinent in supportive living (SL) as residents are at high risk of cognitive decline and changes in health status, but the readiness of residents, families, and health care practitioners to engage in ACP discussions is not known. The purpose of this study was to explore the readiness among these stakeholders and the factors that influence the degree of readiness.Twenty-seven participants (10 residents, 8 family members, 9 health care practitioners) affiliated with 4 SL facilities in Calgary, AB, Canada took part in semistructured, one-on-one interviews. An interpretive descriptive approach was utilized to generate clinically relevant findings.	Variability in the conceptualization of ACP, including confusion regarding terminology, emerged as a major theme. Themes that influenced readiness for engagement in ACP discussions included the influence of prior experience for residents and family members, perception of treatment goals, and understanding of roles in the process between the groups.	Recommendations for clinicians include clarifying ACP concepts for themselves and residents, shifting focus toward an elucidation of values and preferences rather than on documentation, greater clarity about the roles of the various stakeholders, and recognizing the importance of prior experience for residents and family members. These findings can be used to contribute to the understanding of ACP engagement in SL and inform an approach to engaging in meaningful discussions about ACP.	
28329428	To explore the impact of the diagnosis of polycystic ovary syndrome on health/ill health identity, how women experience this diagnosis and their health beliefs.Polycystic ovary syndrome is a common and heterogeneous condition, giving rise to a wide range of different health concerns. Previous research on polycystic ovary syndrome has been dominated by the medical perspective and less is known about the experiences and needs of women.	A qualitative study of 32 premenopausal adult women with polycystic ovary syndrome (diagnosis confirmed by Rotterdam criteria), aged between 18 and 45 years, recruited from a primary and secondary care setting.	Thematic analysis of transcripts from 11 focus groups conducted between 2013-2015.	Women identified a range of concerns affecting personal and reproductive identity, health knowledge and beliefs: (1) delays and barriers to diagnosis; (2) general lack of empathy by the medical profession; (3) difficulty in accessing specialist referral; (4) lack of information from professionals; (5) inconsistent and sometimes unsatisfactory experiences with medications; (6) insufficient help and advice regarding in/fertility; (7) relative lack of awareness or concern about longer term risks such as diabetes; and (8) significant discrepancies between the beliefs of women with polycystic ovary syndrome and how they experienced the attitudes of healthcare professionals.	There appears to be a divergence between women's experience and attitudes of healthcare professionals. The diagnosis, support and lived experience of women with polycystic ovary syndrome could be enhanced by better professional recognition of these concerns, improved knowledge and communication about polycystic ovary syndrome and better access to support and specialist advice.	
28328392	Family caregivers are socially isolated and burdened as they care for their loved one, often for many years. Internet support groups can address some of the barriers related to the social isolation, self-efficacy, and burden experienced during caregiving by connecting individuals with similar problems to one another. The purpose of the meta-analysis was to analyze the effect of Internet-based group support interventions on social support, self-efficacy, and burden.A two-step search process was used to identify peer reviewed evidence to answer the research question. Multiple databases, including MEDLINE, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, and several others, were searched to identify systematic reviews from which to identify the final articles for data extraction.	Seven systematic reviews identified 10 studies to answer the research question. A statistically significant effect was found from the interventions targeting social support and self-efficacy. We were unable to assess the effect of these interventions on caregiver burden due to the variance in measurement constructs.	While it has been found that Internet group support interventions have a positive effect on social support and self-efficacy, the size and quality of studies are moderate, and thus, large-scale randomized controlled trials are needed for a higher level of evidence.	
28328305	Online training for care managers to identify, report, and prevent abuse, neglect, and exploitation was developed for a demonstration involving the dually eligible Medicare and Medicaid population. It was composed of three modules covering background, screening, and reporting abuse. Of 453 enrollees, 273 completed at least one module and 212 completed all three. Pre- and post-training surveys for each module were used to examine changes in the proportion of correct answers for each question, using the related-samples Cochran's Q statistic. Improvements in knowledge from pre- to post-training were evident in modules covering background on abuse and reporting abuse, but not in the module about communication principles and screening for abuse. Its content may have already been familiar to the trainees, who were primarily social workers and nurses. Lessons learned are being used to adapt the training for a wider audience to increase public awareness of abuse.
28327593	The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand the patients' own experiences, and only record cross-sectional, professional impressions at the point of care. Social media platforms have become a source of 'in the moment' daily exchange, with topics including well-being and mental health. In this study, we analysed posts from the social media platform Reddit and developed classifiers to recognise and classify posts related to mental illness according to 11 disorder themes. Using a neural network and deep learning approach, we could automatically recognise mental illness-related posts in our balenced dataset with an accuracy of 91.08% and select the correct theme with a weighted average accuracy of 71.37%. We believe that these results are a first step in developing methods to characterise large amounts of user-generated content that could support content curation and targeted interventions.
28327154	An understanding of maternal knowledge of the danger signs of obstetric and newborn complications is fundamental to attaining universal health coverage. In Northern Ghana, where maternal and newborn morbidity and mortality is high, little is known about the current knowledge level and associated determinants of these danger signs. This study assessed the effect of social behavior change communication (SBCC) package on knowledge of obstetric and newborn danger signs among mothers with children under 24 months of age.This study used a non-randomized controlled community-based intervention design with pre and post-intervention household surveys in the intervention and comparison communities of the East Mamprusi District in Ghana. The study population were selected using a two-stage cluster sampling procedure.	Only 521 (51.1%), 300 (29.4%) and 353 (34.6%) of the study participants knew at least three key danger signs during pregnancy, delivery and postpartum period respectively. The intervention had a positive effect on maternal knowledge of danger signs. Compared to their counterparts in the comparison communities, women in the intervention communities were about 2.6 times (AOR  =  2. 58 [CI: 1.87, 3.57]), 3.4 times (AOR  =  3.39 [CI: 2.31, 4.96]) and 2.2 times (AOR  =  2.19 [CI: 1.68, 2.84]) more likely to have higher knowledge of danger signs of childbirth, postpartum and neonate, respectively. Having sought postnatal services at least once was significantly associated with the mentioning of at least three danger signs of postpartum (AOR  =  3.90 [CI: 2.01, 7.58]) and childbirth (AOR  =  1.75 [CI: 1.06, 2.85]).	There was a significant contribution of social and behavioral change communication as an intervention to maternal knowledge in obstetric danger signs after adjusting for confounding factors such as antenatal and post-natal care attendance. Therefore, provision of information, education and communication targeting women on danger signs of pregnancy and childbirth and associated factors would be an important step towards attaining universal health coverage.	
28327153	The Malay version of the Psychosocial Impact of Dental Aesthetics Questionnaire has been validated for use by Malaysian adolescents. Although Malay is their national language, English is widely used as the lingua franca among Malaysians of different ethnicities. This study aimed to validate an English version of the PIDAQ adapted for use by Malaysian adolescents to optimize data capture from adolescents who prefer English as the medium for communication.The published English version of PIDAQ was pilot tested on 12- to 17-year-old adolescents, resulting in a few modifications to suit the Malaysian variety of English. Psychometric properties were tested on 393 adolescents who attended orthodontic practices and selected schools. Malocclusion was assessed using the Malocclusion Index, an aggregation of Perception of Occlusion Scale and the Aesthetic Component of the Index of Orthodontic Treatment Need, by the subjects (MI-S) and investigators (MI-D). Data were analysed for internal consistency and age-associated invariance, discriminant, construct and criterion validities, reproducibility and floor and ceiling effects using AMOS v.20 and SPSS v.20.	The item Don't like own teeth on video of the Aesthetic Concern (AC) subscale was not relevant to a large proportion of participants (11.7%). Therefore, it was removed and the Malaysian English PIDAQ was analysed based on 22 items instead of 23 items. Confirmatory factor analysis showed good fit statistics (comparative fit index: 0.902, root-mean-square error of approximation: 0.066). Internal consistency was good for the Dental Self-Confidence, Social Impact and Psychological Impact subscales (Cronbach's alpha: 0.70-0.95) but lower (0.52-0.62) though acceptable for the AC subscale as it consisted of only 2 items. The reproducibility test was acceptable (intra-class correlations: 0.53-0.78). For all PIDAQ subscales, the MI-S and MI-D scores of those with severe malocclusion differed significantly from those with no or slight malocclusion. There were significant associations between the PIDAQ subscales with ranking of perceived dental appearance, need for braces and impact of malocclusion on daily activities. There were no floor or ceiling effects.	The adapted Malaysian English PIDAQ demonstrated adequate psychometric properties that are valid and reliable for assessment of psychological impacts of dental aesthetics among Malaysian adolescents.	
28326463	Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause significant social, communication and behavioral challenges. Environmental contribution to ASD is due in large part to the sensitivity of the developing brain to external exposures such as lead (Pb), and mercury (Hg) as toxic heavy metals or due to a poor detoxification ability as the phenotype of this disorder. Selenium (Se) as an antioxidant element that counteracts the neurotoxicity of Hg, and Pb, presumably through the formation of nontoxic complexes. In the present study, Pb, Hg, and Se were measured in red blood cells (RBCs) of 35 children with ASD and 30 age- and gender-matched healthy control children using atomic absorption spectrometry. Receiver Operating Characteristics (ROC) analysis of the obtained data was performed to measure the predictive value of their absolute and relative concentrations. The obtained data demonstrates a significant elevation of Hg and Pb together with a significant decrease in the Se levels in RBCs of patients with ASD when compared to the healthy controls. The ratios of Se to both Pb and Hg were remarkably altered, being indicative of heavy metal neurotoxicity in patients with ASD. In conclusion, the present study indicates the importance of Se for prevention and/or therapy of heavy metal neurotoxicity.
28326133	We present a versatile synthesis of the eukaryotic signaling peptide glorin as well as glorinamide, a synthetic analog. The ability of these compounds to activate glorin-induced genes in the social amoeba Polysphondylium pallidum was evaluated by quantitative reverse transcription PCR, whereby both compounds showed bioactivity comparable to a glorin standard. This synthetic route will be useful in conducting detailed structure-activity relationship studies as well as in the design of chemical probes to dissect glorin-mediated signaling pathways.
28325711	Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting.The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI).	Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement.	The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship.	Messaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations.	
28324861	The aim was to identify the effects of early vitamin D supplementation on autism-like behaviors (ASD) induced by valproic acid (VPA, an anti-convulsant and a mood stabilizer) in rats. 10 male Wistar rat pups with prenatal exposure to saline were in control group, and 20 Pups with prenatal exposure to VPA were divided into ASD-N (0.9% saline treated) and ASD-D group (vitamin D 80,000 IU/kg treated) on postnatal day 12. Self-grooming, olfactory habituation/dishabituation, and social interaction tests were conducted to assess social interaction, communication, and repetitive behaviors. Serum 25-hydroxyvitamin D (25(OH)D3) was measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results showed that compared with the control group, the ASD-N group exhibited increased self-grooming, and decreased pinning and serum 25(OH)D3. Furthermore, the repetitive behavior of the ASD-N group exhibited a negative linear relationship with serum 25(OH)D3 on PND 42. In conclusion, early vitamin D supplementation in infant rat with ASD induced by VPA significantly improved development and behavior of rats related with ASD.
28324205	In order to promote better practices and communication around end-of-life decision-making, several Canadian hospitals in the province of Quebec have developed a tool called "Levels of Intervention" (LOI). No work to date has been published demonstrating improvement since these forms were implemented. The purpose of the present study was to obtain information about the use of LOI forms across Quebec hospitals and to identify gaps in practice as well as areas for improvement. A retrospective study was undertaken of 299 charts of patients who had died in three Quebec hospitals with a LOI ordered. Results were analysed through a principlism ethical framework. High compliance with the level of intervention ordered at the time of death was recorded, as well as high involvement of patient and/or family, demonstrating the efficiency of LOI in promoting respect for autonomy. Other results show delays in end-of-life care discussions in the course of the hospitalization. Only a small proportion of patients who died had a palliative care consultation, which may reflect equity issues in access to care. This study highlights the importance of the LOI in Quebec and the role it is playing in respect for end-of-life preferences as well as in the involvement of patients and families in the decision-making process. Training specific to end-of-life decision-making conversations would help support the LOI form's use, as would developing provincial or national guidelines on the use of LOI to standardize organizational policies and practice around end-of-life care.
28323558	Reproductive tract infections (RTIs) are the cause of severe gynecological and maternal morbidity in India. In marginalized communities, women persevere quietly when faced with a culturally sensitive health issue such as an RTI. To hypothesize on the differential health behavior and low levels of reported incidents among women living in marginalized communities, we undertake an exploratory study in a coastal fishermen community in South India. We identify barriers influencing decisions to seek curative and preventive medical care. Public health practitioners and social workers may find our recommendations relevant for addressing health issues in marginalized communities.
28322981	Autism spectrum disorders (ASD) include a wide range of heterogeneous neurodevelopmental conditions that affect an individual in several aspects of social communication and behavior. Recent advances in molecular genetic technologies have dramatically increased our understanding of ASD etiology through the identification of several autism risk genes, most of which serve important functions in synaptic plasticity and protein synthesis. However, despite significant progress in this field of research, the characterization of the neurobiological mechanisms by which common genetic risk variants might operate to give rise to ASD symptomatology has proven to be far more difficult than expected. The imaging genetics approach holds great promise for advancing our understanding of ASD etiology by bridging the gap between genetic variations and their resultant biological effects on the brain. This paper provides a conceptual overview of the contribution of genetics in ASD and discusses key findings from the emerging field of imaging genetics.
28322882	Widespread concern regarding the detrimental effects of excessive alcohol consumption (especially by minors) and associated social problems (particularly drunk driving) continues to exist among policymakers, law enforcement officers, and the general public. Alcohol consumption is a leading contributor to death from injuries, which itself is one of the main causes of death for people under 21years of age in the United States. This study examines the relationship between the volume and timing of alcohol-control public service announcements (PSAs) and rates of drunk-driving fatal accidents in the U.S. We estimate ordinary least squares (OLS) regression models to predict rates of drunk-driving fatal accidents by state and month as a function of the volume of alcohol-control PSAs aired during the previous 8months. Models include controls for state anti-drunk-driving laws and regulations, state demographic characteristics, state taxes on alcohol, calendar year, and seasonality. Results indicate that higher volumes of anti-drunk driving PSAs airing in the preceding 2 to 3months are associated, albeit modest in magnitude, with reduced rates of drunk-driving fatal accidents. The regression coefficients are largest for adults (relative to underage drunk drivers) and when the PSAs air during prime time (relative to daytime or nighttime). We conclude that PSAs could play an important contributing role in reducing drunk-driving fatal accidents, although levels of exposure and potential effects likely remain modest due to reliance on donated air time. Well-funded anti-drunk driving campaigns could achieve higher levels of exposure and have a larger impact.
28322529	"The multinational corporations producing tobacco, alcohol, soft drinks, and processed foods have a role of vectors in the increase of chronic diseases, so that one can speak of manufacturing epidemics. The main aim of this paper is to conduct a literature review on different approaches in population-based interventions to stem the rise in consumption of unhealthy products. Different approaches were found: • command-and-control regulations: the route is definitely more advanced for tobacco with the implementation of an international treaty, which requires 180 ratifying states to implement a series of tobacco control policies. Similar regulations have been partially adopted to reduce alcohol use and to increase taxes of sugar-sweetened beverages; • multinational corporations in few Countries can voluntarily adopt recommendations on media campaigns and on labelling of soft drinks and processed foods; • in order to reduce salt in foods, many Countries developed voluntary agreements with industries with monitoring systems to assess compliance. Population-based interventions to try to align the interests of multinational corporations with those of public health are described in literature: • the "Health Footprint" programme; • the performance-based regulation which could oblige industry to take responsibility to reduce the harmful consequences of the use of their unhealthy commodities; • the price-cap regulation, usually applied to the utilities sector, would set a cap on the price of the tobacco industry, raising the tobacco taxes by 500 million euros per year. In order to reduce the burden of chronic disease, one of the objectives of the Italian National Prevention Plan, a working group including non-governmental organizations and experts in communication, social marketing, and lifestyles should be organized by the Ministry of Health in order to identify which population-based interventions could be implemented in Italy in next years to stem the rise of consumption of unhealthy products. ".
28322074	Family conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present.To compare language used by PC team and ICU physicians during family conferences.	A retrospective cohort review of ICU family conferences with and without the PC team.	Forty-four bed pediatric ICU in a tertiary medical center.	Nine ICU physicians and 4 PC providers who participated in 18 audio-recorded family conferences.	Of the 9 transcripts without the PC team, we identified 526 ICU physician statements, generating 10 thematic categories. The most common themes were giving medical information and discussing medical options. Themes unique to ICU physicians included statements of hopelessness, insensitivity, and "health-care provider challenges." Among the 9 transcripts with the PC team, there were 280 statements, generating 10 thematic categories. Most commonly, the PC team offered statements of support, giving medical information, and quality of life. Both teams promoted family engagement by soliciting questions; however, the PC team was more likely to use open-ended questions, offer support, and discuss quality of life.	Pediatric ICU physicians spend more time giving medical information, whereas the PC team more commonly offers emotional support. The addition of the PC team to ICU family conferences may provide a balanced approach to communication.	
28322070	Effective communication is a vital component of patient-centered consultations with favorable treatment outcomes. This study aimed in testing the effectiveness of a personalized, communication training program for dermatologists in their practices.Fifteen dermatologists were offered the educational intervention NO.TE.S. (Non-Technical Skills). Depending on the dermatologists' needs, seven to nine sessions with a 60-min duration were performed, focusing on: patient-centered care, principles of Neurolinguistic Programming, a guide to the medical interview, principles of motivational interviewing and self-care. After the program's completion, participants completed anonymously an 18-item evaluation questionnaire.	All 14 participants would suggest NO.TE.S to a colleague. According to the main themes identified, their participation led to (i) re-consideration of the physician-patient relationship, (ii) more conscious application of the patient-centered model, (iii) improvement in communication skills, (iv) awareness of medical interview guides, (v) increase in self-confidence, and (vi) techniques of self-care. Eleven physicians (78.6%) declared improvement in patients' satisfaction, 14 (100%) in their own satisfaction, seven (50%) in adherence to therapeutic plan and seven (50%) in treatment outcomes.	The one-to-one coaching is a convenient and well-received personalized means of enhancing clinical communication in dermatologists, leading to more patient-centered medical encounters with better treatment outcomes.	
28321705	Cognitive control enables successful goal-directed behavior by resolving a conflict between opposing action tendencies, while emotional control arises as a consequence of emotional conflict processing such as in irony. While negative emotion facilitates both cognitive and emotional conflict processing, it is unclear how emotional conflict processing is affected by positive emotion (e.g., humor). In 2 EEG experiments, we investigated the role of positive audiovisual target stimuli in cognitive and emotional conflict processing. Participants categorized either spoken vowels (cognitive task) or their emotional valence (emotional task) and ignored the visual stimulus dimension. Behaviorally, a positive target showed no influence on cognitive conflict processing, but impeded emotional conflict processing. In the emotional task, response time conflict costs were higher for positive than for neutral targets. In the EEG, we observed an interaction of emotion by congruence in the P200 and N200 ERP components in emotional but not in cognitive conflict processing. In the emotional conflict task, the P200 and N200 conflict effect was larger for emotional than neutral targets. Thus, our results show that emotion affects conflict processing differently as a function of conflict type and emotional valence. This suggests that there are conflict- and valence-specific mechanisms modulating executive control.
28321298	Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30st April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool - where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented. Failure to meet PDSA predictions about sharing risk reducing actions with staff and length of time to complete the tool prompted a focus on communication and the processes whereby the tool is completed. "Teach back" was employed to highlight communication difficulties and ultimately the introduction of Huddles out improved the flow of information about residents and informed the Falls Risk/Intervention tool. 5 PDSAs were completed and within them multiple tests of change. The improvement shift came following a root cause analysis of the nature & cause of one resident's falls and applying the tool & communication processes. The average falls rate fell from 49 per 1000 occupied bed days to 23.6 and was sustained because of the attention to the importance of communication. The aim was achieved with a 36.6% reduction in Falls rate. Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30th April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool - where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented. Failure to meet PDSA predictions about sharing risk reducing actions with staff and length of time to complete the tool prompted a focus on communication and the processes whereby the tool is completed. "Teach back" was employed to highlight communication difficulties and the introduction of Huddles improved the flow of information. 5 PDSAs were completed and within them multiple tests of change. The improvement shift came following a root cause analysis of the nature & cause of one resident's falls and applying the tool & communication processes. The average falls rate fell from 49 per 1000 occupied bed days to 23.6 and was sustained because of the attention to the importance of communication. The aim was achieved with a 36.6% reduction in Falls rate.
28320372	Interdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients' perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity.The study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West's seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables.	Outpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89-8.41). High ITW intensity also positively affected patients' perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25-4.51), Person-centred response (OR = 2.11; CI = 1.05-4.24], and Continuity of care (OR = 2.18; CI = 1.07-4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68-2.52) or Quality of the care environment (OR = 0.66; CI = 0.31-1.39).	This study provides empirical evidence, from the patient's perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences.	
28319528	Microstomia, an abnormally small oral orifice, is a complication of perioral facial burns. In this case, contraction of the circumoral tissues and hypotonia of the musculature is responsible for this microstomia, which can produce aesthetic and functional impairment with eating, swallowing, communication (speech and facial expressions), compromised dental care and maintenance due to limited oral access, social interactions, and psychological well-being. Conservative management involves providing physical resistance to scar contracture, with opposing horizontal and vertical circumoral forces by means of appliances that aim to stretch the commissures and fibrotic muscles. Numerous appliances, either intraoral or extraoral, have been described to prevent or treat microstomia by delivering a static or dynamic stretch horizontally or vertically, with most designed to stretch the mouth horizontally. Finding a comfortable effective way to stretch the mouth vertically has proved to be a challenge. This article describes the fabrication of a dynamic commissural appliance, constructed using acrylic resin and expansion screws, which provide simultaneous horizontal and vertical circumoral forces. This appliance is constructed easily and inexpensively without the need for taking impressions, can be adjusted so that it is almost painlessly inserted, and is progressively activated. It is convenient for use because the patient controls the pressure that is applied by the appliance. Its use in a case is described where the appliance has improved mouth opening and consequently functional outcomes.
28318393	One-in-five children in Guatemala is born to a mother aged 15-19 years, which poses social, economic and health risks to both mother and child. In Guatemala, adolescent childbearing is directly associated with education, ethnicity and poverty, which increases vulnerability among Indigenous young women living in poverty. This study examines the context and experiences of adolescent childbearing from the perspectives of young mothers in the Kaqchikel Indigenous ethnic group of Sololá, Guatemala. Data were collected in 19 qualitative in-depth interviews with women who had given birth to one or more children when aged 15 to 19 years. Grounded theory and narrative analysis were used to develop a conceptual framework of the process and influences on childbearing. Four distinct pathways were identified, which were influenced by gender expectations, limited communication about sex and stigma around sex. The study identifies key sociocultural influences that lead to adolescent childbearing and reveals variability within these. Identifying distinct pathways to early childbearing and their influences enables a clearer understanding of potential opportunities to interrupt these pathways with culturally relevant policies and programmes, in particular those that promote gender equality and intergenerational communication about sex.
28318293	Yawning is a multifunctional behavior with a role in social communication. In Old World monkeys, the "tension yawn" is often used as a threat, allowing individuals to completely expose their canines. To explore the role of this phenomenon, we selected 2 closely related species-Japanese macaques (Macaca fuscata) and Tonkean macaques (M. tonkeana)-which differ primarily in terms of their tolerance levels. Japanese macaques are classified as despotic; Tonkean macaques are classified as tolerant. Both species live in multimale-multifemale societies, show a high level of sexual dimorphism, and have comparable yawning repertoires that include displaying a covered teeth yawn and an uncovered gums yawn. We found comparable baseline frequencies of the 2 yawning types and a similar distribution of these behaviors according to sex (males yawned more frequently than females). This morphological homogeneity permitted us to evaluate potential differences in the meaning of yawning as a function of social tension, aggressive contexts, and dominance hierarchy. Divergent social styles determine a functional dichotomy in the use of the covered teeth yawn and the uncovered gums yawn. The covered teeth yawn is not susceptible to social and environmental stimuli and seems to be a form of yawning mostly linked to the physiology of the sleep-wake cycle. However, the uncovered gums yawn is modulated according to different social contexts, and its use could be favored by natural selection, especially in tolerant species, which apparently require more elaborate forms of social communication. (PsycINFO Database Record
28316774	Autism spectrum disorder (ASD) is a neurodevelopmental disease characterized by difficulties in social communication, unusually restricted, repetitive behavior and interests, and specific abnormalities in language and perception. The precise etiology of ASD is still unknown and probably heterogeneous. In a subgroup of patients, toxic environmental exposure might lead to an imbalance between oxidative stress and anti-oxidant systems. Previous serum and postmortem studies measuring levels of glutathione (GSH), the main cellular free radical scavenger in the brain, have supported the hypothesis that this compound might play a role in the pathophysiology of autism.Using the method of single-voxel proton magnetic resonance spectroscopy (MRS), we analyzed the GSH signal in the dorsal anterior cingulate cortex (dACC) and the dorsolateral prefrontal cortex (DLPFC) of 24 ASD patients with normal or above average IQs and 18 matched control subjects. We hypothesized that we would find decreased GSH concentrations in both regions.	We did not find overall group differences in neurometabolites including GSH, neither in the dorsal ACC (Wilks' lambda test; p = 0.429) nor in the DLPFC (p = 0.288). In the dACC, we found a trend for decreased GSH signals in ASD patients (p = 0.076).	We were unable to confirm our working hypothesis regarding decreased GSH concentrations in the ASD group. Further studies combining MRS, serum, and cerebrospinal fluid measurements of GSH metabolism including other regions of interest or even whole brain spectroscopy are needed.	
28316771	Socio-emotional difficulties in autism spectrum disorder (ASD) are thought to reflect impaired functional connectivity within the "social brain". Nonetheless, a whole-brain characterization of the fast responses in functional connectivity during implicit processing of emotional faces in adults with ASD is lacking.The present study used magnetoencephalography to investigate early responses in functional connectivity, as measured by interregional phase synchronization, during implicit processing of angry, neutral and happy faces. The sample (n = 44) consisted of 22 young adults with ASD and 22 age- and sex-matched typically developed (TD) controls.	Reduced phase-synchrony in the beta band around 300 ms emerged during processing of angry faces in the ASD compared to TD group, involving key areas of the social brain. In the same time window, de-synchronization in the beta band in the amygdala was reduced in the ASD group across conditions.	This is the first demonstration of atypical global and local synchrony patterns in the social brain in adults with ASD during implicit processing of emotional faces. The present results replicate and substantially extend previous findings on adolescents, highlighting that atypical brain synchrony during processing of socio-emotional stimuli is a hallmark of clinical sequelae in autism.	
28316126	This study describes patient social networks within a new hemodialysis clinic and models the association between social network participation and kidney transplantation. Survey and observational data collected between August 2012 and February 2015 were used to observe the formation of a social network of 46 hemodialysis patients in a newly opened clinic. Thirty-two (70%) patients formed a social network, discussing health (59%) and transplantation (44%) with other patients. While transplant-eligible women participated in the network less often than men (56% vs. 90%, p = 0.02), women who participated discussed their health more often than men (90% vs. 45.5%, p = 0.02). Patients in the social network completed a median of two steps toward transplantation compared with a median of 0 for socially isolated patients (p = 0.003). Patients also completed more steps if network members were closely connected (β = 2.23, 95% confidence interval [CI] 0.16-4.29, p = 0.03) and if network members themselves completed more steps (β = 2.84, 95% CI 0.11-5.57, p = 0.04). The hemodialysis clinic patient social network had a net positive effect on completion of transplant steps, and patients who interacted with each other completed a similar number of steps.
28315898	Worldwide, the prevalence of childhood obesity has increased, amounting to 42 million overweight or obese children, and there is increasing evidence that the origins are within the first 1,000 days: the period of conception through 2 years. Antecedents of early childhood obesity are multifactorial, and associations of varying strength have been documented for genetic/epigenetic, biologic, dietary, environmental, social, and behavioral influences. Modifiable factors in pregnancy and early infancy associated with childhood obesity include maternal overweight/obesity, maternal smoking, gestational weight gain, infant and young child feeding, caregiver responsive feeding practices, as well as sleep duration, and physical activity. Promising obesity prevention interventions include those beginning during the first 1,000 days, using a multicomponent approach, with roots in nutrition education theories or behavior change communication that can continue over time. However, the limited number of completed interventions to date (within pediatric clinics or in home-based or community settings) may not be scalable to the magnitude needed for sustainable obesity prevention. Scale-up interventions that can be maintained for the durations needed, addressing infant and young child feeding and other modifiable risk factors associated with childhood obesity are needed.
28315481	Few interventions to improve asthma outcomes have targeted low-income minority adults. Even fewer have focused on the real-world practice where care is delivered. We adapted a patient navigator, here called a Patient Advocate (PA), a term preferred by patients, to facilitate and maintain access to chronic care for adults with moderate or severe asthma and prevalent co-morbidities recruited from clinics serving low-income urban neighborhoods. We describe the planning, design, methodology (informed by patient and provider focus groups), baseline results, and challenges of an ongoing randomized controlled trial of 312 adults of a PA intervention implemented in a variety of practices. The PA coaches, models, and assists participants with preparations for a visit with the asthma clinician; attends the visit with permission of participant and provider; and confirms participants' understanding of what transpired at the visit. The PA facilitates scheduling, obtaining insurance coverage, overcoming patients' unique social and administrative barriers to carrying out medical advice and transfer of information between providers and patients. PA activities are individualized, take account of comorbidities, and are generalizable to other chronic diseases. PAs are recent college graduates interested in health-related careers, research experience, working with patients, and generally have the same race/ethnicity distribution as potential participants. We test whether the PA intervention, compared to usual care, is associated with improved and sustained asthma control and other asthma outcomes (prednisone bursts, ED visits, hospitalizations, quality of life, FEV1) relative to baseline. Mediators and moderators of the PA-asthma outcome relationship are examined along with the intervention's cost-effectiveness.
28314086	Research has documented that immigrants tend to experience more negative consequences from natural disasters compared to native-born individuals, although research on how immigrants perceive and respond to natural disaster risks is sparse. We investigated how risk perception and disaster preparedness for natural disasters in immigrants compared to Canadian-born individuals as justifications for culturally-adapted risk communication and management. To this end, we analyzed the ratings on natural disaster risk perception beliefs and preparedness behaviors from a nationally representative survey (N = 1,089). Factor analyses revealed three underlying psychological dimensions of risk perception: external responsibility for disaster management, self-preparedness responsibility, and illusiveness of preparedness. Although immigrants and Canadian-born individuals shared the three-factor structure, there were differences in the salience of five risk perception beliefs. Despite these differences, immigrants and Canadian-born individuals were similar in the level of risk perception dimensions and disaster preparedness. Regression analyses revealed self-preparedness responsibility and external responsibility for disaster management positively predicted disaster preparedness whereas illusiveness of preparedness negatively predicted disaster preparedness in both groups. Our results showed that immigrants' risk perception and disaster preparedness were comparable to their Canadian-born counterparts. That is, immigrant status did not necessarily yield differences in risk perception and disaster preparedness. These social groups may benefit from a risk communication and management strategy that addresses these risk perception dimensions to increase disaster preparedness. Given the diversity of the immigrant population, the model remains to be tested by further population segmentation.
28314047	Seasonal flu vaccination rates are low for U.S. adults, with significant disparities between African and white Americans. Risk perception is a significant predictor of vaccine behavior but the research on this construct has been flawed. This study addressed critical research questions to understand the differences between African and white Americans in the role of risk perception in flu vaccine behavior: (1) What is the dimensionality of risk perception and does it differ between the two races?  (2) Were risk perceptions of white and African-American populations different and how were sociodemographic characteristics related to risk for each group? (3) What is the relation between risk perception and flu vaccine behaviors for African Americans and whites? The sample, drawn from GfK's Knowledge Panel, consisted of 838 whites and 819 African Americans. The survey instrument was developed from qualitative research. Measures of risk perception included cognitive and emotional measures of disease risk and risk of side effects from the vaccine. The online survey was conducted in March 2015. Results showed the importance of risk perception in the vaccine decision-making process for both racial groups. As expected, those who got the vaccine reported higher disease risk than those who did not. Separate cognitive and emotional factors did not materialize in this study but strong evidence was found to support the importance of considering disease risk as well as risk of the vaccine. There were significant racial differences in the way risk perception predicted behavior.
28306717	Canine rabies was reintroduced to the city of Arequipa, Peru in March 2015. The Ministry of Health has conducted a series of mass dog vaccination campaigns to contain the outbreak, but canine rabies virus transmission continues in Arequipa's complex urban environment, putting the city's 1 million inhabitants at risk of infection. The proximate driver of canine rabies in Arequipa is low dog vaccination coverage. Our objectives were to qualitatively assess barriers to and facilitators of rabies vaccination during mass campaigns, and to explore strategies to increase participation in future efforts.We conducted 8 focus groups (FG) in urban and peri-urban communities of Mariano Melgar district; each FG included both sexes, and campaign participants and non-participants. All FG were transcribed and then coded independently by two coders. Results were summarized using the Social Ecological Model. At the individual level, participants described not knowing enough about rabies and vaccination campaigns, mistrusting the campaign, and being unable to handle their dogs, particularly in peri-urban vs. urban areas. At the interpersonal level, we detected some social pressure to vaccinate dogs, as well as some disparaging of those who invest time and money in pet dogs. At the organizational level, participants found the campaign information to be insufficient and ill-timed, and campaign locations and personnel inadequate. At the community level, the influence of landscape and topography on accessibility to vaccination points was reported differently between participants from the urban and peri-urban areas. Poor security and impermanent housing materials in the peri-urban areas also drives higher prevalence of guard dog ownership for home protection; these dogs usually roam freely on the streets and are more difficult to handle and bring to the vaccination points.	A well-designed communication campaign could improve knowledge about canine rabies. Timely messages on where and when vaccination is occurring could increase dog owners' perception of their own ability to bring their dogs to the vaccination points and be part of the campaign. Small changes in the implementation of the campaign at the vaccination points could increase the public's trust and motivation. Location of vaccination points should take into account landscape and community concerns.	
28306609	Primary care teams (hereafter referred to as primary care units [PCUs]) composed of general practitioners (GPs), nurses, and specialist doctors have recently been established in the Italian context, with the main aim of improving integrated care for chronic diseases.The aim of the study was to assess whether the increased professional diversity of PCUs has resulted in an improvement in the integrated care of type II diabetes and to identify a potential mechanism mediating this effect.	We analyzed 213 PCUs, comparing their performance in integrated type II diabetes care at two time points. Using social categorization theory and a fixed effects regression analysis, we tested a mediation model in which the frequency of communication among GPs in the PCUs, that is, within-subgroup communication, mediates the relationship between PCU professional diversity and team performance in diabetes care.	We show that when the professional diversity of the PCUs increases, integrated care of type II diabetes improves and better meets the standards of optimal care. Within-GP subgroup communication works as a mediating mechanism that translates the PCU professional diversity into better team performance. The mediation effect, however, is curvilinear. Beyond certain levels, within-subgroup communication can hamper PCUs' capacity to work collaboratively in integrated type II diabetes care.	The article suggests that, when creating interprofessional primary care teams, managers might be able to steer teams toward a better performance by encouraging communication among peers of the same profession.	
28306511	Much like social networks are used to connect with friends or relatives, bacteria communicate with relatives through quorum sensing. Viruses, though, were thought to be asocial-until now. Erez et al. (2017) reveal that viruses are also sharing information with relatives.
28304333	Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, and other-focused concern, and reduce the chances of distress and burnout. There is substantial evidence for the contribution of different management strategies to achieve these aims. The goal of this article is to review the potential effect of mindfulness and compassion-based strategies for the improvement of physician-patient interactions. The acquisition of the necessary skills by physicians requires continuous education. Future research will be useful for identifying more evidence on the cost-effectiveness of this type of intervention.
28303197	Important part of the multivariate selection shaping social and interspecific interactions among and within animal species emerges from communication. Therefore, understanding the diversification of signals for animal communication is a central endeavor in evolutionary biology. Over the last decade, the rapid development of phylogenetic approaches has promoted a stream of studies investigating evolution of communication signals. However, comparative research has primarily focused on visual and acoustic signals, while the evolution of chemical signals remains largely unstudied. An increasing interest in understanding the evolution of chemical communication has been inspired by the realization that chemical signals underlie some of the major interaction channels in a wide range of organisms. In lizards, in particular, chemosignals play paramount roles in female choice and male-male competition, and during community assembly and speciation. Here, using phylogenetic macro-evolutionary modeling, we show for the very first time that multiple compounds of scents for communication in lizards have diversified following highly different evolutionary speeds and trajectories. Our results suggest that cholesterol, α-tocopherol, and cholesta-5,7-dien-3-ol have been subject to stabilizing selection (Ornstein-Uhlenbeck model), whereas the remaining compounds are better described by Brownian motion modes of evolution. Additionally, the diversification of the individual compounds has accumulated substantial relative disparity over time. Thus, our study reveals that the chemical components of lizard chemosignals have proliferated across different species following compound-specific directions.
28303094	In this digital age social robots will increasingly be used for educational purposes, such as second language tutoring. In this perspective article, we propose a number of design features to develop a child-friendly social robot that can effectively support children in second language learning, and we discuss some technical challenges for developing these. The features we propose include choices to develop the robot such that it can act as a peer to motivate the child during second language learning and build trust at the same time, while still being more knowledgeable than the child and scaffolding that knowledge in adult-like manner. We also believe that the first impressions children have about robots are crucial for them to build trust and common ground, which would support child-robot interactions in the long term. We therefore propose a strategy to introduce the robot in a safe way to toddlers. Other features relate to the ability to adapt to individual children's language proficiency, respond contingently, both temporally and semantically, establish joint attention, use meaningful gestures, provide effective feedback and monitor children's learning progress. Technical challenges we observe include automatic speech recognition (ASR) for children, reliable object recognition to facilitate semantic contingency and establishing joint attention, and developing human-like gestures with a robot that does not have the same morphology humans have. We briefly discuss an experiment in which we investigate how children respond to different forms of feedback the robot can give.
28302638	For the optimal management of children with cystic fibrosis, there are currently no efficient tools for the precise adjustment of pancreatic enzyme replacement therapy, either for advice on appropriate dietary intake or for achieving an optimal nutrition status. Therefore, we aim to develop a mobile application that ensures a successful nutritional therapy in children with cystic fibrosis.A multidisciplinary team of 12 partners coordinate their efforts in 9 work packages that cover the entire so-called 'from laboratory to market' approach by means of an original and innovative co-design process. A cohort of 200 patients with cystic fibrosis aged 1-17 years are enrolled. We will develop an innovative, clinically tested mobile health application for patients and health professionals involved in cystic fibrosis management. The mobile application integrates the research knowledge and innovative tools for maximising self-management with the aim of leading to a better nutritional status, quality of life and disease prognosis. Bringing together different and complementary areas of knowledge is fundamental for tackling complex challenges in disease treatment, such as optimal nutrition and pancreatic enzyme replacement therapy in cystic fibrosis. Patients are expected to benefit the most from the outcomes of this innovative project.	The project is approved by the Ethics Committee of the coordinating organisation, Hospital Universitari La Fe (Ref: 2014/0484). Scientific findings will be disseminated via journals and conferences addressed to clinicians, food scientists, information and communications technology experts and patients. The specific dissemination working group within the project will address the wide audience communication through the website (http://www.mycyfapp.eu), the social networks and the newsletter.	
28302390	This study aimed to investigate the performance on pair-matching tasks in children with Spinal Muscular Atrophy type I (SMA-I) and the relationship between this performance and motor function, functional independence and quality of life. SMA-I (n = 12; 6.0 ± 2.3 yrs; 9 boys, 3 girls) and control sex-, age-matched children (n = 12; 6.2 ± 2.6 yrs) performed four pair-matching figure, number and letter tasks. The eye tracker detected eye movements. SMA-I children were assessed with CHOP INTEND, Pediatric Evaluation of Disability Inventory, and Pediatric Quality of Life Inventory. Analysis of variance showed that SMA-I children had a lower percentage of correct answers and longer timed performance compared to controls (p < 0.05). Pediatric Evaluation of Disability Inventory score (social function domain) was correlated to the percentage of correct answers on the pair-matching tasks on task 1 (r = 0.81; p = 0.001) and task 2 (r = 0.66; p = 0.020). Pair-matching performance of SMA-I children was poorer than the performance of control children. There was a relationship between pair-matching performance and social function. The restricted interaction with the environment, due to severe paralysis and poor verbal communication, is associated with cognitive difficulties in SMA-I children. The eye tracker was helpful in cognitive assessment of SMA-I children, who responded to the cognitive tests with eye movements.
28302095	Researchers involved in biomedical community-based projects rarely seek the perspectives of community fieldworkers, who are the 'foot soldiers' in such projects. Understanding the effect of biomedical research on community-based field workers could identify benefits and shortfalls that may be crucial to the success of community-based studies. The present study explored the perceptions of community-based field workers on the effect of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project" (MAL-ED) South Africa on their tangible and intangible capital which together comprise sustainable livelihoods.The study was conducted in Dzimauli community in Limpopo Province of South Africa between January-February 2016. The sustainable livelihoods framework was used to query community-based field workers' perspectives of both tangible assets such as income and physical assets and intangible assets such as social capital, confidence, and skills. Data were collected through twenty one individual in-depth interviews and one focus group discussion. Data were analysed using the Thematic Content Analysis approach supported by ATLAS.ti, version 7.5.10 software.	All the field workers indicated that they benefitted from the MAL-ED South Africa project. The benefits included intangible assets such as acquisition of knowledge and skills, stronger social capital and personal development. Additionally, all indicated that MAL-ED South Africa provided them with the tangible assets of increased income and physical assets. Observations obtained from the focus group discussion and the community-based leaders concurred with the findings from the in-depth interviews. Additionally, some field workers expressed the desire for training in public relations, communication, problem solving and confidence building.	The MAL-ED South Africa, biomedical research project, had positive effects on tangible and intangible assets that compose the sustainable livelihoods of community-based fieldworkers. However, the field workers expressed the need to acquire social skills to enable them carry out their duties more efficiently.	
28301967	Based on their analysis of Internet gaming disorder (IGD) criteria, Kuss, Griffiths, and Pontes (2017) come to the conclusion that the current situation can be described as "chaos and confusion." Their assessment is not an exaggeration. It can be argued that there are even more issues, on logical/definitional and political/social levels: (a) the IGD diagnosis is lacking a well-defined object, (b) the cause and effect cannot be differentiated outside lab conditions, (c) the social and political effects of declaring a social behavior as a disease are worrying, and (d) a rushed diagnosis may construct an addiction with potentially harmful effects on (formerly) healthy populations. Instead of closing the debate by declaring a consensus and codifying IGD in the DSM, an undogmatic, intensified, and broader discussion is needed.
28301538	Levels of physical activity (PA) decrease when transitioning from adolescence into young adulthood. Evidence suggests that social support and intrapersonal factors (self-efficacy, outcome expectations, PA enjoyment) are associated with PA. The aim of the present study was to explore whether cross-sectional and longitudinal associations of social support from family and friends with leisure-time PA (LTPA) among young women living in disadvantaged areas were mediated by intrapersonal factors (PA enjoyment, outcome expectations, self-efficacy).Survey data were collected from 18-30 year-old women living in disadvantaged suburbs of Victoria, Australia as part of the READI study in 2007-2008 (T0, N = 1197), with follow-up data collected in 2010-2011 (T1, N = 357) and 2012-2013 (T2, N = 271). A series of single-mediator models were tested using baseline (T0) and longitudinal data from all three time points with residual change scores for changes between measurements.	Cross-sectional analyses showed that social support was associated with LTPA both directly and indirectly, mediated by intrapersonal factors. Each intrapersonal factor explained between 5.9-37.5% of the associations. None of the intrapersonal factors were significant mediators in the longitudinal analyses.	Results from the cross-sectional analyses suggest that the associations of social support from family and from friends with LTPA are mediated by intrapersonal factors (PA enjoyment, outcome expectations and self-efficacy). However, longitudinal analyses did not confirm these findings.	
28301181	Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed 3 antimarijuana advertisements, each followed immediately by videotaped discussions involving 4 adults or 4 adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants' perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants' perceived control (both p < .02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p < .05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p < .05). The findings may facilitate development of more effective prevention methods that emphasize the importance of the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. (PsycINFO Database Record
28301091	Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), IQ scores, and parent reports of the average amount of time slept per night that were available in the medical histories of 2,714 children with ASD in the Simons Simplex Collection (SSC). The mean (SD) sleep duration was 555 minutes. Sleep duration and severity of core ASD symptoms were negatively correlated, and sleep duration and IQ scores were positively correlated. Regression results indicated that more severe social impairment, primarily a failure to develop peer relationships, is the core symptom most strongly associated with short sleep duration. Furthermore, increased severity for numerous maladaptive behaviors assessed on the Child Behavior Checklist, as well as reports of attention deficit disorder, depressive disorder, and obsessive compulsive disorder were associated with short sleep duration. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ≤420 minutes per night (lower 5th percentile) compared to children sleeping ≥660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1221-1238. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28301083	Fragile X syndrome (FXS) is a major developmental disorder and the most frequent monogenic cause of autism. Surprisingly, most existing studies on the Fmr1-KO mouse model for FXS have focused on males, although FX women, who are mostly heterozygous for the Fmr1 mutation, are known to exhibit several behavioral deficits, including autistic-like features. Furthermore, most animal research has been carried out on adults only; so that little is known about the age progression of the behavioral phenotype of Fmr1 mutants, which is a crucial issue to optimize the impact of therapeutic interventions. Here, we performed an extensive analysis of autistic-like social behaviors in heterozygous (HET) Fmr1-KO females and their WT littermates at different ages. No behavioral difference between HET and WT mice was observed at infancy, but some abnormalities in social interaction and communication were first detected at juvenile age. At adulthood some of these alterations disappeared, but avoidance of social novelty appeared, together with other FXS-relevant behavioral deficits, such as hyperactivity and reduced contextual fear response. Our data provide for the first time evidence for the presence of autistic-relevant behavioral abnormalities in Fmr1-HET female mice, demonstrating the utility of this mouse line to model autistic-like behaviors in both sexes. These results also highlight the importance of taking into account age differences when using the Fmr1-KO mouse model, suggesting that the early post-natal phases are the most promising target for preventive interventions and the adult age is the most appropriate to investigate the behavioral impact of potential therapies. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1067-1078. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28301068	To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective.The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial.	A descriptive design with a qualitative inductive approach was used.	Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis.	Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being.	The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students.	Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication.	
28300997	The Spanish health system has recently been marked by the emergence of more active patients who are characterized as being better informed about their disease, having a more participatory attitude, wanting to have a greater influence in making decisions about their health and asserting their rights as patients. Therefore, this article aims to report on how the introduction of Web 2.0 technologies can contribute to the empowering of more active patients. To achieve this, 14 semi-structured interviews were conducted with patients and representatives of patient associations who have used Web 2.0 technologies to interact with other patients or to communicate with health professionals. From the results obtained, we highlight the fact that Web 2.0 technologies provide greater access to health-related information, improve communication between patients and health professionals, and enable the creation of new spaces of interaction among patients. All of the facts above contribute to the formation of a more active role on the part of patients.
28300952	The present study aims to analyze the perceptions of individuals with epilepsy about the disease and its impact in their quality of life (QoL).This is a cross-sectional, qualitative and quantitative study conducted in a tertiary referral hospital associated with the Brazilian National Health System (SUS). Data were collected from 30 individuals with diagnosis of refractory temporal lobe epilepsy (RTLE). The study participants responded to a questionnaire to collect sociodemographic and clinical data, as well as their perceptions about the disease. QoL was assessed by the Subjective Handicap of Epilepsy (SHE) and the Stigma Scale of Epilepsy (SSE).	Significant correlation was found between stigma and quality of life and the work and activity and social and personal life domains, as well as between stigma and perceptions about epilepsy. The responses provided by the participants were organized into four categories: definitions and causes, seizures and treatment, family and social impacts, and impact on individuals' lives.	The results show that participants have limited knowledge about epilepsy and that there is a negative impact caused by the stigma related to this disease on their QoL. It was possible to verify that QoL and stigma are directly related to the understanding of participants about epilepsy. Therefore, it is important to implement programs and actions that aim to provide patients and their families with more comprehensive knowledge about epilepsy; promote communication between health professionals and patients; and encourage the participation of patients and their families during treatment.	
28299880	Atypical development, behavioral difficulties, and academic underachievement are common morbidities in children with a history of congenital heart defects and impact quality of life. Language and social-cognitive deficits have been described, which are associated with autism spectrum disorders. The current study aimed to assess the rates of autism spectrum disorders in a large sample of children with a history of congenital heart defects and to assess medical, behavioral, and individual factors that may be associated with the risk of autism spectrum disorders.Participants included 195 children with a history of congenital heart defects, who are followed in a large-scale longitudinal study. Measures included behavioral data from 4-year-old neurodevelopmental evaluations and parent-report data from a later annual follow-up.	Using established cutoffs on an autism spectrum disorder screener, children with congenital heart defects showed higher rates of "possible" autism spectrum disorders than national rates, (Chi-square Test of Equal Proportions), all Ps < .05. A stepwise variable selection method was used to create a "best prediction model" and multivariable logistic regression was used to identify variables predicting diagnostic status. Factors associated with diagnostic risk included medical (delayed sternal closure, prematurity, positive genetic findings), behavioral (cognitive, language, attention issues), and individual (socioeconomic, cultural/racial) variables. ROC analyses identified a cutoff of 7 to maximize sensitivity/specificity based on parent-reported diagnosis.	Risk of autism spectrum disorder screening status in children with congenital heart defects was higher than expected from population rates. Findings highlight the need for referral to a specialist to assess the presence and severity of social-communication issues and congenital heart defects population-specific screening thresholds for children with concern for autism spectrum disorders.	
28299792	This article discusses, from a psychological perspective, the life experience of the adult and ageing person with haemophilia, including psychological issues, aspects of his personal and social integration, decision-making, communication and other factors that may affect treatment adherence and quality of life. The aim was to provide haematologists and healthcare staff with knowledge and resources to improve communication and support for adult persons with haemophilia, and raise awareness on psychosocial issues related to quality of life, sexuality and aspects associated with ageing with haemophilia. Adulthood is a period of many personal and social changes, and ageing with haemophilia is a relatively new phenomenon due to increased life expectancy in this population. Patients have to adapt to the disease continuously when facing new expectations, life projects and issues arising with increasing age, so the healthcare team should be ready to provide support. A good therapeutic alliance with the patient must be accompanied by assessment and counselling in aspects including satisfaction, perceived difficulties and barriers, and emotional needs. Raising awareness of all this will result in the patient benefiting from the recent improvements in treatments.
28299627	Autism spectrum disorder (ASD) is a neurodevelopment disorder with abnormalities of social interaction, communication and repetitive behaviors. The higher prevalence of ASD in men implies a potential relationship between sex hormones and ASD etiology. The ESR2 gene encodes estrogen receptor beta (ESR2) and plays an important role during brain development. A relationship between ESR2 and ASD has been suggested by studies on single nucleotide polymorphisms and mRNA and protein expression levels in ASD patients. Here, we explored the possible epigenetic regulation of the ESR2 gene in autism. We collected genomic DNA from the peripheral blood of Chinese Han males with autism and age-matched normal males and measured DNA methylation of CpG islands in the ESR2 gene, which consisted of 41 CpG sites among the proximal promoter region and an untranslated exon, by bisulfite sequencing. We also investigated a relationship between DNA methylation and phenotypic features of autism, as assessed by the Children Autism Rating Scale. We found little overall difference in the DNA methylation of the ESR2 5'-flanking region in individuals with autism compared with normal individuals. However, detailed analyses revealed that eight specific CpG sites were hypermethylated in autistic individuals and that four specific CpG sites were positively associated with the severity of autistic symptoms. Our study indicates that the epigenetic dysregulation of ESR2 may govern the development of autism.
28299419	The attraction of sexual partners is a vital necessity among insects, and it involves conflict of interests and complex communication systems among male and female. In this study, we investigated the developing of sexual attractiveness in virgin queens (i.e., gynes) of Melipona flavolineata, an eusocial stingless bee. We followed the development of sexual attractiveness in 64 gynes, belonging to seven age classes (0, 3, 6, 9, 15, 18 days post-emergence), and we also evaluated the effect of different social interactions (such as competition between queens and interactions with workers) on the development of attractiveness in other 60 gynes. We used the number of males that tried to mate with a focal gyne as a representative variable of its sexual attractiveness. During the essays, each gyne was individually presented to 10 sexually mature males, and during 3 min, we counted the number of males that everted their genitalia in response to the presence of a gyne. Here, we show that M. flavolineata gynes are capable to (i) maintain their sexual attractiveness for long periods through adult life, (ii) they need a minimum social interaction to trigger the development of sexual attractiveness, and (iii) that gynes express this trait only within a social context. We conclude that the effective occurrence of matings is conditional on potential social interactions that gynes experienced before taking the nuptial flight, when they are still in the nest. These findings bring insights into the factors determining reproductive success in social insects.
28298896	Coleoid cephalopods (squid, octopus, and sepia) are renowned for their elaborate body patterning capabilities, which are employed for camouflage or communication. The specific chromatic appearance of a cephalopod, at any given moment, is a direct result of the combined action of their intradermal pigmented chromatophore organs and reflecting cells. Therefore, a lot can be learned about the cephalopod coloration system by video recording and analyzing the activation of individual chromatophores in time. The fact that adult cephalopods have small chromatophores, up to several hundred thousand in number, makes measurement and analysis over several seconds a difficult task. However, current advancements in videography enable high-resolution and high framerate recording, which can be used to record chromatophore activity in more detail and accuracy in both space and time domains. In turn, the additional pixel information and extra frames per video from such recordings result in large video files of several gigabytes, even when the recording spans only few minutes. We created a software plugin, "SpotMetrics," that can automatically analyze high resolution, high framerate video of chromatophore organ activation in time. This image analysis software can track hundreds of individual chromatophores over several hundred frames to provide measurements of size and color. This software may also be used to measure differences in chromatophore activation during different behaviors which will contribute to our understanding of the cephalopod sensorimotor integration system. In addition, this software can potentially be utilized to detect numbers of round objects and size changes in time, such as eye pupil size or number of bacteria in a sample. Thus, we are making this software plugin freely available as open-source because we believe it will be of benefit to other colleagues both in the cephalopod biology field and also within other disciplines.
28298345	Chemical communication is central for the formation and maintenance of insect societies. Generally, social insects only allow nest-mates into their colony, which are recognized by their cuticular hydrocarbons (CHCs). Social parasites, which exploit insect societies, are selected to circumvent host recognition. Here, we studied whether chemical strategies to reduce recognition evolved convergently in slavemaking ants, and whether they extend to workers, queens and males alike. We studied CHCs of three social parasites and their related hosts to investigate whether the parasitic lifestyle selects for specific chemical traits that reduce host recognition. Slavemaker profiles were characterized by shorter-chained hydrocarbons and a shift from methyl-branched alkanes to n-alkanes, presumably to reduce recognition cue quantity. These shifts were consistent across independent origins of slavery and were found in isolated ants and those emerging in their mother colony. Lifestyle influenced profiles of workers most profoundly, with little effect on virgin queen profiles. We detected an across-species caste signal, with workers, for which nest-mate recognition is particularly important, carrying more and longer-chained hydrocarbons and males exhibiting a larger fraction of n-alkanes. This comprehensive study of CHCs across castes and species reveals how lifestyle-specific selection can result in convergent evolution of chemical phenotypes.
28298197	Access to most contraceptives in Australia requires a prescription from a doctor, and it has been shown that doctors can influence women's decision-making with respect to contraception. However, little research has documented how women experience their interactions with doctors within the context of a contraceptive consultation. Understanding such experiences may contribute to our knowledge of factors that may influence women's contraceptive decisions more broadly.We report on findings from the Contraceptive Use, Pregnancy Intentions and Decisions (CUPID) survey of young Australian women, a large-scale longitudinal study of 3,795 women aged 18-23 years. We performed a computer-assisted search for occurrences of words that indicated an interaction within the 1,038 responses to an open-ended question about contraception and pregnancy. We then applied a combination of conventional and summative content analysis techniques to the 158 comments where women mentioned an interaction about contraception with a doctor.	Our analysis showed that women desire consistent and accurate contraception information from doctors, in addition to information about options other than the oral contraceptive pill. Some young women reported frustrations about the choice limitations imposed by doctors, perceived by these women to be due to their young age. Several women expressed disappointment that their doctor did not fully discuss the potential side-effects of contraceptives with them, and that doctors made assumptions about the woman's reasons for seeking contraception. Some women described discomfort in having contraception-related discussions, and some perceived their doctor to be unsupportive or judgmental.	Both the content and the process of a contraceptive consultation are important to young Australian women, and may be relevant contributors to their choice and ongoing use of a contraceptive method. These findings provide useful insights into aspects of the patient-provider interaction that will enhance the efficacy of the contraceptive consultation. It is recommended that doctors adopt patient-centred, shared decision-making strategies to support women in making choices about contraception that suit their individual circumstances. We also acknowledge the need to involve other health care providers, other than doctors, in educating, informing, and assisting women to make the best contraceptive choice for themselves.	
28296973	Deficits in social communication, particularly pragmatic language, are characteristic of individuals with autism spectrum disorder (ASD). Speech disfluencies may serve pragmatic functions such as cueing speaking problems. Previous studies have found that speakers with ASD differ from typically developing (TD) speakers in the types and patterns of disfluencies they produce, but fail to provide sufficiently detailed characterizations of the methods used to categorize and quantify disfluency, making cross-study comparison difficult. In this study we propose a simple schema for classifying major disfluency types, and use this schema in an exploratory analysis of differences in disfluency rates and patterns among children with ASD compared to TD and language impaired (SLI) groups. 115 children ages 4-8 participated in the study (ASD = 51; SLI = 20; TD = 44), completing a battery of experimental tasks and assessments. Measures of morphological and syntactic complexity, as well as word and disfluency counts, were derived from transcripts of the Autism Diagnostic Observation Schedule (ADOS). High inter-annotator agreement was obtained with the use of the proposed schema. Analyses showed ASD children produced a higher ratio of content to filler disfluencies than TD children. Relative frequencies of repetitions, revisions, and false starts did not differ significantly between groups. TD children also produced more cued disfluencies than ASD children.
28295883	People diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population. These health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts.To elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health-care services.	Qualitative exploratory design involving focus groups.	The research was conducted in the Australian Capital Territory. Participants were consumers of mental health services.	The Commission on Social Determinants of Health Framework was drawn on to lead deductive analysis of focus group interview transcripts.	Issues impacting consumers included poverty, the neglect of public services and being treated as second-class citizens because of diagnosis of mental illness and/or experiencing a psychosocial disability. These factors were connected with significant barriers in accessing physical health care, including the quality and relevance of health provider communication, especially when the broader contexts of mental health consumer's lives are not well understood.	These findings suggest the Commission on Social Determinants of Health Framework could be utilized in research and policy, and may provide an effective platform for exploring better health communication with mental health consumers regarding this neglected health inequity.	
28295845	This study reports on the feasibility of an intergenerational mentoring programme for youth with intellectual disability (ID) aimed at developing skills and building networks.Youth with ID were paired with older male mentors who were trained to support the mentees participate in activities and social interactions during weekly sessions. We interviewed the mentees and mentors, and assessed them on a range of outcomes using standardized measures.	Interviews highlighted that the programme presented a great "opportunity" for the mentees and mentors. The participants described facilitators and challenges to the acquisition of practical skills by mentees and the development of relationships between mentors and mentees, including communication, transportation and mentor training. The youth with ID had difficulty completing the self-report measures.	Mentoring programmes are viable to support youth with ID during the transition to adulthood; however, refinement is required in the rollout out of a pilot intervention.	
28295744	The objective of this integrative review is to identify the factors that contribute to diet adherence in people suffering from kidney disease who are receiving haemodialysis treatment.Adherence to the therapeutic regimen determines therapeutic success, quality of life and survival in patients on haemodialysis. Lack of diet adherence ranges from 25%-86% in patients receiving haemodialysis treatment and affects patient morbidity and mortality.	An integrative literature review was conducted based on the criteria of Whittemore & Knafl.	A literature review was performed by two members of the team using twelve databases including PubMed, CUIDEN, CINAHL, The Cochrane Library and ScienceDirect.	The main issues identified after analysing the results were as follows: the intrinsic barriers (age, dialysis time, motivation, perceived benefit, distorted perception of adherence) and facilitators (self-efficacy, perception of disease, perception of control), extrinsic barriers (family dysfunction, lack of social support, cultural patterns of consumption of food) and facilitators (social support, relationship with healthcare providers), and interventions to encourage diet adherence, such as the use of motivational interviewing in educational interventions, and the training and education of relevant professionals in communication skills.	Diet nonadherence remains a serious health problem and suffers from a lack of solid criteria to identify this condition. The onset of depression signs and the level of social support available to the patient should be assessed, because these are important factors that determine adherence to treatment.	Professionals should be trained in health education and communication techniques to contribute to the patient's self-management and motivation for diet adherence. Controlled and randomised clinical studies involving predialysis stages should be performed to investigate the impact of the assessment and control of barriers to diet adherence.	
28295294	Inequalities between men and women are common and well-documented. Objective indexes show that men are better positioned than women in societal hierarchies-there is no single country in the world without a gender gap. In contrast, researchers have found that the women-are-wonderful effect-that women are evaluated more positively than men overall-is also common. Cross-cultural studies on gender equality reveal that the more gender egalitarian the society is, the less prevalent explicit gender stereotypes are. Yet, because self-reported gender stereotypes may differ from implicit attitudes towards each gender, we reanalysed data collected across 44 cultures, and (a) confirmed that societal gender egalitarianism reduces the women-are-wonderful effect when it is measured more implicitly (i.e. rating the personality of men and women presented in images) and (b) documented that the social perception of men benefits more from gender egalitarianism than that of women.
28294463	Respite services play an important role in supporting older adults and their carers. When an older person is unable to fully represent themselves, provision of respite care relies on effective information-sharing between carers and respite staff. This study aimed to explore, from carers' perspectives, the scope, quality and fit of information-sharing between carers, older people and respite services. An explorative, cross-sectional qualitative study involving a purposive sample of 24 carers, recruited via carer support groups and community groups in voluntary organisations, was undertaken in North East Scotland. Data were collected from August 2013 to September 2014, with participants taking part in a focus group or individual interview. Data were analysed systematically using the Framework Approach. The multiple accounts elicited from carers identified how barriers and facilitators to information-sharing with respite services changed over time across three temporal phases: 'Reaching a point', 'Trying it out' and 'Settled in'. Proactive information-sharing about accessibility and eligibility for respite care, and assessment of carers' needs in their own right, were initially important; as carers and older people moved on to try services out, time and space to develop mutual understandings and negotiate care arrangements came to the fore; then, once shared expectations had been established, carers' chief concerns were around continuity of care and maintaining good interpersonal relationships. The three temporal phases also impacted on which modes of information-sharing were available to, and worked best for, carers as well as on carers' perceptions of how information and communication technologies should be utilised. This study highlights the need for respite staff to take proactive, flexible approaches to working with carers and to make ongoing efforts to engage with carers, and older people, throughout the months and years of them utilising respite services. Information and communication technologies have potential to enhance information-sharing but traditional approaches will remain important.
28293614	Skillful, collaborative conversations are powerful tools to improve physical and mental health. Whether you are a parent talking with your child about the dangers of substance abuse, an educator concerned about a student's signs of psychological distress, a veteran worried about a buddy who is contemplating suicide, or a healthcare professional wanting to better engage patients to increase treatment compliance, having the skill, confidence and motivation to engage in conversations can truly transform the health and well-being of those you interact with. Kognito develops role-play simulations that prepare individuals to effectively lead real-life conversations that measurably improve social, emotional, and physical health. The behavior change model that drives the simulations draws upon components of game mechanics, virtual human simulation technology and integrates evidence-based instructional design components as well as principles of social-cognitive theory and neuroscience such as motivational interviewing, emotional regulation, empathy and mindfulness. In the simulations, users or enter a risk-free practice environment and engage in a conversation with intelligent, fully animated, and emotionally responsive virtual characters that model human behavior. It is in practicing these conversations, and receiving feedback from a virtual coach, that users learn to better lead conversations in real life. Numerous longitudinal studies have shown that users who complete Kognito simulations demonstrate statistically significant and sustained increases in attitudinal variables that predict behavior change including preparedness, likelihood, and self-efficacy to better manage conversations. Pending the target population, each online or mobile simulation resulted in desired behavior changes ranging from increased referrals of students, patients or veterans in psychological distress to mental health support services, or increasing physician patient-centered communication or patient self-confidence and active involved in the decision-making processes. These simulations have demonstrated a capability to address major health and public health concerns where effective conversations are necessary to bring about changes in attitudes and behaviors.
28293611	The successful prevention and treatment of cancer is dependent upon efficient and reliable communication between healthcare workers and patients. Advances in social media and mHealth platforms have provided new ways in which to enhance the sharing of cancer related information. Other benefits of embracing this technology include utilising its analytic capabilities which can process the vast quantity of information generated from genome exploration in a highly efficient manner. The aim of this review is to provide an overview of the rapidly evolving areas through which digital engagement is proving useful in the prevention and control of cancer.
28293610	Mobile technologies offer potentially critical ways of delivering mental health support to those experiencing war, ethnic conflict, and human-caused and natural disasters. Research on Internet interventions suggests that effective mobile mental health technologies can be developed, and there are early indications that they will be acceptable to war and disaster survivors, and prove capable of greatly increasing the reach of mental health services. Promising mhealth interventions include video teleconferencing, text messaging, and smartphone-based applications. In addition, a variety of social media platforms has been used during and immediately after disasters to increase agility in responding, and strengthen community and individual resilience. Globally, PTSD Coach has been downloaded over 243,000 times in 96 countries, and together with large-scale use of social media for communication during disasters, suggests the potential for reach of app technology. In addition to enabling improved self-management of post-trauma problems, mobile phone interventions can also enhance delivery of face-to-face care by mental health providers and increase the effectiveness of peer helpers and mutual aid organizations. More research is needed to establish the efficacy of mhealth interventions for those affected by war and disaster. Research should also focus on the identification of active elements and core processes of change, determination of effective ways of increasing adoption and engagement, and explore ways of combining the various capabilities of mobile technologies to maximize their impact.
28292289	Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013.In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews. We used quantitative content analysis for open-ended questions besides descriptive statistics and nonparametric tests by SPSS 16 at 0.05 Sig level.	Sixteen (5.93%) patients made voluntary informal payments. The purpose of payment was: "gratitude" (43.75%), satisfaction with health services provided" (31.25%) and (18.75%) for better quality of services. About 75% of the payments were occurred during receiving health care services. The main causes were "no request for informal payments" (98.14%), "not affording to pay for informal payments" (73.33%) and "paying the hospital expenses by taking out a loan" (55.91%). Responders said they would pay informally in demand situation (51.85%) just for patient's health priority, 40.71% would also "search for other alternative solutions" and 27.33% "accepted the demand as a kind of gratitude culture". Twenty four patients (8.9%) had experienced mandatory informal payments during the last 6 months. The minimum amount of payment was 62.5$ and the maximum was 3125$. There was a significant relationship between the way of referring to medical centers and informal patient's payment (P ≤0.05).	Despite the widespread prevalent belief about informal payments in public hospitals -particularly to the well-known physicians - such judgment cannot be generalized. The main reasons for the low informal payments in the current study were the personality characteristics of the physicians and hospital staff, their moral conscience and commitment to professional ethics, cultural factors and social-economic status of the patients. Health care system should notify people about their rights specially the payments calculation mechanism and methods. Better communication with the public and especially the media can help to correct attitude toward these payments.	
28292083	Communication between parents and adolescents regarding sexuality is an important reproductive health topic. Due to complexities associated with adolescent's physiological development, sexuality should be dealt with holistically. This study aimed to investigate factors affecting effective communication between parents and adolescents concerning sexual and reproductive health issues.An exploratory qualitative study using the focus group discussions method was done to explore amongst other things; social, cultural and religious barriers to communication. Thematic content analysis was done.	Factors identified included: embarrassment when discussing sexual topics; adolescent misperceptions that guardians want to engage in sexual activities with them; strong belief amongst guardians that reproductive health discussions with adolescents encourages sexual experimentation; belief that adolescents were too young to understand; non-conducive environment for open discussions of sexual and reproductive health matters; cultural and religious beliefs.	In view of these findings, there are still barriers in terms of parent-adolescent engagement on issues related to risks associated with sexual behaviours and erroneous reproductive health choices among adolescents. Therefore, there is a need to encourage engagement by creating neutral platforms facilitated by community healthcare providers and/ or social workers. This will help create awareness and bridge the communication and interaction gap by emphasising the importance of effective engagement among adolescents and their parents on matters related to risks associated with sexual behaviours and erroneous reproductive health choices. Post implantation intervention studies are needed to inform on the outcomes of the intervention.	
28291690	Autism spectrum disorder (ASD) and schizophrenia are neurodevelopmental conditions that are characterized by significant social impairment. Emerging genomic and neurobiological evidence has increasingly pointed to shared pathophysiologic mechanisms in the two disorders. Overlap in social impairment may reflect similar underlying neural dysfunction in social-cognitive brain networks, yet few studies have directly compared brain function and communication between those with ASD and schizophrenia.Outpatients with schizophrenia (n=36), ASD (n=33), and healthy volunteers (n=37) completed a visual perspective-taking task during functional neuroimaging at 3T to assess similarities and differences in fronto-temporal brain function and connectivity during social-cognitive processing. Analyses employed general linear models to examine differences in amplitude of BOLD-signal response between disorder groups, and computed functional connectivity coefficients to investigate differences in the connectivity profiles of networks implicated in social cognition.	Despite similar behavioral impairments, participants with ASD and schizophrenia evidenced distinct neural abnormalities during perspective-taking. Functional activation results indicated reduced temporo-parietal junction and medial prefrontal activity in ASD compared to schizophrenia (all Puncor<0.002). Functional connectivity analyses further revealed significantly greater local orbitofrontal connectivity in ASD than schizophrenia (all PFDR<0.028) during perspective-taking. Differences in brain activation and connectivity were unrelated to antipsychotic medication dose.	Autism and schizophrenia are characterized by similar social-cognitive impairments that may stem from different underlying abnormalities in the functional organization and communication of the social brain.	
28291576	Medically unexplained symptoms (MUS) are common, with particularly high rates observed in military veterans. Effective patient-provider-communication is thought to be a key aspect of care; however there have been few empirical studies on the association between communication and outcomes for patients with MUS. We evaluate whether discussing veterans' MUS-illness representations and good interpersonal skills have the potential to promote MUS-treatment adherence and improvement.Veterans experiencing MUS (n=204) reported on their primary care providers' communication about illness representations and interpersonal skills; correlation, regression, and bootstrap-mediation analyses were conducted to test hypotheses regarding veteran-reported outcomes. Main outcomes included satisfaction with the provider, MUS-treatment adherence, intentions to adhere, and expectations for MUS improvement.	Veterans reported infrequent discussion of MUS illness representations but high degrees of provider interpersonal skills. Communication regarding patients' illness representations and treatment expectations was significantly related to treatment adherence and adherence intentions; provider interpersonal skills were not. Both were related to veteran satisfaction.	Providers' interpersonal skills may be important in chronic illness contexts, such as MUS, by contributing to satisfaction with the provider. The current study suggests that providers may better promote MUS-treatment adherence through discussing MUS illness representations and treatment expectations.	
28291575	To understand the dynamic experiences of parents undergoing the decision-making process regarding cochlear implants for their child(ren).Thirty-three parents of d/Deaf children participated in semi-structured interviews. Interviews were digitally recorded, transcribed, and coded using iterative and thematic coding.	The results from this study reveal four salient topics related to parents' decision-making process regarding cochlear implantation: 1) factors parents considered when making the decision to get the cochlear implant for their child (e.g., desire to acculturate child into one community), 2) the extent to which parents' communities influence their decision-making (e.g., norms), 3) information sources parents seek and value when decision-making (e.g., parents value other parent's experiences the most compared to medical or online sources), and 4) personal experiences with stigma affecting their decision to not get the cochlear implant for their child.	This study provides insights into values and perspectives that can be utilized to improve informed decision-making, when making risky medical decisions with long-term implications.	With thorough information provisions, delineation of addressing parents' concerns and encompassing all aspects of the decision (i.e., medical, social and cultural), health professional teams could reduce the uncertainty and anxiety for parents in this decision-making process for cochlear implantation.	
28291485	The aim of this study was to describe deployed National Guard members' and their families' perceptions of their experience with family reintegration, and the causes and conditions of challenges reintegration presents after deployment.A total of 26 National Guard members and 19 family members participated in individual (n = 22), couples (n = 6), or focus group (n = 17) interviews. In-depth interviews were used to assess needs and maximize input from military families regarding deployment-related experiences and reintegration issues. Qualitative coding and analysis of data were completed using NVivo.	Finding their way back in is the key process that the military members must complete to successfully reestablish their desired social connections with the family and reclaim their place within the family. Several conditions shape the degree of challenges with reintegration that veterans and their family will encounter. These include preparation for deployment, length and type of deployment, communication during deployment, and finally, awareness of how deployment changes the military member and the family.	Support resources dedicated to providing National Guard members and their families with assistance in preparing for deployments and educating them about the importance of communication during deployment should be maintained and expanded. Broader educational efforts that increase awareness of what to expect regarding how deployment changes the military member and the family are needed.	
28291301	Autism spectrum disorders (ASD) are neuropsychiatric disorders characterized by impairment in social interactions, in verbal and non-verbal communication, and restricted and stereotyped patterns of interest and behavior within the first 3 years of life. Pharmacologic interventions may be needed for the treatment of temper tantrums, aggression, hyperactivity, and stereotypes in children with ASD. The approval of aripiprazole by the United States Food and Drug Administration (USFDA) for the treatment of temper tantrums in children and adolescents with ASD has gained increased interest for the use in these patients. Aripiprazole is a partial agonist for the dopamine D2, serotonin 5-HT1A receptors, and an antagonist for 5HT2A receptors. Because aripiprazole is a partial agonist, it has been is speculated that aripiprazole has a protective effect for extrapyramidal side effects, movement disorders, and metabolic problems. But the increased use in children and adolescents is associated with an increase in the number of case reports related with such problems. Nevertheless, our review of the literature uncovered limited data regarding the association between acute dystonia and aripiprazole use in ASD children under five years of age is. In this paper, we present two cases of autistic spectrum disorder children with ages under 5 years that developed acute dystonia taking aripiprazole.
28290234	The Birmingham Cognitive Screen (BCoS) is designed for use with individuals who have acquired language impairment following stroke. Our goal was to develop a Russian version of the BCoS (Rus-BCoS) by translating the battery following cultural and linguistic adaptations and establishing preliminary data on its psychometric properties.Fifty patients with left-hemisphere stroke were recruited, of whom 98% were diagnosed with mild to moderate aphasia. To check whether the Rus-BCoS provides stable and consistent scores, internal consistency, test-retest, and interrater types of reliability were determined. Eight participants with stroke and 20 neurologically intact participants were assessed twice. To inspect the discriminative power of the battery, 63 participants without brain impairment were tested with the Rus-BCoS. Additionally, the Russian version of the Montreal Cognitive Assessment (MoCA), Quantitative Assessment of Speech in Aphasia, and Luria's Neuropsychological Assessment Battery were used to examine convergent validity, sensitivity, and specificity of the Rus-BCoS.	The internal consistency as well as test-retest and interrater reliability of the Rus-BCoS satisfied criteria for the research use. Performance on a majority of tasks in the battery correlated significantly with independently validated tests that putatively measure similar cognitive processes. Critically, all patients with aphasia returned nonzero scores in at least one task in all the Rus-BCoS sections, with the exception of the Controlled Attention section where two patients with severe executive control deficits could not perform.	The Rus-BCoS shows promise as a comprehensive cognitive screening tool that can be used by clinicians working with Russian-speaking persons experiencing poststroke aphasia after much further validation and development of reliable normative standards. Given a lack of quantitative neuropsychological assessment tools in Russia, however, we contend the Rus-BCoS offers potential benefits to clinicians and patients. However, data from research studies with a broader sample of Russian speakers are needed.	
28289853	As genetics and genomics become part of mainstream Medicine, these advances have the potential to reduce or exacerbate health disparities. Gaps in effective communication (where all parties share the same meaning) are widely recognized as a major contributor to health disparities. The purpose of this study was to examine GC-patient communication in real time, to assess its effectiveness from the patient perspective, and then to pilot intervention strategies to improve the communication. We observed 64 English-, 35 Spanish- and 25 Chinese-speaking (n = 124) public hospital patients and 10 GCs in 170 GC appointments, and interviewed 49 patients who were offered testing using the audio recordings to stimulate recall and probe specific aspects of the communication. Data analyses were conducted using grounded theory methods and revealed a fundamental mismatch between the information provided by GCs and the information desired and meaningful to patients. Several components of the communication that contributed to this mismatch and often resulted in ineffective communication included: (1) too much information; (2) complex terminology and conceptually difficult presentation of information; (3) information perceived as not relevant by the patient; (4) unintentional inhibition of patient engagement and question-asking; (5) vague discussions of screening and prevention recommendations. Our findings indicate a need to transform the standard model of genetic counseling communication using evidence-based principles and strategies from other fields of Medicine. The high rates of limited health literacy in the US, increasing access of diverse populations to genetic services, and growing complexity of genetic information have created a perfect storm. If not directly addressed, this convergence is likely to exacerbate health disparities in the genomic age.
28289681	Thanatophobia is omnipresent in our lives. Research has shown separate but connected constructs: fear of death or fear of the dying process. The influences on death anxiety are varied including religiosity, gender, psychological state, and age. It is often assumed by the children of the elderly that the fear of death is prevalent in their parents. Daily the medical staff encounters the presence of death anxiety: from family members or the staff itself. In order to understand this phenomenon, a three-tier study was conducted on non-terminal elderly inpatients in an acute geriatric care ward. The study showed that the elderly had low levels of anxiety (scoring 4/15 on Templer's Death Anxiety Scale) but their children scored higher for themselves (6.9/15) and for their parents (8.9/15). A regression model showed that only the presence of generalized anxiety and religiosity of parent had an effect explaining 33.6% of the variance. Death anxiety of death is usually absent in the elderly but rather they fear the dying process. On the other hand, their children do fear death, which they extrapolate onto their parents. This causes conflicts since the children prevent disclosure of relevant medical information to their parents. This has to be addressed by the staff when dealing with family members, to allow open and honest communication with their patients. The staff need to explain to the family that the elderly are not afraid of death but of the suffering from the dying process.
28288954	Breast cancer is one of the leading contributors to preventable illness and death among women. Although mobile phone apps provide unprecedented opportunity to engage women along the cancer continuum, little is known about the availability, content, and usability of breast cancer mobile phone apps.This study analyzed the content and adherence to literate design standards of all breast cancer-related apps available on the App Store and Google Play, as well as the relationship between their content, user ratings, and price.	Following identification and downloading of all available breast cancer mobile phone apps in October 2015, 101 apps were confirmed as focusing on breast cancer. Based on prior research, we adapted and applied a content analysis scheme that was specific to breast cancer apps, including their main purpose, relevance to the cancer care continuum, and adherence to usability standards outlined by the Institute of Medicine (IOM).	The most common aim of apps was educational (73/101, 72.3%), followed by behavior change (24/101, 23.9%), fundraising (20/101, 19.8%), and advocacy (14/101, 13.9%). On the cancer continuum, primary prevention (strategies to prevent cancer cells from occurring) was mentioned in almost one-third of the apps (30/101, 29.7%). Less than half of the apps (46/101, 45.5%) presented information about mammography and/or breast clinical exam, and 53 apps (52.5%) discussed breast self-exam (which is no longer recommended). Symptoms of cancer prediagnosis, such as a lump, were discussed in almost half of the apps (48/101, 47.5%) and a similar number of apps included information about genetic risk for breast cancer (47/101, 46.5%). Information about breast cancer diagnosis was included in 42 apps (41.58%) and 43 (42.6%) apps discussed treatment options. Survivorship issues were addressed in 17 (16.8%) apps. Only one (1.0%) app discussed hospice. Adherence to usability recommendations was low. The median composite score was 3 (mean 2.60, SD 1.20) of the six recommended usability items. With eight plain language items, the median of the composite health literacy score was 5 (mean 5.06, SD 2.00). Most apps did not use easy-to-understand words (44/101, 43.6%) and few (24/101, 23.8%) defined key terms.	Current breast cancer apps provide important information about breast cancer, but the most common topic covered is breast self-examination, a non-evidence-based screening strategy. Apps that focus on evidence-based strategies on the cancer continuum are needed, with a notable pressing need for apps that would address survivorship and end of life. Finally, developers of breast cancer apps should adhere to IOM standards to meet the needs of diverse populations and reduce current disparities.	
28288695	Knowledge translation (KT) is a buzzword in modern medical science. However, there has been little theoretical reflection on translation as a process of meaning production in KT. In this paper, we argue that KT will benefit from the incorporation of a more theoretical notion of translation as an entangled material, textual and cultural process.We discuss and challenge fundamental assumptions in KT, drawing on theories of translation from the human sciences. We show that the current construal of KT as separate from and secondary to the original scientific message is close to the now deeply compromised literary view of translation as the simple act of copying the original. Inspired by recent theories of translation, we claim that KT can be more adequately understood in terms of a 'double supplement' - on the one hand, KT offers new approaches to the communication of scientific knowledge to different groups in the healthcare system with the aim of supplementing a lack of knowledge among clinicians (and patients). On the other, it demonstrates that a textual and cultural supplement, namely a concern with target audiences (clinicians and patients), is inevitable in the creation of an 'autonomous' science. Hence, the division between science and its translation is unproductive and impossible to maintain. We discuss some possible implications of our suggested shift in concept by drawing on pharmaceutical interventions for the prevention of HIV as a case. We argue that such interventions are based on a supplementary and paradoxical relation to the target audiences, both presupposing and denying their existence. More sophisticated theories of translation can lay the foundation for an expanded model of KT that incorporates a more adequate and reflective description of the interdependency of scientific, cultural, textual and material practices.	
28288647	Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014.The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services.	The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses.	To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour change communication campaigns.	
28288518	The aim of the study was to describe and compare the confidence and knowledge of health professionals (HPs) with and without specialized speech-language training for communicating with people with aphasia (PWA) in a metropolitan hospital setting.Ninety HPs from multidisciplinary teams completed a customized survey to identify their demographic information, knowledge of aphasia, current use of supported conversation strategies and overall communication confidence when interacting with PWA using a 100 mm visual analogue scale (VAS) to rate open-ended questions. Conventional descriptive statistics were used to examine the demographic information. Descriptive statistics and the Mann-Whitney U test were used to analyse VAS confidence rating data. The responses to the open-ended survey questions were grouped into four previously identified key categories.	The HPs consisted of 22 (24.4%) participants who were speech-language pathologists and 68 (75.6%) participants from other disciplines (non-speech-language pathology HPs, non-SLP HPs). The non-SLP HPs reported significantly lower confidence levels (U = 159.0, p < 0.001, two-tailed) and identified fewer strategies for communicating effectively with PWA than the trained speech-language pathologists. The non-SLP HPs identified a median of two strategies identified [interquartile range (IQR) 1-3] in contrast to the speech-language pathologists who identified a median of eight strategies (IQR 7-12).	These findings suggest that HPs, particularly those without specialized communication education, are likely to benefit from formal training to enhance their confidence, skills and ability to successfully communicate with PWA in their work environment. This may in turn increase the involvement of PWA in their health care decisions. Implications for Rehabilitation Interventions to remediate health professional's (particularly non-speech-language pathology health professionals) lower levels of confidence and ability to communicate with PWA may ultimately help ensure equal access for PWA. Promote informed collaborative decision-making, and foster patient-centred care within the health care setting.	
28288034	Social media, including blogs, Twitter, wikis, Facebook, YouTube, and Ning, provides an opportunity for nurse educators to engage undergraduate nursing students who are members of the millennial generation in active learning while enhancing knowledge and fostering communication. Despite the rise of social media usage in undergraduate nursing education, there is a significant deficiency of empirical evidence supporting the efficacy and outcomes of these teaching strategies. This article provides an overview of social media use in undergraduate nursing education and a review of the existing research related to social media use in prelicensure nursing education. Overall, undergraduate nursing students respond positively to social media use in nursing education; however, no outcome measures are available to determine the effect of these teaching strategies on student learning.
28287850	In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.
28287805	Mental disorders influence people with a high prevalence and exert remarkable burden on community members. This study was carried out aiming to assess mental health status within the age range category of 15 and above in the Islamic Republic of Iran.The statistical population of this cross-sectional survey consisted of residents of urban and rural areas in Iranian provinces. An estimated sample size of 36000 people was chosen using systematic random sampling and the cluster method. Access was provided by the contribution of the Geographical Post Office for each province. The GHQ-28 was used as a screening tool for mental disorders. Data analysis was carried out using SPSS-18 software.	The results were gathered by the traditional scoring method. A total of 23.44% of samples were suspected of having mental disorders. The prevalence of suspicion for mental disorders was higher in urban (24.55%) than rural areas (20.89%). The prevalence of anxiety and somatization symptoms was higher than social dysfunction and depression symptoms. The outcomes also revealed that the prevalence of suspicion for mental disorders increased noticeably with aging. Suspicion for these disorders was more common in women, divorcees and widows, illiterates, less educated, unemployed and disabled individuals compared with other potential groups of the society.	Comparison of the outcomes from this study with the research conducted in 1999, demonstrated an increasing prevalence rate of suspicion for mental disorders. Therefore, it is mandatory for Iranian public health authorities to take the needed steps to ensure that necessary requirements encompassing prevention and promotion of mental health are implemented.	
28287754	[Correction Notice: An Erratum for this article was reported in Vol 131(2) of Journal of Comparative Psychology (see record 2017-20237-001). In the article, the scientific name for the species was missing in the title. All versions of this article have been corrected.] Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted, repetitive behaviors. It can be difficult to model the complex behavioral features of this disorder with rodent models, which have limited similarity to human behaviors. The domestic dog may be a promising model of complex human behavior, including core features of ASD. The present study examines ASD-relevant social behavior in Miniature and Standard Poodles using an owner-report questionnaire with questions adapted from the Autism Diagnostic Observation Schedule (Lord, Rutter, DiLavore, & Risi, 2000). A previous study identified 3 behavioral constructs examined by this questionnaire: initiation of reciprocal social behaviors, response to social interaction, and communication. In the present study, confirmatory and experimental factor analyses used to assess how collected data fit with the previous model revealed moderate model fit and a similar factorial structure. Between-breed comparisons across these factors and at the individual question level revealed differences between Miniature and Standard Poodles in showing behaviors. Cluster analyses used to group dogs within each breed according to social behavior identified smaller subgroups of dogs with less social behavior across all 3 factors compared with the average within each breed. Within- and between-breed differences in social behavior warrant investigation of genetic variation underlying this complex trait as it relates to ASD-relevant behavior. (PsycINFO Database Record
28287270	More boys than girls are diagnosed with autism spectrum disorder; however, there are conflicting findings about whether they differ in their presentation. This study involved a survey of parents of school-aged children on the autism spectrum (171 parents of girls and 163 parents of boys) that was distributed via social media. The surveys provided insights regarding the characteristics of boys and girls (as perceived by parents) as well as some demographic information. There were very few differences reported regarding communication and social strengths and difficulties of boys and girls with autism. No differences were reported in the number of boys and girls on the autism spectrum with special interests or repetitive behaviours; however, significant differences were found in the types of special interests with boys and girls showing generally interests along traditional gender lines. Qualitative analysis of open comments indicated that some parents of girls on the autism spectrum described their daughter as trying to hide or mask her difficulties more but no parents of boys on the spectrum described this phenomenon.
28287045	This study assessed the effects of an intervention program, which combined the use of a walker with assistive technology, on the ambulation and indices of positive involvement of persons with advanced Alzheimer's disease. A social validation assessment of the program was also carried out.The study included 10 participants with moderate to severe Alzheimer's disease and inability to walk independently. During baseline, the participants sat in their chair or were provided with a walker. During the intervention, the participants were provided with the walker and assistive technology, which delivered (a) preferred stimulation contingent on step responses and (b) encouragements to ambulate if needed.	The participants' mean step frequencies were between 17 and 45 per session during the baseline and between 83 and 127 per session during the intervention. Sessions lasted 3 min. Most participants also had an increase in indices of positive involvement during the intervention sessions, thus showing an interest in those sessions. The social validation assessment showed that staff personnel rated the program favorably.	A program combining the use of a walker with assistive technology may be a practical resource for improving ambulation and positive involvement of persons with advanced Alzheimer's disease. Implications for rehabilitation A program based on relatively simple technology combined to a walker device may support ambulation in participants with advanced Alzheimer's disease who are no longer able to walk independently. The same program may also help increase the indices of positive involvement (i.e., improve the general attention/activity and mood) of most participants. The staff's positive ratings of the program suggest that there may be a favorable attitude toward the acceptance and application of the program in daily contexts.	
28287018	Contrasting results in visual and auditory spatial memory stimulate the debate over the role of sensory modality and attention in identity-to-location binding. We investigated the role of sensory modality in the incidental/deliberate encoding of the location of a sequence of items. In 4 separated blocks, 88 participants memorised sequences of environmental sounds, spoken words, pictures and written words, respectively. After memorisation, participants were asked to recognise old from new items in a new sequence of stimuli. They were also asked to indicate from which side of the screen (visual stimuli) or headphone channel (sounds) the old stimuli were presented in encoding. In the first block, participants were not aware of the spatial requirement while, in blocks 2, 3 and 4 they knew that their memory for item location was going to be tested. Results show significantly lower accuracy of object location memory for the auditory stimuli (environmental sounds and spoken words) than for images (pictures and written words). Awareness of spatial requirement did not influence localisation accuracy. We conclude that: (a) object location memory is more effective for visual objects; (b) object location is implicitly associated with item identity during encoding and
28285893	Children with Autism Spectrum Disorder (ASD) have difficulty communicating with others nonverbally, via mechanisms such as hand gestures, eye contact and facial expression. Individuals with ASD also have marked deficits in planning future actions (Hughes, 1996), which might contribute to impairments in non-verbal communication. Perspective taking is typically assessed using verbal scenarios whereby the participant imagines how an actor would interact in a social situation (e.g., Sally Anne task; Baron-Cohen, Leslie, & Frith, 1985).The current project evaluated motor perspective taking in five children with ASD (8-11 years old) as they participated in a narrative intervention program over the course of about 16 weeks. The goal of the motor perspective-taking task was to facilitate the action of an experimenter either hammering with a tool or putting it away.	Initially, children with ASD facilitated the experimenter's action less than neurotypical control children. As the narrative intervention progressed, children with ASD exhibited increased motor facilitation that paralleled their increased use of mental state and causal language, indicating a link between verbal and motor perspective taking.	Motoric perspective taking provides an additional way to assess understanding and communication in children with ASD and may be a valuable tool for both early assessment and diagnosis of children with ASD.	
28285719	Symptoms in autism, a neurodevelopmental disorder, appear at an early age. Research consensus shows impairments in communication and especially joint attention, defined as the capacity to intentionally share attention between two persons or a person and an object. Recent studies in autism spectrum disorder (ASD) focus on infants' processes associated to joint attention, such as visual and auditive regulation, attentional engagement and social motivation. The present research's objective is to examine the role of these factors in joint attention.A group of 50 children with ASD, aged 21 to 50 months, were selected. They went through a clinical assessment which included evaluations of development and symptoms, a scale measuring auditive and visual regulation; a grid elaborated to quantify motivation behavior towards a person and an object in two different engagement states: alone or with an adult and finally a measure of the child's capacity to disengage from an object. A joint attention score was obtained with the Early Communication Scale for Children (ECSC). Results show: (1) an effect of visual regulation on joint attention, (2) a relation between visual regulation and joint attention partially mediated by motivation. Our results clarify the nature of the relationship between visual regulation and joint attention, with motivation modulating visual regulation in its relation to joint attention, (3) a relation between attentional disengagement and joint attention. Visual regulation, social and non-social motivation and attentional disengagement are all associated to joint attention. A clinical measure of motivation behaviors for children with ASD has been created and can be applied in clinical settings, as it is adapted to young children with ASD symptomatology and enriches diagnosis.	Statistical analyses of our clinical observations suggest a mediation model highlighting the influence of motivation in the mechanisms underlying joint attention. The measurement of processes and mechanisms associated with social communicative skills at a very early age, here motivation and attentional disengagement processes associated with joint attention, help include these factors in early intervention programs.	
28285043	Promises are speech acts that create an obligation to do the promised action. In three studies, we investigated whether 3- and 5-year-olds (N=278) understand the normative implications of promising in prosocial interactions. In Study 1, children helped a partner who promised to share stickers. When the partner failed to uphold the promise, 3- and 5-year-olds protested and referred to promise norms. In Study 2, when children in this same age range were asked to promise to continue a cleaning task-and they agreed-they persisted longer on the task and mentioned their obligation more frequently than without such a promise. They also persisted longer after a promise than after a cleaning reminder (Study 3). In prosocial interactions, thus, young children feel a normative obligation to keep their promises and expect others to keep their promises as well.
28283809	Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorders characterized by impaired social interactions, communication deficits, and repetitive behavior. Although the mechanisms underlying its etiology and manifestations are poorly understood, several lines of evidence from rodent and human studies suggest involvement of the evolutionarily highly-conserved oxytocin (OXT) and arginine-vasopressin (AVP), as these neuropeptides modulate various aspects of mammalian social behavior. As far as we know, there is no comprehensive review of the roles of the OXT and AVP systems in the development of ASD from the genetic aspect. In this review, we summarize the current knowledge regarding associations between ASD and single-nucleotide variants of the human OXT-AVP pathway genes OXT, AVP, AVP receptor 1a (AVPR1a), OXT receptor (OXTR), the oxytocinase/vasopressinase (LNPEP), and ADP-ribosyl cyclase (CD38).
28282707	While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009), 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS). Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204) and control (N=467) groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ) and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively). PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.
28281999	The late 1960s was a period of significant upheaval of social, cultural, and scientific norms. The generally accepted notion of mandatory laparotomy for all penetrating abdominal injuries was among those norms being called into question across the country and many advocated expectant management of selected patients presenting with this type of injury. Leaders of the surgical community published opinions on either side of the argument. The house staff at Charity Hospital during this period was among the busiest in the nation in treating these injuries, many of them inmates of the Louisiana State Penitentiary who used self-inflicted stab wounds to the abdomen as a means of temporary respite from the inhumane conditions in the prison. Inspired, in part, by the overabundance of negative laparotomies among this group, F. Carter Nance went on to systematically challenge the standard of care. This effort constitutes one of the major forces for change of the surgical dogma of mandatory laparotomy for all abdominal stab wounds. It is the first major study to show conclusively that delayed laparotomy for perforated viscous was not significantly detrimental and posed less of a risk than unnecessary laparotomy. The circumstances surrounding this initiative constitute a powerful and heretofore unknown chapter in the history of surgical innovation.
28281354	People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts. Thematic synthesis was used to develop descriptive themes in client and provider experiences. The search yielded 11 articles for inclusion, along with 8 expert and policy reports. We identify five descriptive themes: the convenience and comprehensive nature of co-located care, contrasting care philosophies and their role in shaping integration, the limits to disclosure and communication between clients and providers, opioid substitution therapy enabling HIV care access and engagement, and health system challenges to delivering integrated services. The discussion explores how integrated opioid substitution therapy and HIV care needs to adapt to specific social conditions, rather than following universal approaches. We identify priorities for future research. Acceptable integrated opioid substitution therapy and HIV care for people who use drugs and providers is most likely through co-located care and relies upon attention to stigma, supportive relationships and client centred cultures of delivery. Further research is needed to understand experiences of integrated care, particularly delivery in low and middle income settings and models of care focused on community and non-clinic based delivery.
28280057	There is no evidence that learning a natural human language is cognitively harmful to children. To the contrary, multilingualism has been argued to be beneficial to all. Nevertheless, many professionals advise the parents of deaf children that their children should not learn a sign language during their early years, despite strong evidence across many research disciplines that sign languages are natural human languages. Their recommendations are based on a combination of misperceptions about (1) the difficulty of learning a sign language, (2) the effects of bilingualism, and particularly bimodalism, (3) the bona fide status of languages that lack a written form, (4) the effects of a sign language on acquiring literacy, (5) the ability of technologies to address the needs of deaf children and (6) the effects that use of a sign language will have on family cohesion. We expose these misperceptions as based in prejudice and urge institutions involved in educating professionals concerned with the healthcare, raising and educating of deaf children to include appropriate information about first language acquisition and the importance of a sign language for deaf children. We further urge such professionals to advise the parents of deaf children properly, which means to strongly advise the introduction of a sign language as soon as hearing loss is detected.
28279843	Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant.Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms.	The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months.	The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention.	The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed.	
28278606	Communication networks contribute to health-related quality of life (HRQOL) for men living with prostate cancer. However, the mechanisms for understanding how communication networks shape HRQOL are not well understood. The purpose of this study was to test three models explaining the communication networks and related communication variables for HRQOL. A total of 214 men with prostate cancer in New Zealand completed a survey questionnaire describing aspects of their networks including opportunities for connection, social support/undermining, status disclosure, communication efficacy, and HRQOL. The findings support a mediating model of communication networks where social undermining has a direct and negative impact on HRQOL, and an indirect effect mediated through communication efficacy, which has a direct and positive impact on HRQOL. Contrary to previous studies, social support and disclosure did not significantly impact HRQOL in this sample. The benefits of developing communication efficacy and reducing social undermining for enhancing long-term psychosocial health in this cohort of men are two key findings.
28278604	African-American and Hispanic men are disproportionately affected by cancer experiencing higher rates of cancer-related morbidity and mortality for many cancers (but not all). These challenges may be magnified for a subpopulation of African-American and Hispanic men who have been incarcerated. A survey assessing demographics, incarceration experience, psychosocial, behavioral, and cancer health information seeking was administered to 230 previously incarcerated men aged 35 years and older. Data analysis was performed to assess the association between fatalism, perceived susceptibility, and health information seeking in this population. This study revealed the following: the majority of the participants (68.7%) held the fatalistic belief: "When I think of cancer, I automatically think of death." Second, the fatalistic belief, "There's not much you can do to lower your chances of getting cancer," is more prevalent among those who perceived a higher risk of developing cancer. Third, older participants (those between 55 and 70 years old) and widowed are less likely to think of death when they think of cancer. In addition, those who use the Internet to look for health or medical information (i.e., engaging in health information seeking) are less likely to agree with the fatalistic belief: "It seems like everything causes cancer." Given the high incidence of certain cancers among African-American and Hispanic men and the vulnerability of those involved in the criminal justice system, our findings highlight the importance of understanding perceived susceptibility to cancer, fatalistic beliefs about cancer, and information seeking in formerly incarcerated men.
28278240	The interpretation of social cues is a fundamental function of human social behavior, and resolution of inconsistencies between spoken and gestural cues plays an important role in successful interactions. To gain insight into these underlying neural processes, we compared neural responses in a traditional color/word conflict task and to a gesture/word conflict task to test hypotheses of domain-general and domain-specific conflict resolution. In the gesture task, recorded spoken words ("yes" and "no") were presented simultaneously with video recordings of actors performing one of the following affirmative or negative gestures: thumbs up, thumbs down, head nodding (up and down), or head shaking (side-to-side), thereby generating congruent and incongruent communication stimuli between gesture and words. Participants identified the communicative intent of the gestures as either positive or negative. In the color task, participants were presented the words "red" and "green" in either red or green font and were asked to identify the color of the letters. We observed a classic "Stroop" behavioral interference effect, with participants showing increased response time for incongruent trials relative to congruent ones for both the gesture and color tasks. Hemodynamic signals acquired using functional near-infrared spectroscopy (fNIRS) were increased in the right dorsolateral prefrontal cortex (DLPFC) for incongruent trials relative to congruent trials for both tasks consistent with a common, domain-general mechanism for detecting conflict. However, activity in the left DLPFC and frontal eye fields and the right temporal-parietal junction (TPJ), superior temporal gyrus (STG), supramarginal gyrus (SMG), and primary and auditory association cortices was greater for the gesture task than the color task. Thus, in addition to domain-general conflict processing mechanisms, as suggested by common engagement of right DLPFC, socially specialized neural modules localized to the left DLPFC and right TPJ including adjacent homologous receptive language areas were engaged when processing conflicting communications. These findings contribute to an emerging view of specialization within the TPJ and adjacent areas for interpretation of social cues and indicate a role for the region in processing social conflict.
28278059	Increasingly, advocacy organizations employ social networking sites as inexpensive and often effective ways to disseminate outreach messages. For groups working to reach lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, social media provide key platforms for connecting with target audiences. Although these young people increasingly utilize social media, little is known about how digital advocacy campaigns influence their sexual identity formation. This article applies concepts of social identity to examine how LGBTQ youth understand advocacy campaigns, how they perceive LGBTQ as a social category presented in campaigns, and what values they assign to LGBTQ group membership.
28278003	Disabled people face multiple personal, environmental and social barriers that interfere with leading a physically active lifestyle. Thus, there is an urgent need for behaviour change interventions to increase physical activity (PA) by specifically addressing the situations of disabled people, and barriers to participation. This original meta-synthesis of qualitative research was undertaken to explore participants' experiences and perceptions of PA-enhancing interventions for adults with physical impairments resulting in mobility limitations. Published articles were identified through a rigorous systematic search. Based on the inclusion/exclusion criteria, 10 articles were included for review. Following a critical appraisal of the articles, methods of thematic synthesis were drawn upon to generate overarching concepts through interpretation and conceptual synthesis. Seven interrelated concepts were constructed representing both components and outcomes of the interventions. These were (i) Diversity of interventions; (ii) Importance of communication; (iii) Need for social support; (iv) Behavioural strategies; (v) Gaining knowledge; (vi) Re-framing thoughts about exercise and the self and (vii) Health and well-being. The results revealed that a combination of informational, social and behavioural interventions is perceived as crucial for PA initiation and maintenance. Furthermore, key elements of effective intervention design and implications for policies and practices to increase PA participation are proposed.
28277556	Bayley Scales of infant & toddler development is a well-known diagnostic developmental assessment tool for children aged 1-42 months. Our aim was investigating the validity & reliability of this scale in Persian speaking children.The method was descriptive-analytic. Translation- back translation and cultural adaptation was done. Content & face validity of translated scale was determined by experts' opinions. Overall, 403 children aged 1 to 42 months were recruited from health centers of Tehran, during years of 2013-2014 for developmental assessment in cognitive, communicative (receptive & expressive) and motor (fine & gross) domains. Reliability of scale was calculated through three methods; internal consistency using Cronbach's alpha coefficient, test-retest and interrater methods. Construct validity was calculated using factor analysis and comparison of the mean scores methods.	Cultural and linguistic changes were made in items of all domains especially on communication subscale. Content and face validity of the test were approved by experts' opinions. Cronbach's alpha coefficient was above 0.74 in all domains. Pearson correlation coefficient in various domains, were ≥ 0.982 in test retest method, and ≥0.993 in inter-rater method. Construct validity of the test was approved by factor analysis. Moreover, the mean scores for the different age groups were compared and statistically significant differences were observed between mean scores of different age groups, that confirms validity of the test.	The Bayley Scales of Infant and Toddler Development is a valid and reliable tool for child developmental assessment in Persian language children.	
28277553	Children with autism have sitting and on-task behavior problems in class. In this study, the effect of three alternative classroom-seating devices such as regular classroom chairs, therapy balls, and air cushions were examined on students' classroom behavior.15 students with autism participated in this A1-B-A2-C multiple treatments study from Mashhad's Tabasom School, Mashhad, Iran in 2014. Students' behaviors were video recorded in three phases: sitting on their common chairs during phase A, air-sit cushioned in phase B, and ball chairs in phase C. Sitting times and on-task behaviors were quantified by momentary time sampling and compared during different phases for important changes during 8 wk. Additionally, the Gilliam Autism Rating Scale-Second Edition test was used to examine stereotyped movements, social and communication skills of the students in the before and after research.	Significant increases in in-seat behaviors in 86.7% (thirteen out of 15) of the students and on-task behaviors in 53.3% of the students (eight out of 15) when seated on therapy balls. Air cushions had no significant effects on in-seat/on-task behaviors. The results also showed significant decrease in stereotyped movement and increase in communication and social skills of these students. The teachers also preferred the use of the balls and/or air-cushioned chairs for their students.	Therapy ball chairs facilitated in-seat behavior and decreased autism related behavior of the students with Autism Spectrum Disorder in class.	
28277334	This review is intended to give an up-to-date overview of key developments in the evidence base relating specifically to the social and quality of life (QOL) impact of using a voice prosthesis, with reflections on the impact on clinical practice.Recent studies have shed light on the role of social support on psychological adjustment after laryngectomy, developing the existing evidence base on psychological sequelae. Investigations into the relationship between voice intensity/intelligibility and voice handicap/QOL may suggest a relationship for some patients, and current tools for measuring these constructs are evaluated. Recent qualitative research on the lived experience and social impact of using a voice prosthesis is presented.	Little research is currently available exploring the impact of using a voice prosthesis on social participation, which is reflected in the dearth of participation-focused interventions for laryngectomy patients. Further research on the lived experience of tracheoesophageal speech is required to understand this phenomenon and develop appropriate interventions for enhancing communication, participation and QOL with a voice prosthesis after laryngectomy.	
28277276	Motivational Interviewing, pharmacist-based health coaching and traditional patient counseling techniques all show merit in improving communication between patients and health care providers. However, in order to effectively utilize these techniques one should have the ability to draw upon internal cognitive and psychological resources. Some patients have difficulty obtaining optimal health outcomes due to an unconscious inability to learn and connect with psychological resources. When this is the case, other methods of communication may need to be considered. With the appropriate training, Eriksonian Hypnosis or the use of techniques such as hypnotic language patterns (HLP) have the potential to be implemented into pharmacy practice settings and assist those patients who have previously failed to make positive behavior changes and act upon their health issues.
28277020	To understand the perspectives of healthcare professionals and interpreters in relation to working with and caring for non-English speaking families accessing National Health Service paediatric tertiary health care services.Focus group and interview methods were used to elicit the views of healthcare professionals and interpreters at one tertiary paediatric hospital in the United Kingdom. Data were subjected to framework analysis.	Participants identified a number of factors affecting communication and their interaction with non-English speaking families in this setting, including time, role uncertainty, and interlinked dimensions of culture and gender. They also described how the nature of this communication could impact on both the delivery of care and the patient and family experience. These findings highlight gaps in services, training, and support for families, staff and interpreters. These need to be recognised and addressed by those in practice to improve care delivery and help tackle health inequalities.	Our data show how significant the impact of language barriers can be, and the need to consider not only how communication can be improved, but also how this is situated in the specific context of tertiary paediatric care as well as a wider social context of inequity.	
28275850	To further the understanding of climate change adaptation processes, more attention needs to be paid to the various contextual factors that shape whether and how climate-related knowledge and information is received and acted upon by actors involved. This study sets out to examine the characteristics of forest owners' in Sweden, the information and knowledge-sharing networks they draw upon for decision-making, and their perceptions of climate risks, their forests' resilience, the need for adaptation, and perceived adaptive capacity. By applying the concept of ego-network analysis, the empirical data was generated by a quantitative survey distributed to 3000 private forest owners' in Sweden in 2014 with a response rate of 31%. The results show that there is a positive correlation, even though it is generally weak, between forest owner climate perceptions and (i) network features, i.e. network size and heterogeneity, and (ii) presence of certain alter groups (i.e. network members or actors). Results indicate that forest owners' social networks currently serve only a minimal function of sharing knowledge of climate change and adaptation. Moreover, considering the fairly infrequent contact between respondents and alter groups, the timing of knowledge sharing is important. In conclusion we suggest those actors that forest owners' most frequently communicate with, especially forestry experts providing advisory services (e.g. forest owner associations, companies, and authorities) have a clear role to communicate both the risks of climate change and opportunities for adaptation. Peers are valuable in connecting information about climate risks and adaptation to the actual forest property.
28274370	This study examines a diverse set of social motives (e.g. peer support, peer pressure, social loneliness) for e-cigarette use, through the mediating effects of opinion leadership, among both male and female adolescents.Prospective cohort study.	The data were obtained from a survey conducted among 666 adolescents across 14 school classes, namely, students at three urban schools, public and private, in Lille, France. The proposed integrative model includes social motives, opinion leadership and e-cigarette use in a trilateral relationship; gender is proposed and tested as a potential moderator in a structural equation model.	More positive peer support is negatively associated with opinion leadership and e-cigarette use. Both loneliness and susceptibility to peer influence are positively related to opinion leadership and e-cigarette use. Moreover, social support from peers and opinion leadership shape e-cigarette use differently across genders.	Policy makers should account for the various (positive and negative) roles of peers and consider the gender of their audience when designing anti-e-cigarette policies.	
28274244	Investing in research that is not accessible or used is a waste of resources and an injustice to human subject participants. Post-graduate students' research in institutions of higher learning involves considerable time, effort and money, warranting evaluation of the return on investment. Although individual studies addressing research productivity of post-graduate students are available, a synthesis of these results in low-income settings has not been undertaken. Our first aim is to identify the types of approaches that increase productivity and those that increase the application of medical post-graduate students' research and to assess their effectiveness. Our second aim is to assess the determinants of post-graduate students' research productivity.We propose a two-stage systematic review. We will electronically search for published and grey literature in PubMed/MEDLINE and the ERIC databases, as well as contact authors, research administration units of universities, and other key informants as appropriate. In stage one, we will map the nature of the evidence available using a knowledge translation framework adapted from existing literature. We will perform duplicate screening and selection of articles, data abstraction, and risk of bias assessments for included primary studies as described in the Cochrane handbook for systematic reviews. Our primary outcome is publication output as a measure of research productivity, whilst we defined research use as citations in peer-reviewed journals or policy-related documents as our secondary outcome. In stage two, we will perform a structured narrative synthesis of the findings and advance to quantitative meta-analysis if the number of studies are adequate and their heterogeneity is low. Adapting the Grading, Recommendations, Assessment, Development and Evaluation (GRADE) approach, we will assess the overall quality of evidence for effects, and report our results in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.	We will share our findings with universities, other training institutions, civil society, funders as well as government departments in charge of education and health particularly in low- and middle-income countries.	
28274220	Intimate Partner Violence (IPV) is a significant public health problem with negative health consequences for women and their pregnancies. While social support has a protective effect against IPV and reduces health consequences of violence, its association with experiencing IPV during pregnancy remain less explored. In our study we aimed to determine the effect of social support on IPV during pregnancy among women attending antenatal care in Moshi, Tanzania METHODS: The study was part of a prospective cohort study that assessed the impact of violence on reproductive health of 1,116 participants. Pregnant women were enrolled below 24 weeks of gestation and followed until delivery. The experiences of social support and IPV during pregnancy were assessed at the 34th week of gestation. Logistic regression analysis was performed to assess the relationship between social support and IPV, with adjustment for potential confounders.The prevalence of IPV during pregnancy was 30.3% where the majority (29.0%) experienced repeated episodes of abuse. Regarding practical social support, having no one to help financially was associated with increased odds of IPV and repeated episodes of abuse during pregnancy, AOR 3.57, (95% CI 1.85 - 6.90) and AOR 3.21, (95% CI 1.69 - 6.11) respectively. For social support in terms of communication, talking to a member of the family of origin at least monthly was associated with decreased odds of IPV and repeated episodes of IPV during pregnancy, AOR 0.46 (95% CI 0.26 - 0.82) and AOR 0.41 (95% CI 0.23 - 0.73) respectively. Perceiving that family of origin will not offer support was associated with a increased odds of IPV and repeated episodes of IPV, AOR 2.29, (95% CI 1.31 - 3.99) and AOR 2.14, (95% CI 1.23 - 3.74) respectively.	Nearly one third of women experienced IPV during pregnancy. Social support to women is associated with decreased odds of experiencing IPV during pregnancy. The family of origin plays an important role in providing social support to women who experience abuse during pregnancy; however, their true involvement in mitigating the impact of violence in the African setting needs further research.	
28273232	To describe the translation and early stages of cross-cultural adaptation of the questionnaire Verwachtingen over werken (or "Return-to-work self-efficacy") for workers in sick leave due to mental disorders, from the original in Dutch to the Brazilian Portuguese language.A panel gathering experts was formed to determine the questionnaire conceptual and item equivalence. For semantic equivalence, the Dutch-Portuguese Brazilian translations were consolidated and consensus meetings were held to structure versions of the instrument. Each version was back-translated from Brazilian Portuguese to Dutch and evaluated by one of the authors of the original version. The final version was submitted to two pre-tests for operational equivalence.	The original questionnaire in Dutch was translated twice to Brazilian Portuguese. During the process, four consensus meetings of the experts' panel were performed to create the versions. Each version was back-translated to Dutch. One of the authors of the original questionnaire performed an evaluation on the first three versions until the definition of the final one, which was titled Expectativas sobre o trabalho (Expectations about work). Pre-tests' participants did not reported problems to fill the questionnaire.	Results indicate that the Brazilian Portuguese cross-culturally adapted version maintains the original meaning of the questionnaire, while including characteristics peculiar to the Brazilian reality. Measurement and functional equivalence of this version must still be evaluated before its application can be recommended for workers who have been absent from work due to mental disorders.	
28272293	The objectives were (1) to describe barriers and facilitators of adverse event reporting by adolescent patients and parents in a pediatric hospital and (2) to identify characteristics the participants wished to have in a formal reporting system of adverse events.We used a qualitative design in which 6 focus groups, 3 with parents and 3 with adolescents, were conducted. The transcripts of audio recordings, notes of team debriefings, and written field notes of group behaviors were analyzed using NVivo software for qualitative data analysis.	Participants reported that the quality of the experience with the health care system, type of communication with health care providers, and degree of personal self-confidence in communication within the health care system were 3 interacting factors influencing willingness to report adverse events. Preferred reporting mechanisms were different for different participants and included face-to-face meetings with hospital representatives, Web sites, smart phone capability, phone calls from a human, and paper mail. Reporting systems should be easy to use, ensure confidentiality, and provide user feedback.	Experience, communication, and confidence are 3 factors that can engage an adolescent patient and parents in their health care. Confident adolescent patients and parents in turn have a possibility of reporting an adverse safety event given an opportunity.	
28272198	Physical and mental changes associated with aging commonly lead to a decrease in communication capacity, reducing social interactions and increasing loneliness. Computer classes for older adults make significant contributions to social and cognitive aspects of aging. Games in a virtual reality (VR) environment stimulate the practice of communicative and cognitive skills and might also bring benefits to older adults. Furthermore, it might help to initiate their contact to the modern technology. The purpose of this study protocol is to evaluate the effects of practicing VR games during computer classes on the level of loneliness of students of an elderly reference center.This study will be a prospective longitudinal study with a randomised cross-over design, with subjects aged 50 years and older, of both genders, spontaneously enrolled in computer classes for beginners. Data collection will be done in 3 moments: moment 0 (T0) - at baseline; moment 1 (T1) - after 8 typical computer classes; and moment 2 (T2) - after 8 computer classes which include 15 minutes for practicing games in VR environment. A characterization questionnaire, the short version of the Short Social and Emotional Loneliness Scale for Adults (SELSA-S) and 3 games with VR (Random, MoviLetrando, and Reaction Time) will be used. For the intervention phase 4 other games will be used: Coincident Timing, Motor Skill Analyser, Labyrinth, and Fitts. The statistical analysis will compare the evolution in loneliness perception, performance, and reaction time during the practice of the games between the 3 moments of data collection. Performance and reaction time during the practice of the games will also be correlated to the loneliness perception.	
28271970	Some patients are hesitant to disclose when they are experiencing pain. However, the reasons for this, such as stoicism and concern about being a bother to others, are poorly understood. If patient pain goes unrecognized during clinical encounters, patients may also be at greater risk for pain-related crises, use of hospice/palliative care on-call services, and in-patient transfers. This is an evidence-informed development of a practice-oriented conceptual model to understand and address patient reluctance to admit pain. We used a review of the available evidence to better understand the various factors that contribute to an unwillingness to disclose one's pain, create a conceptual model, and identify relevant assessment measures that may be useful to practitioners. Our review identified six primary attitudes and beliefs that contribute to patient reluctance to openly admit pain: (a) stigma; (b) stoicism; (c) cautiousness; (d) fatalism; (e) bother; and (f) denial. Four assessment measures that address elements of barriers to pain-related communication and four measures of nonverbal signs of pain were also identified and reviewed. Based on the model, social workers and other palliative care providers should consistently and vigilantly inquire about how comfortable patients are about discussing their own pain. Implications for practice and research are presented.
28271576	Recently, evidence has shown that variations in the cuticular hydrocarbons (CHCs) profile allow healthy honeybees to identify diseased nestmates, eliciting agonistic responses in the former. Here, we determined whether these 'immunologic cues' emitted by diseased nestmates were only detected by workers, who consequently took hygienic measures and excluded these individuals from the colony, or whether queens were also able to detect these cues and respond accordingly. Healthy honeybee queens were exposed to (i) healthy, (ii) Ringer-injected and (iii) lipopolysaccharide (LPS)-injected nestmates by allowing direct body contact. Quantitative differences in the CHC profiles of these three groups were measured using GC-MS. The transcript levels of the products of four genes that encode for antimicrobial peptides (AMPs), which are part of the queen's immune response, were measured in bees exposed to direct contact using qPCR. A significant increase in the transcript levels of these AMP genes over baseline levels in queens was observed when body contact was allowed between the queens and the Ringer- and LPS-injected nestmates. These results provide the first evidence that the detection of CHCs contributes to the initiation of an immune response in insects. In an additional experiment, CHCs were extracted from diseased workers and directly presented to queens, which also evoked a similar immune response. A potential mechanism that relied on volatile compounds could be ruled out by conducting a distance experiment. The study helps to expand our knowledge of chemical communication in insects and sheds light on a likely new mechanism of social immunity.
28271462	The use of Web portals has several benefits. They have been proven to enhance communication between patients and health care professionals, allow patients to play a more active role in their own treatment and self-management, increase self-efficiency. Doctors can access patients' medical data and give recommendations to the patients. Some evidence of positive outcomes has been reported including improved clinical indicators and reduced health service use, as well as enhanced feelings of security and increased satisfaction with health and social care services. However, a number of studies have demonstrated that these types of solutions often fail to be successfully implemented and adopted within routine healthcare. The goal of the study was to analyze attitude of tuberculosis patients and doctors and identify perceived opportunities and barriers to operate a Web portal. The perceptions of 30 tuberculosis patients and 18 doctors (10 general practitioners and 8 phthisiatricians) from Tomsk, Russia were collected through semi-structured interviews. The responses were analyzed using grounded theory and thematic analysis, in order to understand the participants' opinions and attitudes towards accepting tuberculosis web-portal in the treatment and rehabilitation process. We have recognized core topics that represented the participants' responses. These core topics indicated that most respondents mentioned "the potential of tuberculosis web-portal to establish a better communication between doctors and patients" and "the increased health status of the patients" as the most valuable outcomes of adopting the tool. Both doctors and patients also expressed their opinions on the usability of the solutions, with no significant concerns reported about its usability. The main barrier we identified was different expectations of doctors and patients: doctors expected that the portal would decrease the amount of paper work and will help them to quickly react in acute cases, however, the patients were disappointed that the portal did not allow them to be able to reach doctors on the 24/7 basis and have a consultation whenever they felt they needed it. Finally, our findings disclosed that participants appreciated the perceived clinical utility of the portal, which could further have an influence on their intention to use it. The findings from our reported study in the area of tuberculosis treatment and rehabilitation suggested that the participants generally accepted the introduction of web-portal for the purpose of reporting health status and getting recommendation from the doctors as an alternative to the traditional doctor visits.
28271437	Transgenic mice carrying mutations that cause Autism Spectrum Disorders (ASDs) continue to be valuable for determining the molecular underpinnings of the disorders. Recently, researchers have taken advantage of such models combined with Cre-loxP and similar systems to manipulate gene expression over space and time. Thus, a clearer picture is starting to emerge of the cell types, circuits, brain regions, and developmental time periods underlying ASDs. ASD-causing mutations have been restricted to or rescued specifically in excitatory or inhibitory neurons, different neurotransmitter systems, and cells specific to the forebrain or cerebellum. In addition, mutations have been induced or corrected in adult mice, providing some evidence for the plasticity and reversibility of core ASD symptoms. The limited availability of Cre lines that are highly specific to certain cell types or time periods provides a challenge to determining the cellular and circuitry bases of autism, but other technological advances may eventually overcome this obstacle.
28271211	To investigate the longitudinal associations between social cognitive ability an external locus of control (externality) and adolescent psychopathology.7058 participants from a prospective population-based cohort provided data on externality, social communication, and emotion perception between 7 and 16 years and psychotic experiences and depressive symptoms at 12 and 18 years. Bivariate probit modelling was used to investigate associations between these risk factors and psychopathological outcomes.	Externality was associated with psychopathology at 12 (psychotic experiences OR 1.23 95% CI 1.14, 1.33; depression OR 1.12 95% CI 1.02, 1.22) and 18 years (psychotic experiences OR 1.38 95% CI 1.23, 1.55; depression OR 1.40 95% CI 1.28, 1.52). Poor social communication was associated with depression at both ages (12 years OR 1.22 95% CI 1.11, 1.34; 18 years OR 1.21 95% CI 1.10, 1.33) and marginally associated with psychotic experiences. There was marginal evidence of a larger association between externality and psychotic experiences at 12 years (p = 0.06) and between social communication and depression at 12 years (p = 0.03).	Externality was more strongly associated with psychotic experiences. At 18 years change in externality, between 8 and 16 years were associated with a larger increase in the risk of depression. Poor social communication was more strongly associated with depression.	
28271168	Age-related hearing loss is one of the most common chronic sensory impairments in the older population. This chronic condition is associated with bio-psychosocial consequences such as cognitive decline, depression, withdrawal, isolation, and reduced wellbeing.This study aimed to investigate the perception of hearing problems among older women and men (≥55 years) with age-related hearing loss. Furthermore, the association between functional hearing loss and perceived hearing problems was examined. Lastly, this study undertook a detailed investigation of subjective experiences in order to better understand the consequences of age-related hearing loss for daily life.	With the aid of mixed methods, quantitative data were gathered from 65 participants with age-related hearing impairment in Austria using the Hearing Handicap Inventory for the Elderly (HHIE). Moreover, qualitative data regarding experiences with hearing problems were collected by performing semi-structured problem-centered interviews and analyzing the results of a further 14 older adults with hearing loss.	On average, participants assessed their hearing handicap as mild and perceived consequences on emotional, social, and communication levels. Moreover, feelings of insecurity were evident. In addition, the findings indicate a relationship but also a discrepancy between hearing loss and hearing handicap, i. e., not all participants perceived a hearing handicap.	Patient-centered care encompassing (1) objective and self-report measures for assessing hearing problems, (2) involvement of family members and significant others, (3) counseling and exchange of information, and (4) a shared decision-making approach could enhance quality of life and quality of care.	
28271057	An estimated 400,000 urinary tract infections (UTIs) are diagnosed annually in children aged <3 years in the United States; yet >50% of febrile UTIs may be missed in this population. Here, we explored possible barriers to diagnosing febrile UTIs in very young children through social research of community pediatricians.Following qualitative interviews, a quantitative survey was developed that included a high-risk case for febrile UTI, presented before prompting for the topic of the survey, to gauge practice of delayed testing. Factors associated with delay were explored using univariate logistic regression. The final survey link was sent to three populations via email, with the largest response from a survey sent to pediatricians in Pennsylvania, which formed the basis of our primary results.	Of the 218 evaluable responses, 59.6% of physicians would initially test urine in the high-risk case patient, while 21.6% would choose to continue fever reducer and follow-up in 2 days. In the knowledge-based questions, 67.5, 34.0, and 35.6% of respondents identified the correct prevalences in total population, Caucasian girls, and uncircumcised boys, respectively. Many pediatricians (59.5%) believed that delays in detection are common in clinical practice. Physicians who chose to delay testing were more likely to be female, in practice for <25 years, to underestimate prevalence of febrile UTIs and have greater number of children seen per week (all P ≤ 0.02).	Our findings support the need for improved communication and education about prevalence in higher risk populations, outcomes associated with delayed diagnosis, and optimal skills for collection of urine in young patients.	
28270384	Widespread application of research findings to improve patient outcomes remains inadequate, and failure to routinely translate research findings into daily clinical practice is a major barrier for the implementation of any evidence-based guideline. Strategies to increase guideline uptake in primary care pediatric practices and to facilitate adherence to recommendations are required.Our objective was to operationalize the US National Heart, Lung, and Blood Institute's Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents into a mobile clinical decision support (CDS) system for healthcare providers, and to describe the process development and outcomes.	To overcome the difficulty of translating clinical practice guidelines into a computable form that can be used by a CDS system, we used a multilayer framework to convert the evidence synthesis into executable knowledge. We used an iterative process of design, testing, and revision through each step in the translation of the guidelines for use in a CDS tool to support the development of 4 validated modules: an integrated risk assessment; a blood pressure calculator; a body mass index calculator; and a lipid management instrument.	The iterative revision process identified several opportunities to improve the CDS tool. Operationalizing the integrated guideline identified numerous areas in which the guideline was vague or incorrect and required more explicit operationalization. Iterative revisions led to workable solutions to problems and understanding of the limitations of the tool.	The process and experiences described provide a model for other mobile CDS systems that translate written clinical practice guidelines into actionable, real-time clinical recommendations.	
28269957	With online social platforms gaining popularity as venues of behavior change, it is important to understand the ways in which these platforms facilitate peer interactions. In this paper, we characterize temporal trends in user communication through mapping of theoretically-linked semantic content. We used qualitative coding and automated text analysis to assign theoretical techniques to peer interactions in an online community for smoking cessation, subsequently facilitating temporal visualization of the observed techniques. Results indicate manifestation of several behavior change techniques such as feedback and monitoring' and 'rewards'. Automated methods yielded reasonable results (F-measure=0.77). Temporal trends among relapsers revealed reduction in communication after a relapse event. This social withdrawal may be attributed to failure guilt after the relapse. Results indicate significant change in thematic categories such as 'social support', 'natural consequences', and 'comparison of outcomes' pre and post relapse. Implications for development of behavioral support technologies that promote long-term abstinence are discussed.
28269890	Analysis of user interactions in online communities could improve our understanding of health-related behaviors and inform the design of technological solutions that support behavior change. However, to achieve this we would need methods that provide granular perspective, yet are scalable. In this paper, we present a methodology for high-throughput semantic and network analysis of large social media datasets, combining semi-automated text categorization with social network analytics. We apply this method to derive content-specific network visualizations of 16,492 user interactions in an online community for smoking cessation. Performance of the categorization system was reasonable (average F-measure of 0.74, with system-rater reliability approaching rater-rater reliability). The resulting semantically specific network analysis of user interactions reveals content- and behavior-specific network topologies. Implications for socio-behavioral health and wellness platforms are also discussed.
28269467	A multitude of assistive devices is available for deaf people (i.e. deaf, deafened, and hard of hearing). Besides hearing and communication aids, devices to access environmental sounds are available commercially. But the devices have two major drawbacks: 1. they are targeted at indoor environments (e.g. home or work), and 2. only specific events are supported (e.g. the doorbell or telephone). Recent research shows that important sounds can occur in all contexts and that the interests in sounds are diverse. These drawbacks can be tackled by using modern information and communication technology that enables the development of new and improved assistive devices. The smartwatch, a new computing platform in the form of a wristwatch, offers new potential for assistive technology. Its design promises a perfect integration into various different social contexts and thus blends perfectly into the user's life. Based on a smartwatch and algorithms from pattern recognition, a prototype for awareness of environmental sounds is presented here. It observes the acoustic environment of the user and detects environmental sounds. A vibration is triggered when a sound is detected and the type of sound is shown on the display. The design of the prototype was discussed with deaf people in semi-structured interviews, leading to a set of implications for the design of such a device.
28269016	Heterogeneity in Autism Spectrum Disorder (ASD) is complex including variability in behavioral phenotype as well as clinical, physiologic, and pathologic parameters. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now diagnoses ASD using a 2-dimensional model based social communication deficits and fixated interests and repetitive behaviors. Sorting out heterogeneity is crucial for study of etiology, diagnosis, treatment and prognosis. In this paper, we present an ensemble model for analyzing ASD phenotypes using several machine learning techniques and a k-dimensional subspace clustering algorithm. Our ensemble also incorporates statistical methods at several stages of analysis. We apply this model to a sample of 208 probands drawn from the Simon Simplex Collection Missouri Site patients. The results provide useful evidence that is helpful in elucidating the phenotype complexity within ASD. Our model can be extended to other disorders that exhibit a diverse range of heterogeneity.
28268779	People with social communication difficulties tend to have superior skills using computers, and as a result computer-based social skills training systems are flourishing. Social skills training, performed by human trainers, is a well-established method to obtain appropriate skills in social interaction. Previous works have attempted to automate one or several parts of social skills training through human-computer interaction. However, while previous work on simulating social skills training considered only acoustic and linguistic features, human social skills trainers take into account visual features (e.g. facial expression, posture). In this paper, we create and evaluate a social skills training system that closes this gap by considering audiovisual features regarding ratio of smiling, yaw, and pitch. An experimental evaluation measures the difference in effectiveness of social skill training when using audio features and audiovisual features. Results showed that the visual features were effective to improve users' social skills.
28267098	This study aimed to examine the impacts of key barriers to improving the occupational health status of Australian train drivers.From May to June, 2015, five semi-structured qualitative focus groups were conducted with 29 train drivers from South Australian, Victorian, and New South Wales-based rail organizations in Australia.	Occupational health was impeded by multiple barriers regarding sleep (patterns/fatigue), diet (planning/context), mental health (occupational stress), rostering (low autonomy), sedentary time, low fitness motivation, and family/social life conflicts. Work organizational barriers included communication issues, low organizational support, and existing social norms. Job design barriers included rostering, fatigue, stimulant reliance, and family/social life imbalances. Self-regulatory barriers included dietary and exercise patterns habits and patterns.	Occupational health interventions for Australian train drivers must address work organizational, job design, and self-regulatory barriers to healthier lifestyle behaviors.	
28266883	Interprofessional communication and collaboration during hospitalisation is critically important to provide safe and effective care. Clinical rounds are an essential interprofessional process in which the clinical problems of patients are discussed on a daily basis. The objective of this exploratory study was to identify healthcare professionals' perspectives on the "ideal" interprofessional round for patients in a university teaching hospital. Three focus groups with medical residents, registered nurses, medical specialists, and quality improvement officers were held. We used a descriptive method of content analysis. The findings indicate that it is important for professionals to consider how team members and patients are involved in the decision-making process during the clinical round and how current social and spatial structures can affect communication and collaboration between the healthcare team and the patient. Specific aspects of communication and collaboration are identified for improving effective interprofessional communication and collaboration during rounds.
28266878	Health messages can be tailored by applying different tailoring ingredients, among which personalisation, feedback and adaptation. This experiment investigated the separate effects of these tailoring ingredients on behaviour in auditory health persuasion. Furthermore, the moderating effect of self-efficacy was assessed.The between-participants design consisted of four conditions. A generic health message served as a control condition; personalisation was applied using the recipient's first name, feedback was given on the personal state, or the message was adapted to the recipient's value.	The study consisted of a pre-test questionnaire (measuring fruit and vegetable intake and perceived difficulty of performing these behaviours, indicating self-efficacy), exposure to the auditory message and a follow-up questionnaire measuring fruit and vegetable intake two weeks after message exposure (n = 112).	ANCOVAs showed no main effect of condition on either fruit or vegetable intake, but a moderation was found on vegetable intake: When self-efficacy was low, vegetable intake was higher after listening to the personalisation message. No significant differences between the conditions were found when self-efficacy was high.	Individuals with low self-efficacy seemed to benefit from incorporating personalisation, but only regarding vegetable consumption. This finding warrants further investigation in tailoring research.	
28266790	Many people diagnosed with autism spectrum disorder (ASD) also experience significant symptoms of anxiety, while many people with anxiety disorders likewise experience social difficulties. These concerns can be difficult to tease apart in general clinical settings. The Social Responsiveness Scale (SRS) is one of the most frequently used measures of dimensional ASD symptoms. In order to investigate the overlap of autism and anxiety on the SRS, we compared three groups of adults (an ASD group, n = 40; a high anxious group, n = 56; and a typical comparison group, n = 29) using the new Adult Self Report version of the SRS-2nd Edition (SRS-2-ASR) alongside a battery of anxiety questionnaires. Based on previous research with children from the parent-report SRS (first edition), we hypothesized that the SRS-2-ASR would have difficulty discriminating between the ASD and high anxious groups. Results showed that both these clinical groups scored significantly higher on the SRS than a typical control group. Discriminant validity was poor, including sensitivity of 0.65 when including all participants and 0.48 when only the two clinical groups were included. In particular, the Social Motivation subscale of the SRS-ASR failed to distinguish between ASD and anxiety groups. As recommended in the SRS-2 manual, we highlight the need for caution when using the SRS-2-ASR to support diagnostic decision making, especially in clinical settings involving anxiety, ADHD, or other concerns that can affect reciprocal social communication and/or behavioral flexibility. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1215-1220. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28266789	The aim of this study was to classify children with Autism Spectrum Disorder (ASD) according to Autism Classification System of Functioning: Social Communication (ACSF:SC) criteria, in order to investigate the association between social communication ability, ASD severity, adaptive functioning, cognitive abilities and psychoeducational profile. The severity of social communication impairment was specified through Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) and ACSF:SC tool. The ADOS-2, Vineland-II and PEP-3 were administered to all participants. We found a positive correlation between DSM-5 levels and ACSF:SC-Typical Performance (r = 0.35; P = 0.007) and ACSF:SC-Capacity (r = 0.31; P = 0.01) levels. Children included in the five levels of ACSF:SC (Typical Performance and Capacity) showed statistically significant differences in ADOS-2 (Social Affect), Vineland-II (Communication and Socialization), and PEP-3 (Communication, motor skills, maladaptive behavior) scores. The results of this study indicate that ACSF:SC provide a better understanding of functional profile of children with ASD based on the social communication abilities. Children with greater severity of social communication showed more difficulty in adaptive behavior and psychoeducational profiles. In conclusion, the ACSF:SC could help clinicians and therapists not only to understand the strength and weakness of preschool children with ASD but also to devise specific treatment in order to promote their social integration. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1249-1258. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
28266321	Previous studies on patients diagnosed with social anxiety disorder (SAD) reported changed patterns of the resting-state functional connectivity network (rs-FCN) between the prefrontal cortices and other prefrontal, amygdalar or striatal regions. Using a graph theory approach, this study explored the modularity-based community profile and patterns of inter-/intra-modular communication for the rs-FCN in SAD.In total, for 28 SAD patients and 27 healthy controls (HC), functional magnetic resonance imaging (fMRI) data were acquired in resting-state and subjected to a graph theory analysis.	The within-module degree z-score for a hub region [out of a total of 10 hub regions ranked using the participation coefficient] named left middle temporal gyrus was impaired in SAD compared to HC, proportional to the severity of clinician-scored and patient-reported functional impairment in SAD.	Most of participants included in this study were undergraduate students in their early-to-mid 20's.	This study showed the importance of functional communication from the left middle temporal gyrus with other opercular-insular-subcortical regions for better objective functioning and lesser subjective disability in SAD.	
28266319	Collaborative Care is an evidence-based approach to the management of depression within primary care services recommended within NICE Guidance. However, uptake within the UK has been limited. This review aims to investigate the barriers and facilitators to implementing Collaborative Care.A systematic review of the literature was undertaken to uncover what barriers and facilitators have been reported by previous research into Collaborative Care for depression in primary care.	The review identified barriers and facilitators to successful implementation of Collaborative Care for depression in 18 studies across a range of settings. A framework analysis was applied using the Collaborative Care definition. The most commonly reported barriers related to the multi-professional approach, such as staff and organisational attitudes to integration, and poor inter-professional communication. Facilitators to successful implementation particularly focussed on improving inter-professional communication through standardised care pathways and case managers with clear role boundaries and key underpinning personal qualities.	Not all papers were independent title and abstract screened by multiple reviewers thus limiting the reliability of the selected studies. There are many different frameworks for assessing the quality of qualitative research and little consensus as to which is most appropriate in what circumstances. The use of a quality threshold led to the exclusion of six papers that could have included further information on barriers and facilitators.	Although the evidence base for Collaborative Care is strong, and the population within primary care with depression is large, the preferred way to implement the approach has not been identified.	
28266228	The current study examined whether gender, HIV-related stigma, social support, and the interaction between gender and social support are associated with coping responses among people living with HIV and AIDS (PLWHA) in Guangxi, China. A total of 2987 PLWHA in Guangxi participated from October 2012 to August 2013. Multivariate analysis of covariance was conducted with gender and social support as main factors in the model, and stigma and other variables as covariates. After controlling for demographic variables and stigma, there were significant main effects of emotional social support (F = 1.61, p < .001), functional social support (F = 1.67, p < .001), and informational social support (F = 3.67, p < .001) on various coping strategies. The interaction between gender and informational social support (F = 1.33, p < .05), internalized stigma (F = 37.03, p < .001) and perceived stigma (F = 9.16, p < .001) were associated with various coping strategies. Findings signify the importance of HIV-related stigma and social support differences in the coping strategies among PLWHA in Guangxi, China.
28265451	International social networking is eminent in medical practice, mainly in sharing knowledge and mutual inspiring and in social and professional bonding. Since 2006, the International Medical Course is taking place in Commander Branch at the Military Medicine Academy of the Medical Corps, Israeli Defense Forces; in which medical officers from other military forces are participating along with Israeli officers. One of the course's objectives is international networking. The purpose of this study was to assess the level of networking in the International Medical Course compared to others means of networking, and to examine which components in the course are the most important in networking formation.Questionnaires were e-mailed to the course participants. Demographic data and data regarding the networking possibilities in the international medical course was collected.	The answers of 35 participants (17 Majors, 12 Lieutenant-Colonels, and 6 Colonels; mean age of 44.1 years) were included in this study. Response rate was 42%. Of the participants, 24 were Israelis and 11 from other military forces. Most of the responders (88.6%) reported the course is a major networking tool, with no influence of age, sex, rank, education profession or origin. Networking potential among participants from the same origin country was significantly higher in Israeli officers in comparison to officers from other countries (p = 0.001). Clinical practice and research purposes were the reason for communication in one fifth of the participants.	The International Medical Course fulfils its purpose in forming international military medical networking.	
28265450	The International Preparedness & Response to Emergencies & Disasters (IPRED) conferences are conducted bi-annually in order to share insights and lessons learned from diverse crises. The aim of the article is to bring the IPRED conferences into better professional attention and to share the main insights that were presented in IPRED IV, which was held in January 2016.The major lessons learned included: Planning, regional/global collaboration and public-private cooperation should be implemented in developing novel technologies. International humanitarian action necessitates coordination between diverse actors concerning all potential threats. Leadership/coordination and decision-making capacities of emergency response leaders should be enhanced to ensure quality of care. Ethics in disaster management: Triage decisions must not discriminate against terrorists, even when attackers and victims are treated simultaneously. Resilience management: Establishing family and community networks increases resilience of individuals and society. Training programs & exercises must be evaluated considering cost-benefits. Human resources: Teams of experts should be transformed into expert teams. Communication: A common disaster-management language needs to be established. Social media is useful due to bi-directional communication. Civil-military cooperation should be established to facilitate a coordinated response including common terminologies and exercises. Animal sheltering: First responders and pet owners are jeopardized if animals are not included in emergency planning. Re-unification of animals with their owners should be included in response models.	IPRED conferences provide a platform for sharing insights and lessons learned from diverse emergencies and disasters. The conferences offer a unique opportunity to share knowledge aimed at improving emergency preparedness, networking between various parties, and substantiates the knowledge and experience of all professionals who take part in the proceedings.	
28264793	Web-based interventions with a self-tracking component have been found to be effective in promoting adults' fruit and vegetable consumption. However, these interventions primarily focus on individual- rather than group-based self-tracking. The rise of social media technologies enables sharing and comparing self-tracking records in a group context. Therefore, we developed an online group-based self-tracking program to promote fruit and vegetable consumption.This study aims to examine (1) the effectiveness of online group-based self-tracking on fruit and vegetable consumption and (2) characteristics of online self-tracking groups that make the group more effective in promoting fruit and vegetable consumption in early young adults.	During a 4-week Web-based experiment, 111 college students self-tracked their fruit and vegetable consumption either individually (ie, the control group) or in an online group characterized by a 2 (demographic similarity: demographically similar vs demographically diverse) × 2 (social modeling: incremental change vs ideal change) experimental design. Each online group consisted of one focal participant and three confederates as group members or peers, who had their demographics and fruit and vegetable consumption manipulated to create the four intervention groups. Self-reported fruit and vegetable consumption were assessed using the Food Frequency Questionnaire at baseline and after the 4-week experiment.	Participants who self-tracked their fruit and vegetable consumption collectively with other group members consumed more fruits and vegetables than participants who self-tracked individually (P=.01). The results did not show significant main effects of demographic similarity (P=.32) or types of social modeling (P=.48) in making self-tracking groups more effective in promoting fruit and vegetable consumption. However, additional analyses revealed the main effect of performance discrepancy (ie, difference in fruit and vegetable consumption between a focal participant and his/her group members during the experiment), such that participants who had a low performance discrepancy from other group members had greater fruit and vegetable consumption than participants who had a high performance discrepancy from other group members (P=.002). A mediation test showed that low performance discrepancy led to greater downward contrast (b=-0.78, 95% CI -2.44 to -0.15), which in turn led to greater fruit and vegetable consumption.	Online self-tracking groups were more effective than self-tracking alone in promoting fruit and vegetable consumption for early young adults. Low performance discrepancy from other group members lead to downward contrast, which in turn increased participants' fruit and vegetable consumption over time. The study highlighted social comparison processes in online groups that allow for sharing personal health information. Lastly, given the small scale of this study, nonsignificant results with small effect sizes might be subject to bias.	
28264658	Understanding why some recently with HIV diagnosed men who have sex with men (MSM) choose for safer sex and regular STI testing, whereas others do not, is important for the development of interventions that aim to improve the sexual health of those newly infected.To gain insight into motives and barriers to condom use and regular STI testing among MSM soon after HIV diagnosis, 30 HIV-positive MSM participated in semi-structured qualitative interviews on sexual health behaviours in the first year after HIV diagnosis.	Typical barriers to condom use soon after diagnosis were emotions such as anger, relief, and feelings of vulnerability. Additional barriers were related to pre-diagnosis patterns of sexual-social behaviour that were difficult to change, communication difficulties, and substance use. Barriers to STI testing revolved around perceptions of low STI risk, faulty beliefs, and burdensome testing procedures.	The great diversity of motives and barriers to condom use and STI testing creates a challenge to accommodate newly infected men with information, motivation, and communication skills to match their personal needs. An adaptive, tailored intervention can be a promising tool of support.	
28264614	Inpatients admitted to rehabilitation express needs not linked to disease causing hospitalization. This observational cross-sectional study identifies features and occupational needs of complex inpatients during rehabilitation, focusing on function and ability, regardless of diagnosis.This study included sixteen adult inpatients with stroke, deemed complex according to Rehabilitation Complexity Scale-Extended, at admission to Rehabilitation ward (from July 2014 to February 2015). Patients with primary psychiatric disorders, language barriers, cognitive or severe communication deficits were excluded. Upon admission, a multidisciplinary team collected data on general health, independence in daily activities (Modified Barthel Index), fatigue (Fatigue Severity Scale), resistance to sitting and ability to perform instrumental activities (Instrumental Activities of Daily Living). The occupational therapist identified occupational needs according to Canadian Occupational Performance Measure.	Inpatients enrolled in this study were dependent in basic ADL, limited in instrumental ADL and easily fatigable. Their occupational needs related to self-care (75%) and, to a lesser extent, productivity (15%) and leisure (10%). According to inpatients, rehabilitation process should firstly address self-care needs, followed by productivity and leisure problems.	
28264500	Bipolar disorder (BPD) and schizophrenia (SCH) show similar neuropsychiatric behavioral disturbances, including impaired social interaction and communication, seen in autism spectrum disorder (ASD) with multiple overlapping genetic and environmental influences implicated in risk and course of illness. GeneAnalytics software was used for pathway analysis and genetic profiling to characterize common susceptibility genes obtained from published lists for ASD (792 genes), BPD (290 genes) and SCH (560 genes). Rank scores were derived from the number and nature of overlapping genes, gene-disease association, tissue specificity and gene functions subdivided into categories (e.g., diseases, tissues or functional pathways). Twenty-three genes were common to all three disorders and mapped to nine biological Superpathways including Circadian entrainment (10 genes, score = 37.0), Amphetamine addiction (five genes, score = 24.2), and Sudden infant death syndrome (six genes, score = 24.1). Brain tissues included the medulla oblongata (11 genes, score = 2.1), thalamus (10 genes, score = 2.0) and hypothalamus (nine genes, score = 2.0) with six common genes (BDNF, DRD2, CHRNA7, HTR2A, SLC6A3, and TPH2). Overlapping genes impacted dopamine and serotonin homeostasis and signal transduction pathways, impacting mood, behavior and physical activity level. Converging effects on pathways governing circadian rhythms support a core etiological relationship between neuropsychiatric illnesses and sleep disruption with hypoxia and central brain stem dysfunction.
28264487	Prader-Willi syndrome (PWS), a rare genetic disorder caused by the lack of expression of paternal genes from chromosome 15q11-13, has been investigated for autism spectrum disorder (ASD) symptomatology in various studies. However, previous findings have been variable, and no studies investigating ASD symptomatology in PWS have exclusively studied children. We aimed to characterize social communication functioning and other ASD-related symptoms in children with PWS, and assessed agreement across measures and rates of ASD diagnosis. Measures included the Autism Diagnostic Observation Schedule-2 (ADOS-2), the Social Communication Questionnaire (SCQ), Social Responsiveness Scale-2 (SRS-2), Social Skills Improvement System-Rating Scales (SSIS-RS), and the Vineland Adaptive Behavioral Scales-II (VABS-II). General adaptive and intellectual skills were also assessed. Clinical best estimate (CBE) diagnosis was determined by an experienced developmental pediatrician, based on history and review of all available study measures, and taking into account overall developmental level. Participants included 10 children with PWS, aged 3 to 12 years. Three of the 10 children were male and genetic subtypes were two deletion (DEL) and eight uniparental disomy (UPD) (with a total of 6 female UPD cases). Although 8 of the 10 children exceeded cut-offs on at least one of the ASD assessments, agreement between parent questionnaires (SCQ, SRS-2, SSIS-RS) and observational assessment (ADOS-2) was very poor. None of the children were assigned a CBE diagnosis of ASD, with the caveat that the risk may have been lower because of the predominance of girls in the sample. The lack of agreement between the assessments emphasizes the complexity of interpreting ASD symptom measures in children with PWS.
28264451	Urban green spaces encourage outdoor activity and social communication that contribute to the health of local residents. Examining the relationship between the use of urban green spaces and factors influencing their utilization can provide essential references for green space site selection in urban planning. In contrast to previous studies that focused on internal factors, this study highlights the external factors (traffic convenience, population density and commercial facilities) contributing to the use of urban green spaces. We conducted a spatiotemporal analysis of the distribution of visitors in 208 selected green spaces in central Beijing. We examined the relationship between the spatial pattern of visitor distribution within urban green spaces and external factors, using the Gini coefficient, kernel density estimation, and geographical detectors. The results of the study were as follows. The spatial distribution of visitors within central Beijing's green spaces was concentrated, forming different agglomerations. The three examined external factors are all associated with the use of green spaces. Among them, commercial facilities are the important external factor associated with the use of green spaces. For the selection of sites for urban green spaces, we recommend consideration of external factors in order to balance urban green space utilization.
28264016	Side effects of antiretroviral therapy (ART) can have a negative impact on health-related quality of life threatening long-term retention in HIV care and adherence to ART. The aim of the French community-based survey EVE was to document personal experiences with side effects, the related physician-patient communication, and solutions found to deal with them.Cross-sectional study of women between September 2013 to September 2014.	An anonymous online questionnaire included the HIV Symptom Distress Module, which explores 20 symptoms.	In all, 301 women on ART participated in the study (median age: 49 years; median duration of ART: 14 years). They reported having experienced a median of 12 symptoms (Q1-Q3: 9-15) during the previous 12 months. Overall, 56% of them reported having found at least a partial solution to dealing with their symptoms. Women reporting financial difficulties were twice less likely to have found solutions to coping with their side effects (AOR: 0.5; 95% CI: 0.3-0.8). Feeling supported by the health-care provider (AOR: 2.1; 95% CI: 1.1-3.9) and being in contact with HIV/AIDS organisations (AOR: 1.9; 95% CI: 1.2-3.2) were positively associated with coping. Seventeen percent reported having modified their ART regimen to improve tolerance, with only 2 in 3 informing their physician afterwards. Reporting financial difficulties and living with more bothersome symptoms increased the risk of ART regimen modification without health-care provider consultation.	The EVE study has called attention to the large number of side effects experienced by WLWHIV, only half of whom have found self-care strategies to manage their symptoms. Modification of ART regimen by the women themselves was not uncommon.	
28263685	This study aims to understand the impact of descriptive social norms on message believability and transmission and its underlying mechanism on Twitter. Using two types of information (i.e., news and rumor) presented as a tweet message, the influence of the number of retweets as a normative cue was tested. A result of an online experiment with 639 Twitter users suggests that regardless of the label of the information, message believability and intention to share were stronger for a tweet with a high number of retweets. The mediation test showed that the presumption that a message is believable to others mediates the relationship between a high number of retweets and message believability.
28263682	Social networking sites (SNSs) provide emerging adults with extreme and unprecedented transparency, exposing them to a plethora of opportunities for social comparison. In light of the growing use of the popular SNS, Instagram, among emerging adults, the purpose of this study was to examine the impact of exposure to social media-based social comparison information on self-esteem. The study recruited 237 participants through social media. The sample was narrowed to young adults aged 18-29 years. The study used a correlational nonexperimental approach to investigate two mediation models proposed in the literature. First, the study investigated the mediating role of social comparison on Instagram in the relationship between intensity of Instagram use and self-esteem. Second, the study examined the mediating role of social comparison in the relationship between self-worth contingent on approval from others and self-esteem. Although the first model was found to be nonsignificant, results observed a significant indirect pathway that confirmed the second model. Thus, social comparison on Instagram mediated the relationship between contingent self-worth and self-esteem. Furthermore, moderation analyses found that self-worth contingent on approval from others moderated the relationship between intensity of Instagram use and social comparison on Instagram. Thus, although Instagram did not directly affect self-esteem, the significant moderation suggested that intensity of Instagram use is influential when the young person's self-worth is contingent on approval from others. Overall, the findings are consistent with previous research and enhance our understanding of the mechanisms that link SNS use to low self-esteem.
28263441	Children with autism spectrum disorder (ASD) demonstrate impairments in social interaction and communication, and in repetitive/stereotypical behaviors. The degree to which children with ASD also manifest impairments in structural language-such as lexicon and grammar-is currently quite controversial. We reframe this controversy in terms of Naigles' (Naigles, Cognition 2002, 86: 157-199) 'form is easy, meaning is hard' thesis, and propose that the social difficulties of children with ASD will lead the meaning-related components of their language to be relatively more impaired than the form-related components. Our review of the extant literature supports this proposal, with studies (1) reporting that children with ASD demonstrate significant challenges in the areas of pragmatics and lexical/semantic organization and (2) highlighting their good performance on grammatical assessments ranging from wh-questions to reflexive pronouns. Studies on children with ASD who might have a co-morbid grammatical impairment are discussed in light of the absence of relevant lexical-semantic data from the same children. Most importantly, we present direct comparisons of assessments of lexical/semantic organization and grammatical knowledge from the same children from our laboratory, all of which find more children at a given age demonstrating grammatical knowledge than semantic organization. We conclude with a call for additional research in which in-depth grammatical knowledge and detailed semantic organization are assessed in the same children. For further resources related to this article, please visit the WIREs website.
28263321	The immune system is unique in its dynamic interplay between numerous cell types. However, a system-wide view of how immune cells communicate to protect against disease has not yet been established. We applied high-resolution mass-spectrometry-based proteomics to characterize 28 primary human hematopoietic cell populations in steady and activated states at a depth of >10,000 proteins in total. Protein copy numbers revealed a specialization of immune cells for ligand and receptor expression, thereby connecting distinct immune functions. By integrating total and secreted proteomes, we discovered fundamental intercellular communication structures and previously unknown connections between cell types. Our publicly accessible (http://www.immprot.org/) proteomic resource provides a framework for the orchestration of cellular interplay and a reference for altered communication associated with pathology.
28262660	In this study the reliability and validity of the Korean version of the Cancer Stigma Scale (KCSS) was evaluated.The KCSS was formed through translation and modification of Cataldo Lung Cancer Stigma Scale. The KCSS, Psychological Symptom Inventory (PSI), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30) were administered to 247 men and women diagnosed with one of the five major cancers. Construct validity, item convergent and discriminant validity, concurrent validity, known-group validity, and internal consistency reliability of the KCSS were evaluated.	Exploratory factor analysis supported the construct validity with a six-factor solution; that explained 65.7% of the total variance. The six-factor model was validated by confirmatory factor analysis (Q (χ²/df)= 2.28, GFI=.84, AGFI=.81, NFI=.80, TLI=.86, RMR=.03, and RMSEA=.07). Concurrent validity was demonstrated with the QLQ-C30 (global: r=-.44; functional: r=-.19; symptom: r=.42). The KCSS had known-group validity. Cronbach's alpha coefficient for the 24 items was .89.	The results of this study suggest that the 24-item KCSS has relatively acceptable reliability and validity and can be used in clinical research to assess cancer stigma and its impacts on health-related quality of life in Korean cancer patients.	
28262553	Through their Sustainable Development Goals the United Nations recognizes the moral significance of health, stating that the elimination of maternal and early neonatal mortality are health outcomes that should be available to all women in the world. Complete prevention requires addition of a skill set for maternal care teams that is a magnitude greater than what we have today. As universities, individuals, institutions and NGO's engage in initiatives to end preventable maternal and neonatal mortality, an expanded context of ethical imperatives becomes increasingly important. Besides the traditional principles of non-maleficence, beneficence, autonomy, and social justice, imbalances between high and low income countries and cultural relativity give rise to broader ethical imperatives: mutual respect, trust, open communication, accountability, transparency, leadership capacity building and sustainability. The elimination of disparities in other women's issues, HIV, malaria, tuberculosis, chronic non-infectious diseases, can all be more effectively addressed through a lens of ethical global health engagement.
28262427	The domestication of new crops would promote agricultural diversity and could provide a solution to many of the problems associated with intensive agriculture. We suggest here that genome editing can be used as a new tool by breeders to accelerate the domestication of semi-domesticated or even wild plants, building a more varied foundation for the sustainable provision of food and fodder in the future. We examine the feasibility of such plants from biological, social, ethical, economic, and legal perspectives.
28262144	This study aimed to determine the prevalence of addiction to social networking sites/platforms (SNS) and its comorbidity with other behavioral addiction and affective disorder among college students in Singapore. 1110 college students (age: M=21.46, SD=1.80) in Singapore completed measures assessing online social networking, unhealthy food intake and shopping addiction as well as depression, anxiety and mania. Descriptive analyses were conducted to investigate the prevalence and comorbidity of behavioral addiction and affective disorder. Chi-square tests were used to examine gender differences.The prevalence rates of SNS, food and shopping addiction were 29.5%, 4.7% and 9.3% respectively for the total sample. SNS addiction was found to co-occur with food addiction (3%), shopping addiction (5%), and both food and shopping addiction (1%). The comorbidity rates of SNS addiction and affective disorder were 21% for depression, 27.7% for anxiety, and 26.1% for mania. Compared with the total sample, students with SNS addiction reported higher comorbidity rates with other behavioral addiction and affective disorder. In general, females as compared to males reported higher comorbidity rates of SNS addiction and affective disorder.	SNS addiction has a high prevalence rate among college students in Singapore. Students with SNS addiction were vulnerable to experience other behavior addiction as well as affective disorder, especially among females.	
28261846	Given the degree of public mistrust and provider hesitation regarding the human papillomavirus (HPV) vaccine, it is important to explore how information regarding the vaccine is shared online via social media outlets. The purpose of this study was to evaluate the content of messaging regarding the HPV vaccine on the social media and microblogging site Twitter, and describe the sentiment of those messages.This study utilized a cross-sectional descriptive approach. Over a 2-week period, Twitter content was searched hourly using key terms "#HPV and #Gardasil," which yielded 1,794 Twitter posts for analysis. Each post was then analyzed individually using an a priori coding strategy and directed content analysis.	The majority of Twitter posts were written by lay consumers and were sharing commentary about a media source. However, when actual URLs were shared, the most common form of share was linking back to a blog post written by lay users. The vast majority of content was presented as polarizing (either as a positive or negative tweet), with 51% of the Tweets representing a positive viewpoint.	Using Twitter to understand public sentiment offers a novel perspective to explore the context of health communication surrounding certain controversial issues.	
28261528	Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals.Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases.	During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively.	From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital.	
28261400	Use of social media (SM) by physicians has exposed issues of privacy and professionalism. While guidelines have been created for SM use, details regarding specific SM behaviors that could lead to disciplinary action presently do not exist.To compare State Medical Board (SMB) directors' perceptions of investigation for specific SM behaviors with those of emergency medicine (EM) physicians.	A multicenter anonymous survey was administered to physicians at 3 academic EM residency programs. Surveys consisted of case vignettes, asking, "If the SMB were informed of the content, how likely would they be to initiate an investigation, possibly leading to disciplinary action?" (1, very unlikely, to 4, very likely). Results were compared to published probabilities using exact binomial testing.	Of 205 eligible physicians, 119 (58%) completed the survey. Compared to SMB directors, EM physicians indicated similar probabilities of investigation for themes involving identifying patient images, inappropriate communication, and discriminatory speech. Participants indicated lower probabilities of investigation for themes including derogatory speech (32%, 95% confidence interval [CI] 24-41 versus 46%, P < .05); alcohol intoxication (41%, 95% CI 32-51 versus 73%, P < .05); and holding alcohol without intoxication (7%, 95% CI 3-13 versus 40%, P < .05). There were no significant associations with position, hospital site, years since medical school, or prior SM professionalism training.	Physicians reported a lower likelihood of investigation for themes that intersect with social identity, compared to SMB directors, particularly for images of alcohol and derogatory speech.	
28261129	Users of social networking sites such as Facebook frequently post self-portraits on their profiles. While research has begun to analyze the motivations for posting such pictures, less is known about how selfies are evaluated by recipients. Although producers of selfies typically aim to create a positive impression, selfies may also be regarded as narcissistic and therefore fail to achieve the intended goal. The aim of this study is to examine the potentially ambivalent reception of selfies compared to photos taken by others based on the Brunswik lens model Brunswik (1956). In a between-subjects online experiment (N = 297), Facebook profile mockups were shown which differed with regard to picture type (selfie vs. photo taken by others), gender of the profile owner (female vs. male), and number of individuals within a picture (single person vs. group). Results revealed that selfies were indeed evaluated more negatively than photos taken by others. Persons in selfies were rated as less trustworthy, less socially attractive, less open to new experiences, more narcissistic and more extroverted than the same persons in photos taken by others. In addition, gender differences were observed in the perception of pictures. Male profile owners were rated as more narcissistic and less trustworthy than female profile owners, but there was no significant interaction effect of type of picture and gender. Moreover, a mediation analysis of presumed motives for posting selfies revealed that negative evaluations of selfie posting individuals were mainly driven by the perceived motivation of impression management. Findings suggest that selfies are likely to be evaluated less positively than producers of selfies might suppose.
28260834	Examining online social interactions along with patterns of video gaming behaviors and game addiction symptoms has the potential to enrich our understanding of disorders related to excessive video game play.We performed latent class analysis in a sample of 9733 adolescents based on heavy use of games, social networking and instant messaging, and game addiction symptoms. We used latent class regression to determine associations between classes, psychosocial well-being and friendship quality.	We identified two types of heavy gaming classes that differed in probability of online social interaction. Classes with more online social interaction reported fewer problematic gaming symptoms than those with less online social interaction. Most adolescents estimated to be in heavy gaming classes had more depressive symptoms than normative classes. Male non-social gamers had more social anxiety. Female social gamers had less social anxiety and loneliness, but lower self-esteem. Friendship quality attenuated depression in some male social gamers, but strengthened associations with loneliness in some male non-social gamers.	In adolescents, symptoms of video game addiction depend not only on video game play but also on concurrent levels of online communication, and those who are very socially active online report fewer symptoms of game addiction.	
28259745	Food insecurity remains a public health concern in the United States, particularly among low-income urban ethnically diverse families, even with the Supplemental Nutrition Assistance Program (SNAP). Limited phenomenologic data exist to capture how programmatic changes to SNAP address the needs of users and why a gap in SNAP use may exist.The primary aim of this study was to examine the experiences of low-income, Baltimore, MD, mothers in applying for and maintaining access to SNAP. Secondary aims included understanding participants' perspectives on the influence of changes in SNAP over a 3-year period and how SNAP fits into the overall system of social services for families.	In this qualitative, phenomenologic study, in-depth interviews were conducted with 13 mothers and three focus groups with 20 mothers, for a total sample of 33 mothers receiving SNAP benefits. Ten mothers participated in the first round of data collection (January to May 2010), and 23 in the second round (February to May 2013).	Participants were 33 mothers receiving SNAP benefits in Baltimore City, MD.	Baltimore SNAP users' experiences with applying for and maintaining access to SNAP, as well as with program changes to the SNAP program.	Data were analyzed using an iterative emergent design and phenomenologic approach. A constructivist perspective was implemented throughout the coding process.	SNAP functioned as a valuable support system within the broader social safety net for mothers living in poverty, yet participants expressed frustration about the processes of applying for and maintaining benefits due to communication problems and poor integration of services. In applying for and accessing SNAP, positive interactions with caseworkers and previous knowledge of the SNAP program were important for maintaining benefits. Interviews and focus group discussions revealed the need for additional outreach and education about the implemented program changes to build trust and improve access to SNAP among participants.	Improving communication and supporting participants' ability to maintain relationships with the same caseworkers, as well as developing better integration with other aid programs, could improve the SNAP program.	
28259620	To determine how adolescents and young adults (AYAs) use social media to share health information and to assess attitudes toward using social media to obtain health information and communicate with medical providers.A cross-sectional study of AYAs, 12 years or older, attending a primary care adolescent and young adult clinic. Participants completed an anonymous survey about health-related social media use, personal health, and communication with their health care team.	Of the 244 patients approached, 204 enrolled (83.6% participation rate). Almost all (98%) had used social media within the prior month, but only 51.5% had shared health information in these networks. These participants shared about mood (76.2%), wellness (57.1%), and acute medical conditions (41.9%). Those with self-reported poor health were more likely to share health information than other groups. Privacy was the most important factor determining which platform to use. Only 25% thought that social media could provide them with useful health information. Few AYAs connected with their health care team on social media and most did not want to use this method; texting was preferred.	AYAs maintain their privacy on social media regarding their health. Those with self-perceived poor health are more likely to share health information, potentially biasing online content and impairing the generalizability of social media research. AYAs do not view social media as a useful source of health information, which may limit the utility of public health messages through these platforms, and it may not be adequate for communication between patients and their health care team.	
28259522	To explore nurses' experiences and perceptions of delirium, managing delirious patients, and screening for delirium, five years after introduction of the Confusion Assessment Method for Intensive Care into standard practice.Twelve nurses from a medical-surgical intensive care unit in a large teaching hospital attended two focus group sessions. The collected qualitative data was thematically analysed using Braun and Clarke's framework (2006).	The analysis identified seven themes: (1) Delirium as a Secondary Matter (2) Unpleasant Nature of Delirium (3) Scepticism About Delirium Assessment (4) Distrust in Delirium Management (5) Value of Communication (6) Non-pharmacological Therapy (7) Need for Reviewed Delirium Policy.	Nurses described perceiving delirium as a low priority matter and linked it to work culture within the intensive care specialty. Simultaneously, they expressed their readiness to challenge this culture and to promote the notion of providing high-quality delirium care. Nurses discussed their frustrations related to lack of confidence in assessing delirium, as well as lack of effective therapies in managing this group of patients. They declared their appreciation for non-pharmacological interventions in treatment of delirium, suggested improvements to current delirium approach and proposed introducing psychological support for nurses dealing with delirious patients.	
28259500	The purpose of this study was to evaluate the efficacy of the Family Check-up (FCU), a parent-focused brief motivational intervention, in families where parents were concerned about one adolescent's alcohol or marijuana use and the referred adolescent also had a sibling close in age. The primary goal of the FCU was to provide individualized feedback on specific parenting skills, including monitoring and supervision, limit setting, and alcohol-related communication. A total of 92 adolescents (37 female) between the ages of 12-19years of age along with a sibling (48 female) between the ages of 11-21years old, were randomized to the FCU or a psychoeducation (PE) comparison condition. Findings indicated that the FCU did not produce better effects on alcohol and other drug use outcomes than the PE condition, in either the adolescent or sibling. Brief interventions addressing parenting behaviors may not be sufficient to reduce alcohol use in adolescent drinkers not referred due to an alcohol-related incident. Future research might be conducted to explore whether brief parent interventions, such as those in the present study, could be useful as a preventive intervention for parents whose teens report low levels of substance use.
28258989	The role of personal social networks on health inequalities is little understood. Theoretically, the characteristics of social network features can contribute to, both, increase and attenuate health inequalities. Few empirical studies that focus on the interaction between socioeconomic position and social networks provide little insight on the topic. Using data from the Survey of Health, Ageing and Retirement in Europe, this study analyses the moderation role of personal social networks on health inequalities in later life among northern, central, and southern European regions. Social advantages of higher socioeconomic individuals are re-enforced by the quality of social connections and the provision of social support. In turn, health inequality is attenuated by marital partnership and participation on social activities that benefits more the health of people at lower socioeconomic positions. Furthermore, results suggest that the influence of social network features on health inequalities is shaped by regions' different policy commitments to familiarization/defamilialization pressures.
28258685	Spasmodic dysphonia (SD) is rather a rare voice disorder. It is most often seen in woman aged 40-50. The disease is caused by deep emotional and neurological disorders of extrapyramidal system. Two main clinical forms of SD are distinguished: about 90% of cases - adductor spasmodic dysphonia and abductor spasmodic dysphonia roughly 10%. Conservative therapy does not always yield sufficient effects. Botulinum toxin - type A injections into the thyroarytenoid muscle are also used in therapy. Though results are temporary and reversible. Among phonosurgical methods thyroplasty type II according to Isshiki and tyroarytenoid muscle myectomy (TAM) should be also mentioned among phonosurgical methods. The aim of the work is to evaluate results of conservative and phonosurgical treatment of SD. Spasmodic dysphonia markedly restricts communication process of patients and public relations both social and occupational.
28258509	Autism spectrum disorder (ASD) encompasses a complex set of developmental neurological disorders, characterized by deficits in social communication and excessive repetitive behaviors. In recent years, ASD is increasingly being considered as a disease of the synapse. One main type of genetic aberration leading to ASD is gene duplication, and several mouse models have been generated mimicking these mutations. Here, we studied the effects of MECP2 duplication and human chromosome 15q11-13 duplication on synaptic development and neural circuit wiring in the mouse sensory cortices. We showed that mice carrying MECP2 duplication had specific defects in spine pruning, while the 15q11-13 duplication mouse model had impaired spine formation. Our results demonstrate that spine pathology varies significantly between autism models and that distinct aspects of neural circuit development may be targeted in different ASD mutations. Our results further underscore the importance of gene dosage in normal development and function of the brain.
28258320	The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child's risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2-11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child's risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3-4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09-3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05-4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91-3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions.
28258279	Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective using across-sectional qualitative research design based on the theoretical domains framework and the Capability, Opportunity and Motivation-B model. In-depth interviews were conducted with 30 primary care providers to explore their knowledge, views and management of respiratory tract infections in young children. Interviews focused on symptomatic management, over-the-counter medications and antibiotic use, and data were thematically analysed. Our findings showed that factors such as primary care providers' time constraints, parental anxiety, general practitioners' perception of what parents want, perceived parental pressure, and fear of losing patients were some of the reasons why primary care providers did not always adhere to guideline recommendations. Primary care providers also provided conflicting advice to parents concerning over-the-counter medications and when children should resume normal activities. Overall, this study showed that complex interactions involving emotional and psychological factors influenced the decision making process of primary care providers' management of respiratory tract infections in young children. A team care approach with consistent advice, and improved communication between primary care providers and parents is vital to overcome some of these barriers and improve guideline adherence. The findings of this research will inform the development of interventions to better manage respiratory tract infections in young children.CLINICIANS SWAYED BY PARENTAL ANXIETY AND PRESSURE: The emotions and psychology of both parents and clinicians influence how respiratory tract infections (RTIs) are managed in young children. Researchers in Australia, led by Ruby Biezen from Monash University, interviewed 30 primary care clinicians about their views on how to care for children with RTIs, such as the common cold. The interviews focused on symptomatic management, over-the-counter medications and antibiotic use. Despite the availability of best-practice guidelines, clinicians did not always follow the recommendations owing to factors such as time constraints, parental anxiety, perceived parental pressure, and fear of losing patients. These are some of the reasons why clinicians sometimes advise or prescribe unnecessary medications. The authors suggest that a team approach involving multiple healthcare professionals who deliver consistent advice could improve guideline adherence.	
28257521	Extracellular vesicles (EV) secreted by pathogens function in a variety of biological processes. Here, we demonstrate that in the protozoan parasite Trypanosoma brucei, exosome secretion is induced by stress that affects trans-splicing. Following perturbations in biogenesis of spliced leader RNA, which donates its spliced leader (SL) exon to all mRNAs, or after heat-shock, the SL RNA is exported to the cytoplasm and forms distinct granules, which are then secreted by exosomes. The exosomes are formed in multivesicular bodies (MVB) utilizing the endosomal sorting complexes required for transport (ESCRT), through a mechanism similar to microRNA secretion in mammalian cells. Silencing of the ESCRT factor, Vps36, compromised exosome secretion but not the secretion of vesicles derived from nanotubes. The exosomes enter recipient trypanosome cells. Time-lapse microscopy demonstrated that cells secreting exosomes or purified intact exosomes affect social motility (SoMo). This study demonstrates that exosomes are delivered to trypanosome cells and can change their migration. Exosomes are used to transmit stress signals for communication between parasites.
28257319	Safe surgery should be available to all patients, no matter the setting. The purpose of this study was to explore the contextual-specific challenges to safe surgical care encountered by surgeons and surgical teams in many in low- and middle-income countries (LMICs), and to understand the ways in which surgical teams overcome them.Optimal surgical performance is highly complex and requires providers to integrate and communicate information regarding the patient, task, team, and environment to coordinate team-based care that is timely, effective, and safe. Resource limitations common to many LMICs present unique challenges to surgeons operating in these environments, but have never been formally described.	Using a grounded theory approach, we interviewed 34 experienced providers (surgeons, anesthetists, and nurses) at the 4 tertiary referral centers in Rwanda, to understand the challenges to safe surgical care and strategies to overcome them. Interview transcripts were coded line-by-line and iteratively analyzed for emerging themes until thematic saturation was reached.	Rwandan-described challenges related to 4 domains: physical resources, human resources, overall systems support, and communication/language. The majority of these challenges arose from significant variability in either the quantity or quality of these domains. Surgical providers exhibited examples of resilient strategies to anticipate, monitor, respond to, and learn from these challenges.	Resource variability rather than lack of resources underlies many contextual challenges to safe surgical care in a LMIC setting. Understanding these challenges and resilient strategies to overcome them is critical for both LMIC surgical providers and surgeons from HICs working in similar settings.	
28257110	Family caregivers have enormous communication responsibilities tied to caregiving, such as sharing the patient's medical history with providers, relaying diagnosis and prognosis to other family members, and making decisions about care with the patient. While caregiver stress and burden has been widely documented in the caregiving literature, little is known about how communication burden, real or perceived communication challenges, impacts caregiver quality of life. In family caregiving, the City of Hope (COH) Quality of Life model proposes that the caregiving experience is reciprocal to the patient experience, impacting physical, social, psychological, and spiritual quality of life. We used data from a pilot study testing a communication coaching call intervention with family caregivers of lung cancer patients to analyze caregiver reported communication burden and quality of life. We found variances in each quality of life domain, suggesting that caregiver interventions should range from self-care skill building for physical care to psycho-educational interventions that support caregiver coping and communication skill building. These findings demonstrate the importance of caregiver assessment and attention to communication burden in quality cancer care.
28256932	Purpose The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys undertaken by the Department of Health between 2013 and 2015 found few NHS Trusts reported high levels of engagement. The purpose of this paper is to gain a better understanding of current working relationships between NHS clinical and finance professionals and how they might be supported to become more effective. Design/methodology/approach Ipsos MORI were commissioned by the NHS FFF programme to undertake an online survey of NHS clinical and finance staff between June and August 2015. Findings The majority of clinicians had a member of a finance team linked to their speciality or directorate. Clinical and finance professionals have a positive view of joint working preferring face-to-face contact. Clinician's confidence in their understanding of finance was generally good and finance staff felt they had a good understanding of clinical issues. Effective working relationships were facilitated by face-to-face contact, a professional relationship, and the availability of clear, well presented finance and activity data. Research limitations/implications Data protection issues limited the accessibility of the survey team to NHS staff resulting in a relatively low-response rate. Other forms of communication, including social media, were utilised to increase access to the survey. Originality/value The FFF programme is a unique programme aimed at making the NHS finance profession fit for the future. The close partnering work stream brings together the finance and clinical perspective to share knowledge, evidence, training, and to develop good practice and engagement.
28256931	Purpose In order to prevent adverse events during the discharge process, coordinating appropriate community resources, medication reconciliation, and patient education needs to be implemented before the patient leaves the hospital. This coordination requires communication and effective teamwork amongst staff members. In order to address these concerns, the purpose of this paper is to incorporate the TeamSTEPPS principles to develop a discharge plan that would best meet the needs of the patients as they return to the community. Design/methodology/approach Through a gap analysis, barriers to discharge were identified from the following disciplines: nursing, social work, physical and occupational therapy, psychology, and rehabilitation physician. To improve communication, weekly meetings and twice-weekly huddles were implemented so that concerns regarding discharge obstacles could be identified and resolved. Visibility of discharge dates were improved by use of graduation certificates in patient rooms and green ribbons on patient wheelchairs. Findings After implementation of this discharge intervention, length of stay was reduced providing cost savings to the hospital, patient satisfaction on HCAHP surveys improved and demonstrated patient satisfaction with the discharge process, and readmission rates improved. Originality/value This study demonstrated that effective teamwork and communication can improve patient safety and satisfaction during the discharge period.
28256685	Intervenciones para promover la comunicacion social en niños con trastornos del espectro autista.Introduccion. Las dificultades en la comunicacion social constituyen una de las alteraciones nucleares que experimentan las personas con trastorno del espectro autista (TEA). Esta problematica provoca sentimientos de soledad y exclusion social, que repercuten negativamente en la calidad de vida. Objetivo. Revisar las caracteristicas de las principales intervenciones en este ambito en el TEA de alto funcionamiento. Desarrollo. Se sintetizan estrategias como las historias sociales, comic-strip conversations o videomodelaje, e intervenciones mediadas por pares y tratamientos multicomponente. Conclusiones. El diseño de los actuales programas ha evolucionado hacia enfoques mas ecologicos, considerandose a la familia, a los profesores y a los compañeros en el tratamiento. Las ultimas sintesis de la bibliografia han evidenciado mejoras significativas tras su implementacion, lo que se ha manifestado en una mejor competencia social y un menor sentimiento de soledad. La intervencion en comunicacion social debe combinar la instruccion individualizada con la consideracion del entorno del niño y de la motivacion hacia la interaccion comunicativa.	The difficulties encountered when it comes to social communication are one of the core disorders experienced by persons with autism spectrum disorders (ASD). This problem leads to feelings of loneliness and social exclusion, which negatively affect the quality of life.	To review the characteristics of the main interventions in this field in high-functioning ASD.	Strategies employed include social stories, comic-strip conversations or videomodelling, and interventions mediated by peers and multicomponent treatments.	The design of the programmes used today has evolved towards more ecological approaches that take the family, teachers and companions into account in the treatment. The most recent literature reviews have found evidence of significant improvements following their implementation, which has been reflected in better social competence and lesser feelings of loneliness. The social communication intervention must combine individualised instruction with consideration of the child's environment and the motivation towards communicative interaction.	
28256683	Autismo: importancia de la dismorfologia en la identificacion de entidades medicas asociadas.Introduccion. Los trastornos del espectro autista (TEA) se caracterizan por deficits en la comunicacion e interaccion social asociados a intereses restringidos y conductas estereotipadas. Considerados trastornos del neurodesarrollo, presentan una base neurobiologica reconocida. Las causas geneticas, las anomalias cromosomicas o los defectos genicos son las etiologias mas frecuentemente reconocidas, seguidas por factores toxicos y ambientales (epigeneticos). Desarrollo. Las dismorfias son alteraciones congenitas de la forma de una parte de un ser vivo, producidas durante su desarrollo, y su reconocimiento es esencial en la delineacion de un sindrome o una entidad especifica. En el caso de los TEA permiten diferenciar las formas primarias o idiopaticas de las secundarias o sindromicas. En este trabajo describimos los aspectos dismorfologicos vinculados a los TEA que permitiran definir una presuncion diagnostica y orientar los estudios complementarios de acuerdo con ellos. Conclusiones. La identificacion de estas entidades medicas especificas, asociadas a los TEA, es fundamental, ya que permite inferir la posible evolucion, prevenir eventuales complicaciones y otorgar un asesoramiento genetico adecuado.	Autism spectrum disorders (ASD) are characterized by deficits in communication and social interaction, associated with restricted interests and stereotyped behaviors. Considered as a neurodepelopment disorders, they present a recognized neurobiological basis. Genetic causes as chromosomes abnormalities, or genetic defects are the most recognized etiologies, followed by the environmental factors.	Dysmorphia are congenital alterations of the shape of a part of a living being, produced during its development. Their recognition is essential in delineating a syndrome or a specific entity. In the case of ASD, is possible to differentiate primary or idiopathic forms, from secondary or syndromic ones. In this work we describe the dysmorphological aspects related to ASD that will allow us to define a diagnostic presumption and guide the complementary studies according to them.	The identification of these specific medical entities, associated with ASDs is fundamental since it allows inferring the possible evolution, preventing eventual complications and granting adequate genetic counseling.	
28256682	Desregulacion emocional y trastornos del espectro autista.Introduccion. Los trastornos del espectro autista (TEA) son trastornos del neurodesarrollo que afectan la comunicacion social y presentan conductas estereotipadas. Muestran una gran variabilidad fenotipica relacionada con la capacidad expresiva del lenguaje, habilidades cognitivas y comorbilidades psiquiatricas, entre otras. La comorbilidad psiquiatrica resulta muy frecuente en TEA y en muchos casos es multiple. La desregulacion emocional se relaciona con TEA y con otros trastornos psiquiatricos y del neurodesarrollo. La comorbilidad multiple asociada a TEA es el grupo que presenta gran incapacidad funcional, multiple farmacologia e ingresos hospitalarios. La desregulacion emocional podria ser la base de la comorbilidad multiple existente en TEA y requerira consideraciones propias en la valoracion diagnostica y tratamiento. Objetivo. Revisar la desregulacion emocional, el concepto actual y su relacion con TEA. Desarrollo. Se exponen las diferentes definiciones de desregulacion emocional, los mecanismos cognitivos y neurobiologicos asociados, la presentacion clinica cuando se asocia a TEA, su papel en la comorbilidad psiquiatrica y consideraciones en las intervenciones psicologicas y farmacologicas. Conclusiones. La desregulacion emocional podria asociarse a la comorbilidad multiple presente en personas con TEA, relacionandose con alta morbilidad, ingresos hospitalarios y uso de psicofarmacos. La falta de identificacion y diagnostico de la desregulacion emocional podria relacionarse con poca efectividad y un elevado numero de efectos secundarios cuando se trata la comorbilidad asociada a TEA.	Autism spectrum disorders (ASD) are neurodevelopmental disorders that affect social communication and present stereotyped behaviours. They exhibit a wide range of phenotypic variability related with the capacity to use language for expression, cognitive skills and psychiatric comorbidities, among others. Psychiatric comorbidity is very frequent in ASD and in many cases it is multiple. Emotional dysregulation is related with ASD and with other psychiatric and neurodevelopmental disorders. Multiple comorbidity associated with ASD is the group that presents a high degree of functional inability, multiple pharmacology and hospital admissions. Emotional dysregulation could be the basis of the multiple comorbidity that exists in ASD and will require its own particular considerations in the diagnostic evaluation and treatment.	To review emotional dysregulation, the currently held concept of it and its relationship with ASD.	This work offers a review of the different definitions of emotional dysregulation, the associated cognitive and neurobiological mechanisms, the clinical presentation when associated to ASD, its role in psychiatric comorbidity and further considerations regarding psychological and pharmacological interventions.	Emotional dysregulation could be associated to the multiple comorbidity present in persons with ASD, as well as being related with high rates of morbidity, hospital admissions and use of psychopharmaceuticals. Failure to identify and diagnose emotional dysregulation could be linked with low effectiveness and a large number of side effects in the case of comorbidity associated to ASD.	
28256376	With approximately 67 million individuals affected worldwide, autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disorder (United Nations, 2011), with a prevalence estimated to be 1/100. In France ASD affects approximately 600,000 individuals (from childhood to adulthood, half of whom are also mentally retarded), who thus have a major handicap in communication and in adapting to daily life, which leads autism to be recognized as a national public health priority. ASD is a neurodevelopmental disorder that affects several domains (i.e., socio-emotional, language, sensori-motor, executive functioning). These disorders are expressed early in life with an age of onset around 18 months. Despite evidence suggesting a strong genetic link with ASD, the genetic determinant remains unclear. The clinical picture is characterized by impairments in social interaction and communication and the presence of restrictive and repetitive behaviors (DSM-5, ICD-10). However, in addition to these two main dimensions there is significant comorbidity between ASD and other neurodevelopmental disorders such as attention deficit hyperactivity disorder or with genetic and medical conditions. One of the diagnostic features of ASD is its early emergence: symptoms must begin in early childhood for a diagnosis to be given. Due to brain plasticity, early interventions are essential to facilitate clinical improvement. Therefore, general practitioners and pediatricians are on the front line to detect early signs of ASD and to guide both medical explorations and early rehabilitation.
28256356	Treatment guidelines for aphasia recommend intensive speech and language therapy for chronic (≥6 months) aphasia after stroke, but large-scale, class 1 randomised controlled trials on treatment effectiveness are scarce. We aimed to examine whether 3 weeks of intensive speech and language therapy under routine clinical conditions improved verbal communication in daily-life situations in people with chronic aphasia after stroke.We randomly assigned 158 patients between April 1, 2012, and May 31, 2014. The modified intention-to-treat population comprised 156 patients (78 per group). Verbal communication was significantly improved from baseline to after intensive speech and language treatment (mean difference 2·61 points [SD 4·94]; 95% CI 1·49 to 3·72), but not from baseline to after treatment deferral (-0·03 points [4·04]; -0·94 to 0·88; between-group difference Cohen's d 0·58; p=0·0004). Eight patients had adverse events during therapy or treatment deferral (one car accident [in the control group], two common cold [one patient per group], three gastrointestinal or cardiac symptoms [all intervention group], two recurrent stroke [one in intervention group before initiation of treatment, and one before group assignment had occurred]); all were unrelated to study participation.	3 weeks of intensive speech and language therapy significantly enhanced verbal communication in people aged 70 years or younger with chronic aphasia after stroke, providing an effective evidence-based treatment approach in this population. Future studies should examine the minimum treatment intensity required for meaningful treatment effects, and determine whether treatment effects cumulate over repeated intervention periods.	German Federal Ministry of Education and Research and the German Society for Aphasia Research and Treatment.	
28256336	The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks.Semi-structured interviews were conducted with 10 physicians and 10 registered nurses from two emergency departments. Interviews were analysed by inductive content analysis.	The experiences reflect the complexities involved in the daily operation of a professional practice, and the perception of risks due to a high workload, lack of control, communication and organizational failures.	The results reflect a complex system in which high workload was perceived as a risk for patient safety and that, in a combination with other risks, was thought to further jeopardize patient safety. Emergency department staff should be involved in the development of patient safety procedures in order to increase knowledge regarding risk factors as well as identify strategies which can facilitate the maintenance of patient safety during periods in which the workload is high.	
28255678	Although graphic health warning labels (GHWs) on cigarette packs have influenced cessation behaviors in other countries, no U.S. studies have explored the impact of avoidance of GHW content among individuals from low socioeconomic position (SEP). The purpose of this study was to determine the predictors of intention to avoid GHWs, and how avoidance impacts cessation intention, in a low SEP sample in the U.S.Data come from low SEP smokers (n = 541) involved in a field experiment. The participants responded to questions pre- and post viewing of GHWs assessing SEP, intention to avoid them, emotional reactions, and intention to seek health information or quit smoking. Backwards stepwise logistic regression determined the predictors for intention to avoid GHWs. Simple and adjusted logistic regression analyzed the association between avoidance and its main predictors and outcomes of intentions to seek information or quit smoking.	Predictors for avoidance included being somewhat addicted to cigarettes (OR 2.3, p = 0.002), younger than 25 (OR 2.6, p = 0.008), and having medium (OR 3.4, p < 0.001) or high (OR 4.7, p < 0.001) levels of negative emotional reaction to the labels. Intention to avoid GHWs was positively associated with the intent to look for health information about smoking (OR 2.2, p = 0.002). Higher levels of negative emotional reaction were positively associated with cessation behaviors, with high negative emotional reaction associated with nine times the odds of quitting (p < 0.001).	Results indicate avoidance of GHWs does not detract from the labels' benefit and that GHWs are an effective means of communicating smoking risk information among low SEP groups.	
28255610	Disasters and major incidents demand a multidisciplinary management. Recent experiences from terrorist attacks worldwide have resulted in a search for better assessment of the needs, resources, and knowledge in the medical and non-medical management of these incidents and also actualized the need for collaboration between civilian and military healthcare. The aim of this study was to evaluate the impact of the civilian-military collaboration in a Swedish context with the main focus on its non-medical management.An exercise, simulating a foreign military attack centrally on Swedish soil, was designed, initiated, and conducted by a team consisting of civilian and military staff. Data were collected prospectively and evaluated by an expert team.	Specific practical and technical issues were presented in collaboration between civilian and military staffs. In addition, shortcomings in decision-making, follow-up, communication, and collaboration due to prominent lack of training and exercising the tasks and positions in all managerial levels of the hospital were identified.	Current social and political unrests and terror attacks worldwide necessitate civilian-military collaboration. Such collaboration, however, needs to be synchronized and adjusted to avoid preventable medical and non-medical consequences. Simulation exercises might be one important source to improve such collaboration.	
28255463	Autism spectrum disorder (ASD) is a neurodevelopmental disorder typified by impaired social communication and restrictive and repetitive behaviors. Mice serve as an ideal candidate organism for studying the neural mechanisms that subserve these symptoms. The Neuroligin-3 (NL3) mouse, expressing a R451C mutation discovered in two Swedish brothers with ASD, exhibits impaired social interactions and heightened aggressive behavior towards male mice. Social interactions with female mice have not been characterized and in the present study were assessed in male NL3R451C and WT mice. Mice were housed in social and isolation conditions to test for isolation-induced increases in social interaction. Tests were repeated to investigate potential differences in interaction in naïve and experienced mice. We identified heightened interest in mating and atypical aggressive behavior in NL3R451C mice. NL3R451C mice exhibited normal social interaction with WT females, indicating that abnormal aggressive behavior towards females is not due to altered motivation to engage. Social isolation rearing heightened interest in social behavior in all mice. Isolation housing selectively modulated the response to female pheromones in NL3R451C mice. This study is the first to show altered mating behavior in the NL3R451C mouse and has provided new insights into the aggressive phenotype in this model.
28255375	The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future.
28255279	This article highlights the contribution of ethnography and qualitative sociology to the ethical challenges that frame the diagnosis of dementia. To illustrate this contribution, the paper draws on an ethnographic study of UK memory clinics carried out between 2012 and 2014. The ethnographic data, set alongside other studies and sociological theory, contest the promotion of a traditional view of autonomy; the limiting of the point of ethical interest to a distinct moment of diagnosis disclosure; and the failure to recognise risk and uncertainty in the building of clinical 'facts' and their communication. In addressing these specific concerns, this article contributes to the wider debate over the relationship between sociology and bioethics (medical ethics). At the heart of these debates lies more fundamental questions: how can we best understand and shape moral decision-making and ethics that guide behaviour in medical practice, and what should be the guiding ideas, concepts and methods to inform ethics in the clinic? Using the case of dementia diagnosis, this article illustrates the benefits of an ethnographic approach, not just for understanding this ethical problem but also for exploring if and how a more empirically informed ethics can help shape healthcare practices for the better.
28255188	Journal maps and classifications for 11,359 journals listed in the combined Journal Citation Reports 2015 of the Science and Social Sciences Citation Indexes are provided at https://leydesdorff.github.io/journals/ and http://www.leydesdorff.net/jcr15. A routine using VOSviewer for integrating the journal mapping and their hierarchical clusterings is also made available. In this short communication, we provide background on the journal mapping/clustering and an explanation about and instructions for the routine. We compare journal maps for 2015 with those for 2014 and show the delineations among fields and subfields to be sensitive to fluctuations. Labels for fields and sub-fields are not provided by the routine, but an analyst can add them for pragmatic or intellectual reasons. The routine provides a means of testing one's assumptions against a baseline without claiming authority; clusters of related journals can be visualized to understand communities. The routine is generic and can be used for any 1-mode network.
28254454	Human voice recognition is critical for many aspects of social communication. Recently, a rare disorder, developmental phonagnosia, which describes the inability to recognise a speaker's voice, has been discovered. The underlying neural mechanisms are unknown. Here, we used two functional magnetic resonance imaging experiments to investigate brain function in two behaviourally well characterised phonagnosia cases, both 32 years old: AS has apperceptive and SP associative phonagnosia. We found distinct malfunctioned brain mechanisms in AS and SP matching their behavioural profiles. In apperceptive phonagnosia, right-hemispheric auditory voice-sensitive regions (i.e., Heschl's gyrus, planum temporale, superior temporal gyrus) showed lower responses than in matched controls (nAS=16) for vocal versus non-vocal sounds and for speaker versus speech recognition. In associative phonagnosia, the connectivity between voice-sensitive (i.e. right posterior middle/inferior temporal gyrus) and supramodal (i.e. amygdala) regions was reduced in comparison to matched controls (nSP=16) during speaker versus speech recognition. Additionally, both cases recruited distinct potential compensatory mechanisms. Our results support a central assumption of current two-system models of voice-identity processing: They provide the first evidence that dysfunction of voice-sensitive regions and impaired connectivity between voice-sensitive and supramodal person recognition regions can selectively contribute to deficits in person recognition by voice.
28253736	Aside from features associated with risk of neurogenetic syndromes in general (e.g., cognitive impairment), limited progress has been made in identifying phenotype-genotype relationships in autism spectrum disorder (ASD). The objective of this study was to extend work in the Simons Simplex Collection by comparing the phenotypic profiles of ASD probands with or without identified de novo loss of function mutations or copy number variants in high-confidence ASD-associated genes or loci.Analyses preemptively accounted for documented differences in sex and IQ in affected individuals with de novo mutations by matching probands with and without these genetic events on sex, IQ, and age before comparing them on multiple behavioral domains.	Children with de novo mutations (N=112) had a greater likelihood of motor delay during early development (later age at walking), but they were less impaired on certain measures of ASD core symptoms (parent-rated social communication abnormalities and clinician-rated diagnostic certainty about ASD) in later childhood. These children also showed relative strengths in verbal and language abilities, including a smaller discrepancy between nonverbal and verbal IQ and a greater likelihood of having achieved fluent language (i.e., regular use of complex sentences).	Children with ASD with de novo mutations may exhibit a "muted" symptom profile with respect to social communication and language deficits relative to those with ASD with no identified genetic abnormalities. Such findings suggest that examining early milestone differences and standardized testing results may be helpful in etiologic efforts, and potentially in clinical differentiation of various subtypes of ASD, but only if developmental and demographic variables are properly accounted for first.	
28253430	Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units.The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress.	A cross-sectional survey design was used with staff nurses who work on inpatient units and ambulatory units at an academic medical center. The moral distress scale-revised (MDS-R) was used to assess the intensity and frequency of moral distress.	The overall mean MDS-R score in this project was low at 94.97 with mean scores in the low to moderate range (44.57 to 134.58). Nurses who work in critical care, perioperative services, and procedure areas had the highest mean MDS-R scores. There have been no previous reports of higher scores for nurses working in perioperative and procedure areas. There was weak positive correlation between MDS-R scores and years of experience (Rho = .17, p = .003) but no correlation between age (Rho = .02, p = .78) or education (Rho = .05, p = .802) and moral distress.	Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions.	
28253067	While effective communication is important in the care of seriously ill patients, little is known about communication challenges faced by healthcare providers serving U.S. patients of South Asian origin, one of the fastest growing demographic groups in the United States.Researchers sought to examine communication challenges faced by healthcare providers serving seriously ill South Asian patients and their families and present strategies recommended by providers for effective communication.	Researchers conducted a thematic analysis of qualitative data obtained through focus groups and individual interviews with 57 healthcare providers, including physicians, social workers, nurses, chaplains, and others drawn from different healthcare settings in one Midwestern city.	While acknowledging the considerable diversity within the U.S. South Asian community, participants discussed three types of communication challenges they often encounter when serving this population: ensuring effective interpretation, identifying a spokesperson, and challenges posed by different cultural norms. Participants shared strategies to address these challenges such as proactively inquiring about patients' and families' preferences and encouraging early appointment of a spokesperson.	While providers should avoid stereotyping patients, an awareness of common challenges and adoption of recommended strategies to address these challenges may enhance the provision of culturally responsive person-centered services for seriously ill South Asian patients and their families receiving care in the United States.	
28253014	Substantial empirical evidence has highlighted the psychological stress and negative well-being of parents whose children are diagnosed with autism spectrum disorder (ASD). It also indicated a need for understanding the mechanisms through which parents come to successfully meet the challenges of caregiving for these children whose condition are often characterized by persistent behavioral, social, and communication problems. This study seeks to explore the relationships between benefit finding and parental well-being and aims to bridge the research gaps in 3 ways. First, it seeks to examine the nature of relationships between benefit finding and parent positive and negative affect among parents whose children have ASD or other special needs. Second, we posit that this relationship would be moderated by the presence of ASD in the child. Third, we hypothesize that this moderation may vary with the children's age. Three hundred and 2 parents responded to a self-report questionnaire. Specifically, for parents of children who are non-ASD, higher levels of perceived benefit finding were found to be associated with lower levels of negative affect, and this holds for those with young children below 7 years of age. For parents having a child with ASD, perceiving high or low levels of benefit did not mitigate their negative feelings regardless of the child's age. The latter findings on the moderating effect of ASD diagnosis were unexpected and inconsistent with current research indications. These were discussed in the light of the literature, with potential implications for future research and practice. (PsycINFO Database Record
28252978	[Correction Notice: An Erratum for this article was reported online in Emotion on Apr 27 2017 (see record 2017-18585-001). ] Emotions are a vital component of social communication, carried across a range of modalities and via different perceptual signals such as specific muscle contractions in the face and in the upper respiratory system. Previous studies have found that emotion recognition impairments after brain damage depend on the modality of presentation: recognition from faces may be impaired whereas recognition from voices remains preserved, and vice versa. On the other hand, there is also evidence for shared neural activation during emotion processing in both modalities. In a behavioral study, we investigated whether there are shared representations in the recognition of emotions from faces and voices. We used a within-subjects design in which participants rated the intensity of facial expressions and nonverbal vocalizations for each of the 6 basic emotion labels. For each participant and each modality, we then computed a representation matrix with the intensity ratings of each emotion. These matrices allowed us to examine the patterns of confusions between emotions and to characterize the representations of emotions within each modality. We then compared the representations across modalities by computing the correlations of the representation matrices across faces and voices. We found highly correlated matrices across modalities, which suggest similar representations of emotions across faces and voices. We also showed that these results could not be explained by commonalities between low-level visual and acoustic properties of the stimuli. We thus propose that there are similar or shared coding mechanisms for emotions which may act independently of modality, despite their distinct perceptual inputs. (PsycINFO Database Record
28252192	Children's value systems develop through youth and influence attitudes and actions. But there is a lack of appropriate measures for children and adolescents. The objective of this study was to construct and validate a questionnaire that reveals distinct value systems among adolescents, and to evaluate the identified value systems' relationship to degree of ego-development and moral development. A quantitative study in a Swedish School with ages 12 through 16 (grades 6 to 9) was performed (N = 204). A set of pattern recognition statistical analyses has been used to identify different profiles of values systems and demonstrate that these systems can be arranged in a hierarchical order similar to other development. Results revealed three value systems in this sample. The identified value systems reflect different degrees of moral and ego-development among children in the study. Three distinct value systems were identified: the first (n = 9) and the second value systems (n = 35) correspond to pre-conventional stages, and the third value system (n = 155) corresponds to early conventional stages of ego development. Ego development scoring of test statements to assess stages. The value system was significantly related to moral development in the personal interest and the maintaining norms schemas of the Defining Issues Test (DIT). However, many students did not complete the entire DIT, so those results should be looked at with caution. It appears that this new test (Test for Adolescent Value Systems - TAVS) does relate to an established ego development rating scale.
28251069	To evaluate social media usage of orthopaedic patients to search for solutions to their health problems.The study data were collected using face-to-face questionnaire with randomly selected 1890 patients aged over 18 years who had been admitted to the orthopaedic clinics in different cities and provinces across Turkey. The questionnaire consists of a total of 16 questions pertaining to internet and social media usage and demographics of patients, patients' choice of institution for treatment, patient complaints on admission, online hospital and physician ratings, communication between the patient and the physician and its effects.	It was found that 34.2% (n = 647) of the participants consulted with an orthopaedist using the internet and 48.7% (n = 315) of them preferred websites that allow users to ask questions to a physician. Of all question-askers, 48.5% (n = 314) reported having found the answers helpful. Based on the educational level of the participants, there was a highly significant difference between the rates of asking questions to an orthopaedist using the internet (P = 0.001). The rate of question-asking was significantly lower in patients with an elementary education than that in those with secondary, high school and undergraduate education (P = 0.001) The rate of reporting that the answers given was helpful was significantly higher in participants with an undergraduate degree compared to those who were illiterate, those with primary, elementary or high school education (P = 0.001). It was also found that the usage of the internet for health problems was higher among managers-qualified participants than unemployed-housewives, officers, workers-intermediate staff (P < 0.05).	We concluded that patients have been increasingly using the internet and social media to select a specific physician or to seek solution to their health problems in an effective way. Even though the internet and social media offer beneficial effects for physicians or patients, there is still much obscurity regarding their harms and further studies are warranted for necessary arrangements to be made.	
28250915	Prudent use of antibiotics is important to prevent antibiotic resistance in humans and in animals. For this reason politicians demanded a decrease of total antibiotic use and of use of critically important antibiotics in animal husbandry in the Netherlands. In the dairy sector the use of antibiotics almost halved in the years 2009-2015, with a decrease of the use of critically important antibiotics to very low levels.To realize a sustainable decrease in antibiotic usage, the mindset towards the subject was considered crucial. Based on several models from social psychology, the RESET Mindset Model was used. This model contains the most important cues to change human behaviour, being Rules and regulations, Education and information, Social pressure, Economics, and Tools. To change behaviour of groups in order to reach a tipping point, it is of utmost importance to not choose among the different cues, but to use them all.	In order to decrease antibiotic usage in dairy cattle in the Netherlands several actions, obliged as well as voluntary, were undertaken. An independent veterinary medicine authority was founded that became active for all animal sectors. In the dairy sector a national database on antibiotic usage called MediRund was developed, which made transparency and benchmarking on antibiotic usage at the national and the herd level possible. Several other activities are described, such as herd health and treatment plans, selective dry cow therapy, and the strong limitation on the use of critically important antibiotics. Antibiotic usage at the herd level, referred to as the 'antibiotic number', became an important and socially accepted herd level parameter.	The actions undertaken worked through different cues, all part of the RESET Mindset Model. As such, different types of dairy farmers sensitive to different types of cues were motivated to change their behaviour.	Antibiotic usage in dairy cattle in the Netherlands decreased significantly by intense cooperation between the most important stakeholders in the dairy chain, taking communication seriously and applying the RESET Mindset Model.	
28250800	Pair compatibility affects the success of a pair; however, its causes and mechanisms are not fully understood. Vocal exchange may be very important for pair formation, coordinating pair activities, maintaining the pair bond and mate guarding. To investigate the role of vocal exchange in pair formation and pair maintenance, we explored whether new and established pairs of zebra finches differed in their calling relationships. We used individualised backpack microphones to examine the entire daily vocal emission of pairs, with parallel video recording of behaviour.We found that in non-breeding, isolated pairs, a specific type of call, the "stack call", was the most common. Furthermore, all pairs used the stack call for precisely timed antiphonal exchange. We confirmed a difference between new and established pairs in social behaviour, with the former spending less time in physical contact. Notably, we found that this was mirrored by a difference in calling behaviour: members of new pairs converged over time on a more symmetric calling relationship. Additionally, we observed different response rates to partners among individuals, but a repeatable relationship of answering within pairs, which may reflect different degrees of motivation to answer the partner.	Our findings show that there is plasticity in calling behaviour and that it changes during pair formation, resulting in a coordinated stack call exchange with a similar number of answers between partners once the pair is established. It is possible that some of the calling relationship measurements that we present reflect pair compatibility.	
28250181	Across species, oxytocin, an evolutionarily ancient neuropeptide, facilitates social communication by attuning individuals to conspecifics' social signals, fostering trust and bonding. The eyes have an important signalling function; and humans use their salient and communicative eyes to intentionally and unintentionally send social signals to others, by contracting the muscles around their eyes and pupils. In our earlier research, we observed that interaction partners with dilating pupils are trusted more than partners with constricting pupils. But over and beyond this effect, we found that the pupil sizes of partners synchronize and that when pupils synchronously dilate, trust is further boosted. Critically, this linkage between mimicry and trust was bound to interactions between ingroup members. The current study investigates whether these findings are modulated by oxytocin and sex of participant and partner. Using incentivized trust games with partners from ingroup and outgroup whose pupils dilated, remained static or constricted, this study replicates our earlier findings. It further reveals that (i) male participants withhold trust from partners with constricting pupils and extend trust to partners with dilating pupils, especially when given oxytocin rather than placebo; (ii) female participants trust partners with dilating pupils most, but this effect is blunted under oxytocin; (iii) under oxytocin rather than placebo, pupil dilation mimicry is weaker and pupil constriction mimicry stronger; and (iv) the link between pupil constriction mimicry and distrust observed under placebo disappears under oxytocin. We suggest that pupil-contingent trust is parochial and evolved in social species in and because of group life.
28250100	Social media are transforming global communication and coordination and provide unprecedented opportunities for studying socio-technical domains. Here we study global dynamical patterns of communication on Twitter across many scales. Underlying the observed patterns is both the diurnal rotation of the Earth, day and night, and the synchrony required for contingency of actions between individuals. We find that urban areas show a cyclic contraction and expansion that resembles heartbeats linked to social rather than natural cycles. Different urban areas have characteristic signatures of daily collective activities. We show that the differences detected are consistent with a new emergent global synchrony that couples behaviour in distant regions across the world. Although local synchrony is the major force that shapes the collective behaviour in cities, a larger-scale synchronization is beginning to occur.
28249639	DSM-5 proposes an Attenuated Psychosis Syndrome (APS) for further investigation, based upon the Attenuated Positive Symptom Syndrome (APSS) in the Structured Interview for Psychosis-Risk Syndromes (SIPS). SIPS Unusual Thought Content, Disorganized Communication and Total Disorganization scores predicted progression to psychosis in a 2015 NAPLS-2 Consortium report. We sought to independently replicate this in a large single-site high-risk cohort, and identify baseline demographic and clinical predictors beyond current APS/APSS criteria.We prospectively studied 200 participants meeting criteria for both the SIPS APSS and DSM-5 APS. SIPS scores, demographics, family history of psychosis, DSM Axis-I diagnoses, schizotypy, and social and role functioning were assessed at baseline, with follow-up every 3 months for 2 years.	The conversion rate was 30% (n = 60), or 37.7% excluding participants who were followed under 2 years. This rate was stable across time. Conversion time averaged 7.97 months for 60% who developed schizophrenia and 15.68 for other psychoses. Mean conversion age was 20.3 for males and 23.5 for females. Attenuated odd ideas and thought disorder appear to be the positive symptoms which best predict psychosis in a logistic regression. Total negative symptom score, Asian/Pacific Islander and Black/African-American race were also predictive. As no Axis-I diagnosis or schizotypy predicted conversion, the APS is supported as a distinct syndrome. In addition, cannabis use disorder did not increase risk of conversion to psychosis.	NAPLS SIPS findings were replicated while controlling for clinical and demographic factors, strongly supporting the validity of the SIPS APSS and DSM-5 APS diagnosis.	
28248628	Hispanics represent a critical target for culturally adapted diet interventions. In this formative research, we translated HealthyYouTXT, an mHealth program developed by the U.S. National Cancer Institute, into HealthyYouTXT en Español, a linguistically and culturally appropriate version for Spanish speakers in the United States. We report a three-stage, mixed-methods process through which we culturally adapted the text messages, evaluated their acceptability, and revised the program based on the findings. In Stage 1, we conducted initial translations and adaptations of the text libraries using an iterative, principle-guided process. In Stage 2, we used mixed methods including focus groups and surveys with 109 Hispanic adults to evaluate the acceptability and cultural appropriateness of the program. We used survey data to evaluate whether self-determination theory (SDT) factors (used to develop HealthyYouTXT) of autonomous motivation, controlled motivation, and amotivation and Hispanic cultural beliefs about familism, fatalism, and destiny predict program interest and its perceived efficacy. Mixed-methods analyses revealed substantial interest in HealthyYouTXT, with most participants desiring to use it and viewing it as highly efficacious. Both cultural beliefs (i.e., beliefs in destiny and, for men, high familism) and SDT motivations (i.e., autonomy) predicted HealthyYouTXT evaluations, suggesting utility in emphasizing them in messages. Higher destiny beliefs predicted lower interest, suggesting that they could impede program use. In Stage 3, we implemented the mixed-methods findings to finalize HealthyYouTXT en Español. The emergent linguistic principles and multistage, multimethods process can be applied in health communication adaptations.
28248623	The increasing popularity of social networking sites (SNSs) has drawn scholarly attention in recent years, and a large amount of efforts have been made in applying SNSs to health behavior change interventions. However, these interventions showed mixed results, with a large variance of effect sizes in Cohen's d ranging from -1.17 to 1.28. To provide a better understanding of SNS-based interventions' effectiveness, a meta-analysis of 21 studies examining the effects of health interventions using SNS was conducted. Results indicated that health behavior change interventions using SNS are effective in general, but the effects were moderated by health topic, methodological features, and participant features. Theoretical and practical implications of findings are discussed.
28248621	On an average, at least one out of eight women are at risk of falling prey to breast cancer during their lifespan. Amongst varied initiatives to spread awareness about breast cancer, the most well-known campaign is Breast Cancer Awareness Month. This article explored, through content analysis, how four different health-related organizations-Susan G. Komen, U.S. News Health, Woman's Hospital, and Breast Cancer Social Media-used their Twitter accounts to talk about varied aspects of breast cancer during the month of October, which is observed as Breast Cancer Awareness Month. All the tweets by these organizations were analyzed for the presence or absence of the theoretical parameters of the Health Belief Model (HBM). A content analysis of 2916 tweets based on the HBM revealed that the content posted by these organizations reflected the use of varied theoretical constructs of the framework. Overall, the study demonstrated that while different organizations shared valuable breast cancer-related content on Twitter, each used the social media platform in a different fashion, evident through focus on different types of HBM constructs while publishing breast cancer-related tweets.
28248555	People use relatively low-cost signals to maintain close relationships, in which they engage in costlier exchanges of tangible support. Paying attention to a partner allows an individual to communicate his or her interest in the relationship with the partner. Previous studies have revealed that when Person A pays attention to Person B, B's feeling of intimacy toward A increases. If social attention strengthens the bond between A and B, it is predicted that A's attention will also increase B's generous behavior toward A. This study tested this prediction. Participants first engaged in a collaborative task using computers. In the task, the putative partner (a computer program) either paid or did not pay attention to participants (high attention condition vs. low attention condition). In the control condition, the partner could not choose when to pay attention to participants. They then played three rounds of the dictator game with the partner. Confirming the previous finding, perceived intimacy was highest in the high attention condition, in the middle in the control condition, and lowest in the low attention condition. More importantly, participants in the high attention condition decided to give more resources to their partner than those in the low attention condition (but the difference between the high attention condition and the control condition was not significant). In addition, self-reported intimacy was positively correlated with the resource allocated to the partner. The results of this study demonstrated that social attention fosters a partner's generosity.


28247543	Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners.A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area. In total, 29 qualitative interviews were conducted: 10 with diabetes practitioners from primary and secondary care, 14 from ID services and 5 from community care services regarding diabetes service provision for this population. Thematic content analysis was undertaken to identify the themes and subthemes.	Three main themes were identified: (1) enabling access to services to meet diabetes-related care needs of people with ID; (2) communication and service improvements between staff, patients and across services; and (3) providing person-centred diabetes care and developing adapted resources to increase patient self-care.	The findings of this study have important international implications in how diabetes practitioners plan and deliver services for people with ID and other vulnerable groups with limited cognitive ability and communication skills and difficulties in self-management. The findings highlight that access to diabetes education and adapted resources is needed, and if 'reasonable adjustments' are made to service provision and practice, people with ID can benefit from improved healthcare. Developing joint clinics to share knowledge and resources between diabetes and ID practitioners may improve service delivery and continuity of care, and thereby diminish the costs of not providing quality care.	
28247150	Chemical communication is a dominant method of communication throughout the animal kingdom and can be especially important in group-living animals in which communicating threats, either from predation or other dangers, can have large impacts on group survival. Social insects, in particular, have evolved a number of pheromonal compounds specifically to signal alarm. There is predicted to be little selection for interspecific variation in alarm cues because individuals may benefit from recognizing interspecific as well as conspecific cues and, consequently, alarm cues are not normally thought to be used for species or nestmate recognition. Here, we examine the composition of the alarm pheromones of seven species of fungus-growing ants (Attini), including both basal and derived species and examine the behavioral responses to alarm pheromone of Acromyrmex leaf-cutting ants, the sister genus to the highly studied Atta leaf-cutting ants. We find surprisingly high interspecific variation in alarm pheromone composition across the attine phylogeny. Interestingly, the active component of the alarm pheromone was different between the two leaf-cutting ant genera. Furthermore, in contrast to previous studies on Atta, we found no differences among morphological castes in their responses to alarm pheromone in Acromyrmex but we did find differences in responses among putative age classes. The results suggest that the evolution of alarm communication and signaling within social insect clades can be unexpectedly complex and that further work is warranted to understand whether the evolution of different alarm pheromone compounds is adaptive.
28247018	Autistic traits vary across the general population, and are linked with face recognition ability. Here we investigated potential links between autistic traits and voice recognition ability for personally familiar voices in a group of 30 listeners (15 female, 16-19 years) from the same local school. Autistic traits (particularly those related to communication and social interaction) were negatively correlated with voice recognition, such that more autistic traits were associated with fewer familiar voices identified and less ability to discriminate familiar from unfamiliar voices. In addition, our results suggest enhanced accessibility of personal semantic information in women compared to men. Overall, this study establishes a detailed pattern of relationships between voice identification performance and autistic traits in the general population.

28246145	In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter.Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis.	A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding.	This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media.	
28246082	Patients who articulate their psychological distress primarily through physical symptoms (referred to as medically unexplained symptoms (MUS)) pose a challenge to the skills of most clinicians, including palliative care physicians. The philosophical underpinnings of palliative care with a stated focus on symptom management and care of the person in their psychosociospiritual context lend itself to the care of these patients. The aim of this study was to investigate the characteristics to improve identification of this patient group within palliative care.Here, we report a case series of 6 patients with severe MUS who were referred to palliative care. We use illustrative case vignettes, examine clinical and demographic characteristics and review the perspectives of the multidisciplinary team to identify the common threads.	This case series highlights the complexities and challenges that are inherent in providing assessment and care for patients with MUS that present to palliative care. Characteristics that were identified included the clustering of 'trigger' symptoms, backgrounds of multiple chronic illnesses and relationship dysfunction. Patient outcomes in this group were universally poor, including the death of 2 patients.	Knowledge of this patient group is vital given the likely increase in prevalence of MUS as palliative care broadens its focus earlier in the trajectory of illness. The strengths of palliative care, including psychosociospiritual assessment, multidisciplinary input and communication skills holds the potential to accurately identify patients with MUS and allow the opportunity for specialist psychiatric input with the hope of improving outcomes for patients and their families.	
28245165	Illness blogs are a way seriously ill people communicate publicly about their illness journey. As communication about serious illness increases on social media, it is important to evaluate how this affects the family caregiver. However, identifying and accessing family caregivers remains challenging, especially via social media.The aim of this article is to report the opportunities, challenges and lessons learned from using social media to recruit family caregivers.	Recruitment methods included posting study invitations on illness blogs, advertising through Facebook and placing study fliers in the community.	Using social media to recruit was inexpensive and provided a wide geographical reach. One important finding was discovering the importance of using language in the recruitment materials that family caregivers could identify with to help deem themselves as eligible to participate in the study.	
28245152	The aim of this study is to compare demographic/disease characteristics of users versus nonusers of a do-it-yourself (DIY) mobile technology system for diabetes (Nightscout), to describe its uses and personalization, and to evaluate associated changes in health behaviors and outcomes.A cross-sectional, household-level online survey was used. Of 1268 household respondents who were members of the CGM in the Cloud Facebook group, there were 1157 individuals with diabetes who provided information about Nightscout use.	The majority of individuals with diabetes in the household sample were 6-12 years old (followed by 18 years and above, and 13-17 years), non-Hispanic whites (90.2%), with type 1 diabetes (99.4%). The majority used an insulin pump (85.6%) and CGM (97.0%) and had private health insurance (83.8%). Nightscout use was more prevalent among children compared with adolescents and adults. Children used Nightscout for nighttime, school, sporting events, and travel; adults used it for nighttime, work, travel, and sporting events. Whereas the majority of adults viewed their own data without assistance from others, among pediatric users, a median of three individuals (range: 0-8) viewed Nightscout, with a median of three devices per viewer (range: 0-7). Individuals reported that after Nightscout adoption, they checked blood glucose values with a meter less often; bolused more frequently; gave more boluses without checking first with a blood glucose meter; and experienced significant improvements in HbA1c and quality of life.	The Nightscout Project is a patient-driven mobile technology for health and may have beneficial effects on glycemic control and quality of life.	
28244813	Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and interactions as well as restricted, repetitive behaviors and interests. Pharmacologic interventions are often needed to manage irritability, aggressive behaviors and hyperactivity. Pharmacogenomic studies have investigated genetic associations with treatment response and side effects in an attempt to better understand drug mechanisms in hopes of optimizing the balance of symptom improvement versus side effects. The majority of pharmacogenomic studies to date have focused on antipsychotics, antidepressants and stimulants that are the most commonly utilized medication classes for ASD. This review is a comprehensive examination of the existing pharmacogenomic studies in ASD highlighting the current state of knowledge regarding genetic variation influencing pharmacokinetics and pharmacodynamics, and associated clinical outcomes.
28244060	الإنهاك ومصادر الإجهاد بين الأطباء المقيمين في مؤسسة حمد الطبية، قطر.عبد الحميد عفانة، جس غنام، إيفيلين هوو، عبد اللطيف الخال، بنان العرب، كارما بيلوند.	هدفت هذه الدراسة إلى وصف المعاناة من الإجهاد والإرهاق والعوامل الاجتماعية والسكانية المرتبطة بأبعاد الإجهاد بن الأطباء المقيمن في مؤسسة حمد الطبية، قطر. وقد طُلِب من الأطباء المقيمن المشاركين في دورة لإدارة الإجهاد استكمال استمارة مسح استطلاعي بدون ذكر الأساء. وشمل المسح أسئلة سكانية، والقائمة المخترة "لماساش"، وأربعة أسئلة ذات إجابات مفتوحة تدور حول معاناة الإجهاد. ومن بن الأطباء المقيمن المشاركين في دورة إدارة الإجهاد، وعددهم 150 ، استجاب 142 منهم للمسح، فذكروا قائمة تضم في المتوسط 2.2 نوعاً من مسبِّبات الإجهاد، واعتروا عبء العمل والعلاقات في مكان العمل من المسبِّبات الأكثر شيوعاً. كا وضعوا قائمة تتألف في المتوسط من 3.1 اسراتيجية من اسراتيجيات التكيُّف، لاسيما استماس الدعم الاجتماعي والترفيه. وبينت الإجابات انخفاضاً في التجرُّد، وارتفاعاً في الإنجاز الشخصي والرضا عن مزاولة مهنة الطب ومستوى الإنهاك الانفعالي. ولقد ذكر الأطباء المقيمون في قطر العديد من العوامل المسبِّبة للإجهاد وكذلك مستويات عالية من الإنهاك الانفعالي، وعن اسراتيجيات صحية وغر صحية للتكيُّف. وتوصي الدراسة بالتدريب لتحسن التكيُّف والتخفيف من وطأة الإنهاك.	Épuisement professionnel et sources de stress parmi les internes en médecine de la Hamad Medical Corporation, Qatar.	La présente étude avait pour objectif de décrire les expériences de stress et d’épuisement professionnel ainsi que les facteurs socio-démographiques associés à l’existence de ce stress parmi les internes en médecine de la Hamad Medical Corporation, au Qatar. Il a été demandé à des internes en médecine participant à un cours de gestion du stress de répondre à une étude anonyme. L’étude incluait des questions d’ordre démographique, la version abrégée de l'inventaire de burnout de Maslach et 4 questions ouvertes sur les expériences de stress. Sur les 150 internes prenant part au cours sur la gestion du stress, 142 ont répondu à l’étude, énumérant une moyenne de 2,2 types de facteurs de stress, à savoir, pour les plus fréquents, la charge de travail et les relations sur le lieu de travail. Ils ont également énuméré une moyenne de 3,1 stratégies d’adaptation, consistant le plus souvent à bénéficier d’un soutien social et à avoir des d’activités divertissantes. Les réponses indiquaient une faible dépersonnalisation, un fort sentiment de réalisation personnelle, un degré de satisfaction élevé concernant le domaine de la médecine et un épuisement émotionnel important. Des formations visant à améliorer l’aptitude des internes à faire face au stress et à l’épuisement professionnel ainsi qu’à réduire ce dernier sont recommandées.	This study aimed to describe the experiences of stress and burnout and sociodemographic factors associated with dimensions of stress among medical residents at Hamad Medical Corporation, Qatar. Medical residents participating in a stress management course were asked to complete an anonymous survey. The survey included demographic questions, the Abbreviated Maslach Inventory, and 4 open-ended questions on experiences with stress. Of the 150 residents participating in the stress management course, 142 responded to the survey, listing an average of 2.2 types of stressors, with workload and workplace relationships as the most frequent. They listed an average of 3.1 coping strategies, most frequently seeking out social support and entertainment. Responses indicated low depersonalization, high personal accomplishment, high satisfaction with medicine and high emotional exhaustion. Training to improve coping and reduce burnout is recommended.	
28243516	Extracellular vesicles (EVs) are lipid-bilayer-enclosed vesicles that contain proteins, lipids and nucleic acids. EVs produced by cells from healthy tissues circulate in the blood and body fluids, and can be taken up by unrelated cells. As they have the capacity to transfer cargo proteins, lipids and nucleic acids (mostly mRNAs and miRNAs) between different cells in the body, EVs are emerging as mediators of intercellular communication that could modulate cell behavior, tissue homeostasis and regulation of physiological functions. EV-mediated cell-cell communications are also proposed to play a role in disease, for example, cancer, where they could contribute to transfer of traits required for tumor progression and metastasis. However, direct evidence for EV-mediated mRNA transfer to individual cells and for its biological consequences in vivo has been missing until recently. Recent studies have reported elegant experiments using genetic tracing with the Cre recombinase system and intravital imaging that visualize and quantify functional transfer of mRNA mediated by EVs in the context of cancer and metastasis.
28243481	Parkinson's disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient's subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver's stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients' and caregiver's point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view.
28243450	To examine the prevalence of the willingness of patients with diabetes to use a self-management tool based on information and communication technology (ICT) such as personal computers, smartphones, and mobile phones; and to examine the patient characteristics associated with that willingness.We conducted a cross-sectional interview survey of 312 adults with diabetes at a university hospital in an urban area in Japan. Participants were classified into 2 groups: those who were willing to use an ICT-based self-management tool and those who were unwilling. Multiple logistic regression analysis was used to identify factors associated with the willingness, including clinical and social factors, current use of ICT, self-management practices, self-efficacy, and diabetes-related emotional distress.	The mean age of the 312 participants was 66.3 years (SD=11.5) and 198 (63%) were male. Most of the participants (93%) had type 2 diabetes. Although only 51 (16%) currently used ICT-based self-management tools, a total of 157 (50%) expressed the willingness to use such a tool. Factors associated with the willingness included: not having nephropathy (OR=2.02, 95% CI 1.14 to 3.58); outpatient visits once a month or more (vs less than once a month, OR=2.13, 95% CI 1.13 to 3.99); current use of personal computers and/or smartphones (OR=4.91, 95% CI 2.69 to 8.98); and having greater diabetes-related emotional distress (OR=1.10, 95% CI 1.01 to 1.20).	Approximately half of the patients showed interest in using an ICT-based self-management tool. Willing patients may expect ICT-based self-management tools to complement outpatient visits and to make self-management easier. Starting with patients who display the willingness factors might optimize programs based on such tools.	
28243412	One of the most important factors in marital satisfaction is the satisfaction of a healthy sexual relationship between spouses. During pregnancy marital satisfaction may decrease due to sexual problems. Sexual counseling to pregnant women may reduce the complications of these problems at this time. This study aimed to investigate the effects of sexual counseling on marital satisfaction of pregnant women. This article is sponsored by the Hamadan University of Medical Sciences.This educational randomized experimental study was conducted on 80 pregnant women referring to health centers of Malayer. Samples were two groups of experimental and control, with forty participants in each group, four consultation sessions were held, and each session lasted 40 to 90 minutes Data gathering tools were demographic questionnaire and Enriching Relationship Issues Communication and Happiness (ENRICH), a short form of marital satisfaction questionnaire with 47 items. Data were analyzed by Software SPSS 22 and the results were compared by independent t-test, chi-square test, and repeated measure ANOVA.	Comparing the marital satisfaction mean scores in the experimental group showed a significant difference between pre-consultation, and the consultation after two and four weeks. Marital satisfaction score of 8.05 ± 51.20 before the consultation was increased to 7.76 ± 54.52 after two weeks and 6.48 ± 59.20 after four weeks (respectively p < 0.001, p < 0.001). In addition, mean and standard deviation of marital satisfaction in the control group before the intervention, two weeks and four weeks after the intervention were respectively 10.10 ± 45.67, 11.75 ± 47.75, and 10.02 ± 46.30 and Bonferroni post hoc test showed a significant difference between before and two weeks after intervention (p = 0.03). However, marital satisfaction before and four weeks after the intervention was not significant (p = 0.59). The results showed that sexual counseling was associated with marital satisfaction and was effective in its promotion.	Sexual counseling can be used as a method of intervention in sexual relationship of spouses particularly in marital dissatisfaction.	
28242678	Information sharing is an integral part of human interaction that serves to build social relationships and affects attitudes and behaviors in individuals and large groups. We present a unifying neurocognitive framework of mechanisms underlying information sharing at scale (virality). We argue that expectations regarding self-related and social consequences of sharing (e.g., in the form of potential for self-enhancement or social approval) are integrated into a domain-general value signal that encodes the value of sharing a piece of information. This value signal translates into population-level virality. In two studies (n = 41 and 39 participants), we tested these hypotheses using functional neuroimaging. Neural activity in response to 80 New York Times articles was observed in theory-driven regions of interest associated with value, self, and social cognitions. This activity then was linked to objectively logged population-level data encompassing n = 117,611 internet shares of the articles. In both studies, activity in neural regions associated with self-related and social cognition was indirectly related to population-level sharing through increased neural activation in the brain's value system. Neural activity further predicted population-level outcomes over and above the variance explained by article characteristics and commonly used self-report measures of sharing intentions. This parsimonious framework may help advance theory, improve predictive models, and inform new approaches to effective intervention. More broadly, these data shed light on the core functions of sharing-to express ourselves in positive ways and to strengthen our social bonds.
28242592	Menthol cigarettes are used disproportionately by African American, female, and adolescent smokers. Twitter is also used disproportionately by minority and younger populations, providing a unique window into conversations reflecting social norms, behavioral intentions, and sentiment toward menthol cigarettes.Our purpose was to identify the content and frequency of conversations about menthol cigarettes, including themes, populations, user smoking status, other tobacco or substances, tweet characteristics, and sentiment. We also examined differences in menthol cigarette sentiment by prevalent categories, which allowed us to assess potential perceptions, misperceptions, and social norms about menthol cigarettes on Twitter. This approach can inform communication about these products, particularly to subgroups who are at risk for menthol cigarette use.	Through a combination of human and machine classification, we identified 94,627 menthol cigarette-relevant tweets from February 1, 2012 to January 31, 2013 (1 year) from over 47 million tobacco-related messages gathered prospectively from the Twitter Firehose of all public tweets and metadata. Then, 4 human coders evaluated a random sample of 7000 tweets for categories, including sentiment toward menthol cigarettes.	We found that 47.98% (3194/6657) of tweets expressed positive sentiment, while 40.26% (2680/6657) were negative toward menthol cigarettes. The majority of tweets by likely smokers (2653/4038, 65.70%) expressed positive sentiment, while 91.2% (320/351) of nonsmokers and 71.7% (91/127) of former smokers indicated negative views. Positive views toward menthol cigarettes were predominant in tweets that discussed addiction or craving, marijuana, smoking, taste or sensation, song lyrics, and tobacco industry or marketing or tweets that were commercial in nature. Negative views toward menthol were more common in tweets about smoking cessation, health, African Americans, women, and children and adolescents-largely due to expression of negative stereotypes associated with these groups' use of menthol cigarettes.	Examinations of public opinions toward menthol cigarettes through social media can help to inform the framing of public communication about menthol cigarettes, particularly in light of potential regulation by the European Union, US Food and Drug Administration, other jurisdictions, and localities.	
28242590	The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully.The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months.	Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS.	We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008).	To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions.	
28242517	Researchers have long questioned whether information presented through different sensory modalities involves distinct or shared semantic systems. We investigated uni-sensory cross-modal processing by recording event-related brain potentials to words replacing the climactic event in a visual narrative sequence (comics). We compared Onomatopoeic words, which phonetically imitate action sounds (Pow!), with Descriptive words, which describe an action (Punch!), that were (in)congruent within their sequence contexts. Across two experiments, larger N400s appeared to Anomalous Onomatopoeic or Descriptive critical panels than to their congruent counterparts, reflecting a difficulty in semantic access/retrieval. Also, Descriptive words evinced a greater late frontal positivity compared to Onomatopoetic words, suggesting that, though plausible, they may be less predictable/expected in visual narratives. Our results indicate that uni-sensory cross-model integration of word/letter-symbol strings within visual narratives elicit ERP patterns typically observed for written sentence processing, thereby suggesting the engagement of similar domain-independent integration/interpretation mechanisms.
28242505	To identify the barriers and facilitators for fall prevention implementation in residential care facilities.Systematic review. Review registration number on PROSPERO: CRD42013004655.	Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles.	This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified.	We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers.	Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills. Effective fall prevention must consist of multifactorial interventions that target each resident's fall risk profile, and should be tailored to overcome context-specific barriers and put into action the identified facilitators.	
28241936	The current and upcoming demographic change in industrial countries is a challenge for our society, economically as well as socially. The aim of this article is to explore the influences of information and communication technologies applied to contribute to these trends and describe its impact to the quality of life and subjective health of elderly.In a structured literature review on (a) scientific publications and (b) outcome reports of ambient assisted living projects, we investigated these associations. The results are summarized according to the multidimensional approach of quality of life considering the bio-psycho-social model of health. The project outcomes of current initiatives are consolidated and recommendations for future research in the field of active and assisted living were issued.	Current research efforts show that assistive information and communication technologies can successfully contribute to all dimensions of elderly's quality of life. As example technologies can empower them to control their health problems, compensate functional disabilities and increase their safety. Otherwise, remote-communication could lead to reduced face-to-face communication and social exclusion.	More research using adequate methods: and instruments is needed to demonstrate the identified effects and to deliver evidence of the impact to the life of the heterogeneous population group of elderly.	
28241759	Public health organisations such as the National Health Service in the United Kingdom and the National Institutes of Health in the United States provide access to online libraries of publicly endorsed smartphone applications (apps); however, there is little evidence that users rely on this guidance. Rather, one of the most common methods of finding new apps is to search an online store. As hundreds of smoking cessation and alcohol-related apps are currently available on the market, smokers and drinkers must actively choose which app to download prior to engaging with it. The influences on this choice are yet to be identified. This study aimed to investigate 1) design features that shape users' choice of smoking cessation or alcohol reduction apps, and 2) design features judged to be important for engagement.Adult smokers (n = 10) and drinkers (n = 10) interested in using an app to quit/cut down were asked to search an online store to identify and explore a smoking cessation or alcohol reduction app of their choice whilst thinking aloud. Semi-structured interview techniques were used to allow participants to elaborate on their statements. An interpretivist theoretical framework informed the analysis. Verbal reports were audio recorded, transcribed verbatim and analysed using inductive thematic analysis.	Participants chose apps based on their immediate look and feel, quality as judged by others' ratings and brand recognition ('social proof'), and titles judged to be realistic and relevant. Monitoring and feedback, goal setting, rewards and prompts were identified as important for engagement, fostering motivation and autonomy. Tailoring of content, a non-judgmental communication style, privacy and accuracy were viewed as important for engagement, fostering a sense of personal relevance and trust. Sharing progress on social media and the use of craving management techniques in social settings were judged not to be engaging because of concerns about others' negative reactions.	Choice of a smoking cessation or alcohol reduction app may be influenced by its immediate look and feel, 'social proof' and titles that appear realistic. Design features that enhance motivation, autonomy, personal relevance and credibility may be important for engagement.	
28241238	This study investigated the utilization of social media by the hearing aid (HA) community. The purpose of this survey was to analyze the participation of HA community in the social media websites.A systematic survey of online HA-related social media sources was conducted. Such sources were identified using appropriate search terms. Social media participation was quantified on the basis of posts and "likes."	Five hundred fifty-seven social media sources were identified, including 174 Twitter accounts, 172 YouTube videos, 91 Facebook pages, 20 Facebook groups, 71 blogs, and 29 forums. Twitter and YouTube platforms showed the highest level of activity among social media users. The HA-related community used social media sources for advice and support, information sharing, and service-related information.	HA users, other individuals, and organizations interested in HAs leave their digital footprint on a wide variety of social media sources. The community connects, offers support, and shares information on a variety of HA-related issues. The HA community is as active in social media utilization as other groups, such as the cochlear implant community, even though the patterns of their social media use are different because of their unique needs.	
28241002	Determinar la frecuencia de adicción a internet y su relación con el grado de desarrollo de habilidades sociales en adolescentes en la localidad de Condevilla, distrito de San Martín de Porres, Lima, Perú.Se evaluó el grado de habilidades sociales y grado de uso de internet en adolescentes de 10 a 19 años, de quinto de primaria a tercero de secundaria de los dos colegios estatales de la localidad de Condevilla. Se escogieron aulas al azar y se aplicó el cuestionario a todos los adolescentes presentes. Las encuestas utilizadas fueron Escala de Adicción a Internet de Lima para determinar el grado de adicción a internet y el Test de Habilidades Sociales del Ministerio de Salud de Perú, en el cual se evaluaron autoestima, asertividad, comunicación y toma de decisiones. El análisis se realizó mediante la prueba de Chi-cuadrado y la prueba exacta de Fisher. Además, se empleó un modelo lineal generalizado, utilizando la familia binomial y el link log para determinar las razones de prevalencias.	Se aplicaron ambos cuestionarios a 179 adolescentes, de los cuales 49,2% eran varones. La mediana de la edad fue 13 años y 78,8% se encontraban en educación secundaria. Se encontró adicción a internet en 12,9% de los casos, la mayoría del sexo masculino (78,3%, p=0,003). En el análisis multivariado, los factores independientes asociados con la adicción a internet fueron sexo masculino (p=0,016) y tener bajas habilidades sociales, en comparación a altas habilidades sociales (p=0,004).	En adolescentes varones, existe relación entre adicción a internet y habilidades sociales bajas, dentro de las cuales resulta estadísticamente significativa en el área de comunicación.	To determine the frequency of Internet addiction and its relationship with the development of social skills in adolescents in the town of Condevilla, district of San Martin de Porres, Lima - Peru.	The degree of social skills and level of internet use was evaluated in adolescents from 10 to 19 years of 5th to 11th grades in two secondary schools in the town of Condevilla. Classrooms were randomly selected, and the questionnaires were applied to all adolescents. Two questionnaires were applied: Scale for Internet Addiction of Lima to determine the extent of Internet use, and the Social Skills Test from the Ministry of Health of Peru, which evaluates self-esteem, assertiveness, communication and decision-making. The analyses by Chi2 test and Fisher's exact test, as well as a generalized linear model (GLM) were performed using the binomial family.	Both questionnaires were applied to 179 adolescents, of whom 49.2% were male. The main age was 13 years, 78.8% of which were in secondary school. Internet addiction was found in 12.9% of respondents, of whom the majority were male (78.3%, p = 0.003) and had a higher prevalence of low social skills (21.7%, p = 0.45). In multivariate analysis, the independent factors associated with Internet addiction were gender (p = 0.016) and to have low social skills compared to high social skills (p = 0.004).	In adolescents, there is a relationship between internet addiction and low social skills, among which the area of communication is statistically significant.	
28240772	Gestural displays are incorporated into the signaling repertoire of numerous animal species. These displays range from complex signals that involve impressive and challenging maneuvers, to simpler displays or no gesture at all. The factors that drive this evolution remain largely unclear, and we therefore investigate this issue in New World blackbirds by testing how factors related to a species' geographical distribution and social mating system predict macro-evolutionary patterns of display elaboration. We report that species inhabiting temperate regions produce more complex displays than species living in tropical regions, and we attribute this to (i) ecological factors that increase the competitiveness of the social environment in temperate regions, and (ii) different evolutionary and geological contexts under which species in temperate and tropical regions evolved. Meanwhile, we find no evidence that social mating system predicts species differences in display complexity, which is consistent with the idea that gestural displays evolve independently of social mating system. Together, these results offer some of the first insight into the role played by geographic factors and evolutionary context in the evolution of the remarkable physical displays of birds and other vertebrates.
28240140	Many patients with atrial fibrillation experience uncertainty and psychological distress. Internet support groups for atrial fibrillation have yet to be studied.To determine the content and dialogue on an online message board for atrial fibrillation with the purpose of elucidating information and support needs from patient perspectives.	Interpretative description methodology was undertaken to explore conversation from a publicly available website for atrial fibrillation over a 3-month period.	Individuals interacted with the message board to make sense of their atrial fibrillation events by sharing experiences with medications, complementary and alternative medicine, trigger avoidance and ablation. The opinions of lay experts on the message board, anecdotal stories and hyperlinked Internet data were all highly valued sources of information in the messages. Using the learning gained from the board, individuals proceeded with strategies to treat their atrial fibrillation, often in a trial and error fashion. Throughout the process, individuals came back to the board, to update on their progress and gain assistance from others.	The studied atrial fibrillation population had unmet needs for education regarding non-pharmacological approaches to treat atrial fibrillation. In the absence of opportunity to discuss these needs with healthcare professionals, patients may be vulnerable to unproved approaches advocated by Internet peers. Further research is suggested to examine the prevalence of complementary and alternative medicine use in the atrial fibrillation population and to understand better how social media can be utilised to support atrial fibrillation patients.	
28239936	Understanding the effects of population diversity on cancer-related experiences is a priority in oncology care. Previous research demonstrates inequalities arising from variation in age, gender and ethnicity. Inequalities and sexual orientation remain underexplored. Here, we report, for the first time in the UK, a quantitative secondary analysis of the 2013 UK National Cancer Patient Experience Survey which contains 70 questions on specific aspects of care, and six on overall care experiences. 68,737 individuals responded, of whom 0.8% identified as lesbian, gay or bisexual. Controlling for age, gender and concurrent mental health comorbidity, logistic regression models applying post-estimate probability Wald tests explored response differences between heterosexual, bisexual and lesbian/gay respondents. Significant differences were found for 16 questions relating to: (1) a lack of patient-centred care and involvement in decision-making, (2) a need for health professional training and revision of information resources to negate the effects of heteronormativity and (3) evidence of substantial social isolation through cancer. These findings suggest a pattern of inequality, with less positive cancer experiences reported by lesbian, gay and (especially) bisexual respondents. Poor patient-professional communication and heteronormativity in the healthcare setting potentially explain many of the differences found. Social isolation is problematic for this group and warrants further exploration.
28239772	The current study examined the relationship between early language ability and autistic-like traits in adulthood, utilising data from 644 participants from a longitudinal study of the general population. Language performance at 2 years was measured with the Language Development Survey (LDS), and at 20 years the participants completed the Autism-Spectrum Quotient (AQ). Vocabulary size at 2 years was negatively associated with Total AQ score, as well as scores on the Communication, and Social Skills subscales. Adults who had been late talkers were also more likely to have 'high' scores on the Communication subscale. This is the first study to show an association between early language ability and autistic-like traits in adulthood.
28239512	Vaccine delay and refusal present very real threats to public health. Since even a slight reduction in vaccination rates could produce major consequences as herd immunity is eroded, it is imperative to understand the factors that contribute to decision-making about vaccines. Recent scholarship on the concept of "vaccine hesitancy" emphasizes that vaccine behaviors and beliefs tend to fall along a continuum from refusal to acceptance. Most research on hesitancy has focused on parental decision-making about childhood vaccines, but could be extended to explore decision-making related to adult immunization against seasonal influenza. In particular, vaccine hesitancy could be a useful approach to understand the persistence of racial/ethnic disparities between African American and White adults. This study relied on a thematic content analysis of qualitative data, including 12 semi-structured interviews, 9 focus groups (N=90), and 16 in-depth interviews, for a total sample of 118 (N=118) African American and White adults. All data were transcribed and analyzed with Atlas.ti. A coding scheme combining both inductive and deductive codes was utilized to identify themes related to vaccine hesitancy. The study found a continuum of vaccine behavior from never-takers, sometimes-takers, and always-takers, with significant differences between African Americans and Whites.  We compared our findings to the Three Cs: Complacency, Convenience, and Confidence framework. Complacency contributed to low vaccine acceptance with both races.  Among sometimes-takers and always-takers, convenience was often cited as a reason for their behavior, while never-takers of both races were more likely to describe other reasons for non-vaccination, with convenience only a secondary explanation.  However, for African Americans, cost was a barrier.  There were racial differences in trust and confidence that impacted the decision-making process. The framework, though not a natural fit for the data, does provide some insight into the differential sources of hesitancy between these two populations. Complacency and confidence clearly impact vaccine behavior, often more profoundly than convenience, which can contribute either negatively or positively to vaccine acceptance. The Three Cs framework is a useful, but limited tool to understanding racial disparities. Understanding the distinctions in those cultural factors that drive lower vaccine confidence and greater hesitancy among African Americans could lead to more effective communication strategies as well as changes in the delivery of vaccines to increase convenience and passive acceptance.
28238788	We present a comprehensive taxonomy of outcomes for childhood vaccination communication interventions. Adding to our earlier map of trial outcomes, we aimed to (1) identify relevant outcomes not measured in trials, (2) identify outcomes from stakeholder focus groups, and (3) organize outcomes into a taxonomy.We identified additional outcomes from nonvaccination health communication literature and through parent and health care professional focus groups. We organized outcomes into the taxonomy through iterative discussion and informed by organizational principles established by leaders in core outcome research.	The taxonomy includes three overarching core areas, divided into eight domains and then into outcomes. Core area one is psychosocial impact, including the domains "knowledge or understanding," "attitudes or beliefs," and "decision-making." Core area two is health impact, covering "vaccination status and behaviors" and "health status and well-being." Core area three is community, social, or health system impact, containing "intervention design and implementation," "community participation," and "resource use."	To our knowledge, this taxonomy is the first attempt to conceptualize the range of potential outcomes for vaccination communication. It can be used by researchers selecting outcomes for complex communication interventions. We will also present the taxonomy to stakeholders to establish core outcome domains.	
28238657	Noise is a ubiquitous source of errors in all forms of communication [1]. Noise-induced errors in speech communication, for example, make it difficult for humans to converse in noisy social settings, a challenge aptly named the "cocktail party problem" [2]. Many nonhuman animals also communicate acoustically in noisy social groups and thus face biologically analogous problems [3]. However, we know little about how the perceptual systems of receivers are evolutionarily adapted to avoid the costs of noise-induced errors in communication. In this study of Cope's gray treefrog (Hyla chrysoscelis; Hylidae), we investigated whether receivers exploit a potential statistical regularity present in noisy acoustic scenes to reduce errors in signal recognition and discrimination. We developed an anatomical/physiological model of the peripheral auditory system to show that temporal correlation in amplitude fluctuations across the frequency spectrum ("comodulation") [4-6] is a feature of the noise generated by large breeding choruses of sexually advertising males. In four psychophysical experiments, we investigated whether females exploit comodulation in background noise to mitigate noise-induced errors in evolutionarily critical mate-choice decisions. Subjects experienced fewer errors in recognizing conspecific calls and in selecting the calls of high-quality mates in the presence of simulated chorus noise that was comodulated. These data show unequivocally, and for the first time, that exploiting statistical regularities present in noisy acoustic scenes is an important biological strategy for solving cocktail-party-like problems in nonhuman animal communication.
28238116	Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental condition characterized by variable impairments in communication and social interaction as well as restricted interests and repetitive behaviors. Heterogeneity of presentation is a hallmark. Investigations of immune system problems in ASD, including aberrations in cytokine profiles and signaling, have been increasing in recent times and are the subject of ongoing interest. With the aim of establishing whether cytokines have utility as potential biomarkers that may define a subgroup of ASD, or function as an objective measure of response to treatment, this review summarizes the role of the immune system, discusses the relationship between the immune system, the brain, and behavior, and presents previously-identified immune system abnormalities in ASD, specifically addressing the role of cytokines in these aberrations. The roles and identification of biomarkers are also addressed, particularly with respect to cytokine profiles in ASD.
28237585	The prevention and control of endemic pathogens within and between farms often depends on the adoption of best management practices. However, farmers regularly do not adopt recommended measures or do not enroll in voluntary disease control programs. This indicates that a more comprehensive understanding of the influences and extension tools that affect farmers' management decisions is necessary. Based on a review of relevant published literature, we developed recommendations to support policy-makers, industry representatives, researchers, veterinarians, and other stakeholders when motivating farmers to adopt best management practices, and to facilitate the development and implementation of voluntary prevention and control programs for livestock diseases. Farmers will make management decisions based on their unique circumstances, agricultural contexts, beliefs, and goals. Providing them with rational but universal arguments might not always be sufficient to motivate on-farm change. Implementation of recommended management practices is more likely if farmers acknowledge the existence of a problem and their responsibility to take action. The perceived feasibility and effectiveness of the recommended management strategy and sufficient technical knowledge further increase the likelihood of adequate adoption. Farmers will also weigh the expected advantages of a proposed change against the expected disadvantages, and these considerations often include internal drivers such as pride or the desire to conform with perceived standards. Extension tools and farmers' social referents (e.g., veterinarians, peers) not only provide technical information but also influence these standards. Whereas mass media have the potential to deliver information to a broad audience, more personal approaches such as participatory group learning or individual communication with farm advisors can enable the tailoring of recommendations to farmers' situations. Approaches that appeal to farmers' internal motivators or that unconsciously elicit the desired behavior will increase the success of the intervention. Collaboration among stakeholders, assisted by social scientists and communication specialists, is necessary to provide a context that facilitates on-farm change and transfers consistent messages across extension tools in the most effective way.
28237357	Failure to address social determinants of health (SDH) may contribute to the problem of readmissions in high-risk individuals. Comprehensive shared care plans (CSCP) may improve care continuity and health outcomes by communicating SDH risk factors across settings.The purpose of this study to evaluate the state of knowledge for integrating SDH into a CSCP. Our scoping review of the literature considered 13,886 articles, of which seven met inclusion criteria.	Identified themes were: integrate health and social sectors; interoperability; standardizing ontologies and interventions; process implementation; professional tribalism; and patient centeredness.	There is an emerging interest in bridging the gap between health and social service sectors. Standardized ontologies and theoretical definitions need to be developed to facilitate communication, indexing, and data retrieval.	We identified a gap in the literature that indicates that foundational work will be required to guide the development of a CSCP that includes SDH that can be shared across settings. The lack of studies published in the United States suggests that this is a critical area for future research and funding.	
28237203	The HTA Core Model® as a science-based framework for assessing dimensions of value was developed as a part of the European network for Health Technology Assessment project in the period 2006 to 2008 to facilitate production and sharing of health technology assessment (HTA) information, such as evidence on efficacy and effectiveness and patient aspects, to inform decisions.It covers clinical value as well as organizational, economic, and patient aspects of technologies and has been field-tested in two consecutive joint actions in the period 2010 to 2016. A large number of HTA institutions were involved in the work.	The model has undergone revisions and improvement after iterations of piloting and can be used in a local, national, or international context to produce structured HTA information that can be taken forward by users into their own frameworks to fit their specific needs when informing decisions on technology. The model has a broad scope and offers a common ground to various stakeholders through offering a standard structure and a transparent set of proposed HTA questions. It consists of three main components: 1) the HTA ontology, 2) methodological guidance, and 3) a common reporting structure. It covers domains such as effectiveness, safety, and economics, and also includes domains covering organizational, patient, social, and legal aspects. There is a full model and a focused rapid relative effectiveness assessment model, and a third joint action is to continue till 2020.	The HTA Core Model is now available for everyone around the world as a framework for assessing value.	
28236688	Diabetes has become a challenging health priority globally. Given the tensions of financially burdened health systems in Europe the mobilisation of community resources like voluntary organisations and community groups is seen as a health policy strategy to sustain the management of long-term conditions like diabetes. However, little is known about how this is happening in practice in Europe.To explore diabetes self-management interventions undertaken or promoted by voluntary organisations and community groups in Europe; and describe the types of working relationships between these organisations, European health systems and users when implementing diabetes self-management programmes in different areas.	A mixed method study (survey/qualitative interviews) was undertaken. This research formed part of a European project (7th Framework programme of the European Commission) exploring the link between resources, like community organisations, and peoples' capacities to manage long-term conditions.	Six European countries (Bulgaria, Greece, Norway, Spain, the Netherlands and the United Kingdom) participated in the study. Three areas: deprived urban area, a relatively affluent urban area and a deprived rural area were purposefully selected.	Through a purposeful sample and bottom up strategies 749 representatives of voluntary organisations and community groups were recruited from the geographical areas above. Organisations with at least three members, existing for at least one year that could provide information or other type of support directly or indirectly relevant to patients with diabetes were included.	Participants completed a 15 item questionnaire for the survey (n=749) and a voice recorded semi structured interview (n=300). Data collection focused on the type of activities and roles developed to promote health, and relationships and communication channels between organisations, health services and users. Descriptive and comparative statistical and qualitative content analyses were used.	Participants perceived they had better reach of people with health needs than health providers, filled the administration gaps left in their capacity to deal with basic diabetes practical needs, humanized care, and acted as mediators between services and communities. There were significant differences between countries in relation to the types of activities (p-value<0.001), roles (p-value<0.001) and funding sources (p-value<0.001) of organisations concerning diabetes self-management. In non-affluent countries organisations tend to promote social activities twice more often.	Community and voluntary organisations provide complimentary and on-going support in diabetes management. This involves a shift from focusing on the illness to also longing for social cohesion, sense of community and wellbeing in diabetes health practices and policies.	
28236266	Loneliness is a known risk factor for poor mental and physical health outcomes and quality of life in the general population, and preliminary research suggests that loneliness is linked to poorer health outcomes in cancer patients as well. Various aspects of the cancer experience contribute to patients feeling alone and misunderstood. Furthermore, loneliness theory suggests that negative social expectations, which may specifically relate to the cancer experience, precipitate and sustain loneliness. Cancer-specific tools are needed to assess key constructs of this theory. In the current study, we developed and tested measures of (1) loneliness attributed to cancer (i.e., cancer-related loneliness) and (2) negative social expectations related to cancer.First, we developed the items for the measures based on theory, prior research, and expert feedback. Next, we assessed the measures' psychometric properties (i.e., internal consistency and construct validity) in a diverse sample of cancer patients.	The final products included a 7-item unidimensional Cancer Loneliness Scale and a 5-item unidimensional Cancer-related Negative Social Expectations Scale. Evidence of excellent reliability and validity was found for both measures.	The resulting measures have both clinical and research utility.	
28236140	Individuals with language barriers may face challenges unique to a host society. By examining and comparing the sociocultural conditions that can result in providers and patients not sharing the same language in the United States and in Taiwan, I argue that (a) language discordance is a social phenomenon that may entail diverging meanings and experiences in different countries; (b) language-discordant patients may not share similar experiences even if they are in the same country; and (c) disparities in language concordance may be confounded with other disparities and cultural particulars that are unique to a host society. In addition, because English is a dominant language in medicine, language-discordant patients' quality of care in Taiwan can be moderated by their fluency in English.
28236100	Parent-reported developmental concerns can be a first step toward further screening and intervention for children at risk for ASD. However, little is known about the extent to which parental well-being and child behavior contribute to parental concerns, especially in families who already have one child with ASD. This study included 54 parents and their 18-month-old high-risk toddlers to examine the extent to which parents' well-being (i.e., parenting stress and self-efficacy), and children's behavior (i.e., expressive language and social communication) contribute to parents' concerns regarding their toddler's development. Results revealed that parental concerns were predicted by their own well-being as well as their toddler's expressive language, highlighting the importance of addressing the needs of both parent and child in intervention settings.
28235009	After the 2011 Fukushima Daiichi nuclear power plant accident, little information has been available on individual doses from external exposure among residents living in radioactively contaminated areas near the nuclear plant; in the present study we evaluated yearly changes in the doses from external exposure after the accident and the effects of decontamination on external exposure. This study considered all children less than 16 years of age in Soma City, Fukushima who participated in annual voluntary external exposure screening programs during the five years after the accident (n = 5,363). In total, 14,405 screening results were collected. The median participant age was eight years. The geometric mean levels of annual additional doses from external exposure attributable to the Fukushima accident, decreased each year: 0.60 mSv (range: not detectable (ND)-4.29 mSv), 0.37 mSv (range: ND-3.61 mSv), 0.22 mSv (range: ND-1.44 mSv), 0.20 mSv (range: ND-1.87 mSv), and 0.17 mSv (range: ND-0.85 mSv) in 2011, 2012, 2013, 2014, and 2015, respectively. The proportion of residents with annual additional doses from external exposure of more than 1 mSv dropped from 15.6% in 2011 to zero in 2015. Doses from external exposure decreased more rapidly than those estimated from only physical decay, even in areas without decontamination (which were halved in 395 days from November 15, 2011), presumably due to the weathering effects. While the ratios of geometric mean doses immediately after decontamination to before were slightly lower than those during the same time in areas without decontamination, annual additional doses reduced by decontamination were small (0.04-0.24 mSv in the year of immediately after decontamination was completed). The results of this study showed that the levels of external exposure among Soma residents less than 16 years of age decreased during the five years after the Fukushima Daiichi nuclear power plant accident. Decontamination had only limited and temporal effects on reducing individual external doses.
28233828	Songbird models meaningfully contribute to many fields including learned vocal communication, the neurobiology of social interactions, brain development, and ecology. The value of investigating gene-brain-behavior relationships in songbirds is therefore high. Viral infections typically used in other lab animals to deliver gene editing constructs have been less effective in songbirds, likely due to immune system properties. We therefore leveraged the in vivo electroporation strategy used in utero in rodents and in ovo in poultry, and apply it to posthatch zebra finch songbird chicks. We present a series of experiments with a combination of promoters, fluorescent protein genes, and piggyBac transposase vectors to demonstrate that this can be a reliable, efficient, and flexible strategy for genome manipulation. We discuss options for gene delivery experiments to test circuit and behavioral hypotheses using a variety of manipulations, including gene overexpression, CRISPR/Cas9 gene editing, inducible technologies, optogenetic or DREADD cellular control, and cell type-specific expression.
28233404	Chinese adolescents are increasingly engaging in romantic experiences and high-risk sexual behaviors within a rapidly-changing cultural and socio-economic context. Parental communication about sexuality has been recognized as protective for adolescents to make informed decisions about sexual practice. In this study, we explored what was discussed about adolescent romantic experience between parents and adolescents in China. Twenty-seven parents and 38 adolescents from a northern-eastern city of China were interviewed. Interviews were transcribed verbatim and thematically analyzed using a social constructionism framework. Four themes were identified: (i) detriments of romantic experience to education and future prospect; (ii) health and sociocultural risks of romantic and sexual engagement; (iii) ways of handling romantic experience; and (iv) marriage and family building. The messages were mainly prohibitive and consequence oriented in nature, and lacked specific romantic and sexual information. These messages reflected sociocultural beliefs in education, sexuality, marriage, and family in China, but did not meet the needs of current adolescents. External support from health professionals, such as nurses, is important for parents and adolescents to improve their sexual knowledge and communication skills.
28233147	This study aimed to establish norms for the modified Chinese version of the Autism Spectrum Rating Scale (ASRS). Participants were recruited from Shanghai, Harbin, Guangzhou, and Changsha, China, and their parents and teachers were invited to complete the Chinese Parent version and the Teacher version of the ASRS. In both versions, boys had significantly higher sub-scale scores and total score (T-score) by 1-3 and 4-5 points respectively, than girls (both P < 0.001). Age had weak correlations with some sub-scores and the T-score (r ranged from -0.1859 to 0.0738), and some reached significance (P < 0.03). The correlations appeared stronger and were more common in females. The T-score based on Chinese norms ideally correlated with the score based on the United States norms in boys and girls for both versions. Norms for the Chinese version of the ASRS for children aged 6-12 years are proposed and may be helpful for screening individuals with autism spectrum disorders from the general population of children.
28232515	To understand patients and family caregivers' experiences with home palliative care services, in order to identify, explore and integrate the key components of care that shape the experiences of service users.We performed a meta-ethnography of qualitative evidence following PRISMA recommendations for reporting systematic reviews. The studies were retrieved in 5 electronic databases (MEDLINE, EMBASE, PsycInfo, BNI, CINAHL) using 3 terms and its equivalents ('Palliative', 'Home care', 'Qualitative research') combined with 'AND', complemented with other search strategies. We included original qualitative studies exploring experiences of adult patients and/or their family caregivers (≥18 years) facing life-limiting diseases with palliative care needs, being cared for at home by specialist or intermediate home palliative care services.	28 papers reporting 19 studies were included, with 814 participants. Of these, 765 were family caregivers and 90% were affected by advanced cancer. According to participants' accounts, there are 2 overarching components of home palliative care: presence (24/7 availability and home visits) and competence (effective symptom control and skilful communication), contributing to meet the core need for security. Feeling secure is central to the benefits experienced with each component, allowing patients and family caregivers to focus on the dual process of living life and preparing death at home.	Home palliative care teams improve patients and caregivers experience of security when facing life-limiting illnesses at home, by providing competent care and being present. These teams should therefore be widely available and empowered with the resources to be present and provide competent care.	
28231801	Published descriptions of implementation strategies often lack precision and consistency, limiting replicability and slowing accumulation of knowledge. Recent publication guidelines for implementation strategies call for improved description of the activities, dose, rationale and expected outcome(s) of strategies. However, capturing implementation strategies with this level of detail can be challenging, as responsibility for implementation is often diffuse and strategies may be flexibly applied as barriers and challenges emerge. We describe and demonstrate the development and application of a practical approach to identifying implementation strategies used in research and practice that could be used to guide their description and specification.An approach to tracking implementation strategies using activity logs completed by project personnel was developed to facilitate identification of discrete strategies. This approach was piloted in the context of a multi-component project to improve children's access to behavioural health services in a county-based child welfare agency. Key project personnel completed monthly activity logs that gathered data on strategies used over 17 months. Logs collected information about implementation activities, intent, duration and individuals involved. Using a consensus approach, two sets of coders categorised each activity based upon Powell et al.'s (Med Care Res Rev 69:123-57, 2012) taxonomy of implementation strategies.	Participants reported on 473 activities, which represent 45 unique strategies. Initial implementation was characterised by planning strategies followed by educational strategies. After project launch, quality management strategies predominated, suggesting a progression of implementation over time. Together, these strategies accounted for 1594 person-hours, many of which were reported by the leadership team that was responsible for project design, implementation and oversight.	This approach allows for identifying discrete implementation strategies used over time, estimating dose, describing temporal ordering of implementation strategies, and pinpointing the major implementation actors. This detail could facilitate clear reporting of a full range of implementation strategies, including those that may be less observable. This approach could lead to a more nuanced understanding of what it takes to implement different innovations, the types of strategies that are most useful during specific phases of implementation, and how implementation strategies need to be adaptively applied throughout the course of a given initiative.	
28230944	The Citizens Council provides NICE with a public perspective on overarching moral and ethical issues that NICE should take into account when producing guidance. Made up of members of the public, broadly representative of the adult UK population, the Council operates through a “citizens’ jury” style meeting, to explore and respond to a question set by NICE. At its meeting in May 2014, the Citizens Council considered the question: “What are the societal values that need to be considered when making decisions about trade-offs between equity and efficiency?” We started by defining our understanding of what constitutes a ‛good society’ and the societal values which underpin it. With the help of experts and case studies, the Council examined how different societal values are involved in real life decisions about the provision of care. We then looked at the differences and similarities between public health, social care and health care and also discussed any ‛special circumstances’ where we considered there is a need for greater emphasis on either equity or efficiency. The Council also discussed whether some key values, such as ‛dignity’ and ‛humanity’ should always be taken into account no matter which area or what the circumstances are. At the end of the meeting we created a list of key societal values that we thought should be considered across public health, social care and health care. Accountability. Collective responsibility. Dignity. Education. Fairness. Honesty. Humanity. Individual rights. Justice. Maximising total benefit/benefit for most/utilitarianism. Quality of life. Respect. Right to health and welfare for all. Safeguarding the vulnerable. Value/quality of service. We felt that these values should underpin all three areas of public health, social care and health care, not just when looking at trade-offs between equity and efficiency but as guiding principles for all of NICE’s work. However, we felt that, depending on the situation, some of these are more pertinent than others. Although we found it difficult to define how they should influence the trade-offs between equity and efficiency when making decisions, we hope we have provided insights to form the basis for further exploration by NICE. The theme of ‛good communication’ came up throughout our discussions, in the context of how societal values are felt and experienced when the reasoning behind decisions is not effectively communicated. A lack of good communication could lead to patients or service users feeling that the decision did not match up with their expected values and not feel ‛fair’. The tension between ‛individual rights’ and wider society was also a recurrent theme and we often found it difficult to find a balance between the two, for example how the individual right to drink alcohol can create problems for society and what should constitute ‛‛the greater good’’ in that situation.
28230939	The Citizens Council provides NICE with a public perspective on overarching moral and ethical issues that NICE should take into account when producing guidance. Made up of members of the public, broadly representative of the adult UK population, the Council operates through a “citizens’ jury” style meeting, to explore and respond to a question set by NICE. At its May 2009 meeting, the Citizens Council was asked to provide insight into the public’s view of innovation, and to explore which features of innovation should be considered when assessing its value, specifically in the context of health care. The aim was to provide a report to be fed into a study on the value of innovation in health care being carried out on behalf of NICE by Sir Ian Kennedy. The Council was asked: “What makes innovation valuable to you?” From a list of features that might make a healthcare innovation valuable, each member was asked to choose the three they felt were most valuable. The features, with number of votes shown in brackets, were: It increases quality of life (26). Other innovations may be developed from it in the future (11). A large number of people will benefit from it (10). It saves your life (9). It increases life expectancy (9). It meets a previously unmet need (6). It prevents a condition (5). It cures a condition (5). There are few other treatment options (1). It reduces risk to the patient (0). It has a one-off cost rather than ongoing costs (0). We were also asked to tackle two other questions. First, if the innovation is more expensive than NICE’s current cost per QALY gained threshold and does not demonstrate benefits at the moment but could well do so in the future, what should NICE do? Fifteen of us (a majority of two) responded that we should say “no” for the present, and ask the developers to fund and carry out more research themselves. The remaining 13 of our members also wanted us to say “no” for the present, but preferred that further research be co-funded for the developers on condition that the public would get a return proportionate to any investment. For a clearer insight into these conclusions we were asked more specifically who should bear the costs and risks of research and development. We had five choices: the developer; the NHS; the taxpayer; charities; joint sharing between taxpayer and developer. Seventeen of us felt that the developer of the technology should bear the full cost. The rest, 11 in total, opted for joint sharing between the taxpayer and the developer. We also offered NICE a raft of suggestions (listed in the body of the report) on how it might improve its communication with the public about innovation.
28231637	The uropygial gland is a holocrine complex exclusive to birds that produces an oleaginous secretion (preen oil) whose function is still debated. Herein, I examine critically the evidence for the many hypotheses of potential functions of this gland. The main conclusion is that our understanding of this gland is still in its infancy. Even for functions that are considered valid by most researchers, real evidence is scarce. Although it seems clear that preen oil contributes to plumage maintenance, we do not know whether this is due to a role in reducing mechanical abrasion or in reducing feather degradation by keratinophilic organisms. Evidence for a function against pathogenic bacteria is mixed, as preen oil has been demonstrated to act against bacteria in vitro, but not in vivo. Nor is it clear whether preen oil can combat pathogenic bacteria on eggshells to improve hatching success. Studies on the effect of preen oil against dermatophytes are very scarce and there is no evidence of a function against chewing lice. It seems clear, however, that preen oil improves waterproofing, but it is unclear whether this acts by creating a hydrophobic layer or simply by improving plumage structure. Several hypotheses proposed for the function of preen oil have been poorly studied, such as reduction of drag in flight. Similarly, we do not know whether preen oil functions as repellent against predators or parasites, makes birds unpalatable, or functions to camouflage birds with ambient odours. On the other hand, a growing body of work shows the important implications of volatiles in preen oil with regard to social communication in birds. Moreover, preen oil clearly alters plumage colouration. Finally, studies examining the impact of preen oil on fitness are lacking, and the costs or limitations of preen-oil production also remain poorly known. The uropygial gland appears to have several non-mutually exclusive functions in birds, and thus is likely to be subject to several selective pressures. Therefore, future studies should consider how the inevitable trade-offs among different functions drive the evolution of uropygial gland secretions.
28231252	A major success in personality has been the development of a consensual structure of traits. However, much less progress has been made on the structure of an equally important aspect of human psychology: motives. We present an empirically and theoretically structured hierarchical taxonomy of 161 motives gleaned from a literature review from McDougall to the present and based on the cluster analysis of similarity judgments among these 161 motives, a broader sampling of motives than previous work. At the broadest level were: Meaning, Communion, and Agency. These divided into nine clusters: Morality & Virtue, Religion & Spirituality, Self-Actualization, Avoidance, Social Relating, Family, Health, Mastery & Competence, and Financial & Occupational Success. Each divided into more concrete clusters to form 5 levels. We discuss contributions to research on motives, especially recent work on goal systems, and the aiding of communication and systematization of research. Finally, we compare the taxonomy to other motive organizations.
28230272	Research suggests that hurricane-related risk perception is a critical predictor of behavioral response, such as evacuation. Less is known, however, about the precursors of these subjective risk judgments, especially when time has elapsed from a focal event. Drawing broadly from the risk communication, social psychology, and natural hazards literature, and specifically from concepts adapted from the risk information seeking and processing model and the protective action decision model, we examine how individuals' distant recollections, including attribution of responsibility for the effects of a storm, attitude toward relevant information, and past hurricane experience, relate to risk judgment for a future, similar event. The present study reports on a survey involving U.S. residents in Connecticut, New Jersey, and New York (n = 619) impacted by Hurricane Sandy. While some results confirm past findings, such as that hurricane experience increases risk judgment, others suggest additional complexity, such as how various types of experience (e.g., having evacuated vs. having experienced losses) may heighten or attenuate individual-level judgments of responsibility. We suggest avenues for future research, as well as implications for federal agencies involved in severe weather/natural hazard forecasting and communication with public audiences.

28229248	Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth's behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and healthcare providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth.
28228630	Objectives The purpose of this study was to analyze the social activities of older men who require daily support, and to clarify the purpose of such activities, in order to develop effective living support and preventive long-term care service, suitable for this population.Methods Individual, semi-structured interviews were conducted with 17 older men. Data were analyzed using inductive and qualitative methods.Results Four categories of social activities were identified, and four categories of purposes of these social activities were extracted. The following were the identified social activities: maintenance of "comfortable relationships with others," including family, relatives, friends, and neighbors; "participation and use of services and programs with clear objectives and relationships with others," such as long-term care insurance system services, clubs for the elderly, and hobby groups; maintenance of "relationships with former colleagues, depending on their experience of working with them," where some individuals actively participated in gatherings with former colleagues, while others did not keep in touch at all; and participation in "activities to enrich their feelings and quality of life within their living space," such as reading, watching TV, and doing household chores. The purposes of the observed social activities were to build "relationships with society through communication with other people" and to have a "sense of security by spending time with people of the same age and with those older than them." Hence, participants engaged in clubs for the elderly, as well as in hobby groups. In addition, participants made time for exercising regularly, which maintained their cognitive function and was intended for the "maintenance and activation of their physical functions by continuing to exercise," and "continuing to learn by thinking." Furthermore, participants engaged in the exercise or hobby groups that they were interested in, in order to "utilize their time in a meaningful way" that lead to pleasure and enjoyment.Conclusion The following were the characteristics of the observed social activities: (1) the activities helped participants to maintain relationships with their coworkers, (2) participants had comfortable relationships with others, with these relationships exhibiting different levels (i.e. intimate relationships or casual), and (3) participants actively followed current events. They have clear purpose join and participate in social activities. In addition, it is suggested that this population engage in social activities to enrich physical function and overall quality of life.
28228196	The late 1960s was a period of significant upheaval of social, cultural, and scientific norms. The generally accepted notion of mandatory laparotomy for all penetrating abdominal injuries was among those norms being called into question across the country and many advocated expectant management of selected patients presenting with this type of injury. Leaders of the surgical community published opinions on either side of the argument. The house staff at Charity Hospital during this period was among the busiest in the nation in treating these injuries, many of them inmates of the Louisiana State Penitentiary who used self-inflicted stab wounds to the abdomen as a means of temporary respite from the inhumane conditions in the prison. Inspired, in part, by the overabundance of negative laparotomies among this group, F. Carter Nance went on to systematically challenge the standard of care. This effort constitutes one of the major forces for change of the surgical dogma of mandatory laparotomy for all abdominal stab wounds. It is the first major study to show conclusively that delayed laparotomy for perforated viscous was not significantly detrimental and posed less of a risk than unnecessary laparotomy. The circumstances surrounding this initiative constitute a powerful and heretofore unknown chapter in the history of surgical innovation.
28226017	to evaluate the physical facilities, human resources and activities developed in the Psychosocial Care Centers (CAPS) in the region of Médio Paraopeba, Minas Gerais, Brazil, in 2014.this is an evaluation study of the dimensions of structure and processes proposed by Donabedian, based on recommendations of the Ministry of Health and current laws; semi-structured forms were used to interview health managers; direct observation of mental health services was performed.	in 12 of the 14 CAPS studied, it was found the minimum recommended of physical facilities and full professional staff and in greater number than established by law; the use of community spaces, communication and exchange of information with other units of health care network was deficient in most of the centers.	although most of the aspects were suitable, some deficiencies were observed; criteria definition and legislation updates are necessary to improve health services and to accomplish the proposal of network service.	
28225448	Social media is an important communication channel that can help hospitals and consumers obtain feedback about quality of care. However, despite the potential value of insight from consumers who post comments about hospital care on social media, there has been little empirical research on the relationship between patients' anecdotal feedback and formal measures of patient experience.The aim of the study was to test the association between informal feedback posted in the Reviews section of hospitals' Facebook pages and scores on two global items from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, Overall Hospital Rating and Willingness to Recommend the Hospital.	We retrieved star ratings and anecdotal comments posted in Reviews sections of 131 hospitals' Facebook pages. Using a machine learning algorithm, we analyzed 57,985 comments to measure consumers' sentiment about the hospitals. We used regression analysis to determine whether consumers' quantitative and qualitative postings would predict global measures from the HCAHPS survey.	Both number of stars and the number of positive comments posted on hospitals' Facebook Reviews sections were associated with higher overall ratings and willingness to recommend the hospital. The findings suggest that patients' informal comments help predict a hospital's formal measures of patient experience.	Consistent with crowd wisdom, ordinary consumers may have valid insights that can help others to assess patient experience at a hospital. Given that some people will judge hospital quality based on opinions voiced in social media, further research should continue to explore associations between anecdotal commentary and a variety of quality indicators.	Administrators can tap into the wealth of commentary on social media as the forum continues to expand its influence in health care. Comments on social media may also serve as an early snapshot of patient-reported experiences, alerting administrators to problems that may appear in subsequent HCAHPS survey results.	
28225175	It has been well-established that social environmental factors can increase the risk of rehospitalization for people receiving home healthcare services. For caregivers who might be challenged to keep up with sometimes unfamiliar health monitoring tasks or to know when to seek help, mobile health technology offers the potential to enhance the skills of informal caregivers and to improve the communication between home and clinical care. This paper described our recent work to determine the usability, functionality, and style of interaction that would be needed to provide an effective and well-accepted tool. Caregivers would likely adopt new mobile health tools, as long as care is taken to eliminate potential barriers, for example, by providing adequate training, and to include design aspects that enhance one's motivation to use a tool, such as by supporting autonomy and engagement.
28225021	Mouse lemurs are basal primates that rely on chemo- and acoustic signalling for social interactions in their dispersed social systems. We examined the urinary protein content of two mouse lemurs species, within and outside the breeding season, to assess candidates used in species discrimination, reproductive or competitive communication. Urine from Microcebus murinus and Microcebus lehilahytsara contain a predominant 10 kDa protein, expressed in both species by some, but not all, males during the breeding season, but at very low levels by females. Mass spectrometry of the intact proteins confirmed the protein mass and revealed a 30 Da mass difference between proteins from the two species. Tandem mass spectrometry after digestion with three proteases and sequencing de novo defined the complete protein sequence and located an Ala/Thr difference between the two species that explained the 30 Da mass difference. The protein (mature form: 87 amino acids) is an atypical member of the whey acidic protein family (WFDC12). Seasonal excretion of this protein, species difference and male-specific expression during the breeding season suggest that it may have a function in intra- and/or intersexual chemical signalling in the context of reproduction, and could be a cue for sexual selection and species recognition.
28224943	The criteria for Medicare payment of telehealth nephrology services, and all other Medicare telehealth services, are set forth in section 1834(m) of the Social Security Act. There are just over 80 professional physician or practitioner services that may be furnished via telehealth and paid under Medicare Part B, when an interactive audio and video telecommunication system that permits real-time communication between a beneficiary at the originating site and the physician or practitioner at the distant site substitutes for an in-person encounter. These services include 16 nephrology billing codes for furnishing ESRD services for monthly monitoring and assessment and two billing codes for chronic kidney disease education. In recent years, many mobile health devices and other web-based tools have been developed in support of monitoring, observation, and collaboration for people living with chronic disease. This article reviews the statutory and program guidance that governs Medicare telehealth services, defines payment policy terms (e.g., originating site and distant site), and explains payment policies when telehealth services are furnished.
28224500	Recent innovations in sensing and Information and Communication Technology (ICT) have enabled researchers in animal behavior to collect an enormous amount of data. Consequently, the development of an automated system to substitute for some of the observations and analyses that are performed currently by expert researchers is becoming a crucial issue so that the vast amount of accumulated data can be processed efficiently. For this purpose, we introduce a process for the automated classification of the social interactive status of two mice in a square field on the basis of a Hidden Markov model (HMM). We developed two models: one for the classification of two states, namely, indifference and interaction, and the other for three states, namely, indifference, sniffing, and following. The HMM was trained with data from 50 pairs of mice as provided by expert human observers. We measured the performance of the HMM by determining its rate of concordance with human observation. We found that sniffing behavior was segmented well by the HMM; however, following behavior was not segmented well by the HMM in terms of percentage concordance. We also developed software called DuoMouse, an automated system for the classification of social interactive behavior of mice, that was based on the HMM. Finally, we compared two implementations of the HMM that were based on a histogram and a Gaussian mixture model.
28224133	This paper reports data about the learning performance of students using four different motivational tools: an educational game, a gamified plugin, a social networking website and a gamified social networking website. It also reports a control group. The data pertain to 379 students of an undergraduate course that covers basic Information and Communication Technology (ICT) skills in Spain. Data corresponds to different learning modules of the European Computer Driving License (ECDL) initiative. The data include variables of four pre-test scores, four post-test scores and a final examination. It was gathered using a quasi-experimental research design during 2014. Data reported here refers to the research paper in (de-Marcos et al., 2016) [1].
28223033	Autism spectrum disorder (ASD) is a complex and prevalent neurodevelopmental disorder characterized by social and communicative deficits, as well as repetitive behaviors and atypical sensitivity to sensory stimulation. Alterations in network connectivity are widely recognized, but their interplay with social and sensory symptoms remains largely unclear. Here, functional magnetic resonance imaging and diagnostic and behavioral assessments were used in a cohort of children and adolescents with ASD (n=40) and matched typically developing (TD, n=38) controls to examine the relation between auditory processing, interhemispheric and thalamocortical network connectivity, and social-behavioral symptom severity. We found that atypical processing of sounds was related to social, cognitive, and communicative impairments. Additionally, severity of sensory processing deficits and lower verbal IQ were related to reduced interhemispheric connectivity of auditory cortices in ASD. Increased connectivity between the thalamus and auditory cortex in ASD, however, was associated with reduced cognitive and behavioral symptomatology, suggesting that thalamocortical overconnectivity might reflect a compensatory mechanism in ASD. These findings provide novel evidence for links between auditory sensory deficits and impairments in social interaction and communication.
28222975	In the field of health, information and communication technology (ICT) can create a space that, regardless of place or time, enables information to be shared and disseminated quickly. In addition to the usual challenges of evaluating public health activities, other difficulties are present when evaluating activities using ICT, such as lack of previous standards, unknown individual exposure or lack of information on the characteristics of those exposed. The aim of this paper is to describe some tools and indicators that may help to assess the scope, use and parameters related to website positioning on search engines as well as the connected social networks.
28222781	New approaches to cope with clinical and psychosocial aspects of type 2 diabetes (T2DM) are needed; gender influences the complex interplay between clinical and non-clinical factors. We used data from the BENCH-D study to assess gender-differences in terms of clinical and person-centered measures in T2DM.Clinical quality of care indicators relative to control of HbA1c, lipid profile, blood pressure, and BMI were derived from electronic medical records. Ten self-administered validated questionnaires (SF-12 Health Survey; WHO-5 well-being index; Problem Areas in Diabetes (PAID) 5, Health Care Climate Questionnaire, Patients Assessment of Chronic Illness Care, Diabetes Empowerment Scale, Diabetes Self-care Activities, Global Satisfaction for Diabetes Treatment, Barriers to Taking Medications, Perceived Social Support) were adopted as person-centered outcomes indicators.	Overall, 26 diabetes clinics enrolled 2,335 people (men: 59.7%; women: 40.3%). Lower percentages of women reached HbA1c levels < =7.0% (23.2% vs. 27.8%; p = 0.03), LDL-cholesterol < 100 mg/dl (48.3 vs. 57.8%; p = 0.0005), and BMI <27 Kg/m2 (27.2 vs. 31.6%; p = 0.04) than men. Women had statistically significant poorer scores for physical functioning, psychological well-being, self-care activities dedicated to physical activities, empowerment, diabetes-related distress, satisfaction with treatment, barriers to medication taking, satisfaction with access to chronic care and healthcare communication, and perceived social support than men; 24.8% of women and 8.8% of men had WHO-5 < =28 (likely depression) (p < 0.0001); 67.7% of women and 55.1% of men had PAID-5 > 40 (high levels of diabetes-related distress) (p < 0.0001). At multivariate analysis, factors associated with an increased likelihood of having elevated HbA1c levels (≥8.0%) were different in men and women, e.g. having PAID-5 levels >40 was associated with a higher likelihood of HbA1c ≥8.0% in women (OR = 1.15; 95%CI 1.05-1.25) but not in men (OR = 1.00; 95%CI 0.93-1.08).	In T2DM, women show poorer clinical and person-centered outcomes indicators than men. Diabetes-related distress plays a role as a correlate of metabolic control in women but not in men. The study provides new information about the interplay between clinical and person-centered indicators in men and women which may guide further improvements in diabetes education and support programs.	
28222736	Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice.We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers' fieldwork reports, were coded and thematically analysed by each team using NPT.	In all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants' needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP's diagnoses and GPs reported a clearer understanding of migrants' symptoms.	Migrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.	
28222721	Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability.A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings.	Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81-.99) and access/availability (OR = .78; 95% CI = .72-.84). Several factors involving doctors' incompetence, such as inappropriate handling of critical cases, inaccurate diagnose, excessive reliance on medical tests, absence of physical examination, non-availability of specialist doctors, and experimentation by trainee doctors were related to patient dissatisfaction.	The findings of this study highlight a need to develop the interpersonal and clinical skills of doctors in order to improve the quality of doctor-patient interactions in public clinics for diabetes in Pakistan. Prospective researches should explore context-specific factors that form patient satisfaction.	
28222570	Individuals with Amyotrophic Lateral Sclerosis (ALS) exhibit speech disorders since the early stages that decrease the communication rate and interfere in social participation.To conduct a literature review on communication vulnerable and Augmentative and Alternative Communication (AAC) in Amyotrophic Lateral Sclerosis.	Descriptors of the Health Sciences Descriptors (DeCS) were used: Amyotrophic Lateral Sclerosis, Health Vulnerability, Communication Barriers, Nonverbal Communication, and Communication Aids for Disabled. Articles in Portuguese and English from 2010 to 2015, fully available in the Virtual Health Library, PubMed, and Scopus were used. Duplicate articles and those not related to communication/language were excluded.	Of the 94 articles found, 37 met the criteria. All of them were published in the USA and Europe, none was Brazilian; 27% of 2012 to 2014; 40.5% descriptive studies and 24.3% case studies; 45.9% addressed ALS and 24.3%, other serious motor alterations, including ALS. A large proportion (89.2%) addressed AAC, 70.3% Brain-Computer Interface (BCI).	The results show that the researches recurrently addressed communication vulnerable, although not necessarily in these terms. The device which was most employed was the BCI, mainly in advanced stages of the disease.	
28221952	Food safety is an essential public health issue for all countries. This study was the first attempt to design and develop a home food safety questionnaire (HFSQ), in the conceptual framework of the PRECEDE (predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation) model, and to assess its validity and reliability. The HFSQ was developed by reviewing electronic databases and 12 focus group discussions with 96 women volunteers. Ten panel members reviewed the questionnaire, and the content validity ratio and content validity index were computed. Twenty women completed the HFSQ, and face validity was assessed. Women who were responsible for food handling in their households (n =320) were selected randomly from 10 health centers and completed the HFSQ based on the PRECEDE model. To examine the construct validity, a principal components factor analysis with varimax rotation was used. Internal consistency was determined with Cronbach's α. Reproducibility was checked by Kendall's τ after 4 weeks with 30 women. The developed HSFQ was considered acceptable with a content validity index of 0.88. Face validity revealed that 95% of the participants understood the questions and found them easy to answer, and 90% confirmed the appearance of the HFSQ and declared the layout acceptable. Principal component factor analysis revealed that the HFSQ could explain 33.7, 55.3, 34.8, and 60.0% of the total variance of the predisposing, reinforcing, practice, and enabling components, respectively. Cronbach's α was acceptable at 0.73. For Kendall's τc, r = 0.89, with a 95% confidence interval of 0.85 to 0.93. The HFSQ developed based on the PRECEDE model met the standards of acceptable reliability and validity, which can be generalized to a wider population. These results can provide information for the development of effective communication strategies to promote home food safety.
28221066	Many adolescents are heavily engaged with social media and text messaging (George & Odgers, 2015; Lenhart, 2015), yet few psychologists have studied what digital communication means for adolescents' relationships and adjustment. This article proposes that psychologists should embrace the careful study of adolescents' digital communication. We discuss theoretical frameworks for understanding adolescents' involvement with social media, present less widely recognized perils of intense involvement with social media, and highlight positive features of digital communication. Coconstruction theory suggests that adolescents help to create the content of digital communication that shapes their lives, and that there may be strong continuity between adolescents' offline and online lives (Subrahmanyam, Smahel, & Greenfield, 2006). However, psychological theories and research methods could further illuminate the power and the pain of adolescents' digital communication. Psychologists need to understand more about subtle but potentially serious risks that adolescents might face: The agony of victimization by even a single episode of cyberbullying and the pain of social exclusion and comparison resulting from vast amounts of time reading large social media feeds and seeing friends doing things without you and comparing your inner emotional experience to everyone else's highly groomed depictions of their seemingly marvelous lives. If we seek to understand developmental psychopathology and to help youth at risk, psychologists need to embrace careful study of the content of adolescents' online communication, parents need to talk with their children about their own online experiences and become familiar with social media themselves, and clinicians need to address adolescents' online social lives in prevention and treatment programs. (PsycINFO Database Record
28220984	Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurses report as facilitating the enactment of open disclosure.Semistructured interviews with 13 doctors and 22 nurses from a range of levels and specialities from 5 national health service hospitals and primary care trusts in the UK were conducted and analysed using a framework approach.	Five themes were identified which appear to capture the factors that are critical in supporting open disclosure: open disclosure as a moral and professional duty, positive past experiences, perceptions of reduced litigation, role models and guidance, and clarity.	Greater openness in relation to adverse events requires health professionals to recognise candour as a professional and moral duty, exemplified in the behaviour of senior clinicians and that seems more likely to occur in a nonpunitive, learning environment. Recognising incident disclosure as part of ongoing respectful and open communication with patients throughout their care is critical.	
28220912	Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1-3 shifts of the same kind in a row) and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work-family and family-work positive and negative spillover, marital communication style, job satisfaction and health.Employees (N = 168) of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system) participated in the study. They completed the Work- Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index).	The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165) = 4.175, p = 0.007) and a higher level of constructive style of marital communication (Engagement F(3, 165) = 2.761, p = 0.044) than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction.	A higher level of work-family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night). This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1):121-131.	
28220518	Health professional student evaluation during experiential training is notably subjective and assessor judgements may be affected by socio-cultural influences.This study sought to explore how clinical preceptors in pharmacy conceptualise varying levels of student performance and to identify any contextual differences that may exist across different countries.	The qualitative research design employed semi-structured interviews. A sample of 20 clinical preceptors for post-baccalaureate Doctor of Pharmacy programmes in Canada and the Middle East gave personal accounts of how students they had supervised fell below, met or exceeded their expectations. Discussions were analysed following constructivist grounded theory principles.	Seven major themes encompassing how clinical pharmacy preceptors categorise levels of student performance and behaviour were identified: knowledge; team interaction; motivation; skills; patient care; communication, and professionalism. Expectations were outlined using both positive and negative descriptions. Pharmacists typically described supervisory experiences representing a series of these categories, but arrived at concluding judgements in a holistic fashion: if valued traits of motivation and positive attitude were present, overall favourable impressions of a student could be maintained despite observations of a few deficiencies. Some prioritised dimensions could not be mapped to defined existing educational outcomes. There was no difference in thresholds for how student performance was distinguished by participants in the two regions.	The present research findings are congruent with current literature related to the constructs used by clinical supervisors in health professional student workplace-based assessment and provide additional insight into cross-national perspectives in pharmacy. As previously determined in social work and medicine, further study of how evaluation instruments and associated processes can integrate these judgements should be pursued in this discipline.	
28219955	A Needs Assessment Tool (NAT) was developed previously to help clinicians identify the supportive/palliative needs of people with interstitial lung disease (ILD) (NAT:ILD). This letter presents barriers and facilitators to clinical implementation. Data from (1) a focus group of respiratory clinicians and (2) an expert consensus group (respiratory and palliative clinicians, academics, patients, carers) were analysed using Framework Analysis. Barriers related to resources and service reconfiguration, and facilitators to clinical need, structure, objectiveness, flexibility and benefits of an 'aide-memoire'. Identified training needs included communication skills and local service knowledge. The NAT:ILD was seen as useful, necessary and practical in everyday practice.
28219258	Most research on ethnicity has focused on visual cues. However, accents are strong social cues that can match or contradict visual cues. We examined understudied reactions to people whose one cue suggests one ethnicity, whereas the other cue contradicts it. In an experiment conducted in Germany, job candidates spoke with an accent either congruent or incongruent with their (German or Turkish) appearance. Based on ethnolinguistic identity theory, we predicted that accents would be strong cues for categorization and evaluation. Based on expectancy violations theory we expected that incongruent targets would be evaluated more extremely than congruent targets. Both predictions were confirmed: accents strongly influenced perceptions and Turkish-looking German-accented targets were perceived as most competent of all targets (and additionally most warm). The findings show that bringing together visual and auditory information yields a more complete picture of the processes underlying impression formation.
28219114	Alcohol marketing is known to be a significant risk factor for underage drinking. However, little is known about youth and adult exposure to alcohol advertising in digital and social media. This study piloted a comparative assessment of youth and adult recall of exposure to online marketing of alcohol.From September to October 2013, a pilot survey of past 30-day exposure to alcohol advertising and promotional content in traditional and digital media was administered to a national sample of 1,192 youth (ages 13 to 20) and 1,124 adults (ages ≥21) using a prerecruited Internet panel maintained by GfK Custom Research. The weighted proportions of youth and adults who reported this exposure were compared by media type and by advertising and promotional content.	Youth were more likely than adults to recall exposure to alcohol advertising on television (69.2% vs. 61.9%), radio (24.8% vs. 16.7%), billboards (54.8% vs. 35.4%), and the Internet (29.7% vs. 16.8%), but less likely to recall seeing advertising in magazines (35.7% vs. 36.4%). Youth were also more likely to recall seeing advertisements and pictures on the Internet of celebrities using alcohol (36.1% vs. 20.8%) or wearing clothing promoting alcohol (27.7% vs. 15.9%), and actively respond (i.e., like, share, or post) to alcohol-related content online.	Youth report greater exposure to alcohol advertising and promotional content than adults in most media, including on the Internet. These findings emphasize the need to assure compliance with voluntary industry standards on the placement of alcohol advertising and the importance of developing better tools for monitoring youth exposure to alcohol marketing, particularly on the Internet.	
28219097	Work-anxieties are often going along with workplace problems and long-term sick leave. Psychopathologically, different qualities of work anxiety can be distinguished: worrying, phobic anxiety, health-related anxiety, anxiety of insufficiency. An evaluation of a work-anxiety treatment showed that confronting patients with the topic work during medical rehabilitation leads to a better course. In work-oriented capacity trainings or behavior therapy groups, coping with everyday phenomena at work may be trained (self-presentation, social rules, work organization and problem solving, coping with chronic illness and impairment conditions). Active coping and communication (explaining impairment to the supervisor and occupational physician for making problem solving possible) are helpful. In some cases, correction of expectations must be done, and normalizing everyday work problems (conflicts and achievement requirements are normal at work, work does not make happy all the time).
28219035	The present research addresses cultural variation in concepts of agency. Across two experiments, we investigate how Indigenous Ngöbe of Panama and US college students interpret and make inferences about nonhuman agency, focusing on plants as a critical test case. In Experiment 1, participants predicted goal-directed actions for plants and other nonhuman kinds and judged their capacities for intentional agency. Goal-directed action is pervasive among living kinds and as such we expected cultural agreement on these predictions. However, we expected that interpretation of the capacities involved would differ based on cultural folktheories. As expected, Ngöbe and US participants both inferred that plants would engage in goal-directed action but Ngöbe were more likely to attribute intentional agency capacities to plants. Experiment 2 extends these findings by investigating action predictions and capacity attributions linked to complex forms of plant social agency recently discovered in botanical sciences (communication, kin altruism). We hypothesized that the Ngöbe view of plants as active agents would productively guide inferences for plant social interaction. Indeed, Ngöbe were more likely than US participants to infer that plants can engage in social behaviors and they also attributed more social agency capacities to plants. We consolidate these findings by using bottom-up consensus modeling to show that these cultural differences reflect two distinct conceptual models of agency rather than variations on a single (universal) model. We consider these findings in light of current theories of domain-specificity and animism, and offer an alternative account based on a folktheory of communication that infers agency on the basis of relational interactions rather than having a mind.
28218158	Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services.To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts.	An innovative strategy was designed to collect routine monitoring data, namely community behavior tracking survey using mobile technology. The catchment area of an Accredited Social Health Activist (ASHA) was the primary sampling unit, and in each district 200, ASHA areas were selected. Women from these selected ASHA areas were interviewed and information collected on various MNCH care outcomes. Multivariate logistic regression was used to assess changes in selected MNCH care indicators.	Gradual increase was noticed in institutional delivery, hospital stay for 48 or more hours, initiation of breastfeeding within 1 hour and continuum of MNCH care. Forty-eight hours stay and initiation of breastfeeding improved marginally possibly due to health systems and cultural norms.	Results indicated that the interventions were successful in changing the critical MNCH care indicators and hence have potential for replication in similar high priority district settings.	
28218009	The global growth and development of social media has had a positive impact on many individuals who use augmentative and alternative communication (AAC), who use it to communicate and connect with others. Research evidence into the use of social media by adults with acquired conditions who use AAC is limited. These individuals are a heterogeneous population, who can present with a range of linguistic, cognitive and physical needs, some of which progress rapidly, making accessing social media a challenge. These issues warrant research focusing on developing interventions to support the use of social media and the impact of these interventions. For individuals with acquired conditions who have previously used social media and for those who are new to the experience, social media can offer a vital connection to friends, family and health professionals. This paper examines current gaps in knowledge in this area in the field of AAC and proposes potential methodologies for future research. These include combining qualitative and quantitative methodologies (e.g., analysis of online interactions and observational data) that would be useful tools for data collection in an under-researched field.
28218007	Rehabilitation positively influences return to activities and social roles in people with aphasia. The cognitive-communication disorder (CCD) found following a right hemisphere stroke has been less extensively researched with rehabilitation access and outcomes yet to be determined.To document rehabilitation access and outcomes for people with CCD post-stroke; and compare outcomes based on presence (viz CCD; aphasia) or absence of communication impairment.	A retrospective chart audit was completed for patients with first onset unilateral stroke, with a hospital length of stay (LOS) of at least two days and a communication assessment by a speech pathologist. Data extracted included presence and severity of communication impairment, access to and LOS in a rehabilitation unit, and functional outcome measures recorded at rehabilitation discharge.	The majority of the 115 patients who met inclusion criteria were living independently (n = 112, 97.4%) at the time of stroke. CCD (66%) was diagnosed with similar frequency to aphasia (68%). The presence of communication impairment did not result in significant differences in rehabilitation LOS and discharge destination when compared to hemispheric strokes without communication impairment. Severity of CCD was an independent predictor of functional gain by rehabilitation discharge.	People with CCD require comparable access to rehabilitation as people with aphasia, and severity of CCD should be considered in determining rehabilitation LOS. A large number of people are discharged with ongoing CCD which warrants exploration of potential participation restrictions created by the communication impairment.	
28217532	In order to develop an application that addresses the most significant challenges facing IBD patients, this qualitative study explored the major hurdles of living with IBD, the information needs of IBD patients, and how application technology may be used to improve quality of life.15 IBD patients participated in two focus groups of 120 minutes each. Data collection was achieved by combining focus groups with surveys and direct observation of patients looking at a patient-engaged app (HealthPROMISE) screenshots. The survey elicited information on demographics, health literacy and quality of life through the Short IBD Questionnaire (SIBDQ).	The needs of IBD patients center around communication as it relates to both patient information needs and navigating the social impacts of IBD on patients' lives: Communication Challenges regarding Information Needs: Patients cited a doctor-patient communication divide where there is a continued lack of goal setting when discussing treatments and a lack of objectivity in disease control. When objectively compared with the SIBDQ, nearly half of the patients in the focus groups wrongly estimated their IBD control.Communication Challenges regarding Social Impacts of IBD: Patients strongly felt that while IBD disrupts routines, adds significant stress, and contributes to a sense of isolation, the impact of these issues would be significantly alleviated through more conversation and better support.Implication for Mobile Health Solutions: Patients want a tool that improves tracking of symptoms, medication adherence and provides education. Physician feedback to patient input on an application is required for long-term sustainability.	IBD patients need mobile health technologies that evaluate disease control and the goals of care. Patients feel an objective assessment of their disease control, goal setting and physician feedback will greatly enhance utilization of all mobile health applications.	
28217177	Over the past two decades, there has been a significant evolution in the technologies and techniques employed within the radiation oncology environment. Over the same period, extensive research into the use of nanotechnology in medicine has highlighted a range of potential benefits to its incorporation into clinical radiation oncology. This short communication describes key tools and techniques that have recently been introduced into specific stages of a patient's radiotherapy pathway, including diagnosis, external beam treatment and subsequent follow-up. At each pathway stage, consideration is given towards how nanotechnology may be combined with clinical developments to further enhance their benefit, with some potential opportunities for future research also highlighted. Prospective challenges that may influence the introduction of nanotechnology into clinical radiotherapy are also discussed, indicating the need for close collaboration between academic and clinical staff to realise the full clinical benefit of this exciting technology.
28216951	The self-treatment with complementary and alternative medicines (CAMs) in chronic diseases is portraying an expanding trend worldwide. Yet, little is known concerning patients' motives to use CAM in the control of blood pressure.This study aims to explore the self-use of CAM in the management of hypertension and explore patients' attitudes, perceived benefits, and disclosure to the physician.	A qualitative technique was adopted and face-to-face interviews, using a validated interview guide, were carried out among twenty hypertensive patients. A purposive sampling method was used to recruit patients at Al-Karama Teaching Hospital in Baghdad; the capital of Iraq; from January to April 2015. All the interviews were audio-recorded, then transcribed verbatim and examined for thematic relationships.	Three major themes were identified through thematic content analysis of the interviews. These encompassed patients' understanding of CAM; experience and perceived benefits; and communication with the doctors. The use of CAM was prevalent among the majority of the respondents. The most commonly used therapies were biological-based practices (herbal remedies, special diet, vitamins, and dietary supplements); traditional therapies (Al-Hijama or cupping); and to a less extent of manipulative body-based therapies (reflexology). Factors influencing the use of CAM were traditions, social relationships, religious beliefs, low-cost therapy, and safety of natural products.	The use of CAM was common as a practice of self-treatment among hypertensive patients in Iraq. This was underpinned by the cultural effects, social relationships, religious beliefs, and the perception that natural products are effective and safe. Understanding patients' usage of CAM is of great importance as long as patient's safety and interaction with the standard prescribed treatment are major concerns.	
28216281	Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, ACP is not widely implemented in chronic kidney disease (CKD) care settings. This study aims to describe clinicians' beliefs, challenges, and perspectives of ACP in patients with CKD.Qualitative study.	Nephrologists (n=20), nurses (n=7), and social workers (n=4) with a range of experience in facilitating ACP for patients with CKD across Australia.	Semistructured interviews were digitally recorded and transcribed verbatim.	Transcripts were analyzed using thematic analysis.	5 major themes were identified: facilitating informed decision making (avoiding preconceptions, conveying complete truths, focusing on supportive care, and synchronizing with evolving priorities), negotiating moral boundaries (contending with medical futility and respecting patient vs family autonomy), navigating vulnerable conversations (jeopardizing the therapeutic relationship, compromising professional confidence, emotionally invested, and enriching experiences), professional disempowerment (unsupportive culture, doubting logistical feasibility, and making uncertain judgments), and clarifying responsibilities (governing facilitation, managing tensions, and transforming multidisciplinary relationships).	Some findings may be specific to the Australian context.	The tensions among themes reflect that ACP is paradoxically rewarding for clinicians because ACP empowers patients yet can expose personal and professional vulnerabilities. Clinicians believe that a more collaborative approach is needed, with increased efforts to identify the evolving and individualized needs and goals of patients with CKD. Models of ACP that address clinicians' personal and professional vulnerabilities when initiating ACP may foster greater confidence and cultural acceptance of ACP in the CKD setting.	
28215826	African American (AA) women have disproportionately high rates of cardiovascular (CV) risk factors that, coupled with potentially cardiotoxic breast cancer (BC) therapies, place them at risk of adverse CV outcomes. The purpose of this study was to assess CV risk factors among white and AA BC survivors and perceptions of patient-provider CV-related communication and post-treatment information needs.Early-stage, English-speaking BC survivors were recruited through community-based survivorship organizations/clinics in New Jersey. Qualitative, semi-structured interviews and a brief survey of socio-demographics and comorbidities were conducted.	BC survivors reported high rates of CV risk factors. Most reported their health as good/excellent despite their cancer history and CV risk profile. Approximately half of overweight/obese BC survivors reported no weight-related conversation with their health care team and, among those who reported discussion, 36% indicated it was self-initiated and dismissed. More than half of BC survivors' reported a desire for lifestyle-related information and guidance.	BC survivors may not understand how their separate, yet cumulative, health issues can impact their CV risk.	Patient-provider communication on behavioral risk factor modification and CV risk is needed, particularly among at-risk subgroups such as AA and obese BC survivors, to improve BC and CV outcomes.	
28215755	Interest in the practice of narrative care with older adults is continuing to grow (Kenyon & Randall, 2015). Significant attention has been paid thus far to various formal interventions or programs that enhance the narrative development of individuals in later life by helping them to express and explore their unique life story. Comparatively little, however, has been paid to the many informal opportunities for practicing narrative care in long term settings that occur amidst everyday interpersonal interactions - e.g., staff-resident interactions in nursing homes. Even less attention has been paid to the importance of cultivating an overarching institutional narrative that provides a supportive context for the practice of narrative care in general. This paper will contribute to discussions of "person-centered care" by arguing the need to change the culture of long-term care so that narrative care is practiced on all three levels at once: individual, interpersonal, and institutional.
28215389	Dissemination and implementation research training has great potential to improve the impact and reach of health-related research; however, research training needs from the end user perspective are unknown. This paper identifies and prioritizes dissemination and implementation research training needs.A diverse sample of researchers, practitioners, and policymakers was invited to participate in Concept Mapping in 2014-2015. Phase 1 (Brainstorming) gathered participants' responses to the prompt: To improve the impact of research evidence in practice and policy settings, a skill in which researchers need more training is… The resulting statement list was edited and included subsequent phases. Phase 2 (Sorting) asked participants to sort each statement into conceptual piles. In Phase 3 (Rating), participants rated the difficulty and importance of incorporating each statement into a training curriculum. A multidisciplinary team synthesized and interpreted the results in 2015-2016.	During Brainstorming, 60 researchers and 60 practitioners/policymakers contributed 274 unique statements. Twenty-nine researchers and 16 practitioners completed sorting and rating. Nine concept clusters were identified: Communicating Research Findings, Improve Practice Partnerships, Make Research More Relevant, Strengthen Communication Skills, Develop Research Methods and Measures, Consider and Enhance Fit, Build Capacity for Research, and Understand Multilevel Context. Though researchers and practitioners had high agreement about importance (r =0.93) and difficulty (r =0.80), ratings differed for several clusters (e.g., Build Capacity for Research).	Including researcher and practitioner perspectives in competency development for dissemination and implementation research identifies skills and capacities needed to conduct and communicate contextualized, meaningful, and relevant research.	
28214963	Interpersonal communication among participants plays an important role in the impact and effectiveness of prevention programs (Southwell & Yzer, Communication Theory 19:1-8, 2009). This study focused on adolescents' informal conversations about a prevention program, referred to as social talk, from a social network perspective. We provide both a conceptualization of social talk in relation to prevention programs and an operationalization of it by examining adolescents' social networks. Participants (N = 185) were eighth-grade students attending a middle school substance-abuse prevention program called keepin' it REAL (kiR). Participants engaged in both positive and negative social talk about kiR. Students with higher friendship indegree centrality were more likely to have greater positive social talk indegree centrality (r = .23 p < .01). These results indicated that youth considered as friends by most of their classmates were also reported as being positive in their comments with respect to kiR. Youth who talked positively about kiR tended to report personal anti-substance injunctive norms (b = 0.71, p < .05). On the other hand, youth who were nominated as negative social talkers by their peers appeared to have less personal anti-substance injunctive norms (b = -0.92, p < .05). Furthermore, youth who were more likely to talk negatively about kiR were less likely to perceive that their best friends (b = -1.66, p < .05) or most youth in their age (b = -1.49, p < .05) disapprove of substance use.
28214663	Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people.The aim of this study was to investigate student nurses' views on the care of and communication with older people.	A descriptive study with a mixed-method approach was conducted.	Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015.	The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites.	Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed.	
28214050	Understanding how emotional faces are processed is important to help characterize the social deficits in Autism Spectrum Disorder (ASD).We examined: (i) whether attention is modulated by emotional facial expression; (ii) the time course of the attentional preferences (short vs. long stimulus presentation rates); and (iii) the association between attentional biases and autistic symptomatology.	We applied a dot-probe experiment with emotional faces (happy, sad, and angry). The sample was composed of ASD children without additional language and/or intellectual impairments (n=29) and age-matched Typically Developing (TD) children (n=29).	When compared to the TD group, the ASD group showed an attentional bias away from angry faces at long presentation rates. No differences between groups were found for happy or sad faces. Furthermore, correlational analyses showed that the higher avoidance of angry faces, the greater are the social communication difficulties of ASD children. The attentional bias away from angry faces may be an underlying mechanism of social dysfunction in ASD. We discuss the implications of these findings for current theories of emotional processing in ASD.	
28213805	Since the documented observations of Kanner in 1943, there has been great debate about the diagnoses, the sub-types, and the diagnostic threshold that relates to what is now known as autism spectrum disorder (ASD). Reflecting this complicated history, there has been continual refinement from DSM-III with 'Infantile Autism' to the current DSM-V diagnosis. The disorder is now widely accepted as a complex, pervasive, heterogeneous condition with multiple etiologies, sub-types, and developmental trajectories. Diagnosis remains based on observation of atypical behaviors, with criteria of persistent deficits in social communication and restricted and repetitive patterns of behavior. This review provides a broad overview of the history, prevalence, etiology, clinical presentation, and heterogeneity of ASD. Factors contributing to heterogeneity, including genetic variability, comorbidity, and gender are reviewed. We then explore current evidence-based pharmacological and behavioral treatments for ASD and highlight the complexities of conducting clinical trials that evaluate therapeutic efficacy in ASD populations. Finally, we discuss the potential of a new wave of research examining objective biomarkers to facilitate the evaluation of sub-typing, diagnosis, and treatment response in ASD.
28213595	A qualitative study of the BREATHER (PENTA 16) randomised clinical trial, which compared virological control of Short Cycle Therapy (SCT) (5 days on: 2 days off) with continuous efavirenz (EFV)-based antiretroviral therapy (CT) in children and young people (aged 8-24) living with HIV with viral load <50 c/mL to examine adaptation, acceptability and experience of SCT to inform intervention development.Paediatric HIV clinics in the UK (2), Ireland (1), the USA (1) and Uganda (1).	All BREATHER trial participants who were over the age of 10 and aware of their HIV diagnosis were invited to participate. 49 young people from both arms of the BREATHER trial (31 females and 18 males; 40% of the total trial population in the respective sites; age range 11-24) gave additional consent to participate in the qualitative study.	Young people from both trial arms had initial concerns about the impact of SCT on their health and adherence, but these decreased over the early months in the trial. Young people randomised to SCT reported preference for SCT compared with CT pre-trial. Attitudes to SCT did not vary greatly by gender or country. Once short-term adaptation challenges were overcome, SCT was positively described as reducing impact of side effects, easing the pressure to carry and remember medication and enabling more weekend social activities. Young people on both arms reported frequent medication side effects and occasional missed doses that they had rarely voiced to clinical staff. Participants liked SCT by trial end but were concerned that peers who had most problems adhering could find SCT disruptive and difficult to manage.	To realise the potential of SCT (and mitigate possible risks of longer interruptions), careful dissemination and communication post-trial is needed. SCT should be provided alongside a package of monitoring, support and education over 3 months to allow adaptation.	
28213292	For children with autism spectrum disorders (ASDs), social robots are increasingly utilized as therapeutic tools in order to enhance social skills and communication. Robots have been shown to generate a number of social and behavioral benefits in children with ASD including heightened engagement, increased attention, and decreased social anxiety. Although social robots appear to be effective social reinforcement tools in assistive therapies, the perceptual mechanism underlying these benefits remains unknown. To date, social robot studies have primarily relied on expertise in fields such as engineering and clinical psychology, with measures of social robot efficacy principally limited to qualitative observational assessments of children's interactions with robots. In this review, we examine a range of socially interactive robots that currently have the most widespread use as well as the utility of these robots and their therapeutic effects. In addition, given that social interactions rely on audiovisual communication, we discuss how enhanced sensory processing and integration of robotic social cues may underlie the perceptual and behavioral benefits that social robots confer. Although overall multisensory processing (including audiovisual integration) is impaired in individuals with ASD, social robot interactions may provide therapeutic benefits by allowing audiovisual social cues to be experienced through a simplified version of a human interaction. By applying systems neuroscience tools to identify, analyze, and extend the multisensory perceptual substrates that may underlie the therapeutic benefits of social robots, future studies have the potential to strengthen the clinical utility of social robots for individuals with ASD.
28212634	The aim of this study was to investigate the relationship between knowledge of the current UK physical activity (PA) guidelines and amount of daily PA using a sample population of 11-16 year olds in Northern Ireland.Cross-sectional survey data from the 2010 and 2013 Young Persons' Behaviour and Attitudes Survey of 10,790 young people provided information on PA, knowledge of guidelines and socio-demographic characteristics. Multinomial logistic regression was used to investigate the associations between knowledge and amount of daily PA.	Results from 2013 showed 67.0% of respondents were aware of PA guidelines with 15.4% reporting meeting them. Males were more likely to meet PA guidelines than females (OR 3.36, 95% CI 2.47, 4.59). Males who were active for 60 min or more, 7 days per week were less likely to be aware of guidelines (OR = 1.51, 95% CI 1.02, 2.24). For females, knowledge of PA guidelines had no significant association with amount of daily PA (OR = 1.74, 95% CI 0.99, 3.07). Those who did not enjoy being active were less likely to meet the guidelines (OR = 0.05, 95% CI 0.02, 0.12).	Knowledge did not appear to be an important predictor of PA in young people. Consequently, threshold based messaging containing recommended minimum PA guideline information may not be appropriate for this age group. Re-branding PA promotion to include the use of humour may offer a new direction for public health messaging based around fun and enjoyment.	
28212616	Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM.As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list). The interview guideline included generic and patient-specific questions. Interviews were digitally recorded and transcribed verbatim. We content analyzed the interviews using deductive and inductive category development.	The majority of the general practitioners were not aware of the PRISCUS list. Agents deemed potentially inappropriate from the general practitioners' point of view and the PRISCUS list are not completely superimposable. General practitioners named their criteria to identify appropriate medication for elderly patients (e.g. renal function, cognitive state) and emphasized the importance of monitoring. We identified prescription- (e.g. benzodiazepines on alternative private prescription), medication- (e.g. subjective perception that PIM has no alternative), general practitioner- (e.g. general practitioner relies on specialists), patient- (e.g. "demanding high-user", positive subjective benefit-risk-ratio) and system-related aspects (e.g. specialists lacking holistic view, interface problems) related to the (long term) use of PIM.	While the PRISCUS list does not seem to play a decisive role in general practice, general practitioners are well aware of risks associated with PIM. Our study identifies some starting points for a safer handling of PIM, e.g. stronger dissemination of the PRISCUS list, better compensation of medication reviews, "positive lists", adequate patient information, multifaceted interventions and improved communication between general practitioners and specialists.	
28211668	Beta-propeller protein-associated neurodegeneration (BPAN) is typically characterized by early-onset seizures, infantile-onset global developmental delay, intellectual disability, absent to limited expressive language, motor dysfunction (ataxia), and abnormal behaviors often similar to autism spectrum disorder. Seizure types including generalized (absence, tonic, atonic, tonic-clonic and myoclonic), focal with impaired consciousness, and epileptic spasms, as well as epileptic syndromes (West syndrome and Lennox Gastaut syndrome) can be seen. With age seizures tend to resolve or become less prominent, whereas cognitive decline and movement disorders (progressive parkinsonism and dystonia) emerge as characteristic findings.The diagnosis of BPAN is established by identifying on molecular genetic testing: In females. A heterozygous WDR45 germline pathogenic variant; In males. Either a hemizygous WDR45 pathogenic variant or partial deletion of WDR45. Somatic mosaicism has been reported in rare females (and possibly in 1 male).	Treatment of manifestations: Seizure management, tailored to the individual, may include antiepileptic drugs (AEDs), ketogenic diet, and/or vagus nerve stimulation. Global developmental delays and intellectual disability are managed in infancy and early childhood with early intervention programs and in school-age children with individual education programs. Consultation with a developmental pediatrician to ensure appropriate services is recommended. Discussion about transition plans including financial, vocation/employment, and medical arrangements should begin at age 12 years. Consider alternative means of communication, such as an Augmentative and Alternative Communication (AAC) program, for individuals who have expressive language difficulties. Motor dysfunction in childhood is managed with physical therapy to maximize mobility and to reduce the risk for later-onset orthopedic complications (e.g., contractures, scoliosis, hip dislocation). Occupational therapy may aid in writing, feeding, grooming, and dressing. For those with feeding difficulties, feeding therapy may be considered. For individuals with social/behavioral difficulties, consider applied behavior analysis (ABA) therapy, medical management strategies in conjunction with a developmental specialist, and pediatric psychiatry consultation to address aggressive or destructive behaviors. In adolescents/adults with parkinsonism, dystonia, and spasticity, the usual pharmacologic agents can be considered with the caveat that these therapies could exacerbate the cognitive deficits that also occur in this age group. Children with abnormal behaviors may qualify for and benefit from interventions used in treatment of autism spectrum disorder. Surveillance: Routine follow up by a neurologist for medication management and interval assessment of ambulation, seizure activity, speech, and evidence of swallowing dysfunction. For those receiving dopaminergic drugs (for parkinsonism), monitor for adverse neuropsychiatric effects and disabling motor fluctuations and dyskinesias. Pregnancy management: Use of AEDs during pregnancy for women with a seizure disorder is generally recommended, despite an increased risk for adverse fetal outcome associated with some AEDs. Discussion of the risks and benefits of using a given antiepileptic medication during pregnancy ideally should take place prior to conception. Transitioning to a lower-risk medication may be possible.	BPAN is inherited in an X-linked manner; to date, most affected individuals have been female, and the vast majority are simplex cases (i.e., a single occurrence in a family) resulting from a de novoWDR45 pathogenic variant. The exceptions include two familial cases, one with presumed maternal germline mosaicism and one with transmission of a WDR45 pathogenic variant by a phenotypically normal mother who demonstrated significantly skewed X-chromosome inactivation. Females with the typical BPAN phenotype do not reproduce. In rare instances, a female who is mildly affected may reproduce. Affected males do not reproduce. Once the WDR45 pathogenic variant has been identified in an affected family member, prenatal testing for a pregnancy at increased risk and preimplantation genetic diagnosis for BPAN are possible.	
28212508	Autism spectrum disorder (ASD) is characterized by social and communication impairments as well as restricted, repetitive behavior patterns. Despite the fact that ASD is reported worldwide, very little research exists examining ASD characteristics on a multinational scale. Cross-cultural comparisons are especially important for ASD, since cultural differences may impact the perception of symptoms. Identifying behaviors that are similarly reported as problematic across cultures as well as identifying behaviors in which there is cultural variation could aid in the development and refinement of more universally effective measures. The present study sought to examine similarities and differences in caregiver endorsement of symptom severity through scores on the Baby Infant Screen for Children with aUtIsm Traits (BISCUIT). The BISCUIT was utilized to examine ASD core symptomology in 250 toddlers diagnosed with ASD from Greece, Italy, Japan, Poland, and the United States. Significant differences in overall ASD symptom severity and endorsement were found between multinational groups. Implications of the results are discussed.
28212056	We know very little about how transgender people create their families and the issues involved in these decisions. This qualitative study explored the parenting intentions and desires of 32 self-identified transgender individuals who want to become parents in the future.Data were collected using an open-ended survey with 32 transgender men and transgender women regarding when and how they want to become parents in the future.	We found that transgender individuals expressed specific desires for parenthood, such as biological relatedness and barriers to parenthood, such as physical limitations or lack of legal protections, which influence how transgender individuals choose to become parents in the future. For example, many participants described wanting to be biologically related to a future child and how this can be complicated by being transgender due to hormonal treatments, surgeries, or not having the biological means of become a parent using "traditional" methods.	The barriers and desires discussed provide invaluable insight into the parenting intentions and reproductive health of transgender people. This study revealed numerous examples where healthcare professionals could benefit from this new knowledge, such as increasing communication with patients about these desires and issues related to treatment and reproduction.	
28211981	Patient satisfaction is an integral part of quality health care. We assessed whether health literacy and psychosocial factors are associated with patient satisfaction among adults with neurofibromatosis. Eighty adults (mean age = 44 years; 55% female, 87% white) with NF (50% NF1, 41% NF2, and 9% schwannomatosis) completed an adapted Functional, Communicative, and Critical Health Literacy Questionnaire (FCCHL), the Health Literacy Assessment, a series of Patient Reported Outcome Measures Information System (PROMIS) psychosocial tests, and demographics before the medical visit. After, participants completed two measures of satisfaction: the Medical Interview Satisfaction Scale (MISS) to assess satisfaction with the medical visit, and an adapted version of the Consumer Assessment of Healthcare Providers and Systems Health Literacy Item Set (CAHPS-HL) to assess satisfaction with communication with the provider. Although higher FCCHL health literacy (r = 0.319, P = 0.002), male gender (t = 2.045, P = 0.044) and better psychosocial functioning (r = -0.257 to 0.409, P < 0.05) were associated with higher satisfaction with the medical visit in bivariate correlations, only male gender and higher health literacy remained as significant predictors in multivariable analyses. Higher FCCHL health literacy, less pain interference, fewer pain behaviors, and higher satisfaction with social roles and social discretionary activities (r = -0.231 to 0.331, P < 0.05) were associated with higher satisfaction with the communication with the provider in bivariate analyses. Results support the use of psychosocial and health literacy measures in clinical practice. Referrals to psychosocial treatments in addition to brief interventions focused on increasing health literacy may also be beneficial. © 2017 Wiley Periodicals, Inc.
28211817	Although extensive research has been published about the emotional consequences of stroke, most studies have focused on emotional words, speech prosody, voices, or facial expressions. The emotional processing of musical excerpts following stroke has been relatively unexplored.The present study was conducted to investigate the effects of chronic stroke on the recognition of basic emotions in music.	Seventy persons, including 25 normal controls (NC), 25 persons with right brain damage (RBD) from stroke, and 20 persons with left brain damage (LBD) from stroke between the ages of 31-71 years were studied. The Musical Emotional Bursts (MEB) test, which consists of a set of short musical pieces expressing basic emotional states (happiness, sadness, and fear) and neutrality, was used to test musical emotional perception.	Both stroke groups were significantly poorer than normal controls for the MEB total score and its subtests (p < 0.001). The RBD group was significantly less able than the LBD group to recognize sadness (p = 0.047) and neutrality (p = 0.015). Negative correlations were found between age and MEB scores for all groups, particularly the NC and RBD groups.	Our findings indicated that stroke affecting the auditory cerebrum can cause acquired amusia with greater severity in RBD than LBD. These results supported the "valence hypothesis" of right hemisphere dominance in processing negative emotions.	
28211618	This study evaluated provider satisfaction in a sample of colorectal cancer (CRC) survivors with and without Lynch syndrome (LS). Participants were case-case-matched CRC survivors with (n = 75) or without (n = 75) LS (mean age of 55; range: 27-93). Participants completed a mailed questionnaire assessing demographics, clinical characteristics, healthcare utilization, psychosocial variables, and provider satisfaction. LS CRC survivors reported lower provider satisfaction scores on three subscales of the Primary Care Assessment Survey: communication (78.14 vs. 83.96; P < 0.05), interpersonal treatment (78.58 vs. 85.30; P < 0.05), and knowledge of the patient (60.34 vs. 69.86; P < 0.01). Among LS CRC survivors, predictors for mean communication and trust subscale scores were location of treatment and socioeconomic status. Higher mean depression scores also were associated with trust, while social support predicted higher satisfaction with communication. Sporadic CRC survivor satisfaction is driven largely by age (communication, interpersonal treatment) and patient anxiety (communication), while seeing a provider more often was associated with increased satisfaction with knowledge of the patient. LS CRC survivors reported lower levels of provider satisfaction than sporadic CRC survivors. LS survivors who received care at The University of Texas MD Anderson Cancer Center, a comprehensive cancer center (CCC), reported higher satisfaction than those receiving care at other institutions. Depressive symptoms and socioeconomic status may impact provider satisfaction ratings. Exploration of other potential predictors of provider satisfaction should be examined in this population. Additionally, further research is needed to examine the potential impact of provider satisfaction on adherence to medical recommendations in LS CRC survivors, particularly those being treated outside of CCCs.
28211550	Psychometric evaluation of reliability and usefulness of the Polish version of the CESD-R - a revised version of the CES-D - screening test for depression.In an online survey the CESD-R and the Beck Depression Inventory were applied to 260 participants (men and women). Reliability was assessed with Cronbach's method and split-half (odd-even) method. Same as in the original English publication, factor analysis was performed and three factors were distinguished. Additionally, the CESD-R results were compared with the Beck Depression Inventory results.	Analysis of the CESD-R resulted in high values of reliability, for Cronbach's alpha coefficient the result was 0.95, for split-half (odd-even) method based on Spearman-Brown formula . = 0.95. Factor analysis distinguished 3 principal factors such as cognitive-affective factors, physical factors, and self-destructive factors.	Polish version of the CESD-R appears to have reliability values (over 0.7) high enough to be applicable to assess depression in population-based samples. Usefulness of the CESD-R in an individual diagnosis needs further research. However, general analysis of the scale enables to expect the usefulness in at least introductory diagnosis in clinical practice.	
28211318	Persons with low health literacy have difficulty dealing with the health care system and understanding health-related information. Studies from multiple countries have shown that low health literacy negatively affects health, health-related and illness-related behavior, and the utilization of health care resources. The data available till now on health literacy in Germany have been sparse. The goal of this study is to acquire representative data on the health literacy of the German population.In a cross-sectional study, we collected data from a representative group of 2000 persons over age 15 in Germany by means of computer-assisted personal interviews (CAPI) that were based on the long version of the questionnaire used in the European Health Literacy Survey (HLS-EU-Q47). Sociodemographic data were also collected.	The respondents were a representative sample of the German population. 54.3% of them were found to have limited health literacy. Multiple logistic regression revealed associations of limited health literacy with advanced age (odds ratio [OR] 1.83, 95% confidence interval [CI] [1.36; 2.48]), an immigrant background (OR 1.87 [1.27; 2.75]), low self-assessed social status (OR 5.25 [3.57; 7.72]), and low functional literacy (OR 1.94 [1.49; 2.52]).	The low health literacy of many Germans can impair communication between doctors and patients and exacerbate existing problems in health policy. In the future, greater effort will have to be made to foster health literacy, make health-related information for patients easier to understand, and intensify research in the field of health literacy.	
28210612	Background: Socioeconomic status has been found to have a significant impact on the health as well as risk behaviors of adolescents across different contexts. This study was conducted to assess the effect of social relations adjusted by social class on physical and psychological well-being of adolescences in Teheran, Iran. Methods: This was a cross- sectional study and carried out on 1,742 adolescences living in Tehran during 2011. Adolescences were selected, using proportional stratified sampling method and a questionnaire was filled over an interview for data gathering. Data were analyzed, using SPSS18 logistic regression. Results: The prevalence of psychological symptoms was more than 24% and had a large range (24%-93%), while physical symptoms showed a lower prevalence with a smaller range (12%-33%). Furthermore, there was a significant relation between the adolescences gender and feeling the need for others' help (p<0.001). Factors related to feeling the need for others help, anxiety, and worrying were the most prevalent among both boys and girls. In the section of family social relations, talking to the mother and talking to the father had the lowest and the highest prevalence among girls and boys, respectively. With respect to relations, the number of close friends and after school gathering time with close friends had the highest prevalence among girls, while the number of close friends and E-communication with close friends had the lowest and the highest prevalence among boys, respectively. Conclusion: The physical and psychological symptoms were common among adolescents from families with high socioeconomic status.
28209607	Children with autistic spectrum disorder (ASD) often have associated behavioural difficulties that can present a challenge for parents and parenting. There are several effective social learning theory-based parenting programmes for dealing with behavioural difficulties, including the Incredible Years (IY) parent programmes. However, these programmes typically do not specifically target parents of children with ASD. Recently, a new addition to the IY suite of programmes known as the IY Autistic Spectrum and Language Delays (IY-ASLD) parent programme was developed. The main aims of the present study are to examine the feasibility of delivering this programme within child health services and to provide initial evidence for effectiveness and economic costs.The Parenting for Autism, Language, And Communication Evaluation Study (PALACES) trial is a pragmatic, multicentre, pilot randomised controlled trial comparing the IY-ASLD programme with a wait-list control condition. 72 parents of children with ASD (aged 3-8 years) will be randomly allocated to either the intervention or control condition. Data will be collected prior to randomisation and 6 months postrandomisation for all families. Families in the intervention condition only will also be followed up at 12 and 18 months postrandomisation. This study will provide initial evidence of effectiveness for the newly developed IY-ASLD parenting programme. It will also add to the limited economic evidence for an intervention targeting parents of children with ASD and provide longer term data, an important component for evaluations of parenting programmes.	Approval for the study was granted by the Research Ethics Committee at the School of Psychology, Bangor University (reference number: 2016-15768) and the North Wales Research Ethics Committee, UK (reference number: 16/WA/0224). The findings will be disseminated through research conferences and peer-reviewed journals.	ISRCTN57070414; Pre-results.	
28209605	We sought to clarify how large a proportion of fatal medical accidents can be considered to be caused by poor non-technical skills, and to support development of a policy to reduce number of such accidents by making recommendations about possible training requirements.Summaries of reports of fatal medical accidents, published by the Japan Medical Safety Research Organization, were reviewed individually. Three experienced clinicians and one patient safety expert conducted the reviews to determine the cause of death. Views of the patient safety expert were given additional weight in the overall determination.	A total of 73 summary reports of fatal medical accidents were reviewed. These reports had been submitted by healthcare organisations across Japan to the Japan Medical Safety Research Organization between April 2010 and March 2013.	The cause of death in fatal medical accidents, categorised into technical skills, non-technical skills and inevitable progress of disease were evaluated. Non-technical skills were further subdivided into situation awareness, decision making, communication, team working, leadership, managing stress and coping with fatigue.	Overall, the cause of death was identified as non-technical skills in 34 cases (46.6%), disease progression in 33 cases (45.2%) and technical skills in two cases (5.5%). In two cases, no consensual determination could be achieved. Further categorisation of cases of non-technical skills were identified as 14 cases (41.2%) of problems with situation awareness, eight (23.5%) with team working and three (8.8%) with decision making. These three subcategories, or combinations of them, were identified as the cause of death in 33 cases (97.1%).	Poor non-technical skills were considered to be a significant cause of adverse events in nearly half of the fatal medical accidents examined. Improving non-technical skills may be effective for reducing accidents, and training in particular subcategories of non-technical skills may be especially relevant.	
28208800	Significant others are often crucial for suicidal persons or suicide attempters' access to care, yet little is known about their efforts to seek help. This article presents the findings of a qualitative pilot study carried out in Switzerland on the help-seeking process of 18 significant others, their perception of the care received by their loved one, and the interactions and collaboration they experienced with professionals. Most significant others repeatedly sought out support for their loved one and themselves. The help-seeking process seemed mostly difficult, was seldom successful on the first attempt, and was filled with multiple difficulties, such as availability and continuity of care and cooperation issues with professionals. Two-thirds of participants were not satisfied with the care provided to their loved ones and half of them faced challenges in their cooperation with professionals, i.e., poor sharing of information or not being acknowledged as partners or supported by professionals. Based on their experience, providing education about suicidal crises and care programs to significant others might lighten their burden and improve their cooperation with professionals, who in turn may benefit from training in communication issues and specific methods of cooperation with significant others in suicidal situations.
28207723	To assess the extent and nature of unhealthy food marketing to New Zealand children and adolescents through the internet.Internet traffic data for January 2014 was purchased from AC Nielsen to identify the most popular websites (n=110) among children and adolescents aged 6-17 years. In addition, websites (n=70) of food and beverage brands most frequently marketed to children through television, sports, magazines and Facebook were included. Marketing techniques and features on those websites were analysed.	The extent of food marketing on popular non-food websites was low. A wide range of marketing techniques and features was, however, identified on food brand websites, including advercation (87%), viral marketing (64%), cookies (54%), free downloadable items (43%), promotional characters (39%), designated children's sections (19%) and advergaming (13%). Most techniques appeared more frequently on websites specifically targeting children and adolescents, than on other websites targeting the general public.	Compared to traditional media, the internet allows food marketers to use engaging techniques to directly interact with children. While the range of marketing techniques and features identified on food brand websites was extensive, the most popular websites among children and adolescents were non-food related, and the extent of food marketing on those websites was found to be low. Additional assessment of food marketing to children through social and other digital media is recommended.	
28207365	The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and there has been little in the bioethics literature to guide investigators and institutional review boards (IRBs) faced with navigating the ethical issues such use raises. We begin to fill this gap by first defending a nonexceptionalist methodology for assessing social media recruitment; second, examining respect for privacy and investigator transparency as key norms governing social media recruitment; and, finally, analyzing three relatively novel aspects of social media recruitment: (i) the ethical significance of compliance with website "terms of use"; (ii) the ethics of recruiting from the online networks of research participants; and (iii) the ethical implications of online communication from and between participants. Two checklists aimed at guiding investigators and IRBs through the ethical issues are included as appendices.
28205360	Sturmberg et al write about multimorbidity as "several diagnosable diseases within the same individual." They posit that this syndrome is the result of multiple interconnected disturbances reflecting scale-free, fractal signs of pathology ranging from biochemical/hormonal alterations at one end of a spectrum to community and societal ills at the other. In this commentary, I will be focusing on 3 perspectives: 1) a preterminal phase of multimorbidity that is indicative of that loss of reparative or even homeokinetic properties, known by some as "advanced serious illness"; 2) the manifestations of advanced serious illness multimorbidity that, using the same networks that connect into the patient, are signs of this syndrome at the levels of the immediate family/friend social network, the broader community, and society at large; and 3) the potential for these same networks that transmit pathological forces to convey the positive effects of therapeutic interventions in a scale-free manner, with a focus on how conversation can lead to what I'm calling "multibeneficence."

28205221	The understanding of the first movements of the ancestral populations within the African continent is still unclear, particularly in West Africa, due to several factors that have shaped the African genetic pool across time. To improve the genetic representativeness of the Beninese population and to better understand the patterns of human settlement inside West Africa and the dynamics of peopling of the Democratic Republic of Benin, we analyzed the maternal genetic variation of 193 Beninese individuals belonging to Bariba, Berba, Dendi, and Fon populations. Results support the oral traditions indicating that the western neighbouring populations have been the ancestors of the first Beninese populations, and the extant genetic structure of the Beninese populations is most likely the result of admixture between populations from neighbouring countries and native people. The present findings highlight how the Beninese populations contributed to the gene pool of the extant populations of some American populations of African ancestry. This strengthens the hypothesis that the Bight of Benin was not only an assembly point for the slave trade during the Trans-Atlantic Slave Trade but also an important slave trapping area.
28204993	The aims of this study are to identify neuro-oncological patients' and their caregivers' needs during hospitalization (T0) and at 4 months after discharge (T1); to analyze the longitudinal changes in patients' and caregivers' needs and burden; to identify correlations between patients' needs and caregivers' burden and needs.A pilot observational longitudinal study was conducted on 94 neuro-oncological patients and their caregivers using NEQ to evaluate patients' needs, CNA, and FSQ for caregivers' needs and burden at T0 and T1. Descriptive statistics were performed to illustrate the distribution of questionnaires' scores. The longitudinal change of NEQ, FSQ, and CNA scores were investigated using Wilcoxon test. Spearman's correlation was used to measure the relation between NEQ and FSQ and CNA scores.	The most frequent patients and caregivers' needs were material and informative. Needs tend to decrease over time; in particular FSQ factor "need for knowledge about the disease", CNA factor "Information/communication needs" and CNA total score significantly decreased (p < 0.001). NEQ total score significantly correlated with FSQ factors "emotional burden" and "need for knowledge about the disease" and CNA total and factors scores at T0 and T1. At T0, NEQ correlated significantly with FSQ factor "thoughts about death", while at T1, it correlated with FSQ factor "problems in social involvement".	It is crucial to plan an assessment of patients' and caregivers' needs from the very beginning, in order to identify those individuals potentially at risk of developing high level of distress and to provide information and support following the illness trajectory of the brain tumor.	
28203613	This interdisciplinary research, drawing on cognitive psychology and linguistics, extended to middle childhood past research during early childhood or adulthood on thinking aloud prior to written composing. In year 5 of a longitudinal study of typical writing, when cohort 1 was in grade 5 (n = 110 ten year-olds) and cohort 2 in grade 7 (n = 97 twelve year-olds), a cross-sectional study was conducted. Children were first asked to think aloud while they generated ideas and second while they planned their essays to express and defend their opinions on a controversial topic in the region of the United States where they lived. Third, they wrote their essays. Their think-aloud protocols were audio-recorded and later transcribed into writing for analysis. The authors developed and applied rating scales for quality of idea generating and planning in the written transcriptions and quality of opinion expression, opinion defense, organization, and content in the essays children wrote after thinking aloud; total number of words in essays was also counted. Seventh graders scored significantly higher than fifth graders on quality of idea generation but not planning, and higher on all variables rated for quality in the written essays including length. Quality of expressing opinions and defending opinions were uncorrelated in grade 5, but moderately correlated in grade 7. Whether idea generating or planning quality explained unique variance in essays varied with coded written essay variables and grade. Educational applications of results for assessment, assessment-instruction links, instruction in social studies, and theory of mind in persuasive essay writing are discussed.
28203335	Advances in perinatal and neonatal care have substantially improved the survival of at-risk infants over the past two decades.The purpose of this study was to assess the reliability and validity of the Bayley Scales of infant and toddler developmental Screening test in Persian-speaking children.	This was a cross-sectional prospective study of 403 children aged 1 - 42-months. The Bayley scales screening instrument, which consists of five domains (cognitive, receptive, and expressive communication and fine and gross motor items), was used to measure infants' and toddlers' development. The psychometric properties examined included the face and content validity of the scale, in addition to cultural and linguistic modifications to the scale and its test-retest and inter-rater reliability.	An expert team changed some of the test items relating to cultural and linguistic issues. In almost all the age groups, cultural or linguistic changes were made to items in the communication domains. According to Cronbach's alpha for internal consistency, the reliability of the cognitive scale was r = 0.79, and the reliability of the receptive scale was r = 0.76. The reliability for expressive communication, fine motor, and gross motor scales was r = 0.81, r = 0.80, and r = 0.81, respectively. The construct validity of the tests was confirmed using a factor analysis and comparison of the mean scores of the age groups. The intra- and inter-rater reliabilities of the Bayley Scales were good-to-excellent.	The results indicated that the Bayley Scales had a high level of reliability in the present study. Thus, the scale can be used in a Persian population.	
28203249	Autism spectrum disorder (ASD) is a developmental disorder that significantly impairs patients' ability to perform normal social interaction and communication. Moreover, the diagnosis procedure of ASD is highly time-consuming, labor-intensive, and requires extensive expertise. Although there exists no known cure for ASD, there is consensus among clinicians regarding the importance of early intervention for the recovery of ASD patients. Therefore, to benefit autism patients by enhancing their access to treatments such as early intervention, we aim to develop a robust machine learning-based system for autism detection by using Natural Language Processing techniques based on information extracted from medical forms of potential ASD patients. Our detecting framework involves converting semi-structured and unstructured medical forms into digital format, preprocessing, learning document representation, and finally, classification. Testing results are evaluated against the ground truth set by expert clinicians and the proposed system achieve a 83.4% accuracy and 91.1% recall, which is very promising. The proposed ASD detection framework could significantly simplify and shorten the procedure of ASD diagnosis.
28203083	Sex-related differences in clinical manifestations and consequences of Parkinson's disease (PD) have been poorly explored. Better understanding of sexual dimorphism in neurologic diseases such as PD has been announced as a research priority. The aim of our study was to determine independent sex differences in clinical manifestations and subtypes, psychosocial functioning, quality of life (QoL) and its domains between male and female individuals with PD.A comprehensive list of demographics, motor symptoms and subtypes, nonmotor features, health-related quality of life (HRQoL), psychosocial functioning and general aspects of daily life was assessed in 157 individuals (108 males and 49 females) with idiopathic PD. In order to control for potential confounding variables, we applied Orthogonal Partial Least Squares - Discriminant Analysis (OPLS-DA) to explore the strength of each feature to discriminate male and female patients with PD.	While no sex difference was found in the total Unified Parkinson's Disease Rating Scale (UPDRS) score and cumulative daily dose of levodopa, females had significantly more severe anxiety (mean difference =2.2 [95% confidence interval, CI: 0.5-4.0], P=0.011), worse nutritional status (23.8 [standard deviation, SD =4.2] vs 25.8 [SD =2.6], P=0.003) and poorer QoL (28.3 [SD =15.7] vs 17.9 [SD =14.2], P<0.001). Based on multivariate discriminant analysis, emotional well-being, bodily discomfort, social support, mobility and communication domains of HRQoL, together with anxiety, depression and psychosocial functioning, were the strongest features with more severe/worse status in females after adjustment for potential statistical confounders.	Our study provides a comprehensive understanding of sexual dimorphism in PD. Anxiety, depression, specific domains of HRQoL (mobility, emotional well-being, social support and bodily discomfort) and psychosocial functioning were significantly worse in female individuals with PD. Sexual dimorphism in PD highlights the features that are more likely to be affected in each sex and should be specifically targeted when managing male and female individuals with PD.	
28203037	We examined the effects of social and cultural contexts on smiles displayed by children during gameplay. Eight-year-old Dutch and Chinese children either played a game alone or teamed up to play in pairs. Activation and intensity of facial muscles corresponding to Action Unit (AU) 6 and AU 12 were coded according to Facial Action Coding System. Co-occurrence of activation of AU 6 and AU 12, suggesting the presence of a Duchenne smile, was more frequent among children who teamed up than among children who played alone. Analyses of the intensity of smiles revealed an interaction between social and cultural contexts. Whereas smiles, both Duchenne and non-Duchenne, displayed by Chinese children who teamed up were more intense than those displayed by Chinese children who played alone, the effect of sociality on smile intensity was not observed for Dutch children. These findings suggest that the production of smiles by children in a competitive context is susceptible to both social and cultural factors.
28202154	This article seeks to extend social science scholarship on social media technology use during disruptive events. Though social media's role in times of crisis has been previously studied, much of this work tends to focus on first-responders and relief organizations. However, social media use during disasters tends to be decentralized and this organizational structure can promote different types of messages to top-down information systems. Using 142,786 geo-tagged tweets collected before and after Hurricane Sandy's US landfall as a case study, this article seeks to explore shifts in social media behavior during disruptive events and highlights that though Sandy disrupted routine life within Twitter, users responded to the disaster by employing humor, sharing photos, and checking into locations. We conclude that social media use during disruptive events is complex and understanding these nuanced behaviors is important across the social sciences.
28201730	Information and communication technology holds promise in terms of providing support and reducing isolation among older adults. We evaluated the impact of a specially designed computer system for older adults, the Personal Reminder Information and Social Management (PRISM) system.The trial was a multisite randomized field trial conducted at 3 sites. PRISM was compared to a Binder condition wherein participants received a notebook that contained paper content similar to that contained in PRISM. The sample included 300 older adults at risk for social isolation who lived independently in the community (Mage = 76.15 years). Primary outcome measures included indices of social isolation, social support, loneliness, and well-being. Secondary outcome measures included indices of computer proficiency and attitudes toward technology. Data were collected at baseline and at 6 and 12 months post-randomization.	The PRISM group reported significantly less loneliness and increased perceived social support and well-being at 6 months. There was a trend indicating a decline in social isolation. Group differences were not maintained at 12 months, but those in the PRISM condition still showed improvements from baseline. There was also an increase in computer self-efficacy, proficiency, and comfort with computers for PRISM participants at 6 and 12 months.	The findings suggest that access to technology applications such as PRISM may enhance social connectivity and reduce loneliness among older adults and has the potential to change attitudes toward technology and increase technology self-efficacy.	
28199923	Malnutrition is one of the key issues affecting the health of older people (>65years). With an aging population the problem is expected to increase further since the prevalence of malnutrition increases with age. Studies worldwide have identified that some older patients with good appetites do not receive sufficient nourishment because of inadequate feeding assistance. Mealtime assistance can enhance nutritional intake, clinical outcomes and patient experience.To determine the effectiveness of meal time assistance initiatives for improving nutritional intake and nutritional status for older adult patients (>65years) in hospital settings and rehabilitation units. The review also sought to identify and explore the perceptions and experiences of older adult patients and those involved with their care.	Mixed methods systematic review.	A search of electronic databases to identify published studies (CINAHL, MEDLINE, British Nursing Index, Cochrane Central Register of Controlled Trials, EMBASE, PsychINFO, Web of Science (1998-2015) was conducted. Relevant journals were hand-searched and reference lists from retrieved studies were reviewed. The search was restricted to English language papers. The key words used were words that described meal time assistance for adult patients in hospital units or rehabilitation settings.	The review considered qualitative, quantitative and mixed methods studies that included interventions for mealtime assistance, observed mealtime assistance or discussed experiences of mealtime assistance with staff, patients, relatives, volunteers or stakeholders. Extraction of data was undertaken independently by two reviewers. A further two reviewers assessed the methodological quality against agreed criteria.	Twenty one publications covering 19 studies were included. Three aggregated mixed methods syntheses were developed: 1) Mealtimes should be viewed as high priority. 2a) Nursing staff, employed mealtime assistants, volunteers or relatives/visitors can help with mealtime assistance. 2b) Social interaction at mealtimes should be encouraged. 3) Communication is essential.	A number of initiatives were identified which can be used to support older patients (>65years) at mealtimes in hospital settings and rehabilitation units. However, no firm conclusions can be drawn in respect to the most effective initiatives. Initiatives with merit include those that encourage social interaction. Any initiative that involves supporting the older patient (>65years) at mealtimes is beneficial. A potential way forward would be for nurses to focus on the training and support of volunteers and relatives to deliver mealtime assistance, whilst being available at mealtimes to support patients with complex nutritional needs.	
28198108	This paper explores two questions central to understanding the nature of formulaic sequences: (1) What are they for? and (2) What determines how many there are? The "Communicative Impact" model draws into a single account how language is shaped by cognitive processing on the one hand and socio-interactional function on the other: Formulaic sequences play a range of coordinated roles in neutralizing unanticipated perturbations in the cognitive management of language, so the speaker's socio-interactional goals can still be achieved. One role involves compensatory actions to sustain fluency. However, these actions are themselves context-sensitive, so the balance of types of formulaic sequence will vary according to situation. The model applies equally to temporary cognitive pressure and chronic problems such as dementia and limited linguistic competency in a foreign language.
28198099	CenteringPregnancy (CP) is a specific model of group-based prenatal care for women, implemented in 44 midwifery practices in The Netherlands since 2011. Women have evaluated CP positively, especially in terms of social support, and improvements have been made in birthweight and preterm-birth outcomes; however, there is limited understanding as to why. The purpose of this study was to examine the mechanisms that create trusting relationships within CP to better understand CP outcomes and effectiveness.A qualitative study was conducted using in-depth interviews with 26 (former) CP participants, alongside observations of CP sessions. All interviews were transcribed and analyzed following open, axial, and selective coding.	Most women characterized trust as a positive expectation about how others would respond to sensitive information that was shared within the group. Trust emerged within the data as a multidimensional concept and several preconditions seemed crucial in building trusting relations: vulnerability, communication, reciprocity, chemistry, and atmosphere. The facilitating of interpersonal trust among CP participants enhanced group processes, especially as a basis for social support by which women said they were more eager to share sensitive information in a trusting environment.	Processes of trust were interwoven within various CP group dynamics. Trust facilitated social support which in turn enabled reassurance and the building of women's self-confidence.	
28198052	Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.
28197113	Developments and innovation in the areas of mobile information technology, digital media and social networks foster new reflections on computer-mediated communication research, especially in the field of self-presentation. In this context, the selfie as a self-portrait photo is interesting, because as a meaningful gesture, it actively and directly relates the content of the photo to the author of the picture. From the perspective of the selfie as an image and the impression it forms, in the first part of the research we explored the distinctive characteristics of selfie pictures; moreover, from the perspective of the potential reflection of a selfie image on the personality of its author, in the second part we related the characteristics of selfie pictures to various personality constructs (e.g., Big Five personality traits narcissism and femininity-masculinity). Important aspects of selfies especially in relation to gender include the tilt of the head, the side of the face exhibited, mood and head position, later related also to the context of the selfie picture. We found no significant relations between selfie cues and personality constructs. The face-ism index was related to entitlement, and selfie availability to neuroticism.
28196828	The general practitioner (GP) has a critical role in an integrated model of palliative care as they often know the patient and carer well, are experts in generalist care and have knowledge of health and social services in the community. Specialist palliative services have insufficient capacity to meet demand and those with non-cancer terminal conditions and those from rural and remote areas are underserved. Research has focused on improving access to palliative care by engaging the GP with specialist secondary services in integrated palliative care.(1) Evaluate the effectiveness of interventions designed to engage GPs and specialist secondary services in integrated palliative care; and (2) identify the personal, system and structural barriers and facilitators to integrated palliative care.	MEDLINE, EMBASE and CINAHL were searched. Any study of a service that engaged the GP with specialist secondary services in the provision of palliative care was included. GP engagement was defined as any organised cooperation between the GP and specialist secondary services in the care of the patient including shared consultations, case conferences that involved at least both the GP and the specialist clinician and/or other secondary services, and/or any formal shared care arrangements between the GP and specialist services. The specialist secondary service is either a specialist palliative service or a service providing specialist care to a palliative population. A narrative framework was used to describe the findings.	17 studies were included. There is some evidence that integrated palliative care can reduce hospitalisations and maintain functional status. There are substantial barriers to providing integrated care. Principles and facilitators of the provision of integrated palliative care are discussed.	This is an emerging field and further research is required assessing the effectiveness of different models of integrated palliative care.	
28196405	Tobacco smoking remains one of the few preventable factors associated with complications in pregnancy, and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and is increasing in low- to middle-income countries.To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes.	In this sixth update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register (13 November 2015), checked reference lists of retrieved studies and contacted trial authors.	Randomised controlled trials, cluster-randomised trials, and quasi-randomised controlled trials of psychosocial smoking cessation interventions during pregnancy.	Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, with meta-regression conducted in STATA 14.	The overall quality of evidence was moderate to high, with reductions in confidence due to imprecision and heterogeneity for some outcomes. One hundred and two trials with 120 intervention arms (studies) were included, with 88 trials (involving over 28,000 women) providing data on smoking abstinence in late pregnancy. Interventions were categorised as counselling, health education, feedback, incentives, social support, exercise and dissemination.In separate comparisons, there is high-quality evidence that counselling increased smoking cessation in late pregnancy compared with usual care (30 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.73) and less intensive interventions (18 studies; average RR 1.25, 95% CI 1.07 to 1.47). There was uncertainty whether counselling increased the chance of smoking cessation when provided as one component of a broader maternal health intervention or comparing one type of counselling with another. In studies comparing counselling and usual care (largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy. However, a clear effect was seen in smoking abstinence at zero to five months postpartum (11 studies; average RR 1.59, 95% CI 1.26 to 2.01) and 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), with a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77). In other comparisons, the effect was unclear for most secondary outcomes, but sample sizes were small.Evidence suggests a borderline effect of health education compared with usual care (five studies; average RR 1.59, 95% CI 0.99 to 2.55), but the quality was downgraded to moderate as the effect was unclear when compared with less intensive interventions (four studies; average RR 1.20, 95% CI 0.85 to 1.70), alternative interventions (one study; RR 1.88, 95% CI 0.19 to 18.60), or when smoking cessation health education was provided as one component of a broader maternal health intervention.There was evidence feedback increased smoking cessation when compared with usual care and provided in conjunction with other strategies, such as counselling (average RR 4.39, 95% CI 1.89 to 10.21), but the confidence in the quality of evidence was downgraded to moderate as this was based on only two studies and the effect was uncertain when feedback was compared to less intensive interventions (three studies; average RR 1.29, 95% CI 0.75 to 2.20).High-quality evidence suggests incentive-based interventions are effective when compared with an alternative (non-contingent incentive) intervention (four studies; RR 2.36, 95% CI 1.36 to 4.09). However pooled effects were not calculable for comparisons with usual care or less intensive interventions (substantial heterogeneity, I2 = 93%).High-quality evidence suggests the effect is unclear in social support interventions provided by peers (six studies; average RR 1.42, 95% CI 0.98 to 2.07), in a single trial of support provided by partners, or when social support for smoking cessation was provided as part of a broader intervention to improve maternal health.The effect was unclear in single interventions of exercise compared to usual care (RR 1.20, 95% CI 0.72 to 2.01) and dissemination of counselling (RR 1.63, 95% CI 0.62 to 4.32).Importantly, high-quality evidence from pooled results demonstrated that women who received psychosocial interventions had a 17% reduction in infants born with low birthweight, a significantly higher mean birthweight (mean difference (MD) 55.60 g, 95% CI 29.82 to 81.38 g higher) and a 22% reduction in neonatal intensive care admissions. However the difference in preterm births and stillbirths was unclear. There did not appear to be adverse psychological effects from the interventions.The intensity of support women received in both the intervention and comparison groups has increased over time, with higher-intensity interventions more likely to have higher-intensity comparisons, potentially explaining why no clear differences were seen with increasing intervention intensity in meta-regression analyses. Among meta-regression analyses: studies classified as having 'unclear' implementation and unequal baseline characteristics were less effective than other studies. There was no clear difference between trials implemented by researchers (efficacy studies), and those implemented by routine pregnancy staff (effectiveness studies), however there was uncertainty in the effectiveness of counselling in four dissemination trials where the focus on the intervention was at an organisational level. The pooled effects were similar in interventions provided for women classified as having predominantly low socio-economic status, compared to other women. The effect was significant in interventions among women from ethnic minority groups; however not among indigenous women. There were similar effect sizes in trials with biochemically validated smoking abstinence and those with self-reported abstinence. It was unclear whether incorporating use of self-help manuals or telephone support increased the effectiveness of interventions.	Psychosocial interventions to support women to stop smoking in pregnancy can increase the proportion of women who stop smoking in late pregnancy and the proportion of infants born low birthweight. Counselling, feedback and incentives appear to be effective, however the characteristics and context of the interventions should be carefully considered. The effect of health education and social support is less clear. New trials have been published during the preparation of this review and will be included in the next update.	

28194117	Numerous studies have shown an alarming prevalence of depression, anxiety, and behavior disorders in youth. Thus, prevention of psychological problems in this population becomes crucial. According to the World Health Organization (1), prevention should also include the promotion and development of the individual's strengths in order to reduce vulnerability to suffering from mental disorders. In addition, other key elements of prevention are the reach, adoption, implementation, and maintenance of interventions. The information and communication technologies, especially the Internet, have much to offer in terms of the prevention and promotion of positive mental health in adolescents. This paper reviews these fields of research-prevention, positive psychology, Internet, and adolescents-and discusses the potential of positive interventions delivered over the Internet as effective and sustainable health promotion tools. The paper provides a brief description of the systems developed so far and a summary of selected features of the studies detected in the literature review. The overall conclusions are that there is a need for more controlled studies with long-term follow-ups, the interventions should be designed considering the specific features of the target users and the specific contexts where the interventions will be delivered, and they could be enhanced by the use of other technologies, such as smartphones, sensors, or social networks.
28193270	More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a children's hospice.Qualitative research incorporating interviews and a focus group. Data were analysed using thematic analysis. Purposeful sampling led to a total of 15 care team staff recruited from a children's hospice offering palliative and specialist care to life-limited children and young people.	The hospice setting provides a model of excellence in supporting staff and mitigating challenging aspects of their role, which includes peer/organisational support, and regular ongoing training in key aspects of children's palliative care. Key recommendations for improving their experience included advanced communication training and knowledge sharing with other children's palliative care specialists within the acute setting.	Service and policy initiatives should encourage open, informal peer/organisational support among the wider children's palliative care sector. Further research should focus on paediatric palliative care education, particularly in relation to symptom management and communication at end-of-life, harnessing the expertise and breadth of knowledge that could be shared between children's hospices and hospital settings.	
28193265	Food regulatory bodies play an important role in public health, and in reducing the costs of food borne illness that are absorbed by both industry and government. Regulation in the food industry involves a relationship between regulators and members of the industry, and it is imperative that these relationships are built on trust. Research has shown in a variety of contexts that businesses find the most success when there are high levels of trust between them and their key stakeholders. An evidence-based understanding of the barriers to communication and trust is imperative if we are to put forward recommendations for facilitating the (re)building of trusting and communicative relationships.We present data from 72 interviews with regulators and industry representatives regarding their trust in and communication with one another. Interviews were conducted in the UK, New Zealand, and Australia in 2013.	Data identify a variety of factors that shape the dynamic and complex relationships between regulators and industry, as well as barriers to communication and trust between the two parties. Novel in our approach is our emphasis on identifying solutions to these barriers from the voices of industry and regulators.	We provide recommendations (e.g., development of industry advisory boards) to facilitate the (re)building of trusting and communicative relationships between the two parties.	
28193105	In the United States, hospice agencies are required to convene interdisciplinary group (IDG) meetings no less frequently than every 15 days to review patients' care plans. Challenges associated with information sharing during these meetings can impede efficiency and frustrate attendees.We sought to examine information sharing in the context of hospice IDG meetings as a first step toward developing an informatics tool to support interdisciplinary collaboration in this setting. Specifically, we wanted to better understand the purpose of information sharing in IDG meetings and determine the type(s) of information required to fulfill that purpose. Methods, Setting, and Participants: In this qualitative descriptive study, we analyzed video recordings of care plan discussions (n = 57) in hospice IDG meetings and individual interviews of hospice providers (n = 24).	Data indicated that sharing physical, psychosocial, and spiritual information is intended to optimize hospice teams' ability to deliver whole-person care that is aligned with patient and family goals and that satisfies regulatory requirements.	Information sharing is a key function of hospice teams in IDG meetings. Informatics tools may optimize IDG meeting efficiency by succinctly presenting well-organized and required information that is relevant to all team members. Such tools should highlight patient and family goals and ensure that teams are able to satisfy regulatory requirements.	
28192728	The study described the perceived importance of, and proficiency in core agricultural extension competencies among extension workers in Peninsular Malaysia; and evaluating the resultant deficits in the competencies. The Borich's Needs Assessment Model was used to achieve the objectives of the study. A sample of 298 respondents was randomly selected and interviewed using a pre-tested structured questionnaire. Thirty-three core competency items were assessed. Instrument validity and reliability were ensured. The cross-sectional data obtained was analysed using SPSS for descriptive statistics including mean weighted discrepancy score (MWDS). Results of the study showed that on a scale of 5, the most important core extension competency items according to respondents' perception were: "Making good use of information and communication technologies/access and use of web-based resources" (M=4.86, SD=0.23); "Conducting needs assessments" (M=4.84, SD=0.16); "organizing extension campaigns" (M=4.82, SD=0.47) and "Managing groups and teamwork" (M=4.81, SD=0.76). In terms of proficiency, the highest competency identified by the respondents was "Conducting farm and home visits (M=3.62, SD=0.82) followed by 'conducting meetings effectively' (M=3.19, SD=0.72); "Conducting focus group discussions" (M=3.16, SD=0.32) and "conducting community forums" (M=3.13, SD=0.64). The discrepancies implying competency deficits were widest in "Acquiring and allocating resources" (MWDS=12.67); use of information and communication technologies (ICTs) and web-based resources in agricultural extension (MWDS=12.59); and report writing and sharing the results and impacts (MWDS=11.92). It is recommended that any intervention aimed at developing the capacity of extension workers in Peninsular Malaysia should prioritize these core competency items in accordance with the deficits established in this study.
28192440	Helicopter Emergency Medical Services (HEMS) aim to bring a highly specialised crew to the scene of major incidents for triage, treatment and transport. We aim to describe experiences made by HEMS in Norway in the management of major incidents.Doctors, rescue paramedics and pilots working in Norwegian HEMS and Search and Rescue Helicopters (SAR) January 1st 2015 were invited to a cross-sectional study on experiences, preparedness and training in major incident management.	We identified a total of 329 Norwegian crewmembers of which 229 (70%) responded; doctors 101/150, (67%), rescue paramedics 64/78 (82%), pilots 64/101, (63%). HEMS and SAR crewmembers had experience from a median of 2 (interquartile range 0-6) major incidents. Road traffic incidents were the most frequent mechanism and blunt trauma the dominating injury. HEMS mainly contributed with triage, treatment and transport. Communication with other emergency services prior to arrival was described as bad, but good to excellent when cooperating on scene. The respondents called for more interdisciplinary exercises.	HEMS and SAR crewmembers have limited exposure to major incident management. Interdisciplinary training on frequent scenarios with focus on cooperation and communication is called for.	
28191546	Many primary care patients with multimorbidity (two or more chronic conditions) and depression or anxiety have day-to-day challenges that affect health outcomes, such as having financial or housing concerns, or dealing with social or emotional stressors. Yet, primary care providers (PCPs) are often unaware of patients' daily challenges coping with chronic disease. We developed Customized Care, an intervention, to address the barriers to effective communication about patient's day-to-day challenges.In this report we describe the rationale and design of a randomized clinical pilot study to examine the effect of Customized Care on patient-PCP communication and patient health outcomes, including depression, anxiety and functional outcomes. Customized Care comprises two components: (1) a computer-based discussion prioritization tool (DPT) designed to empower patients to communicate their health related priorities; and (2) a customized question prompt list (QPL) tailored to these priorities. Primary care clinic patients and PCPs participated in the study, which consisted of in-person patient assessments, audio recording and transcription of the patient-PCP office visit, and follow-up patient assessments by phone.	We describe study participant demographics and development of a coding manual to assess communication within the office visit. Participants were recruited from an urban primary care clinic. Sixty patients and 12 PCPs were enrolled over six months.	With better communication about everyday challenges, patients and PCPs can have more informed discussions about health care options that positively influence patient outcomes. We expect that Customized Care will improve patient-PCP communication about day-to-day challenges, which can lead to better health outcomes.	
28191505	As posited in multiple health communication theories, it is vital to understand modern health communication preferences among communities in order to develop tailored interventions to reduce Infant Mortality (IM). Literature suggests that health communication inequalities play an important role in infant health knowledge gaps, thus contributing to the disparate IM rates. We sought to understand preferred methods of communication among expectant or mothers of young children of varying sociodemographics. We hypothesized that methods of communication would vary by sociodemographics.A bilingual questionnaire, developed using community based participatory research principles was offered at pre-selected women's health agencies in the Shenandoah Valley of Virginia. Participants chose from a researched list of 22 methods of communication and also designated their "top three choices." Communication methods were compared across sociodemographics using chi-squared statistical tests.	A total of 292 participants completed the questionnaire at the various sites. Participants were predominantly White (60%) or Hispanic/Latina (30%), and lived in Frederick county/Winchester city (77%). Of the 22 communication methods, the five most prevalent were: talking with a healthcare provider (91%), family or friends (85-87%), using internet (84%), and handouts/booklets (80%). Communication methods most frequently chosen as a "top three choice" were: internet (46%), talking with healthcare providers (33%), and talking with family (32%). A higher preference for talking with a healthcare provider was noted among higher income individuals (100%) compared to lower income (82%; p-value=0.0062), a higher preference for call-in hotlines among Hispanic (49%) vs. non-Hispanic women (15%; p-value<0.0001), and a higher preference for placemats at fast-food restaurants among older women (42%) compared to younger (16%, p-value=0.0361).	Results suggest the incorporation of multiple methods may be a practical approach to reaching different segments of the population including those identified as most vulnerable for infant mortality.	
28190944	Although potentially beneficial, task conflict may threaten teams because it often leads to relationship conflict. Prior research has identified a set of interpersonal factors (e.g., team communication, team trust) that help attenuate this association. The purpose of this article is to provide an alternative perspective that focuses on the moderating role of performance-related factors (i.e., perceived team performance). Using social identity theory, we build a model that predicts how task conflict associates with growth in relationship conflict and how perceived team performance influences this association. We test a three-wave longitudinal model by means of random coefficient growth modeling, using data from 60 ongoing teams working in a health care organization. Results provide partial support for our hypotheses. Only when perceived team performance is low, do task conflicts relate with growth in relationship conflict. We conclude that perceived team performance seems to enable teams to uncouple task from relationship conflict.
28190663	An important domain in health-related quality of life evaluations is quality of life perceptions due to having a voice disorder. The objective of this study was to examine the factor structure of the Iranian Voice Quality of Life Profile (IVQLP) based on Exploratory Factor Analysis and confirmatory factor analysis.The study sample consisted of 280 patients (174 males and 106 females) diagnosed with MTD, benign organic disorders such as polyps and nodules, and unilateral vocal fold paralysis and cancer. To evaluate the different dimensions of the IVQLP, a principal component analysis (PCA) was conducted. Confirmatory factor analysis (CFA) was used to investigate the fitting of extracted dimensions and construct validity of the IVQLP.	The results showed that the IVQLP has a 4-factor structure. The first factor has 17 items and refers to Emotions. The second factor has 12 items and refers to Individual/Social Relations. The third factor with 6 items refers to Occupation, and the forth with 5 items relates to Psychosomatic characteristics.	The conclusion of this study is that the concept of quality of life in Iranian patients with voice disorders is somewhat different from that of Western patients. This difference can be seen in. the large number of items related to an Emotional factor and the identification of a Psychosomatic factor.	
28190542	Examine physicians' implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors.Focus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID.	Subjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect.	Greater familiarity may enhance care for these patients.	Increase exposure to patients with ID within training.	

28190148	This contribution is an essay about the notion of family identity reflecting shared significant experiences within a family system originating a set of signs used in social communication within and between families. Significant experiences are considered as experiences of events that have an immediate impact on the adaptation of the family in a given socio-ecological and cultural context at a given historical time. It is assumed that family history is stored in a shared "family memory" holding both implicit and explicit knowledge and exerting an influence on the behavior of each family member. This is described as transgenerational family memory being constituted of a system of meaningful signs. The crucial dimension underlying the logic of this essay are the ideas of adaptation as well as self-reproduction of systems.

28189508	Poor adherence by tuberculosis (TB) patients to their medication contributes not only to the worsening of their TB situation but also paves a way for incidence of drug resistance. This study, hence, aims to explore factors contributing for non-adherence of TB treatment among TB patients in Sodo Woreda, Gurage Zone, Southern Ethiopia. A qualitative study, which included 22 in-depth interviews from four health centers and seven health posts, was conducted from February 25 to April 27, 2014. Although the drugs were given free of charge, many patients were unable to adhere to their treatment because of one or a combination of the following factors; lack of adequate food, poor communication between healthcare providers and patients, beliefs in traditional healing system, unavailability of the service in nearby health facilities, side-effect and pill burden of the drugs, stigma and discrimination. The patients take their anti-TB medications under difficult circumstances and experienced a wide range of interacting factors. This, in turn, has resulted for non-adhered treatment taking behavior by many patients. Health professionals and policy makers should be aware of such factors and initiate sustained educational campaigns directed towards all parties in the study area to obtain a good success with TB treatment.
28189143	In this study, we explore the nexus between social networks and expertise development of Australian breast radiologists. Background literature has shown that a lack of appropriate social networks and interaction among certain professional group(s) may be an obstacle for knowledge acquisition, information flow and expertise sharing. To date there have not been any systematic studies investigating how social networks and expertise development are interconnected and whether this leads to improved performance for breast radiologists.This study explores the value of social networks in building expertise alongside with other constructs of performance for the Australian radiology workforce using semi-structured in-depth interviews with 17 breast radiologists.	The findings from this study emphasise the influences of knowledge transfer and learning through social networks and interactions as well as knowledge acquisition and development through experience and feedback. The results also show that accessibility to learning resources and a variety of timely feedback on performance through the information and communication technologies (ICT) is likely to facilitate improved performance and build social support.	We argue that radiologists' and, in particular, breast radiologists' work performance, needs to be explored not only through individual numerical characteristics but also by analysing the social context and peer support networks in which they operate and we identify multidisciplinary care as a core entity of social learning.	
28188104	Autism is a developmental condition, characterized by difficulties of social interaction and communication, as well as restricted interests and repetitive behaviors. Although several important conceptions have shed light on specific facets, there is still no consensus about a universal yet specific theory in terms of its underlying mechanisms. While some theories have exclusively focused on sensory aspects, others have emphasized social difficulties. However, sensory and social processes in autism might be interconnected to a higher degree than what has been traditionally thought. We propose that a mismatch in sensory abilities across individuals can lead to difficulties on a social, i.e. interpersonal level and vice versa. In this article, we, therefore, selectively review evidence indicating an interrelationship between perceptual and social difficulties in autism. Additionally, we link this body of research with studies, which investigate the mechanisms of action control in social contexts. By doing so, we highlight that autistic traits are also crucially related to differences in integration, anticipation and automatic responding to social cues, rather than a mere inability to register and learn from social cues. Importantly, such differences may only manifest themselves in sufficiently complex situations, such as real-life social interactions, where such processes are inextricably linked.
28187698	A survey of state mental health agencies found that a majority have no specific policy or procedure regarding how to provide mental health services to persons who are deaf or who are deaf-blind. Agency representatives report that staff lack knowledge of how to provide mental health services to persons who are deaf-blind and the agencies lack qualified interpreters. They recommend training for social workers and counselors to address best practices in working with people who are deaf-blind concerning communication methods and strategies, physical interaction, cultural issues, everyday life, sensory deprivation, ethics, use of an interpreter, and other general issues.
28187690	Mexican male to female transgender asylum seekers in the United States suffer from serious health issues that can be attributed to stressors related to their transgender, ethnic minority, and socioeconomic status. This study explored these stressors, the resulting health issues, and the needs of this particularly vulnerable population. Asylum seekers' (n = 45) sworn declarations and psychological evaluations were examined by a multidisciplinary research team using a systematic document review process. The review identified stressors that occurred both in Mexico and the United States: verbal, physical, and sexual assaults; unstable environments; fear for safety/security; hiding undocumented status; and economic insecurity. The health issues that resulted in part from these stressors include posttraumatic stress disorder, depression, anxiety, sleep issues, isolation, avoidance, drug/alcohol use, and suicidal tendencies. Despite suffering from multiple health issues, asylum seekers rarely sought health or social services. Health promotion practitioners can play an important role in serving this silent minority by (1) expanding community-based research focused on the intersection of transgender, ethnic minority, and socioeconomic status; (2) using trusted community members to connect this population to necessary resources; (3) providing communication training/resource development for health care providers; and (4) creating a network of service organizations that understand the needs of transgender asylum seekers.
28187201	Patient-reported disease perceptions are important components to be considered within a holistic model of quality of care. Gender may have an influence on these perceptions. We aimed to explore gender-specific concerns of patients included in a national bilingual inflammatory bowel disease cohort.Following a qualitative study, we built a questionnaire comprising 37 items of concern. Answers were collected on a visual analog scale ranging from 0 to 100. Principal axis factor analysis was used to explore concern domains. Linear multiple regressions were conducted to assess associations with patient characteristics.	Of 1102 patients who replied to the survey, 54% were female and 54% had Crohn's disease. We identified six domains of concern: socialization and stigmatization, disease-related constraints and uncertainty, symptoms and their impact on body and mind, loss of body control (including sexuality), disease transmission, and long-term impact of the disease. Cancer concerns were among the highest scored by all patients (median 61.8). Severity of symptoms was the only factor associated with concerns, unrelated to dimension and gender (p<0.015). In women, being >40 years decreased disease-related constraints and uncertainty concerns, and being at home or unemployed increased them. Treatments were associated with increased socialization and stigmatization and with increased disease-related constraints and uncertainty concerns in men. Overall, psychosomatic characteristics were highly associated with concerns for both men and women. Depending on the concern dimensions, increased levels of concern were associated with the highest signs of anxiety in women or depression in men, as well as lower health-related quality of life in men.	Patients have numerous concerns related to their illness that need to be reassessed regularly. Concerns differ between men and women, suggesting that information and communication about the disease should take gender differences and subjective perceptions of quality of life into consideration.	
28187096	The aim of the study was to assess patterns in the use of social media (SM) platforms and to identify the training needs among European gynecologic oncology trainees.In 2014, a web-based survey was sent to 633 trainees from the European Network of Young Gynaecological Oncologists (ENYGO) database. The 14-item questionnaire (partially using a 1- to 5-point Likert scale) assessed respondents' use of SM and preference for workshop content and organization. Descriptive analysis was used to describe the mean scores reported for different items, and the internal reliability of the questionnaire was assessed by Cronbach α.	In total, 170 ENYGO members (27%) responded to the survey. Of those, 91% said that they use SM platforms, mostly for private purposes. Twenty-three percent used SM professionally and 43% indicated that they would consider SM to be a clinical discussion forum. The respondents said that they would like updates on conferences and professional activities to be shared on SM platforms. Complication management, surgical anatomy, and state of the art in gynecologic oncology were identified as preferred workshops topics. The most frequently indicated hands-on workshops were laparoscopic techniques and surgical anatomy. Consultants attached a higher level of importance to palliative care education and communication training than trainees. The mean duration of the workshop preferred was 2 days.	This report highlights the significance of ENYGO trainees' attachment to SM platforms. Most respondents expect ENYGO to use these online channels for promoting educational activities and other updates. Using SM for clinical discussion will require specific guidelines to secure professional and also consumer integrity. This survey confirms surgical management and the state of the art as important knowledge gaps, and ENYGO has tailored its activities according to these results. Future activities will further direct attention and resources to education in palliative care and molecular tumor biology.	
28186055	Aging creates new information and communication needs for families who are helping to coordinate care for frail parents. To identify how information and communication needs evolve with the aging process, we created a living laboratory of families, supported by an online private social network with tools for care coordination. Site registrants are invite to participate in a more in-depth survey-based longitudinal study. In year one, we assessed the feasibility of an online living laboratory. During this first year, 155 individuals registered on InfoSAGE, and 26% opted into the more in-depth longitudinal study. The survey response rate for those in the study was 61%. We present here a descriptive analysis of our early participants and networks, as well as barriers to participation that the study team encountered.
28185595	Trust is critical to generate and maintain demand for vaccines in low and middle income countries. However, there is little documentation on how health system insufficiencies affect trust in vaccination and the process of re-building trust once it has been compromised. We reflect on how disruptions to immunizations systems can affect trust in vaccination and can compromise vaccine utilization. We then explore key pathways for overcoming system vulnerabilities in order to restore trust, to strengthen the resilience of health systems and communities, and to promote vaccine utilization.Utilizing secondary data and a review of the literature, we developed a causal loop diagram (CLD) to map the determinants of building trust in immunizations. Using the CLD, we devised three scenarios to illustrate common vulnerabilities that compromise trust and pathways to strengthen trust and utilization of vaccines, specifically looking at weak health systems, harmful communication channels, and role of social capital. Spill-over effects, interactions and other dynamics in the CLD were then examined to assess leverage points to counter these vulnerabilities.	Trust in vaccination arises from the interactions among experiences with the health system, the various forms of communication and social capital - both external and internal to communities. When experiencing system-wide shocks such as the case in Ebola-affected countries, distrust is reinforced by feedback between the health and immunization systems where distrust often lingers even after systems are restored and spills over beyond vaccination in the broader health system. Vaccine myths or anti-vaccine movements reinforce distrust. Social capital - the collective value of social networks of community members - plays a central role in increasing levels of trust.	Trust is important, yet underexplored, in the context of vaccine utilization. Using a CLD to illustrate various scenarios helped to explore how common health and vaccine vulnerabilities can reinforce and spill over distrust through vicious, reinforcing feedback. Restoring trust requires a careful balance between eliminating vulnerabilities and strengthening social capital and interactions among communication channels.	
28183347	Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration. Large clinical trials will require a separate Regulatory Administrative arm, and an Information arm, consisting of dedicated data management and information technology staff. We applied ICS principles to organisation and management of the Prehospital Use of Plasma in Traumatic Haemorrhage (PUPTH) trial. This trial was a multidepartmental, multiagency, randomised clinical trial investigating prehospital administration of thawed plasma on mortality and coagulation response in severely injured trauma patients. We describe the ICS system as it would apply to large clinical trials in general, and the benefits, barriers, and lessons learned in utilising ICS principles to reorganise and coordinate the PUPTH trial.Without a formal trial management structure, early stages of the trial were characterised by inertia and organisational confusion. Implementing ICS improved organisation, coordination, and communication between multiple agencies and service groups, and greatly streamlined regulatory compliance administration. However, unfamiliarity of clinicians with ICS culture, conflicting resource allocation priorities, and communication bottlenecks were significant barriers.	ICS is a flexible and powerful organisational tool for managing large complex clinical trials. However, for successful implementation the cultural, psychological, and social environment of trial participants must be accounted for, and personnel need to be educated in the basics of ICS.	
28183332	Given that mothers play a role in the sexual education of their daughters, it is important to understand their views of sexual health and related programs. This study was aimed at exploring mothers' perspectives regarding sexual health education for their adolescent daughters in Mahshahr, Iran.In this qualitative study, in-depth interviews with ten key informants and five focus group discussions involving 28 mothers with daughters aged 12-18 were conducted. All the discussions were audio-recorded and later transcribed. The data were classified, after which the main themes and sub-themes were manually extracted and analyzed.	The five main themes determined were: the necessity of sexual health education for adolescent girls, the sources of information that mothers use, barriers to sexual health education, the need to empower mothers to provide sexual education to their daughters, and recommendations for developing special training programs for mothers. Most participants believed in limiting sexual health education for adolescent girls; nevertheless, they stated that trained mothers were best equipped to educate their daughters. The major barriers identified by the mothers were their own insufficient knowledge about sexual issues, embarrassment surrounding discussions of this issue with their daughters, fear of the arrogance and curiosity of girls, and a lack of skills for effective communication.	The results showed that empowering mothers to provide sexual health education is important. Tailored educational programs, based on mothers' views, should be developed and implemented.	
28183323	It is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality. The aim of this trial is to evaluate the effects of information and communication technology (ICT) on caregiver burden among informal caregivers of people with dementia by reducing the need for supervision.This randomized controlled trial aims to recruit 320 dyads composed of people with dementia living in community settings and their primary informal caregivers. In the intervention group, people with dementia will have a home monitoring kit installed in their home while dyads in the control group will receive usual care. The ICT kit includes home-leaving sensors, smoke and water leak sensors, bed sensors, and automatic lights that monitor the individual's behavior. Alerts (text message and/or phone call) will be sent to the caregiver if anything unusual occurs. All study dyads will receive three home visits by project administrators who have received project-specific training in order to harmonize data collection. Home visits will take place at enrollment and 3 and 12 months following installation of the ICT kit. At every home visit, a standardized questionnaire will be administered to all dyads to assess their health, quality of life and resource utilization. The primary outcome of this trial is the amount of informal care support provided by primary informal caregivers to people with dementia.	This is the first randomized controlled trial exploring the implementation of ICT for people with dementia in a large sample in Sweden and one of the first at the international level. Results hold the potential to inform regional and national policy-makers in Sweden and beyond about the cost-effectiveness of ICT and its impact on caregiver burden.	
28183293	Research has shown that interactions in group therapies for people with schizophrenia are associated with a reduction in negative symptoms. However, it is unclear which specific interactions in groups are linked with these improvements. The aims of this exploratory study were to i) develop and test the reliability of using video-annotation software to measure interactions in group therapies in schizophrenia and ii) explore the relationship between interactions in group therapies for schizophrenia with clinically relevant changes in negative symptoms.Video-annotation software was used to annotate interactions from participants selected across nine video-recorded out-patient therapy groups (N = 81). Using the Individual Group Member Interpersonal Process Scale, interactions were coded from participants who demonstrated either a clinically significant improvement (N = 9) or no change (N = 8) in negative symptoms at the end of therapy. Interactions were measured from the first and last sessions of attendance (>25 h of therapy). Inter-rater reliability between two independent raters was measured. Binary logistic regression analysis was used to explore the association between the frequency of interactive behaviors and changes in negative symptoms, assessed using the Positive and Negative Syndrome Scale.	Of the 1275 statements that were annotated using ELAN, 1191 (93%) had sufficient audio and visual quality to be coded using the Individual Group Member Interpersonal Process Scale. Rater-agreement was high across all interaction categories (>95% average agreement). A higher frequency of self-initiated statements measured in the first session was associated with improvements in negative symptoms. The frequency of questions and giving advice measured in the first session of attendance was associated with improvements in negative symptoms; although this was only a trend.	Video-annotation software can be used to reliably identify interactive behaviors in groups for schizophrenia. The results suggest that proactive communicative gestures, as assessed by the video-analysis, predict outcomes. Future research should use this novel method in larger and clinically different samples to explore which aspects of therapy facilitate such proactive communication early on in therapy.	
28183029	Sustainability Reporting has become a key element in different organisations. Although there have been a number of academic publications discussing the adoption of sustainability reports in the public sector, their numbers have been quite low when compared to those focussing on corporate reports. Additionally, there has been little research on the link between sustainability reporting in Public Sector Organisations (PSOs) and Organisational Change Management for Sustainability (OCMS). This paper focuses on the contribution of sustainability reporting to OCMS. A survey was sent to all PSOs that have published at least one sustainability report based on the GRI guidelines. The study provides a critical analysis of the relation between sustainability reporting and OCMS in PSOs, including the drivers for reporting, the impacts on organisation change management, and the role of stakeholders in the process. Despite still lagging in sustainability reporting journey, PSOs are starting to use sustainability reporting as a communication tool, and this could drive organisational changes for sustainability.
28181851	Relational and organisational factors are key elements of interprofessional collaboration (IPC) and team climate. Few studies have explored the relationship between IPC and team climate. This article presents a study that aimed to explore IPC in primary healthcare teams and understand how the assessment of team climate may provide insights into IPC. A mixed methods study design was adopted. In Stage 1 of the study, team climate was assessed using the Team Climate Inventory with 159 professionals in 18 interprofessional teams based in São Paulo, Brazil. In Stage 2, data were collected through in-depth interviews with a sample of team members who participated in the first stage of the study. Results from Stage 1 provided an overview of factors relevant to teamwork, which in turn informed our exploration of the relationship between team climate and IPC. Preliminary findings from Stage 2 indicated that teams with a more positive team climate (in particular, greater participative safety) also reported more effective communication and mutual support. In conclusion, team climate provided insights into IPC, especially regarding aspects of communication and interaction in teams. Further research will provide a better understanding of differences and areas of overlap between team climate and IPC. It will potentially contribute for an innovative theoretical approach to explore interprofessional work in primary care settings.
28181031	Natural and artificial tanning have become very popular in Western culture, yet at the same time, there is still a psychodermatology concern for this activity. Not much has been examined with the psychological aspects of tanning and sunscreen use. The purpose of this study is to examine the psychosocial effects associated with sun protection, natural, and artificial tanning among individuals 18 years old or older visiting the University of Miami Dermatology Outpatient Clinic. We distributed a survey on tanning and sunscreen use to 150 dermatology outpatients, hospital employees, and hospital visitors for three weeks during June/July 2015 asking about how often they tan, use sunscreen, and how they feel about this topic. Demographics, such as gender, ethnicity, and education were taken into consideration to examine the different responses in each category. Our results suggest that people's perception to tanning and sunscreen use have evolved over time. Most people in South Florida nowadays feel guilty when exposed to natural sunlight without sunscreen and do not tan frequently. The majority of the people, specifically women, utilize the recommended amount of sunscreen with a sun protection factor of 30-50. However, we can conclude that communication between social media and the general public can affect people's decision-making on tanning and sunscreen use with physician advice being the most effective method of encouraging people to use sunscreen. This study will add to the growing knowledge about psychodermatology.
28181003	Indoor tanning (IT), particularly during early adulthood, increases risk for melanoma and is exceedingly common among youth. Social influence, including social norms, promotes IT but little is known about young adults' engagement with friends around tanning. We examined IT behaviors and tanning-related communication with friends at three universities. Of 837 participants, 261 (31%) reported ever tanning (90% female, 85% White). Of those, 113 (43%) were former tanners and 148 (57%) current tanners. Current tanners reported more social tanning and discussions with friends about tanning, more frequent outdoor tanning, high propensity to tan, and greater lifetime IT exposure than former tanners. Risks-to-benefits discussion ratios were greater for former tanners. In adjusted analyses, current tanners were more likely to make plans to tan and to talk about tanning benefits with friends. Findings confirm IT is a social experience. Future work should examine social tanning's role in the promotion and reduction of IT among youth.
28180178	Many topics in science are notoriously difficult for students to learn. Mechanisms and processes outside student experience present particular challenges. While instruction typically involves visualizations, students usually explain in words. Because visual explanations can show parts and processes of complex systems directly, creating them should have benefits beyond creating verbal explanations. We compared learning from creating visual or verbal explanations for two STEM domains, a mechanical system (bicycle pump) and a chemical system (bonding). Both kinds of explanations were analyzed for content and learning assess by a post-test. For the mechanical system, creating a visual explanation increased understanding particularly for participants of low spatial ability. For the chemical system, creating both visual and verbal explanations improved learning without new teaching. Creating a visual explanation was superior and benefitted participants of both high and low spatial ability. Visual explanations often included crucial yet invisible features. The greater effectiveness of visual explanations appears attributable to the checks they provide for completeness and coherence as well as to their roles as platforms for inference. The benefits should generalize to other domains like the social sciences, history, and archeology where important information can be visualized. Together, the findings provide support for the use of learner-generated visual explanations as a powerful learning tool.
28179482	To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties METHODS: A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non-English speaking background,family history of speech/language difficulties); maternal factors (mental health, vocabulary, education, and age); and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life).Almost 19% of children (22/1204;18.9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68-0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85-0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning.	Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties.	
28179410	Effective communication requires animal signals to be readily detected by receivers in the environments in which they are typically given. Certain light conditions enhance the visibility of colour signals and these conditions can vary depending on the orientation of the sun and the position of the signaller. We tested whether Draco sumatranus gliding lizards modified their position relative to the sun to enhance the conspicuousness of their throat-fan (dewlap) during social display to conspecifics. The dewlap was translucent, and we found that lizards were significantly more likely to orient themselves perpendicular to the sun when displaying. This increases the dewlap's radiance, and likely, its conspicuousness, by increasing the amount of light transmitted through the ornament. This is a rare example of a behavioural adaptation for enhancing the visibility of an ornament to distant receivers.
28178958	Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The structure of formal and informal social networks can influence, and be influenced, by the implementation of EIDM interventions.In a mixed methods study we assessed the outcomes of a targeted training intervention to promote EIDM among the staff in three public health units in Ontario, Canada. This report focuses on the qualitative phase of the study in which key staff were interviewed about the process of engagement in the intervention, communications during the intervention, and social consequences.	Senior managers identified staff to take part in the intervention. Engagement was a top-down process determined by the way organizational leaders promoted EIDM and the relevance of staff's jobs to EIDM. Communication among staff participating in the workshops and ongoing progress meetings was influential in overcoming personal and normative barriers to implementing EIDM, and promoted the formation of long-lasting social connections among staff. Organization-wide presentations and meetings facilitated the recognition of expertise that the trained staff gained, including their reputation as experts according to their peers in different divisions.	Selective training and capacity development interventions can result in forming an elite versus ordinary pattern that facilitates the recognition of in-house qualified experts while also strengthening social status inequality. The role of leadership in public health units is pivotal in championing and overseeing the implementation process. Network analysis can guide and inform the design, process, and evaluation of the EIDM training interventions.	
28178858	The extent to which technology may be able to support people with dementia and their carers along the care pathway and in different care settings is of interest to policy makers and governments. In this paper we provide an overview of the role of technology in dementia care, treatment and support by mapping existing technologies - by function, target user and disease progression. Technologies identified are classified into seven functions: memory support, treatment, safety and security, training, care delivery, social interaction and other. Different groups of potential users are distinguished: people with mild cognitive impairment and early stages of dementia, people with moderate to severe dementia and unpaid carers and health- and social care professionals. We also identified the care settings, in which the technologies are used (or for which the technologies are developed): at home in the community and in institutional care settings. The evidence has been drawn from a rapid review of the literature, expert interviews and web and social media searches. The largest number of technologies identified aim to enhance the safety and security of people with dementia living in the community. These devices are often passive monitors, such as smoke detectors. Other safety interventions, such as panic buttons, require active intervention. The second largest number of interventions aims to enhance people's memory and includes global positioning systems devices and voice prompts. These technologies mostly target people in the early stages of dementia. A third group focusing on treatment and care delivery emerged from the literature. These interventions focus on technology-aided reminiscence or therapeutic aspects of care for people with dementia and their carers. While the review found a range of technologies available for people with dementia and carers there is very little evidence of widespread practical application. Instead, it appears that stakeholders frequently rely on everyday technologies re-purposed to meet their needs.
28178361	The "all-natural" label is used extensively in the United States. At many point-of-purchase locations, employed servers provide food samples and call out specific label information to influence consumers' purchase decisions. Despite these ubiquitous practices, it is unclear what information is conveyed to consumers by the all-natural label or how it impacts judgments of perceived food quality, nutritional content, and acceptance. We used a novel approach incorporating immersive technology to simulate a virtual in-store sampling scenario where consumers were asked by a server to evaluate identical products with only one being labeled all-natural. Another condition evaluated the impact of the in-store server additionally emphasizing the all-natural status of one sample. Results indicated the all-natural label significantly improved consumer's perception of product quality and nutritional content, but not liking or willingness to pay, when compared to the regular sample. With the simple emphasis of the all-natural claim by the in-store server, these differences in quality and nutritional content became even more pronounced, and willingness to pay increased significantly by an average of 8%. These results indicate that in a virtual setting consistent with making food purchases, an all-natural front-of-pack label improves consumer perceptions of product quality and nutritional content. In addition, information conveyed to consumers by employed servers has a further, substantial impact on these variables suggesting that consumers are highly susceptible to social influence at the point of purchase.
28178111	Men who have sex with men (MSM) and transgender women (TW) in Peru bear a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). In a context of quickly expanding communication technology, increasing numbers of MSM and TW are using social media applications to seek sex partners. Understanding social media users and their sex partnering practices is needed to update HIV and STI prevention programming.In Lima, Peru, 312 MSM and 89 TW from 2 STI clinics underwent HIV and STI testing and participated in a survey of demographics, behaviors, sexual health, and social media practices. χ, t tests, and Wilcoxon Mann-Whitney tests were used to compare those with and without recent social media sex partners.	Men who have sex with men with social media sex partners were younger, more educated, and more likely to identify as gay. They were significantly more likely to report greater numbers of sex partners, including anonymous sex partners; sex in higher-risk venues, orgies, and have rectal Neisseria gonorrhoeae or Chlamydia trachomatis infection. Transgender women with social media sex partners were also younger, more likely to participate in sex work, and have a lower rate of rapid plasma reagin positivity or history of syphilis. Participants reported using several social media sites including sexual hook-up applications, websites for gay men, pornographic websites, and chat sites, but the most common was Facebook.	Prevention strategies targeting Peruvian MSM and TW who use social media are needed to address higher-risk sexual behavior and the high burden of STIs.	
28177282	Acoustic communication is fundamental to social interactions among animals, including humans. In fact, deficits in voice impair the quality of life for a large and diverse population of patients. Understanding the molecular genetic mechanisms of development and function in the vocal apparatus is thus an important challenge with relevance both to the basic biology of animal communication and to biomedicine. However, surprisingly little is known about the developmental biology of the mammalian larynx. Here, we used genetic fate mapping to chart the embryological origins of the tissues in the mouse larynx, and we describe the developmental etiology of laryngeal defects in mice with disruptions in cilia-mediated Hedgehog signaling. In addition, we show that mild laryngeal defects correlate with changes in the acoustic structure of vocalizations. Together, these data provide key new insights into the molecular genetics of form and function in the mammalian vocal apparatus.
28176207	The purpose of this pilot study was to explore the feasibility of an intervention designed to facilitate partner support for lifestyle change among overweight and obese adults with serious mental illness (SMI). Fifteen adults with SMI enrolled in a lifestyle intervention at community mental health centers participated with a self-selected partner in an additional 12-week intervention component designed to facilitate social support for health behavior change. Participants reported that the program was useful, convenient, and helped them reach their goals. Approximately two-thirds (66%) of participants were below their baseline weight at follow-up, including 27% achieving clinically significant weight loss. Participants reported significant increases in partner support for exercise and use of persuasive social support strategies. Partner support interventions that promote exercising together and positive communication may be effective for helping individuals with SMI initiate and sustain health behavior change necessary to reduce cardiovascular risk.
28174031	Addicts to specific internet applications involving communication features showed increased social anxiety, emotional competence deficits and impaired prefrontal-related inhibitory control. The dorsal Anterior Cingulate Cortex (dACC) likely plays an important role in cognitive control and negative affect (such as social exclusion, pain or anxiety).To assess (social) anxiety-related inhibitory control in specific internet addiction (addicted use of games and social networks) and its relation to altered dACC activation.	N=44 controls and n=51 specific internet addicts completed an anxious words-based Affective Go/No-Go task (AGN). A subsample of n=23 healthy controls and n=25 specific internet addicts underwent functional Magnetic Resonance Imaging (fMRI) while completing an Emotional Stroop Task (EST) with socially anxious, positive, negative and neutral words. Subgroups of internet gaming and social network addicts were exploratively assessed. Psychometric measures of social anxiety, emotional competence and impulsivity were additionally explored.	Specific internet addicts showed higher impulsivity, social anxiety and reduced emotional competence. Between-group differences in AGN and EST behavioral measures were not detected. No group differences were found in the dACC, but explorative analyses revealed decreased left middle and superior temporal gyrus activation during interference of socially anxious words in internet gaming and relative to social network addicts.	Given the function of the left middle temporal gyrus in the retrieval of words or expressions during communication, our findings give a first hint that social words might be less retrievable in the semantic storage of internet gaming addicts, possibly indicating deficiencies in handling speech in social situations.	
28173882	To verify the efficacy of school-based interventions aimed at reducing sugar-sweetened beverage (SSB) consumption among adolescents in order to develop or improve public health interventions.Systematic review of interventions targeting adolescents and/or the school environment.	The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL and EMBASE. Proquest Dissertations and Theses was also investigated for unpublished trials.	Adolescents were defined as individuals between the ages of 12 and 17 years.	A total of thirty-six studies detailing thirty-six different interventions tested among independent samples (n 152 001) were included in the review. Twenty interventions were classified as educational/behavioural and ten were classified as legislative/environmental interventions. Only six interventions targeted both individuals and their environment. Over 70 % of all interventions, regardless of whether they targeted individuals, their environment or both, were effective in decreasing SSB consumption. Legislative/environmental studies had the highest success rate (90·0 %). Educational/behavioural interventions only and interventions that combined educational/behavioural and legislative/environmental approaches were almost equally effective in reducing SSB consumption with success rates of 65·0 and 66·7 %, respectively. Among the interventions that had an educational/behavioural component, 61·5 % were theory-based. The behaviour change techniques most frequently used in interventions were providing information about the health consequences of performing the behaviour (72·2 %), restructuring the physical environment (47·2 %), behavioural goal setting (36·1 %), self-monitoring of behaviour (33·3 %), threat to health (30·6 %) and providing general social support (30·6 %).	School-based interventions show promising results to reduce SSB consumption among adolescents. A number of recommendations are made to improve future studies.	
28173849	In many countries there are now detailed Child Death Review (CDR) processes following unexpected child deaths. CDR can lead to a fuller understanding of the causes for each child's death but this potentially intrusive process may increase the distress of bereaved families. In England, a joint agency approach (JAA) is used where police, healthcare and social services investigate sudden child deaths together and a key part of this is the joint home visit (JHV) where specialist police and paediatricians visit the home with the parents to view the scene of death. This study aimed to learn of bereaved parents' experiences of JAA investigation following Sudden Unexpected Death in Infancy (SUDI).This was a qualitative study of joint agency investigation of SUDI by specialist police, healthcare and social services including case note analysis, parental questionnaires, and in-depth interviews with parents and professionals. Families were recruited at the conclusion of the JAA. Data were analysed using a Framework Approach.	21/113 eligible families and 26 professionals participated giving theoretical saturation of data. There was an inherent conflict for professionals trying to both investigate deaths thoroughly as well as support families. Bereaved parents appreciated the JAA especially for the information it provided about the cause of death but were frustrated with long delays waiting to obtain this. Many parents wanted more emotional support to be routinely provided. Most parents found the JHV helpful but a small minority of mothers found this intensely distressing. In comparison to JHVs, when police visited death scenes without paediatricians, information was missed and parents found these visits more upsetting. There were issues with uniformed non-specialist police traumatising parents by starting criminal investigations and preventing parents from accessing their home or collecting vital possessions.	Overall most parents feel supported by professionals during the JAA; however there is scope for improvement. Paediatricians should ensure that parents are kept updated with the progress of the investigations. Some parents require more emotional support and professionals should assist them in accessing this.	
28173789	Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene.Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene.	The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events. Sanitation science fair projects addressed a range of pastoralist questions and concerns regarding the relationship between water, sanitation and hygiene. Several projects, such as making soap from local materials, demonstrate potential as a sustainable strategy to improve health and livelihoods in the long-term.	The Project SHINE model shows promise as an innovative capacity building approach and as an engagement and empowerment strategy for youth and communities to develop locally sustainable strategies to improve sanitation and hygiene.	
28171735	A therapeutic relationship forms the basis of care of patients in psychiatric mental health nursing. However, individuals with schizophrenia have difficulty participating in these relationships. Recent research in the area of social cognitive psychology offers that deficits in this area affect the flow of perceiving and relating in interpersonal relationships. This literature has not been applied to nursing.The objective of this article is to review the theories underpinning therapeutic relationships from a nursing and psychological perspective, including the newest research from social cognitive psychology.	The article presents a literature review of the theories of nursing, psychology, and social cognitive science. Two patient case studies are used as examples of application of the theories.	This article incorporates new knowledge about the components of social cognition to inform nurses as they build therapeutic relationships with patients with chronic and persistent mental illnesses.	The science of social cognitive psychology offers nursing a new perspective on the evolving therapeutic nurse-patient relationship with patients with chronic and persistent mental illnesses. It has implications for clinicians, educators, and nurse scientists.	
28171681	The purpose of the study was to build a model to explain the relationships between social support, uncontrollability appraisal, adaptive coping, and posttraumatic growth (PTG) among cancer patients in China.The participants who were cancer patients in a cancer hospital in China filled out a survey. The final sample size was 201. Structural equation modeling was used to build a model explaining PTG.	Structural equation modeling results indicated that higher levels of social support predicted higher levels of adaptive coping, higher levels of uncontrollability appraisal predicted lower levels of adaptive coping, and higher levels of adaptive coping predicted higher levels of PTG. Moreover, adaptive coping was a mediator between social support and growth, as well as a mediator between uncontrollability and growth. The direct effects of social support and uncontrollability on PTG were insignificant.	The model demonstrated the relationships between social support, uncontrollability appraisal, adaptive coping, and PTG. It could be concluded that uncontrollability appraisal was a required but not sufficient condition for PTG. Neither social support nor uncontrollability appraisal had direct influence on PTG. However, social support and uncontrollability might indirectly influence PTG, through adaptive coping. It implies that both internal factors (eg, cognitive appraisal and coping) and external factors (eg, social support) are required in order for growth to happen.	
28170308	Some studies indicated that playing online games yields a "rich-get-richer effect" and is especially socially beneficial for extraverted players, while other authors argue that online gaming could have compensational effects for introverted players. The current survey study (N = 409) investigates the connection between introversion/extraversion and social capital outcomes of playing the popular role-playing game World of Warcraft and shows that the rich-get-richer and the compensation perspective are not mutually exclusive. Path analysis revealed that extraverted players communicated and self-disclosed more extensively, more often engaged in team play, and, hence, had better chances to build up social capital than introverts. However, at least some of the introverted players used the game for social compensation. These players chose a more social playing style, which increased their chances to acquire social capital. The results demonstrate that the group of introverted players is more heterogeneous than previously thought and that the links between personality aspects and social outcomes of playing are quite complex and rather indirect than direct.
28170106	The increasing popularity of social networking sites (SNS) such as Facebook and Twitter has given rise to speculations that the intensity of using these platforms is associated with narcissistic tendencies. However, recent research on this issue has been all but conclusive.We present a three-level, random effects meta-analysis including 289 effect sizes from 57 studies (total N = 25,631) on the association between trait narcissism and social networking behavior.	The meta-analysis identified a small to moderate effect of ρ = .17 (τ = .11), 95% CI [.13, .21], for grandiose narcissism that replicated across different social networking platforms, respondent characteristics, and time. Moderator analyses revealed pronounced cultural differences, with stronger associations in power-distant cultures. Moreover, social networking behaviors geared toward self-presentation and the number of SNS friends exhibited stronger effects than usage durations.	Overall, the study not only supported but also refined the notion of a relationship between engaging in social networking sites and narcissistic personality traits.	
28170054	La gran mayoría de jóvenes disponen de teléfono móvil, convirtiéndose en un objeto imprescindible en su vida, que ha desplazado los espacios de socialización tradicionales por espacios virtuales. Es utilizado por ellos, durante muchas horas, en detrimento de su funcionamiento psicológico y social, mostrando mayor vulnerabilidad a su uso abusivo o excesivo, y mayor propensión a convertirse en un uso problemático o adictivo. En este trabajo se pretende estudiar las repercusiones sociales, personales y comunicacionales del abuso del móvil de los estudiantes universitarios, y profundizar en los diferentes perfiles del ciberacoso, analizando quién presenta más problemas personales y sociales con el uso del móvil: ¿víctimas o agresores? También si el número de horas de uso del móvil tiene un efecto sobre dichos problemas. La muestra (1200 estudiantes) fue seleccionada mediante muestreo polietápico por conglomerados de entre las distintas Facultades de la Universidad de Extremadura. Los datos fueron obtenidos a través de las Escalas de Victimización (CYB-VIC) y Agresión (CYB-AGRES) a través del Teléfono Móvil y el Cuestionario de Experiencias relacionadas con el Móvil (CERM). Los resultados muestran que el uso abusivo del móvil genera conflictos en los jóvenes de ambos sexos; aunque las chicas manifiestan más problemas comunicacionales y emocionales que los chicos. Además, la edad, el campo de conocimiento, el perfil víctima/agresor y las horas de uso del móvil son variables determinantes sobre los conflictos comunicacionales y emocionales derivados del uso abusivo del móvil.The vast majority of young people have mobile phones. This has become a must-have item in their lives, with traditional socialization spaces displaced by virtual ones. They use their mobile phones for many hours a day, to the detriment of their psychological and social functioning, showing greater vulnerability to abusive or excessive use, and more likely to become problematic or addicted users. This paper aims to study the impact of mobile phone abuse in a sample of college students, assessing the social, personal, and communicational realms and deepening understanding of the different cyberbullying profiles, analyzing who has more personal and social problems using mobiles: victims or aggressors. Whether the number of hours of mobile phone use has an effect on these problems will also be explored. The sample (1,200 students) was selected by multistage cluster sampling among the faculties of the University of Extremadura. Data were obtained through Victimization (CYB-VIC) and Aggression (CYB-AGRES) through the mobile phone scales, and the Questionnaire of Experiences related to Mobile (CERM). The results show that mobile phone abuse generates conflicts in young people of both sexes, although girls have more communication and emotional problems than boys. In addition, age, field of knowledge, victim/aggressor profile, and hours of mobile phone use are crucial variables in the communication and emotional conflicts arising from the misuse of mobile.	
28169737	Social networks influence health behavior and health status. Within social networks, "key players" often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, discomfort with the medical system, and misinformed perspectives on screening. Ideas to improve screening focused on increasing awareness of women's susceptibility to CRC, providing information on different screening tests, improving access, and the key role of health-care providers and key players themselves. We provide recommendations to leverage these vital community resources. 
28168028	Signals play a key role in the ecology and evolution of animal populations, influencing processes such as sexual selection and conflict resolution. In many species, sexually selected signals have a dual function: attracting mates and repelling rivals. Yet, to what extent males and females under natural conditions differentially respond to such signals remains poorly understood, due to a lack of field studies that simultaneously track both sexes. Using a novel spatial tracking system, we tested whether or not the spatial behavior of male and female great tits (Parus major) changes in relation to the vocal response of a territorial male neighbor to an intruder. We tracked the spatial behavior of male and female great tits (N = 44), 1 hr before and 1 hr after simulating territory intrusions, employing automatized Encounternet radio-tracking technology. We recorded the spatial and vocal response of the challenged males and quantified attraction and repulsion of neighboring males and females to the intrusion site. We additionally quantified the direct proximity network of the challenged male. The strength of a male's vocal response to an intruder induced sex-dependent movements in the neighborhood, via female attraction and male repulsion. Stronger vocal responders were older and in better body condition. The proximity networks of the male vocal responders, including the number of sex-dependent connections and average time spent with connections, however, did not change directly following the intrusion. The effects on neighbor movements suggest that the strength of a male's vocal response can provide relevant social information to both the males and the females in the neighborhood, resulting in both sexes adjusting their spatial behavior in contrasting ways, while the social proximity network remained stable. This study underlines the importance of "silent" eavesdroppers within communication networks for studying the dual functioning and evolution of sexually selected signals.
28168003	Joint attention skills have been shown to predict language outcomes in children with autism spectrum disorder (ASD). Less is known about the relationship between joint attention (JA) abilities in children with ASD and cognitive and adaptive abilities. In the current study, a subset of items from the Autism Diagnostic Observation Schedule (ADOS), designed to quantify JA abilities, were used to investigate social attention among an unusually large cross-sectional sample of children with ASD (n = 1061). An examination of the association between JA and a range of functional correlates (cognitive and adaptive) revealed JA was significantly related to verbal (VIQ) and non-verbal (NVIQ) cognitive ability as well as all domains of adaptive functioning (socialization, communication, and daily living skills). Additional analyses examined the degree to which the relation between adaptive abilities (socialization, communication, and daily living skills) and JA was maintained after taking into account the potentially mediating role of verbal and nonverbal cognitive ability. Results revealed that VIQ fully mediated the relation between JA and adaptive functioning, whereas the relation between these adaptive variables and JA was only partially mediated by NVIQ. Moderation analyses were also conducted to examine how verbal and non-verbal cognitive ability and gender impacted the relation between JA and adaptive functioning. In line with research showing a relation between language and JA, this indicates that while JA is significantly related to functional outcomes, this appears to be mediated specifically through a verbal cognitive pathway.
28167313	Longitudinal research into the development of prosociality contributes vitally to understanding of individual differences in psychosocial outcomes. Most of the research to date has been concerned with prosocial behaviour in typically developing young people; much less has been directed to the course of development in individuals with developmental disorders.This study reports a longitudinal investigation of prosocial behaviour in young people with language impairment (LI), and compares trajectories of development to typically developing age-matched peers (AMPs).	Participants were followed from age 11 years to young adulthood (age 24 years).	Participants with LI perceived themselves as prosocial; their ratings - though lower than those for the AMPs - were well within the normal range and they remained consistently so from 11 to 24 years. Two different developmental trajectories were identified for the LI group, which were stable and differed only in level of prosociality. Approximately one third of participants with LI followed a moderate prosociality trajectory whilst the majority (71%) followed a prosocial trajectory. We found evidence of protective effects of prosociality for social outcomes in young adulthood.	The findings indicate that prosociality is an area of relative strength in LI. WHAT THIS PAPER ADDS?: To our knowledge, this is the first study to examine developmental changes in levels of prosociality from early adolescence to young adulthood in a cohort of young people with LI. Approximately one third of participants with LI followed a moderate prosociality trajectory whilst the majority (71%) followed a prosocial trajectory. We argue that prosociality is different to other areas of functioning in LI. Prosociality appears to be an area of relative strength and can act as a protective factor in social functioning. Prosociality was associated with better community integration in young adulthood and was significantly protective against friendship difficulties for individuals with LI. This paper also raises the thought-provoking issue of potential distal effects of early identification and intensive support for LI. It is important to note that all of the participants with LI in this study had been identified as having language difficulties in childhood and had received intensive intervention for their difficulties in language units attached to mainstream schools across England. The early identification of language difficulties and the context of early, intensive language support received in educational contexts such as language units may have nurtured socialisation processes and the development of emphatic concern, which in turn influence the development of prosociality later in young adulthood. More individual differences in prosociality have been reported for other samples drawn from a variety of schools with different educational provision and levels of language support and younger age groups, such as primary school-aged children with LI.	
28167310	This study examined change trajectories of aggressive behaviors among children in long-term residential care in Israel and identified various child-, family-, and placement-related predictors of the change trajectories. Records of 799 children (average age at the beginning of the four years=10.4, 33.1% female) in their first four consecutive years in care were analyzed using the TRF aggressive behavior subscale (Achenbach, 1991) to measure the outcome variable. Children's and parents' characteristics and placement-related factors were used to explain variance in change trajectories. Latent Class Growth Analyses identified four aggressive behavior trajectories: 'stable-low' levels of aggressiveness over time (45% of the children), 'stable-high' levels (13%), 'improvement' (20%), and 'deterioration' (22%). Predictors of less resilient trajectories (i.e., stable-high or increasing aggressiveness) included mothers' difficulties and disabilities, children's attendance of special education classes, more intensive type of care, and non-immigrant status. The Attachment Theory, Life Course Perspective theories, and the General Strain Theory are used to interpret some of the findings of the study. Identifying the factors that predispose children to certain patterns of change may help direct resources to children at risk of having high or increasing levels of aggression while in residential care.
28166481	Multiple surveys show that patients want medical privacy; however, there are costs to maintaining privacy. There are also risks if information is not shared. A review of previous surveys found that most surveys asked questions about patient's privacy concerns and willingness to share their medical information. We found only one study that asked about sharing medical information for better care and no survey that asked patients about the risk, cost or comparison between medical privacy and privacy in other areas. To fill this gap, we designed a survey to: (1) compare medical privacy preferences to privacy preferences in other areas; (2) measure willingness to pay the cost of additional privacy measures; and (3) measure willingness to accept the risks of not sharing information.A total of 834 patients attending physician offices at 14 sites completed all or part of an anonymous questionnaire.	Over 95% of patients were willing to share all their medical information with their treating physicians. There was no difference in willingness to share between primary care and specialty sites including psychiatry and an HIV clinic. In our survey, there was no difference in sharing preference between standard medical information and information with additional legal protections including genetic testing, drug/alcohol treatment and HIV results. Medical privacy was ranked lower than sharing social security and credit card numbers, but was deemed more private than other information including tax returns and handgun purchases. There was no statistical difference for any questions by site except for HIV/AIDS clinic patients ranking privacy of the medical record more important than reducing high medical costs and risk of medical errors (p < .05). Most patients were willing to spend a modest amount of additional time for privacy, but few were willing to pay more for additional medical privacy. Most patients were unwilling to take on additional risks to keep medical information hidden.	Patients were very willing to share medical information with their providers. They were able to see the importance of sharing medical information to provide the best possible care. They were unwilling to hide information from providers if there was increased medical risk. Patients were willing to spend additional time for privacy, but most were unwilling to spend extra money. Sixty-eight percent of patients favored reducing medical costs over privacy.	
28166439	Mass media shape not only public, but also healthcare professionals' attitudes towards individuals with a mental illness. This study investigates how watching a movie about schizophrenia affects stigma-related attitudes of rehabilitation science students, who are likely to work with affected individuals. Participants watched an entertainment movie portrayal of schizophrenia. Stigma-related attitudes and social distance were assessed one week before watching the movie, directly afterwards, and one week later. No significant differences in stigmatization emerged between viewers and non-viewers. Enjoyment, appreciation, and general movie evaluation mediated viewers' transportation into the story on changes in stigmatization. Results are discussed with respect to media effects on stigma-related attitudes and their implications for mental health nursing practice and education.
28166000	Background We live in an age when education is being internationalized. This can confront students with 'cultural hegemony' that can result from the unequal distribution of power and privilege in global society. The name that is given to awareness of social inequality is 'critical consciousness'. Cross-cultural dialogue provides an opportunity for learners to develop critical consciousness to counter cultural hegemony. The purpose of this research was to understand how learners engage with cross-cultural dialogue, so we can help them do so more effectively in the future. Method The setting for this research was an online discussion in an international health professions educator fellowship program. We introduced scenarios with cultural references to study the reaction of participants to cultural conversation cues. We used an inductive thematic analysis to explore power and hegemony issues. Results Participants reflected that personally they were more likely to take part in cross-cultural discussions if they recognized the context discussed or had prior exposure to educational settings with cultural diversity. They identified barriers as lack of skills in facilitating cross-cultural discussions and fear of offending others. They suggested deliberately introducing cultural issues throughout the curriculum. Conclusion Our results indicate that developing critical consciousness and cross-cultural competency will require instructional design to identify longitudinal opportunities to bring up cross-cultural issues, and training facilitators to foster cross-cultural discussions by asking clarifying questions and navigating crucial/sensitive conversations.
28165418	Background: Conflicting interests, power imbalance and relationships characterized by distrust are just a few of the many challenges community-academic research partnerships face. In addition, the time it takes to build relationships is often overlooked, which further complicates matters and can leave well-intentioned individuals re-creating oppressive conditions through inauthentic partnerships. This paper presents a novel approach of using meeting minutes to explore partnership dynamics. The Community Assessment of Freeway Exposure and Health (CAFEH) partnership is used as an illustrative case study to identify how community academic partnerships overcome the challenges associated with community-based participatory research (CBPR). CAFEH is a study of ultrafine particle exposure (UFP) near highways in the Boston, MA area. Methods: Qualitative analysis was applied to meeting minutes and process evaluation reports from the first three years of the CAFEH study (n = 73 files). In addition, a group meeting was held with project partners in order to contextualize the findings from the document analysis. Results: The three most commonly referenced challenges included language barriers, the overall project structure and budgetary constraints. Meanwhile, a heavy emphasis on process and an approach steeped in participatory democracy facilitated CAFEH's ability to overcome these challenges, as well as sustain and augment strong partnership ties. Conclusions: This experience suggests that leadership that incorporates an organizing approach and a transformational style facilitates CBPR processes and helps teams surmount challenges.
28165368	Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health.
28164412	The article addresses Jürgen Habermas' theory of communicative action, which offers very productive tools for analysing disability. The Habermasian division of social reality helps examine positive and negative effects of tensions between the lifeworld of a person with disability and the system. By exploring such an individual's communicative action, one can obtain an insight into his/her validity claims and disruptions in the communication process and self-understandings inscribed in group narratives. The study reported in the article used in-depth interviews, which narratively reveal the experiences of a person with disability in family, education, sports and labour. The key findings are, first, that the rationalization of lifeworlds of people with disability increases while processes in which they are colonized by the system intensify; second, that education and family are significant factors in the raising of validity claims; and third, that validity claims as tools of verbal communication should be augmented with arguments from non-verbal language (e.g. gesture, empathy).
28163702	Bacteria of the genus Aeromonas display multicellular behaviors herein referred to as "social life". Since the 1990s, interest has grown in cell-to-cell communication through quorum sensing signals and biofilm formation. As they are interconnected, these two self-organizing systems deserve to be considered together for a fresh perspective on the natural history and lifestyles of aeromonads. In this review, we focus on the multicellular behaviors of Aeromonas, i.e., its social life. First, we review and discuss the available knowledge at the molecular and cellular levels for biofilm and quorum sensing. We then discuss the complex, subtle, and nested interconnections between the two systems. Finally, we focus on the aeromonad multicellular coordinated behaviors involved in heterotrophy and virulence that represent technological opportunities and applied research challenges.
28163670	Transcutaneous Vagus Nerve Stimulation (tVNS) on the auricular branch of the vagus nerve has been receiving attention due to its therapeutic potential for neuropsychiatric disorders. Although the mechanism of tVNS is not yet completely understood, studies have demonstrated the potential role of vagal afferent nerve stimulation in the regulation of mood and visceral state associated with social communication. In addition, a growing body of evidence shows that tVNS can activate the brain regions associated with Autism Spectrum Disorder (ASD), trigger neuroimmune modulation and produce treatment effects for comorbid disorders of ASD such as epilepsy and depression. We thus hypothesize that tVNS may be a promising treatment for ASD, not only for comorbid epilepsy and depression, but also for the core symptoms of ASD. The goal of this manuscript is to summarize the findings and rationales for applying tVNS to treat ASD and propose potential parameters for tVNS treatment of ASD.
28163396	Schumpeter's theory of democracy can be read through the lens of the cognitive approach to rationality. Schumpeter himself constructed his theory on the basis of his (neglected) conception of conscious rationality, which considers the process of thinking as composed of conscious/deliberate and unconscious/automatic components. The prevalence of the deliberate over the automatic component can occur in different degrees; as a consequence, individuals exhibit different levels of conscious rationality. Schumpeter makes clear that an essential attribute of democracy is its being a system of government capable of working notwithstanding a low degree of conscious rationality among its citizens. Given this condition, the process of political communication and persuasion can lead to two very different outcomes: a fair social construction of the democratic institutions, in which the struggle for the vote is achieved through a critical debate among leaders and citizens; and an unfair construction, based on the prevalence of emotive forces of persuasion over rationality and on cheating of the leaders at the expense of their citizens. Schumpeter suggests that the main element that fosters a fair construction is the effectiveness of competition, which can advance the rational elements in the political debate and the self-determination of the citizens' will: a slow process that - he warns - may be effective only in the long run, and does not preserve democracy from the risk of decline.
28163325	Learned song is among the best-studied models of animal communication. In oscine songbirds, where learned song is most prevalent, it is used primarily for intrasexual selection and mate attraction. Learning of a different class of vocal signals, known as contact calls, is found in a diverse array of species, where they are used to mediate social interactions among individuals. We argue that call learning provides a taxonomically rich system for studying testable hypotheses for the evolutionary origins of vocal learning. We describe and critically evaluate four nonmutually exclusive hypotheses for the origin and current function of vocal learning of calls, which propose that call learning (1) improves auditory detection and recognition, (2) signals local knowledge, (3) signals group membership, or (4) allows for the encoding of more complex social information. We propose approaches to testing these four hypotheses but emphasize that all of them share the idea that social living, not sexual selection, is a central driver of vocal learning. Finally, we identify future areas for research on call learning that could provide new perspectives on the origins and mechanisms of vocal learning in both animals and humans.

28162073	Other organisations bringing together young people with cancer include Real Share South West, which uses social media to encourage peer-to-peer interaction among young people with cancer who live in remote areas. Such online projects demonstrate how the use of social media and video blogging can be a tool for connecting and communicating. Digital communication and support is being used more and more in healthcare and it is a progressive trend that can be life enhancing for young people with cancer.
28161891	The present research examines the extent to which the recognition of creative performance is structured by social group membership. It does this by analysing the award of merit prizes for Best Actor and Actress in a Leading Role for the international award of US-based Oscars and British-based BAFTAs since BAFTA's inception of this category in 1968. For both awards, the exclusive assessment criterion is the quality of artists' performance in the international arena. Results show that US artists won a greater proportion of Oscars than BAFTAs (odds ratio: 2.10), whereas British artists won a greater proportion of BAFTAs than Oscars (OR: 2.26). Furthermore, results support the hypothesis that these patterns are more pronounced as the diagnostic value of a quality indicator increases - that is, in the conferring of actual awards rather than nominations. Specifically, US artists won a greater proportion of Oscar awards than nominations (OR: 1.77), while British artists won a greater proportion of BAFTA awards than nominations (OR: 1.62). Additional analyses show that the performances of in-group actors in movies portraying in-group culture (US culture in the case of Oscars, British culture in the case of BAFTAs) are more likely to be recognized than the performances of in-group actors in movies portraying the culture of other (out-)groups. These are the first data to provide clear evidence from the field that the recognition of exceptional creative performance is enhanced by shared social identity between perceivers and performers.
28161559	Commentary driving typically involves being trained in how to produce a verbal running commentary about what you can see, what you are doing, what might happen and what action you will take to avoid potential hazards, while driving. Although video-based commentary training has been associated with subsequent hazard perception improvements, it can have a negative impact on hazard perception when a live commentary is produced at test (Young, Chapman, & Crundall, 2014). In the current study we use balanced training and testing blocks to isolate the effects of commentary exposure, production of a commentary with and without practice, and learning from earlier self-generation of commentary on behavioural and eye movement measures. Importantly, both commentary exposed and unexposed groups gave hazard perception responses during the commentary video, ensuring that the unexposed control group remained engaged in the procedure throughout. Results show that producing a live commentary is detrimental to concurrent hazard perception, even after practice, and does not enhance any later effect of commentary exposure. Although commentary exposure led to an initial increase in the accuracy of hazard perception responses, this effect was limited to the first occasion of testing, and showed no later benefits relative to engaged hazard exposure.
28161297	The ability to indicate a failure to understand a message is a critical pragmatic (social) language skill for managing communication breakdowns and supporting successful communicative exchanges. The current study examined the ability to signal noncomprehension across different types of confusing message conditions in children and adolescents with fragile X syndrome (FXS), Down syndrome (DS), autism spectrum disorder (ASD), and typical development (TD). Controlling for nonverbal mental age and receptive vocabulary skills, youth with comorbid FXS and ASD and those with DS were less likely than TD controls to signal noncomprehension of confusing messages. Youth with FXS without ASD and those with idiopathic ASD did not differ from controls. No sex differences were detected in any group. Findings contribute to current knowledge of pragmatic profiles in different forms of genetically-based neurodevelopmental disorders associated with intellectual disability, and the role of sex in the expression of such profiles.Upon completion of this article, readers will have learned about: (1) the social-communicative profiles of youth with FXS, DS, and ASD, (2) the importance of signaling noncomprehension in response to a confusing message, and (3) the similarities and differences in noncomprehension signaling in youth with FXS (with and without ASD), DS, idiopathic ASD, and TD.	
28160640	This paper provides an in-depth understanding of social dynamics in the form of kinship ties in matrilineal societies. It unpacks gender roles and relationships at the community level to understand how social structures, created by the pattern of relations, enhance or hinder coping initiatives during lake recessions in the Lake Chilwa socio-ecological system. Using qualitative and quantitative methods including in-depth interviews, Focus Group Discussions (FGD) and household questionnaires, this paper provides insights into how people in the Lake Chilwa social-ecological system prepare for and cope with Lake Chilwa water recessions by capitalising on their social networks. The findings have shown that during lake recessions poor households in the Lake Chilwa socio-ecological system are cushioned by fellow households through lineage networks. There is strong tradition secured through kinship ties where the generic term 'mwambo wathu' (our tradition) embraces a group of formative norms enforced via a series of rules and rituals. Based in a matrilineal system, women have strong rights over land allocation and use in which the female sorority group 'mbumba' is very stable. There is a great deal of reciprocity and food redistribution among the households. This self-organization provides deeper meaning about how people assimilate the dynamics affecting their social and natural environments. Specifically the findings provide evidence on how households, communities and their livelihoods in Africa are reconstructed as natural resources fluctuate.
28159645	To examine the apparent purpose of interruptions in a Pediatric Intensive Care Unit and opportunities to reduce their burden with informatics solutions.In this prospective observational study, researchers shadowed clinicians in the unit for one hour at a time, recording all interruptions participating clinicians experienced or initiated, their starting time, duration, and a short description that could help to infer their apparent purpose. All captured interruptions were classified inductively on their source and apparent purpose and on the optimal representational media for fulfilling their apparent purpose.	The researchers observed thirty-four one-hour sessions with clinicians in the unit, including 21 nurses and 13 residents and house physicians. The physicians were interrupted on average 11.9 times per hour and interrupted others 8.8 times per hour. Nurses were interrupted 8.6 times per hour and interrupted others 5.1 times per hour. The apparent purpose of interruptions included Information Seeking and Sharing (n=259, 46.3%), Directives and Requests (n=70, 12%), Shared Decision-Making (n=49, 8.8%), Direct Patient Care (n=36, 6.4%), Social (n=71, 12.7%), Device Alarms (n=28, 5%), and Non-Clinical (n=10, 1.8%); 6.6% were not classified due to insufficient description. Of all captured interruptions, 29.5% were classified as being better served with informational displays or computer-mediated communication.	Deeper understanding of the purpose of interruptions in critical care can help to distinguish between interruptions that require face-to-face conversation and those that can be eliminated with informatics solutions. The proposed taxonomy of interruptions and representational analysis can be used to further advance the science of interruptions in clinical care.	
28159021	The 2014-15 Ebola outbreak in West Africa highlighted the challenges many hospitals face when preparing for the potential emergence of highly contagious diseases. This study examined the experiences of frontline health care professionals in an Australian hospital during the outbreak, with a focus on participant views on information, training and preparedness, to inform future outbreak preparedness planning.Semi-structured interviews were conducted with 21 healthcare professionals involved in Ebola preparedness planning, at a hospital in Australia.	The data were systematically coded to discover key themes in participants' accounts of Ebola preparedness.	Three key themes identified were: 1) the impact of high volumes of-often inconsistent-information, which shaped participants' trust in authority; 2) barriers to engagement in training, including the perceived relative risk Ebola presented; and finally, 3) practical and environmental impediments to preparedness.	These clinicians' accounts of Ebola preparedness reveal a range of important factors which may influence the relative success of outbreak preparedness and provide guidance for future responses. In particular, they illustrate the critical importance of clear communication and guidelines for staff engagement with, and implementation of training. An important outcome of this study was how individual assessments of risk and trust are produced via, and overlap with, the dynamics of communication, training and environmental logistics. Consideration of the dynamic ways in which these issues intersect is crucial for fostering an environment that is suitable for managing an infectious threat such as Ebola.	
28159009	Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada's long-term care sector and the extent to which informal advice-seeking relationships tie the sector together as a network.We conducted a sociometric survey of senior leaders in 958 long-term care facilities operating in 11 of Canada's 13 provinces and territories. We used an integrated knowledge translation approach to involve knowledge users in planning and administering the survey and in analyzing and interpreting the results. Responses from 482 senior leaders generated the names of 794 individuals and 587 organizations as sources of advice for improving resident care in long-term care facilities.	A single advice-seeking network appears to span the nation. Proximity exhibits a strong effect on network structure, with provincial inter-organizational networks having more connections and thus a denser structure than interpersonal networks. We found credible individuals and organizations within groups (opinion leaders and opinion-leading organizations) and individuals and organizations that function as weak ties across groups (boundary spanners and bridges) for all studied provinces and territories. A good deal of influence in the Canadian long-term care sector rests with professionals such as provincial health administrators not employed in long-term care facilities.	The Canadian long-term care sector is tied together through informal advice-seeking relationships that have given rise to an emergent network structure. Knowledge of this structure and engagement with its opinion leaders and boundary spanners may provide a route for stimulating the adoption and effective implementation of best practices, improving resident care and strengthening the long-term care advice network. We conclude that informal relational pathways hold promise for helping to transform the Canadian long-term care sector.	
28159008	Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases.A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed.	The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange.	A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and their mutual relations. This information can be an important starting point to enhance the uptake of evidence and build more effective public health policies.	
28157666	Given the pivotal role that social interactions play for adolescents' well-being, understanding the factors that influence communication is key. The present study examined relations between adolescents' communicative perspective-taking, executive function skills, and ADHD traits and explored the role communicative perspective-taking plays in peer relations. Data was collected from a community sample of 15 to 19-years-olds (N = 46) in Waterloo, Canada. Two communicative perspective-taking tasks required participants to infer speakers' communicative intentions. A battery of tasks assessed adolescents' working memory and inhibitory control. Elevated ADHD traits were associated with weaker working memory, inhibitory control, and communicative perspective-taking. Working memory was the strongest predictor of communicative perspective-taking. Highlighting the importance of communicative perspective-taking for social interactions, adolescents with weaker skills in this area reported worse peer relations. Findings underscore the importance of communicative perspective-taking for adolescents' social relations and have relevance for understanding the social difficulties faced by adolescents with elevated ADHD traits.
28157408	Personal communication, in which one person persuades another to engage in a particular behavior, is one means through which behaviors spread. To better understand how personal communication spreads behavior, we investigated adults' (N = 228) likelihood of persuading others in a fictitious social network to buy antibiotic-free food, and who they attempted to persuade, based on behavioral determinants, homophily, and superdiffuser traits. For potential consumers, the findings showed that behavioral determinants, behavioral intentions, and mavenism predicted intentions to persuade others. Homophily, mavenism, and connectivity predicted patterns of interpersonal persuasion. For vegetarians (without homophily in action), behavioral determinants and mavenism predicted persuasion intentions. Persuasiveness was associated with targeting more network members; mavenism was associated with selecting structurally central members.

28156940	Background Bangladesh is facing the unavoidable challenge of adaptation to climate change. However, very little is known in relation to climate change and health. This article provides information on potential climate change impact on health, magnitude of climate-sensitive diseases, and baseline scenarios of health systems to climate variability and change. Design A cross-sectional study using multistage cluster sampling framework was conducted in 2012 among 6,720 households of 224 rural villages in seven vulnerable districts of Bangladesh. Information was obtained from head of the households using a pretested, interviewer-administered, structured questionnaire. A total of 6,720 individuals participated in the study with written, informed consent. Results The majority of the respondents were from the low-income vulnerable group (60% farmers or day labourers) with an average of 30 years' stay in their locality. Most of them (96%) had faced extreme weather events, 45% of people had become homeless and displaced for a mean duration of 38 days in the past 10 years. Almost all of the respondents (97.8%) believe that health care expenditure increased after the extreme weather events. Mean annual total health care expenditure was 6,555 Bangladeshi Taka (BDT) (1 USD=77 BDT in 2015) and exclusively out of pocket of the respondents. Incidence of dengue was 1.29 (95% CI 0.65-2.56) and malaria 13.86 (95% CI 6.00-32.01) per 1,000 adult population for 12 months preceding the data collection. Incidence of diarrhoea and pneumonia among under-five children of the households for the preceding month was 10.3% (95% CI 9.16-11.66) and 7.3% (95% CI 6.35-8.46), respectively. Conclusions The findings of this survey indicate that climate change has a potential adverse impact on human health in Bangladesh. The magnitude of malaria, dengue, childhood diarrhoea, and pneumonia was high among the vulnerable communities. Community-based adaptation strategy for health could be beneficial to minimise climate change attributed health burden of Bangladesh.
28156922	Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although social-structural factors are crucial in understanding sexual behavior, only a few studies focus on understanding safer sex dialogue in a broader social context. Design Drawing on the WHO-Commission on the Social Determinants of Health (WHO-CSDH) framework, this study explored key social-structural constructs for studying health in the context of improving safer sex dialogue between polygamous and monogamous partners. Twenty-four in-depth interviews (IDIs) and six focus group discussions (FGDs) with 38 men and women aged 18-60 years were conducted in Ifakara town located in Kilombero district, Tanzania. The study was nested within the community health surveillance project MZIMA (Kiswahili: 'being healthy'). Partners' experiences of safer sex dialogue in polygamous and monogamous relations were investigated and the challenges to safer sex dialogue explored. Results The study revealed that open safer sex dialogue in marriage is limited and challenged by social norms about marriage (a view that safer sex dialogue imply that partners are 'not really' married); marital status (a belief that safer sex dialogue is not practical in polygamous marriages, the elder wife should be exempted from the dialogue since she is at lower risk of engaging in extramarital affairs); relationship quality (marital conflicts, extramarital affairs, trust, and sexual dissatisfaction); and gender power relations (the notion that females' initiative to discuss condom use and HIV couple counseling and testing may lead to conflict or divorce). Conclusions Implementing safer sex practices requires interventions beyond promotion messages. HIV prevention interventions in Tanzania should be carefully adapted to the local context including respective social norms, gender systems, marital context and relationship uncertainties as aspects that facilitate or hinder safer sex dialogue between partners. The WHO-CSDH framework could be strengthened by explicitly integrating relationship quality, marital status, and social norms as additional determinants of health.
28156898	Background In Vietnam, women are at risk of HIV infection due to many factors. However, there is limited evidence about what women know and how they behave to protect themselves from HIV. Objective The objective of this study was to investigate the trends in comprehensive HIV/AIDS knowledge, attitude, and associated factors among Vietnamese women from 2000 to 2011. Design Data from three waves of the Vietnam Multiple Indicator Cluster Surveys (years 2000, 2006, and 2011) were used. Logistic regression methods examined factors associated with each of two dependent variables, HIV/AIDS knowledge and attitude toward HIV/AIDS. Results Although there was an increasing trend in basic HIV/AIDS knowledge and positive attitude toward the disease, in Vietnamese women in the general population over the survey years, the prevalence of women with basic HIV/AIDS knowledge and positive attitude toward HIV/AIDS was low. Multivariable models indicated that women who had higher levels of education, lived in urban areas, had higher economic status, and knew about places of HIV-related services were more likely to have good HIV/AIDS knowledge (e.g. in 2011, AOR's=3.01; 1.27; 1.88; 2.03, respectively). Women with higher educational attainment, knew about HIV services, and had better HIV knowledge were more likely to report positive attitude toward HIV/AIDS (e.g. in 2011, AOR's=2.50; 1.72; 2.23, respectively). Conclusions This study recommends that public health programs for the control of HIV, such as behavioral change communication campaigns or social policies for women, should focus not only in improving the quality of existing HIV/AIDS counseling and testing services but also on expanding coverage to increase accessibility to these services for women in rural areas. In addition, efforts to raise the level of knowledge about HIV/AIDS and improve attitude toward the disease should be undertaken simultaneously. The results of this study can help inform HIV control policies and practices in other developing countries.
28156897	Background Since the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development goals (SDGs) reflect an attempt to bring together these themes and the complexities involved in defining a comprehensive development framework. However, to date, much less has been done to address the monitoring challenges, that is, how data generation, analysis and use are to become routine tasks. Objective To test proposed indicators of social determinants of health (SDH), gender, equity, and human rights with respect to their relevance in tracking progress in universal health coverage and population health (level and distribution). Design In an attempt to explore these monitoring challenges, indicators covering a wide range of social determinants were tested in four country case studies (Bangladesh, Brazil, South Africa, and Vietnam) for their technical feasibility, reliability, and validity, and their communicability and usefulness to policy-makers. Twelve thematic domains with 20 core indicators covering different aspects of equity, human rights, gender, and SDH were tested through a review of data sources, descriptive analyses, key informant interviews, and focus group discussions. To test the communicability and usefulness of the domains, domain narratives that explained the causal pathways were presented to policy-makers, managers, the media, and civil society leaders. Results For most countries, monitoring is possible, as some data were available for most of the core indicators. However, a qualitative assessment showed that technical feasibility, reliability, and validity varied across indicators and countries. Producing understandable and useful information proved challenging, and particularly so in translating indicator definitions and data into meaningful lay and managerial narratives, and effectively communicating links to health and ways in which the information could improve decision-making. Conclusions This exercise revealed that for monitoring to produce reliable data collection, analysis, and discourse, it will need to be adapted to each national context and institutionalised into national systems. This will require that capacities and resources for this and subsequent communication of results are increased across countries for both national and international monitoring, including the successful implementation of the SDGs.
28156869	Background In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. Design A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender. Results Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health. Conclusions Inequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities.
28156423	Background Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual needs for connectedness to the land and water, reinforce cultural ties, are economically important and promote overall good health for many. The risk and benefit balance associated with the consumption of traditional Arctic foods is complicated to communicate and has been referred to as the "Arctic Dilemma". This article gives an update on health risk communication in the Arctic region. It briefly summarizes some research on risk communication methodologies as well as approaches to an evaluation of the outcomes of risk communication initiatives. It provides information on specific initiatives in several Arctic countries, and particularly those that were directed at Indigenous populations. This article also summarizes some international versus local risk communication activities and the complexity of developing and delivering messages designed for different audiences. Finally, the potential application of social media for risk communication and a summary of "best practices" based on published literature and a survey of Inuit in a few Arctic countries are described. Conclusion Several of the risk communication initiatives portrayed in this article indicate that there is only limited awareness of the outcome of risk communication messages. In some cases, risk communication efforts appear to have been successful, at least when effectiveness is measured in an indirect way, for example, by lower contaminant levels. However, due to missing effectiveness evaluation studies, uncertainty remains as to whether a specific risk communication method was successful and could be clearly linked to behavioural changes that resulted in decreased contaminant exposure.
28156141	The present study clarified factors related to mother-child communication openness when fathers suffer neurobehavioural sequelae after stroke or traumatic brain injury.A cross-sectional study using self-report anonymous questionnaires was conducted.	Forty-one mothers with 6-22-year-old children participated. The questionnaire examined personal factors (mother's psychological distress), social/family factors (family support functioning), illness-related factors (father's time at home and neurobehavioural sequelae severity) and mother's perceived level of open communication. Multiple regression was used to analyse factors related to mother-child communication openness.	Mother-child open communication was explained by family support functioning (β = 0.449), father's time at home (β = -0.325) and mother's psychological distress (β = -0.303). Neurobehavioural sequelae severity was not associated with mother-child open communication.	Personal, social/family and illness-related factors were related to mother-child communication about paternal illness. Professionals should promote optimal family support functioning, connect families with external resources and assess families' interaction processes.	
28155990	Dementia is a collective name for different degenerative brain syndromes which, according to Alzheimer's Disease International, affects approximately 35.6 million people worldwide. The latest NICE guideline for dementia highlights the value of diverse treatment options for the different stages and symptoms of dementia including non-pharmacological treatments. Relevant literature also argues for the value of interventions that acknowledge the complexity of the condition and address the person as a whole, including their physical, emotional, social and cognitive processes. At the same time, there is growing literature that highlights the capacity of the arts and embodied practices to address this complexity. Dance movement therapy is an embodied psychological intervention that can address complexity and thus, may be useful for people with dementia, but its effectiveness remains unclear.To assess the effects of dance movement therapy on behavioural, social, cognitive and emotional symptoms of people with dementia in comparison to no treatment, standard care or any other treatment. Also, to compare different forms of dance movement therapy (e.g. Laban-based dance movement therapy, Chacian dance movement therapy or Authentic Movement).	Searches took place up to March 2016 through ALOIS, Cochrane Dementia and Cognitive Improvement's Specialized Register, which covers CENTRAL, a number of major healthcare databases and trial registers, and grey literature sources. We checked bibliographies of relevant studies and reviews, and contacted professional associations, educational programmes and experts from around the world.	We considered randomised controlled trials (RCTs) in any language, including cross-over design and cluster-RCTs for inclusion. Studies considered had to include people with dementia, in any age group and in any setting, with interventions delivered by a dance movement therapy practitioner who (i) had received formal training (ii) was a dance movement therapist in training or (iii) was otherwise recognised as a dance movement therapist in the country in which the study was conducted.	The two review authors independently reviewed studies on an abstract/title level and again after reading the full paper, and we independently evaluated methodological quality.	Of the 102 studies identified through electronic searches and personal communication, after de-duplication we screened 80 at title/abstract level. We then reviewed 19 full papers, none of which met the inclusion criteria. Although three studies mentioned dance movement therapy as their intervention, they were excluded because they were not delivered by a qualified dance movement therapy practitioner. As a result, no studies were included in this review.	Trials of high methodological quality, large sample sizes and clarity in the way the intervention is put together and delivered are needed to assess whether dance movement therapy is an effective intervention for dementia.	
28155325	Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession's (mistaken) understanding of itself as a natural science on doctor-patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient's psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication.
28155112	On behalf of the Journal of Cell Communication and Signaling Editorial board it is my great pleasure to present through this message of peace and love our warmest wishes of health, happiness and professional success. We sincerely hope that 2017 will be a peaceful year worldwide and that solutions will be brought to resolve the great tensions that crystalized last year into terrible acts of violence which reflected the inability of the political powers to bring satisfactory solutions to human dispair and fear. The year 2017 will be the time for celebration of the 10th JCCS anniversary and 9th International Workshop on the CCN family of Genes. Both events should allow us to meet in a productive interactive way. I have had the opportunity to express several times in these columns my deep belief in the power of communication at all levels of human biological and social interactions. Indeed, « Communication is the key » at large.
28154710	The Acquired Immuno Deficiency Syndrome (AIDS) remains a major global public health challenge especially in Africa. The deadline set for the Millennium Development Goals (MDGs) has elapsed, meanwhile most low and middle income countries did not reach the targets. With regards to the fight against HIV / AIDS, many African countries show slow progress in implementing efficient and effective strategies to counter this pandemic. The fact that most HIV/AIDS programs in Sub-Saharan African countries are still very dependent on external funding to carry out their activities, including the supply of Antiretroviral Treatment (ART), highlights the concern of sustainability. So far, solutions that have been proposed are mainly symptomatic, claiming more budget commitment from government. Without rejecting this view, we call for the implementation of sustainable solutions to deal with the long term ART challenges. A way forward is to promote the establishment of an effective machinery for the manufacturing and large scale distribution of ART. In addition to the health gains, we argue that such an initiative would have a three-dimensional impact: (i) political, (ii) economic and (iii) social.

28153959	Tobacco companies have a long tradition of including promotional material within cigarette packs, such as cigarette cards and coupons. Only in Canada are they required, by the government, to include educational material within cigarette packs, in the form of inserts highlighting the benefits of quitting or providing tips on how to do so.Twenty focus groups were conducted in Glasgow and Edinburgh in 2015, with smokers (n=120) segmented by age (16-17, 18-24, 25-35, 36-50, >50), gender and social grade, to explore perceptions of the inserts used in Canada.	The consensus was that these inserts would capture attention and be read due to their novelty and visibility before reaching the cigarettes, and as they can be removed from the pack. While they may be ignored or discarded, and rotation was considered necessary, they were generally thought to prolong the health message. The positive style of messaging was described as refreshing, educational, encouraging, reassuring and inspirational and thought to increase message engagement. It was regarded as more sympathetic than command-style messaging, offering smokers 'a bit of hope'. The inserts were often considered preferable to the on-pack warnings, although it was felt that both were needed. Some participants suggested that inserts could encourage them to stop smoking, and they were generally viewed as having the potential to alter the behaviour of others, particularly younger people, would-be smokers and those wanting to quit.	Inserts are an inexpensive means of communication and offer regulators a simple way of supplementing on-pack warnings.	
28153932	The preterm infants' developmental outcomes depend on biological and environmental risk factors. The environmental factors include prolonged parental separation, less exposure to early mother/father-infant interactions and the parents' ability to respond to the trauma of premature birth. In the case of premature birth, the father's ability to take an active part in the care of the infant from the start is essential. The parents' emotional closeness to the preterm infant hospitalised in the neonatal intensive care unit (NICU) may be crucial to the well-being of the newborn, the development of mutual regulation, the establishment of a functioning parent-infant affective relationship and the parents' confidence in their ability to provide care for their baby.This is a mixed-method, observational and longitudinal study. The methodological strategy will include: (1) ethnographic observation in a level III NICU located in Italy for a duration of 18 months; (2) 3-minute video recordings of mother-infant and father-infant interaction in the NICU; (3) a semistructured interview with fathers during the infants' hospital stay; (4) 3-minute video recordings of mother-infant and father-infant face-to-face interaction in the laboratory at 4 months of corrected age; (5) self-report questionnaires for parents on depression and quality of the couple relationship at the approximate times of the video recording sessions.	The study protocol was approved by the Ethical Committee for Clinical Trials of the Verona and Rovigo Provinces. Results aim to be published in international peer-reviewed journals, and presented at relevant national and international conferences. This research project will develop research relevant to (1) the quality and modalities of maternal and paternal communication with the preterm infant in the NICU; (2) the influence of maternal/paternal social stimulation on the infant behavioural states; (3) the quality and modalities of paternal support to the partner and possible influences on mother-infant relationship.	
28153857	To develop, test and validate a versatile questionnaire, the East Midlands Evaluation Tool (EMET), for measuring effects of end of life care training events on trainees' self-reported confidence and competence.A paper-based questionnaire was designed on the basis of the English Department of Health's core competences for end of life care, with sections for completion pretraining, immediately post-training and also for longer term follow-up. Preliminary versions were field tested at 55 training events delivered by 13 organisations to 1793 trainees working in diverse health and social care backgrounds. Iterative rounds of development aimed to maximise relevance to events and trainees. Internal consistency was assessed by calculating interitem correlations on questionnaire responses during field testing. Content validity was assessed via qualitative content analysis of (1) responses to questionnaires completed by field tester trainers and (2) field notes from a workshop with a separate cohort of experienced trainers. Test-retest reliability was assessed via repeat administration to a cohort of student nurses.	The EMET comprises 27 items with Likert-scaled responses supplemented with questions seeking free-text responses. It measures changes in self-assessed confidence and competence on 5 subscales: communication skills; assessment and care planning; symptom management; advance care planning; overarching values and knowledge. Test-retest reliability was found to be good, as was internal consistency: the questions successfully assess different aspects of the same underlying concept.	The EMET provides a time-efficient, reliable and flexible means of evaluating effects of training on self-reported confidence and competence in the key elements of end of life care.	
28153414	Anthropogenic noise is an evolutionarily novel and widespread pollutant in both terrestrial and aquatic habitats. Despite increasing evidence that the additional noise generated by human activities can affect vocal communication, the majority of research has focused on the use of conspecific acoustic information, especially sexual signals. Many animals are known to eavesdrop on the alarm calls produced by other species, enhancing their likelihood of avoiding predation, but how this use of heterospecific information is affected by anthropogenic noise has received little empirical attention. Here, we use two field-based playback experiments on a habituated wild population of dwarf mongooses (Helogale parvula) to determine how anthropogenic noise influences the response of foragers to heterospecific alarm calls. We begin by demonstrating that dwarf mongooses respond appropriately to the alarm calls of sympatric chacma baboons (Papio ursinus) and tree squirrels (Paraxerus cepapi); fleeing only to the latter. We then show that mongoose foragers are less likely to exhibit this flee response to tree squirrel alarm calls during road-noise playback compared to ambient-sound playback. One explanation for the change in response is that noise-induced distraction or stress result in maladaptive behaviour. However, further analysis revealed that road-noise playback results in increased vigilance and that mongooses showing the greatest vigilance increase are those that do not subsequently exhibit a flee response to the alarm call. These individuals may therefore be acting appropriately: if the greater gathering of personal information indicates the absence of an actual predator despite an alarm call, the need to undertake costly fleeing behaviour can be avoided. Either way, our study indicates the potential for anthropogenic noise to interfere with the use of acoustic information from other species, and suggests the importance of considering how heterospecific networks are affected by this global pollutant.
28153020	The creation of a clinical network was proposed as a means to promote implementation of a set of recommended clinical practices targeting inpatient paediatric care in Kenya. The rationale for selecting a network as a strategy has been previously described. Here, we aim to describe network activities actually conducted over its first 2.5 years, deconstruct its implementation into specific components and provide our 'insider' interpretation of how the network is functioning as an intervention.We articulate key activities that together have constituted network processes over 2.5 years and then utilise a recently published typology of implementation components to give greater granularity to this description from the perspective of those delivering the intervention. Using the Behaviour Change Wheel we then suggest how the network may operate to achieve change and offer examples of change before making an effort to synthesise our understanding in the form of a realist context-mechanism-outcome configuration.	We suggest our network is likely to comprise 22 from a total of 73 identifiable intervention components, of which 12 and 10 we consider major and minor components, respectively. At the policy level, we employed clinical guidelines, marketing and communication strategies with intervention characteristics operating through incentivisation, persuasion, education, enablement, modelling and environmental restructuring. These might influence behaviours by enhancing psychological capability, creating social opportunity and increasing motivation largely through a reflective pathway.	We previously proposed a clinical network as a solution to challenges implementing recommended practices in Kenyan hospitals based on our understanding of theory and context. Here, we report how we have enacted what was proposed and use a recent typology to deconstruct the intervention into its elements and articulate how we think the network may produce change. We offer a more generalised statement of our theory of change in a context-mechanism-outcome configuration. We hope this will complement a planned independent evaluation of 'how things work', will help others interpret results of change reported more formally in the future and encourage others to consider further examination of networks as means to scale up improvement practices in health in lower income countries.	
28152626	The purpose of the present article is to propose an alternative short form for the 199-item Arizona Life History Battery (ALHB), which we are calling the K-SF-42, as it contains 42 items as compared with the 20 items of the Mini-K, the short form that has been in greatest use for the past decade. These 42 items were selected from the ALHB, unlike those of the Mini-K, making direct comparisons of the relative psychometric performance of the two alternative short forms a valid and instructive exercise. A series of secondary data analyses were performed upon a recently completed five-nation cross-cultural survey, which was originally designed to assess the role of life history strategy in the etiology of interpersonal aggression. Only data from the ALHB that were collected in all five cross-cultural replications were used for the present analyses. The single immediate objective of this secondary data analysis was producing the K-SF-42 such that it would perform optimally across all five cultures sampled, and perhaps even generalize well to other modern industrial societies not currently sampled as a result of the geographic breadth of those included in the present study. A novel method, based on the use of the Cross-Sample Geometric Mean as a criterion for item selection, was used for generating such a cross-culturally valid short form.
28152422	Public services are increasingly operating through network governance, requiring those at all levels of the system to build collaborations and adapt their practice. Agent-focused implementation theories, such as 'street-level bureaucracy', tend to focus on decision-making and the potential of actors to subvert national policy at a local level. While it is acknowledged that network leaders need to be adaptable and to build trust, much less consideration has been given to the requirement for skills of 'diplomacy' needed by those at the front line of delivering public services. In this article, drawing on theoretical insights from international relations about the principles of 'multi-track diplomacy', we propose the concept of street level diplomacy, offer illustrative empirical evidence to support it in the context of the implementation of public health (preventative) policies within primary care (a traditionally responsive and curative service) in the English NHS and discuss the contribution and potential limitations of the new concept. The article draws on qualitative data from interviews conducted with those implementing case finding programmes for cardiovascular disease in the West Midlands. The importance of communication and adaptation in the everyday work of professionals, health workers and service managers emerged from the data. Using abductive reasoning, the theory of multi-track diplomacy was used to aid interpretation of the 'street-level' work that was being accomplished.
28152420	Maternal health outcomes in Central and Eastern Europe (CEE) compare unfavorable with those in Western Europe, despite macro-indicators that suggest well-designed maternal care systems. However, macro-indicators at the system level only capture capacity, funding and utilization of care and not the actual allocation of financial and human resources, the quality of care and access to it. It is these latter which are problematic in the CEE region. In this study service-related indicators of access to maternal care in CEE are examined. These include availability, appropriateness, affordability, approachability and acceptability of maternal care. This study uses a qualitative systematic literature review, analyzing information of peer-reviewed articles published since 2004. Other inclusion criteria included language, setting and publication purpose. The included articles were analyzed using a framework analysis technique and quality was assessed using standardized evaluation checklists. Results indicate improvements in maternal care. However, availability of care is limited by outdated equipment and training curricula, and the lack of professionals and pharmaceuticals. Geographical distance to healthcare institutions, inappropriate communication of providers and waiting times are the main approachability barriers. Some mothers are unaware of the importance of care or are discouraged to utilize healthcare services because of cultural aspects. Finally, a major barrier in accessing maternal care in the CEE is the inability to pay for it. Our findings indicate that major gaps in evidence exist and that more representative and better quality data should be collected. Governments in CEE countries need to establish a reliable system for measuring and monitoring a suitable set of indicators, as well as deal with the general social and economic problem of informality. Medical curricula in the CEE region need to be overhauled and there should be a focus on improving the allocation of medical staff and institutions as well as protecting vulnerable population groups to ensure universal access to care.
28152327	Project ImPACT is a Naturalistic Developmental Behavioral Intervention (NDBI) for young children with ASD. Preliminary research supports its feasibility and efficacy as a parent-mediated intervention; however, its efficacy as a low-intensity, therapist-implemented intervention is unclear. A single-case, multiple-baseline design evaluated the effect of 2 h per week of therapist-implemented Project ImPACT on social engagement, language, and play in nine children with ASD. Language and play skills were targeted separately for five children and together for four children. Children increased their rates of social engagement and language when language or play was the sole target and when language and play were targeted together; however, gains in play skills were evident only when they were targeted separately. This study provides support for the efficacy of the Project ImPACT when implemented by therapists at a low intensity and suggests the way in which skills are targeted can affect child learning.
28151559	This ethnographic study was concerned with how dying patients, palliative care staff and family caregivers communicate about life-threatening illness in a palliative care setting in Ethiopia.Ethiopia, as a developing country, had few resources for caring for those requiring end-of-life care. However, palliative care was supported by local champions in Ethiopia and by the Federal Ministry of Health.	The disclosure of bad news was discouraged because it was believed that such disclosure may lead to unnecessary distress and to loss of hope.	Non-participant observation amounting to 276 h of observation and ethnographic interviews with four patients, six family caregivers and five palliative care staff during two periods of data collection (November 2011-January 2012 and May 2012-August 2012) in Addis Ababa, Ethiopia.	Although palliative care staff create openness in communication with patients and family caregivers about terminal illness and dying, ultimately palliative care staff deferred to family wishes about significant news disclosures, in order to avoid upset. Family caregivers were found to avoid disclosing news of a terminal illness to their family member and wished to keep the patient in closed awareness. In contrast, an open awareness context existed between palliative care staff and family caregivers.	In managing truth telling in different cultural settings, medical and nursing staff as well as health policy makers need to take into account the various awareness contexts highlighted in this study. Palliative care staff should consider how actions such as protecting patients from upset may inadvertently deny the patient the right to exercise control.	Health policy makers should ensure that the design and implementation of palliative care services should not be a wholesale adoption of Western style services but ensure that such services are adapted to reflect the religious, cultural and social needs of the community. Foreign workers and volunteers who deliver palliative care services and education in Ethiopia should reflect local religious and cultural sensitivities.	
28151524	Vaccines are among the scientific topics that draw most interest in the public sphere. The discussion, however, can produce polarization, eventually becoming a controversy between "supporters of science" and "antiscience people". The aggressiveness of some anti-vaxxers, and their resistance to scientific evidence, can induce the belief that the confrontation is worthless, because many think that the top-down approach is the only one that can be used. The premise of this approach is that the gap of information is the main barrier between the scientific community and the society. However, from the '80s to date, studies have shown the fallacy of some assumptions of the so-called "deficit model", including the claim that the communication of science can be reduced only to dissemination and popularization of scientific facts. Studies and experiences, even in public health communications about vaccines, have highlighted the relevance of public engagement, social context, values systems, "lay knowledge" and the complexity of the relationship between science and society, fostering the emergence of new communication models. In the "knowledge society" we need effective communication to all, because people make use of scientific facts when they are involved in decisions on many public issues. Therefore, an evidence-based assessment of each communication approach and an evaluation of the effectiveness of methods in different contexts are required.
28151017	The vast majority of Americans are overweight, and those who are able to lose weight typically regain at least the amount they lost. Some people are confronted with sabotage, criticism, and declines in social support during and following weight loss. However, how individuals negotiate these interpersonal barriers is not very well understood. Such an understanding could help individuals maintain their weight loss while minimizing the risk of adverse health or relational consequences. Thus, through a thematic analysis of 40 interviews of people who were identified as previously overweight or obese and a facework lens (Cupach & Metts, 1994; Goffman, 1967), this study examined how people were communicatively able to sustain their weight loss in the face of challenges from friends, family, and colleagues. The investigation found that altered weight management behaviors (particularly healthy eating) can threaten others' face and uncovered several communication strategies people used to prevent and mitigate face threat. To avoid face threat, participants proactively issued cognitive disclaimers about weight management or designated cheat days, accepted but did not consume food, avoided social situations involving food, or ate unhealthy food in smaller portions to assimilate with the in-group. To remediate face threat, participants provided personal choice and health excuses to save face and accomplish their dual goals of maintaining their weight management practices without compromising their relationships.
28150956	Relationship education programs (REPs) are an effective way to enhance relationship communication, prevent relational distress, and increase relationship quality. Most REPs are delivered in a group format; however, there is little known about the influence of group processes on outcomes for these programs, such as group members' attendance. Therefore, the current study applied a dispersion-consensus model to test the impact of attendance at the member and group levels on group members' REP outcomes. In a sample of 558 lower income, primarily African American participants, we examined whether individual and group attendance rates influenced posttreatment communication patterns and relationship quality. Results indicated that an individual group member's attendance was significantly and positively related to their posttreatment relationship quality, although this relationship is complex. Specifically, this relationship was stronger in groups with higher levels of attendance as well as groups with more attendance variability. In addition, results indicated that group members reported better posttreatment relationship quality in groups with less variability in members' attendance. However, we found a significant interaction between attendance consensus and variability, and an individual group member's posttreatment relationship quality, suggesting that group members report higher levels of relationship quality in groups where the attendance of the group as a whole is lower yet more consistent. No significant relationships were found for group member's posttreatment communication patterns. Our findings suggest that the rate and variability in the group's attendance, as well as an individual group member's own attendance significantly impacts their posttreatment relationship quality in complex ways. (PsycINFO Database Record
28150500	Intimate partner violence (IPV) and child maltreatment (CM) by a parent or caregiver are prevalent and overlapping issues with damaging consequences for those affected. This scoping review aimed to identify opportunities for greater coordination between IPV and CM programmes in low- and middle-income countries (LMIC). Nine bibliographic databases were searched and grey literature was identified through the scoping review team. Eligible studies were published in English; described primary prevention programmes in LMIC that addressed IPV and CM, or addressed one form of violence, but reported outcomes for the other; reported IPV and CM outcomes; and evaluated with any study design. Six studies were identified published between 2013 and 2016 (four randomised controlled trials, one pre-post non-randomised study and one qualitative study). Programmes were based in South Africa (2), Uganda, (2), Liberia (1) and Thailand (1). All except one were delivered within parenting programmes. The emphasis on gender norms varied between programmes. Some parenting programmes addressed gender inequity indirectly by promoting joint decision-making and open communication between caregivers. Conclusions are tentative due to the small evidence base and methodological weaknesses. More robust evaluations are needed. Improved coherence between IPV and CM programmes requires equal attention to the needs of women and children, and the involvement of fathers when it is safe to do so.
28150243	Networks are a powerful and flexible paradigm that facilitate communication and computation about interactions of any type, whether social, economic, or biological. NDEx, the Network Data Exchange, is an online commons to enable new modes of collaboration and publication using biological networks. NDEx creates an access point and interface to a broad range of networks, whether they express molecular interactions, curated relationships from literature, or the outputs of systematic analysis of big data. Research organizations can use NDEx as a distribution channel for networks they generate or curate. Developers of bioinformatic applications can store and query NDEx networks via a common programmatic interface. NDEx can also facilitate the integration of networks as data in electronic publications, thus making a step toward an ecosystem in which networks bearing data, hypotheses, and findings flow seamlessly between scientists.
28150137	Interdisciplinarity is needed to gain knowledge of the ecology of invasive species and invaded ecosystems, and of the human dimensions of biological invasions. We combine a quantitative literature review with a qualitative historical narrative to document the progress of interdisciplinarity in invasion science since 1950. Our review shows that 92.4% of interdisciplinary publications (out of 9192) focus on ecological questions, 4.4% on social ones, and 3.2% on social-ecological ones. The emergence of invasion science out of ecology might explain why interdisciplinarity has remained mostly within the natural sciences. Nevertheless, invasion science is attracting social-ecological collaborations to understand ecological challenges, and to develop novel approaches to address new ideas, concepts, and invasion-related questions between scholars and stakeholders. We discuss ways to reframe invasion science as a field centred on interlinked social-ecological dynamics to bring science, governance and society together in a common effort to deal with invasions.
28150129	Women who are newly diagnosed with breast cancer may consider contralateral prophylactic mastectomy (CPM) to reduce their future risk of cancer in their unaffected breast. Pre-surgical BRCA1/2 genetic testing can provide valuable risk information to guide this choice. However, little is understood about why BRCA1/2 mutation noncarriers, who are generally not at substantially elevated risk of contralateral disease, select CPM.We examined the uptake of CPM among breast cancer patients identified as BRCA1/2 mutation noncarriers (n = 92) as part of a larger prospective study of the impact of pre-surgical BRCA1/2 testing. Data obtained from self-report questionnaires and patient medical records were used to examine associations between theoretically relevant background and psychosocial factors and BRCA1/2 mutation noncarriers' decisions to undergo CPM.	Among BRCA1/2 mutation noncarriers, 25% (n = 23) elected to undergo CPM. Psychosocial factors including a self-reported physician recommendation for CPM, greater perceived contralateral breast cancer risk, and greater perceived benefits of CPM were all significantly associated with the uptake of CPM.	A sizeable minority of BRCA1/2 mutation noncarriers choose to undergo CPM after learning their mutation status through pre-surgical genetic testing. BRCA1/2 mutation noncarriers' cognitive perceptions and social influences appear to be important in shaping their decisions regarding CPM. This work highlights the importance of several psychosocial factors in influencing patients' surgical decisions. Future research is needed that examines the formation of BRCA1/2 mutation noncarriers' beliefs regarding their disease and available treatment options, and that characterizes the physician-patient communication that occurs in this complex decision-making context.	
28149288	One aspect of the social communication impairments that characterize autism spectrum disorder (ASD) include reduced use of often subtle non-verbal social cues. People with ASD, and those with self-reported sub-threshold autistic traits, also show impairments in rapid visual processing of stimuli unrelated to social or emotional properties. Hence, this study sought to investigate whether perceptually non-conscious visual processing is related to autistic traits. A neurotypical sample of thirty young adults completed the Subthreshold Autism Trait Questionnaire and a Posner-like attention cueing task. Continuous Flash Suppression (CFS) was employed to render incongruous hierarchical arrow cues perceptually invisible prior to consciously presented targets. This was achieved via a 10 Hz masking stimulus presented to the dominant eye that suppressed information presented to the non-dominant eye. Non-conscious arrows consisted of local arrow elements pointing in one direction, and forming a global arrow shape pointing in the opposite direction. On each trial, the cue provided either a valid or invalid cue for the spatial location of the subsequent target, depending on which level (global or local) received privileged attention. A significant autism-trait group by global cue validity interaction indicated a difference in the extent of non-conscious local/global cueing between groups. Simple effect analyses revealed that whilst participants with lower autistic traits showed a global arrow cueing effect, those with higher autistic traits demonstrated a small local arrow cueing effect. These results suggest that non-conscious processing biases in local/global attention may be related to individual differences in autistic traits.
28149284	Not only responding to direct social actions toward themselves, infants also pay attention to relevant information from third-party interactions. However, it is unclear whether and how infants recognize the structure of these interactions. The current study aimed to investigate how infants' observation of third-party attentional relationships influence their subsequent gaze following. Nine-month-old, 1-year-old, and 1.5-year-old infants (N = 72, 37 girls) observed video clips in which a female actor gazed at one of two toys after she and her partner either silently faced each other (face-to-face condition) or looked in opposite directions (back-to-back condition). An eye tracker was used to record the infants' looking behavior (e.g., looking time, looking frequency). The analyses revealed that younger infants followed the actor's gaze toward the target object in both conditions, but this was not the case for the 1.5-year-old infants in the back-to-back condition. Furthermore, we found that infants' gaze following could be negatively predicted by their expectation of the partner's response to the actor's head turn (i.e., they shift their gaze toward the partner immediately after they realize that the actor's head will turn). These findings suggested that the sensitivity to the difference in knowledge and attentional states in the second year of human life could be extended to third-party interactions, even without any direct involvement in the situation. Additionally, a spontaneous concern with the epistemic gap between self and other, as well as between others, develops by this age. These processes might be considered part of the fundamental basis for human communication.
28147705	Despite the recent rollout of Isoniazid Preventive Therapy (IPT) to prevent TB in people living with HIV in South Africa, adherence and completion rates are low. To explore barriers to IPT completion in rural KwaZulu-Natal, South Africa, we conducted individual semi-structured interviews among 30 HIV patients who had completed or defaulted IPT. Interview transcripts were analyzed according to the framework method of qualitative analysis. Facilitators of IPT completion included knowledge of TB and IPT, accepting one's HIV diagnosis, viewing IPT as similar to antiretroviral therapy, having social support in the community and the clinic, trust in the healthcare system, and desire for health preservation. Barriers included misunderstanding of IPT's preventive role in the absence of symptoms, inefficient health service delivery, ineffective communication with healthcare workers, financial burden of transport to clinic and lost wages, and competing priorities. HIV-related stigma was not identified as a significant barrier to IPT completion, and participants felt confident in their ability to manage stigma, for example by pretending their medications were for unrelated conditions. Completers were more comfortable communicating with health care workers than were defaulters. Efforts to facilitate successful IPT completion must include appropriate counseling and education for individual patients and addressing inefficiencies within the health care system in order to minimize patients' financial and logistical burden. These patient-level and structural changes are necessary for IPT to successfully reduce TB incidence in this resource-limited setting.
28147612	Vocalizations of cetaceans form a key component of their social interactions. Such vocalization activity is driven by the behavioral states of the whales, which are not directly observable, so that latent-state models are natural candidates for modeling empirical data on vocalizations. In this paper, hidden Markov models are used to analyze calling activity of long-finned pilot whales (Globicephala melas) recorded over three years in the Vestfjord basin off Lofoten, Norway. Baseline models are used to motivate the use of three states, while more complex models are fit to study the influence of covariates on the state-switching dynamics. The analysis demonstrates the potential usefulness of hidden Markov models to concisely yet accurately describe the stochastic patterns found in animal communication data, thereby providing a framework for drawing meaningful biological inference.

28147243	Vocal communication is required for successful social interactions in numerous species. During the breeding season, songbirds produce songs that are reinforced by behavioral consequences (e.g., copulation). However, some songbirds also produce songs not obviously directed at other individuals. The consequences maintaining or reinforcing these songs are less obvious and the neural mechanisms associated with undirected communication are not well-understood. Previous studies indicate that undirected singing is intrinsically rewarding and mediated by opioid or dopaminergic systems; however, endocannabinoids are also involved in regulating reward and singing behavior. We used a conditioned place preference paradigm to examine song-associated reward in European starlings and quantitative real-time PCR to measure expression of endocannabinoid-related neural markers (CB1, FABP7, FABP5, FAAH, DAGLα), in brain regions involved in social behavior, reward and motivation (ventral tegmental area [VTA], periaqueductal gray [PAG], and medial preoptic nucleus [POM]), and a song control region (Area X). Our results indicate that starlings producing high rates of song developed a conditioned place preference, suggesting that undirected song is associated with a positive affective state. We found a significant positive relationship between song-associated reward and CB1 receptors in VTA and a significant negative relationship between song-associated reward and CB1 in PAG. There was a significant positive relationship between reward and the cannabinoid transporter FABP7 in POM and a significant negative relationship between reward and FABP7 in PAG. In Area X, FABP5 and DAGLα correlated positively with singing. These results suggest a role for endocannabinoid signaling in vocal production and reward associated with undirected communication.
28146556	Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania.This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk.	These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide effective and locally relevant interventions. Such studies should consider in their approaches the pastoralists' wider social, cultural and economic set up.	
28145946	Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery.To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared.	Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness.	The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.	
28145805	Adolescent children of U.S. military veterans may be at increased risk for engaging in substance use; however, this has yet to be examined using nationally representative data. Parental involvement and communication are potential protective factors to target with prevention efforts, but veterans' parenting has not been studied in general, nonclinical populations.This study presents data on parenting characteristics among fathers who are veterans of the U.S. military and the substance use behaviors of their adolescent children.	Data were analyzed from approximately 2,200 veteran fathers, 13,100 nonveteran fathers, and their children aged 12 to 17 who participated in the National Survey on Drug Use and Health from 2004 to 2013. Parenting characteristics and adolescent substance use were compared by fathers' veteran status.	Compared with nonveteran fathers, veteran fathers were less likely to have talked with their children about the dangers of substance use, were more likely to believe that their children used substances, and were just as likely to be parentally involved. Higher percentages of adolescent children of veterans than those of nonveterans engaged in tobacco use and nonmedical use of psychotherapeutic drugs. Parental involvement and father-child communication about the dangers of substance use did not explain differences in substance use among adolescents with veteran versus nonveteran fathers. Conclusions/Importance: Adolescent children of veterans appear to be a group in particular need of substance use prevention services. Parental involvement and father-child communication may be appropriate protective factors to address in prevention efforts.	
28145411	Individuals with autism spectrum disorder (ASD), including those who otherwise require less support, face severe difficulties in everyday social interactions. Research in this area has primarily focused on identifying the cognitive and neurological differences that contribute to these social impairments, but social interaction by definition involves more than one person and social difficulties may arise not just from people with ASD themselves, but also from the perceptions, judgments, and social decisions made by those around them. Here, across three studies, we find that first impressions of individuals with ASD made from thin slices of real-world social behavior by typically-developing observers are not only far less favorable across a range of trait judgments compared to controls, but also are associated with reduced intentions to pursue social interaction. These patterns are remarkably robust, occur within seconds, do not change with increased exposure, and persist across both child and adult age groups. However, these biases disappear when impressions are based on conversational content lacking audio-visual cues, suggesting that style, not substance, drives negative impressions of ASD. Collectively, these findings advocate for a broader perspective of social difficulties in ASD that considers both the individual's impairments and the biases of potential social partners.
28144914	The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed at comparing the efficacy of a MCI, based on long-term structured physical activity, nutritional counseling/dietary intervention, and an information and communication technology intervention, versus a healthy aging lifestyle education program designed to prevent mobility disability in 1500 older persons with physical frailty and sarcopenia who will be followed for up to 36 months. The primary outcome of the SPRINTT trial is mobility disability, operationalized as the inability to walk for 400 m within 15 min, without sitting, help of another person, or the use of a walker. Secondary outcomes include changes in muscle mass and strength, persistent mobility disability, falls and injurious falls, disability in activities of daily living, nutritional status, cognition, mood, the use of healthcare resources, cost-effectiveness analysis, quality of life, and mortality rate. SPRINTT results are expected to promote significant advancements in the management of frail older persons at high risk of disability from both clinical and regulatory perspectives. The findings are also projected to pave the way for major investments in the field of disability prevention in old age.

28144769	Parents with limited English proficiency might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. Using a mixed-methods, transformative research approach rooted in grounded theory, we sought to answer these questions: (a) "What is happening? What are people doing?" and (b) "What do these stories indicate? What might they suggest about social justice?" High school students from a community in which 53.4% speak another language at home were invited to participate in a survey and focus groups. Of 238 survey participants, 57.5% (n = 137) indicated they assisted with healthcare tasks. When doing so, 81.7% (n = 112) translated. Common tasks were reading prescriptions and talking to doctors. While some participants cited negative emotions associated with brokering, the net emotion was positive. Focus groups (n = 11) revealed that tasks varied broadly in complexity and type, emotional experiences were dichotomous, and access to interpreting services and other supports was inconsistent. This research adopts an advocacy lens and uses a mixed-methods, transformative research approach rooted in grounded theory to describe and call attention to a social justice phenomenon we call adolescent healthcare brokering. We define adolescent healthcare brokering as young people acting as linguistic interpreters in healthcare situations for themselves and for family members with limited English proficiency (LEP). In such situations, language acts as a barrier to health literacy and access to healthcare [17]. Despite this known barrier, there is a gap in the research regarding how to successfully address this situation (McKee, Paasche-Orlow, Journal of health communication 17(3):7-12, 2012).
28144465	Tracheal stenosis is one of the worst complications associated with endotracheal intubation and it is the most common reason for reconstructive airway surgeries. Due to various local risk factors, the incidence rate of tracheal stenosis may vary in different countries. In order to estimate the incidence rate of post-intubation tracheal stenosis (PITS) in patients admitted to an intensive care unit (ICU), a follow-up study was planned. As there was no similar methodological model in the literature, a feasibility step was also designed to examine the whole project and to enhance the follow-up rate.To estimate the PITS incidence rate in patients admitted to ICUs, as well as to evaluate the feasibility of the study.	This prospective cohort study was conducted in five hospitals in two provinces (Tehran and Arak) of Iran from November 2011 to March 2013. All patients admitted to ICUs who underwent more than 24 hours of endotracheal intubation were included. Upon their discharge from the ICUs, the patients received oral and written educational materials intended to ensure a more successful follow-up. The patients were asked to come back for follow-up three months after their extubation, or sooner in case of any symptoms developing. Those with dyspnea or stridor underwent a bronchoscopy. The asymptomatic patients were given a spirometry and then they underwent a bronchoscopy if the flow-volume loop suggested airway stenosis.	Some seventy-three patients (70% men) were included in the study. Multiple trauma secondary to motor vehicle accidents (52%) was the most common cause of intubation. Follow-ups were completed in only 14 (19.2%, CI = 0.109 - 0.300) patients. One patient (7%, CI = 0.007 - 0.288) developed symptomatic tracheal stenosis that was confirmed by bronchoscopy. The barriers to a successful follow-up were assessed on three levels: ineffective oral education upon discharge, improper usage of educational materials, and difficulties to attending follow-up visits. There were also some important obstacles in terms of human, time, material, and cost resources, as well as data management.	To enhance the follow-up rate, three strategies were proposed: patient-focused strategies such as emphasizing patient education upon discharge and providing rewards; structural-focused strategies such as scheduling home visits and uploading questionnaires onto the research center's website; and provider-focused strategies such as selecting coordinators with good communication skills. All necessary resources should also be re-arranged for a multicenter national study.	
28142016	Health literacy has been increasingly recognized as one of the most important social determinants for health. However, an appropriate and comprehensive assessment tool is not available in many Asian countries. This study validates a comprehensive health literacy survey tool European health literacy questionnaire (HLS-EU-Q47) for the general public in several Asian countries.A cross-sectional survey based on multistage random sampling in the target countries. A total of 10,024 participants aged ≥15 years were recruited during 2013-2014 in Indonesia, Kazakhstan, Malaysia, Myanmar, Taiwan, and Vietnam. The questionnaire was translated into local languages to measure general health literacy and its three domains. To evaluate the validity of the tool in these countries, data were analyzed by confirmatory factor analysis, internal consistency analysis, and regression analysis.	The questionnaire was shown to have good construct validity, satisfactory goodness-of-fit of the data to the hypothetical model in three health literacy domains, high internal consistency (Cronbach's alpha >0.90), satisfactory item-scale convergent validity (item-scale correlation ≥0.40), and no floor/ceiling effects in these countries. General health literacy index score was significantly associated with level of education (P from <0.001 to 0.011) and perceived social status (P from <0.001 to 0.016), with evidence of known-group validity.	The HLS-EU-Q47 was a satisfactory and comprehensive health literacy survey tool for use in Asia.	
28141625	Social media have great impact on all aspects of life throughout the world. The utilization of social media for occupational lung disease, however, has been much more limited. This article summarizes recent literature concerning social media for occupational lung disease and identifies areas for additional use.Social media are used in six relevant areas: information dissemination, peer-to-peer communication, survey research data collection, participatory research and exposome data acquisition, assessing public concerns, and knowledge generation. There are very clear advantages for information dissemination from experts to workers and on a peer-to-peer basis, although variable credibility and accuracy concerns persist. For research, social media have been used for acquiring data posted for nonresearch purposes and for efficiently collecting information specifically for research. The benefits of efficiency, democracy, and very large data sources may counterbalance concerns about inadequate specification of recruitment strategies and limited control over data quality.	The potential benefits of using social media for lung health-workplace interactions are much greater than the very limited current utilization.	
28140768	People often tell each other stories about their past experiences. But do they tell the right ones? Speakers and listeners predicted that listeners would enjoy hearing novel stories (i.e., stories about experiences the listeners had never had) more than familiar stories (i.e., stories about experiences the listeners had already had). In fact, listeners enjoyed hearing familiar stories much more than novel ones (Studies 1 and 2). This did not happen because the familiar and novel stories differed in their content or delivery (Study 3). Rather, it happened because human speech is riddled with informational gaps, and familiar stories allow listeners to use their own knowledge to fill in those gaps (Study 4). We discuss reasons why novel stories are more difficult to tell, and why familiar stories are more enjoyable to hear, than either speakers or listeners expect.
28139707	Echolocating bats face the challenge of actively sensing their environment through their own emissions, while also hearing calls and echoes of nearby conspecifics. How bats mitigate interference is a long-standing question that has both ecological and technological implications, as biosonar systems continue to outperform man-made sonar systems in noisy, cluttered environments. We recently showed that perched bats decreased calling rates in groups, displaying a behavioral strategy resembling the back-off algorithms used in artificial communication networks to optimize information throughput at the group level. We tested whether free-tailed bats (Tadarida brasiliensis) would employ such a coordinated strategy while performing challenging flight maneuvers, and report here that bats navigating obstacles lowered emission rates when hearing artificial playback of another bat's calls. We measured the impact of acoustic interference on navigation performance and show that the calculated reductions in interference rates are sufficient to reduce interference and improve obstacle avoidance. When bats flew in pairs, each bat responded to the presence of the other as an obstacle by increasing emissions, but hearing the sonar emissions of the nearby bat partially suppressed this response. This behavior supports social cohesion by providing a key mechanism for minimizing mutual interference.
28138486	There are a number of factors that influence compliance with prescribed plans of care. However, there remains a need to identify the collective source health, behavioral, and social constructs have on treatment satisfaction. This study aimed to identify indicators of pain treatment satisfaction among older adults receiving outpatient treatment from a comprehensive cancer center in the southeast region of the United States. Data included a sample of 149 Black and White patients diagnosed with cancer, with the majority being White (85%) and female (57%). Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. A series of multivariate models were specified, whereby patients reporting multiple chronic conditions, poor communication, and perceived discrimination were less satisfied with treatment. Positive communication, higher self-efficacy, and fewer perceived discriminatory acts were significant among the female patients only. These findings suggest the need to develop clinical models that assess how these factors influence the degree of treatment satisfaction, while providing a comprehensive mechanism by which to service the long-term needs of older adults.
28138484	Objective: This prospective study aimed to determine the influence social and health factors have on pain interference with everyday activities among older patients receiving outpatient treatment services from a comprehensive cancer center. Method: Participants were surveyed on questions assessing pain interference, and social (communication), health (pain severity, comorbidities), behavioral (self-efficacy, affect), and demographic characteristics. Multivariate analyses were specified to examine determinants of pain interference, with items loading on separate cluster composites: physical interference and psychosocial interference. Results: Pain severity was a significant indicator for physical interference. Similarly, pain severity, education, self-efficacy, negative affect, and communication were predictors of psychosocial interference. Discussion: Factors defining the daily lived experiences of older adults are important in providing baseline information on functional status. This emphasizes the need to rigorously examine the association between pain, and clinical and psychosocial indicators, but more importantly indicators that contribute to the patient's ability to perform normal everyday activities.
28138269	Dating apps play a major role in connecting men who are interested in meeting other men for sex. Besides finding a partner, these tools are also exploited for other activities such as encouraging people to get involved in the habit of illicit drug consumption (substance use).This study evaluated the overall usage of dating apps among Thai men who have sex with men (MSMs), with an emphasis on abusing these apps to convey messages encouraging substance use. A well-structured Survey Monkey questionnaire posted on specialized websites and social sites used by MSMs was used to collect the data. Data were analyzed using regression and correlation analysis in order to establish the relationship between variables.	A substantial proportion (73%) of the Thai MSM community is using dating apps to find their partners as well as for inviting others into illicit drug practice. Unfortunately, persuasion through dating significantly influenced people toward accepting a substance use invitation, with a 77% invitation success rate. Substance use was also linked with unprotected sex, potentially enhancing the transmission of sexually transmitted infections.	Dating apps significantly increased motivational substance use through messaging from their counterparts. One of the major concerns revealed in this study is that Thai MSMs who reported being involved in substance use also reported avoiding use of condoms during intercourse.	
28137998	Medical crowdfunding is growing in terms of the number of active campaigns, amount of funding raised and public visibility. Little is known about how campaigners appeal to potential donors outside of anecdotal evidence collected in news reports on specific medical crowdfunding campaigns. This paper offers a first step towards addressing this knowledge gap by examining medical crowdfunding campaigns for Canadian recipients. Using 80 medical crowdfunding campaigns for Canadian recipients, we analyse how Canadians justify to others that they ought to contribute to funding their health needs. We find the justifications campaigners tend to fall into three themes: personal connections, depth of need and giving back. We further discuss how these appeals can understood in terms of ethical justifications for giving and how these justifications should be assessed in light of the academic literature on ethical concerns raised by medical crowdfunding.
28135430	Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners.We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness.	Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature.	Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge.	
28134548	Understanding how the public perceives uncertainty in scientific research is fundamental for effective communication about research and its inevitable uncertainty. Previous work found that scientific evidence differentially influenced beliefs from individuals with different political ideologies. Evidence that threatens an individual's political ideology is perceived as more uncertain than nonthreatening evidence. The authors present 3 studies examining perceptions of scientific uncertainty more broadly by including sciences that are not politically polarizing. Study 1 develops scales measuring perceptions of scientific uncertainty. It finds (a) 3 perceptual dimensions of scientific uncertainty, with the primary dimension representing a perception of precision; (b) the precision dimension of uncertainty is strongly associated with the perceived value of a research field; and (c) differences in perceived uncertainty across political affiliations. Study 2 manipulated these dimensions, finding that Republicans were more sensitive than Democrats to descriptions of uncertainty associated with a research field (e.g., psychology). Study 3 found that these views of a research field did not extend to the evaluation of individual results produced by the field. Together, these studies show that perceptions of scientific uncertainty associated with entire research fields are valid predictors of abstract perceptions of scientific quality, benefit, and allocation of funding. Yet, they do not inform judgments about individual results. Therefore, polarization in the acceptance of specific results is not likely due to individual differences in perceived scientific uncertainty. Further, the direction of influence potentially could be reversed, such that perceived quality of scientific results could be used to influence perceptions about scientific research fields. (PsycINFO Database Record
28134445	Bullying has been identified as one of the leading workplace stressors, with adverse consequences for the individual employee, groups of employees, and whole organisations. Employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their place of work. Organisations face increased risk of skill depletion and absenteeism, leading to loss of profit, potential legal fees, and tribunal cases. It is unclear to what extent these risks can be addressed through interventions to prevent bullying.To explore the effectiveness of workplace interventions to prevent bullying in the workplace.	We searched: the Cochrane Work Group Trials Register (August 2014); Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1); PUBMED (1946 to January 2016); EMBASE (1980 to January 2016); PsycINFO (1967 to January 2016); Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016); International Bibliography of the Social Sciences (IBSS; 1951 to January 2016); Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016); ABI Global (earliest record to January 2016); Business Source Premier (BSP; earliest record to January 2016); OpenGrey (previously known as OpenSIGLE-System for Information on Grey Literature in Europe; 1980 to December 2014); and reference lists of articles.	Randomised and cluster-randomised controlled trials of employee-directed interventions, controlled before and after studies, and interrupted time-series studies of interventions of any type, aimed at preventing bullying in the workplace, targeted at an individual employee, a group of employees, or an organisation.	Three authors independently screened and selected studies. We extracted data from included studies on victimisation, perpetration, and absenteeism associated with workplace bullying. We contacted study authors to gather additional data. We used the internal validity items from the Downs and Black quality assessment tool to evaluate included studies' risk of bias.	Five studies met the inclusion criteria. They had altogether 4116 participants. They were underpinned by theory and measured behaviour change in relation to bullying and related absenteeism. The included studies measured the effectiveness of interventions on the number of cases of self-reported bullying either as perpetrator or victim or both. Some studies referred to bullying using common synonyms such as mobbing and incivility and antonyms such as civility. Organisational/employer level interventionsTwo studies with 2969 participants found that the Civility, Respect, and Engagement in the Workforce (CREW) intervention produced a small increase in civility that translates to a 5% increase from baseline to follow-up, measured at 6 to 12 months (mean difference (MD) 0.17; 95% CI 0.07 to 0.28).One of the two studies reported that the CREW intervention produced a small decrease in supervisor incivility victimisation (MD -0.17; 95% CI -0.33 to -0.01) but not in co-worker incivility victimisation (MD -0.08; 95% CI -0.22 to 0.08) or in self-reported incivility perpetration (MD -0.05 95% CI -0.15 to 0.05). The study did find a decrease in the number of days absent during the previous month (MD -0.63; 95% CI -0.92 to -0.34) at 6-month follow-up. Individual/job interface level interventionsOne controlled before-after study with 49 participants compared expressive writing with a control writing exercise at two weeks follow-up. Participants in the intervention arm scored significantly lower on bullying measured as incivility perpetration (MD -3.52; 95% CI -6.24 to -0.80). There was no difference in bullying measured as incivility victimisation (MD -3.30 95% CI -6.89 to 0.29).One controlled before-after study with 60 employees who had learning disabilities compared a cognitive-behavioural intervention with no intervention. There was no significant difference in bullying victimisation after the intervention (risk ratio (RR) 0.55; 95% CI 0.24 to 1.25), or at the three-month follow-up (RR 0.49; 95% CI 0.21 to 1.15), nor was there a significant difference in bullying perpetration following the intervention (RR 0.64; 95% CI 0.27 to 1.54), or at the three-month follow-up (RR 0.69; 95% CI 0.26 to 1.81). Multilevel InterventionsA five-site cluster-RCT with 1041 participants compared the effectiveness of combinations of policy communication, stress management training, and negative behaviours awareness training. The authors reported that bullying victimisation did not change (13.6% before intervention and 14.3% following intervention). The authors reported insufficient data for us to conduct our own analysis.Due to high risk of bias and imprecision, we graded the evidence for all outcomes as very low quality.	There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace. We need large well-designed controlled trials of bullying prevention interventions operating on the levels of society/policy, organisation/employer, job/task and individual/job interface. Future studies should employ validated and reliable outcome measures of bullying and a minimum of 6 months follow-up.	
28134358	Online social networks have transformed the way in which humans communicate and interact, leading to a new information ecosystem where people send and receive information through multiple channels, including traditional communication media. Despite many attempts to characterize the structure and dynamics of these techno-social systems, little is known about fundamental aspects such as how collective attention arises and what determines the information life-cycle. Current approaches to these problems either focus on human temporal dynamics or on semiotic dynamics. In addition, as recently shown, information ecosystems are highly competitive, with humans and memes striving for scarce resources -visibility and attention, respectively. Inspired by similar problems in ecology, here we develop a methodology that allows to cast all the previous aspects into a compact framework and to characterize, using microblogging data, information-driven systems as mutualistic networks. Our results show that collective attention around a topic is reached when the user-meme network self-adapts from a modular to a nested structure, which ultimately allows minimizing competition and attaining consensus. Beyond a sociological interpretation, we explore such resemblance to natural mutualistic communities via well-known dynamics of ecological systems.
28134015	The use of narrative has become increasingly popular in the public health, community development, and education fields. Via emotionally engaging plotlines with authentic, captivating characters, stories provide an opportunity for participants to be carried away imaginatively into the characters' world while connecting the story with their own lived experiences. Stories have been highlighted as valuable tools in transformative learning. However, little published literature exists demonstrating applications of stories in group-based transformative learning curricula. This paper describes the creation of a narrative-based transformative learning tool based on an analysis of Nicaraguan adolescents' meaning-making around intimate partner violence (IPV) in their creative narratives. In collaboration with a Nicaraguan organization, US researchers analyzed a sample of narratives ( n = 55; 16 male-authored, 39 female-authored) on IPV submitted to a 2014 scriptwriting competition by adolescents aged 15-19. The data were particularly timely in that they responded to a new law protecting victims of gender-based violence, Law 779, and contradicted social-conservative claims that the Law 779 destroys family unity. We incorporated results from this analysis into the creation of the transformative learning tool, separated into thematic sections. The tool's sections (which comprise one story and three corresponding activities) aim to facilitate critical reflection, interpersonal dialogue, and self- and collective efficacy for social action around the following themes derived from the analysis: IPV and social support; IPV and romantic love; masculinity; warning signs of IPV; and sexual abuse. As a collaboration between a public health research team based at a US university and a Nicaraguan community-based organization, it demonstrates the potential in the age of increasingly smooth electronic communication for novel community-university partnerships to facilitate the development of narrative-based tools to support transformative learning.
28132125	Children with autism spectrum disorder (ASD) experience internalizing and externalizing problems at higher rates than typically developing children, which could worsen social impairment. The present study compared impairment scores (social responsiveness scale, 2nd edition; SRS-2 scores) in 57 children (3-17 years, 82.5% male) with ASD, either with or without heightened levels of anxiety or ADHD symptoms, all per parent report. Children with heightened anxiety problems showed higher scores on four SRS-2 subscales (Social Cognition, Social Communication, Social Motivation, and Restricted Interests and Repetitive Behavior). Children with heightened ADHD traits showed higher scores on two subscales (Social Communication and Social Awareness). These findings suggest similarities and differences in how social deficits in ASD may worsen with anxiety or ADHD symptoms.
28132093	To understand the importance of the home food environment on unhealthy food consumption in children high in reward sensitivity, this study tested the hypothesis that the home availability of unhealthy food moderates the effect of reward sensitivity on children's fast-food consumption frequency, exerted via food cue responsiveness. Children between 7.5 and 14 years (n = 174, 50.6% boys) reported on reward sensitivity and food cue responsiveness (by means of the subscale 'external eating'). Their height and weight were measured. Parents reported on their children's fast-food consumption frequency, food cue responsiveness (by means of the subscale 'food responsiveness'), and on the home availability of unhealthy foods. Two moderated mediation models were conducted, one with the parent- and one with the child-reported food cue responsiveness as mediator. Findings suggested that with a high home availability of unhealthy foods, (a) a higher fast-food consumption frequency was found in children high in reward sensitivity and (b) the relation between reward sensitivity and the fast-food consumption frequency was mediated by external eating.The findings point at the importance of the home food environment in children high in reward sensitivity. They suggest to limit the home availability of unhealthy foods. What is Known: • Reward sensitivity (RS) is positively associated with children's palatable food consumption • In adolescents, this effect is mediated by food cue responsiveness, which determines the strength of an individual's motivation to obtain food when perceiving food cues What is New: • Children high in RS may be more vulnerable to palatable food cues in their everyday food environment because of a higher food cue responsiveness • The home food environment may be an important determining factor of the palatable food consumption of these children.	
28130956	Children with autism spectrum disorder often develop persistent challenging behaviours. A previous study in this journal (Reynolds et al. 2011) reported effective implementation of strategies immediately following involvement in a comprehensive positive behaviour support workshop for parents/school personnel. The current study assessed long-term efficacy more than six months after workshop completion. Parent and school behaviour scores suggested maintained improvement in child behaviour. Parent responses to a verbal questionnaire revealed important perceptions of what made workshop participation beneficial. This study provides evidence for long-term benefits from this innovative approach for caregivers working with children with challenging behaviours.
28130022	Adverse drug events (ADEs) associated with over-the-counter (OTC) medications cause 178,000 hospitalizations each year. Older adults, aged 65 and older, are particularly vulnerable to ADEs. Of the 2.2 million older adults considered at risk for a major ADE, more than 50% are at risk due to concurrent use of an OTC and prescription medication.To refine the intervention and implementation strategy through diagnostic and formative evaluation; to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies.	A system redesign intervention to decrease high-risk OTC medication misuse will be tested to reduce misuse by improving communication between older adults and community pharmacists via the following features: a redesign of the physical environment to sensitize older adults to high-risk OTC medications, and the implementation of a clinical decision tool to support the pharmacist when critically evaluating the older adult's health status. The study will be conducted in three phases: a participatory design phase, a beta phase, and a test phase. The test phase will be conducted in three mass-merchandise stores. A total of 144 older adults will be recruited. A pre (control)/post (intervention) test will determine the effectiveness of the intervention. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention. The process of implementation in the community pharmacy setting will be evaluated using the taxonomy proposed by Proctor et al. The participatory design phase has been approved by the institution's IRB (2016-0743).	It is anticipated that this project, which focuses on achieving systems-based improvement in an underemphasized area of the medication use process, will reduce ADEs associated with inappropriate OTC medication use in older adults.	
28129931	Supervision of communication competency in clinical settings in medicine is an important component of professional training. The purpose of this study was to describe the content and rationale of psychology and social work preceptor feedback to family medicine residents who express educational needs during case-based written vignettes.We conducted a qualitative study with 25 psychology and social work preceptors from family medicine departments of the three French-speaking universities in the province of Quebec, Canada. During an individual interview, preceptors were asked to respond to three short case-based written vignettes depicting resident educational issues regarding communication and to explain their responses. Authors analyzed the content of responses and the conceptual frameworks reported.	The three vignettes elicited 475 responses, including 58 distinct responses and 33 distinct conceptual frameworks. Therapeutic alliance and stages of grief were the two most reported conceptual frameworks.	The vignettes stimulated a wealth of responses and conceptual frameworks among psychology and social work preceptors in family medicine.	The complete list of responses could be useful for faculty development activities by stimulating preceptors' reflexive practice with regard to their responses, the educational goals of these responses and the conceptual frameworks underlying their feedback.	
28129893	Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment.To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS.	A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix.	A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars.	The rate of AS acceptance by patients for management of low-risk prostate cancer.	In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment.	A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs across medicine.	In this study, we evaluated the impact of teaching physicians how to better communicate the benefits and risks of prostate cancer treatments on the willingness of patients to choose active surveillance. Decisions related to cancer are often guided by emotions and biases that lead most patients to seek radical treatment; however, we demonstrated that if discussions are framed differently, these biases can be overcome and more patients will choose active surveillance.	
28129779	Hearing loss (HL) is a disability associated with poorer health-related quality of life including an increased risk for loneliness, isolation, functional fitness declines, falls, hospitalization and premature mortality. The purpose of this pilot trial is to determine the feasibility and acceptability of a novel intervention to reduce loneliness, improve functional fitness, social connectedness, hearing and health-related quality of life in older adults with HL.This 10-week, single-blind, pilot randomized control trial (RCT) will include a convenience sample of ambulatory adults aged 65 years or older with self-reported HL. Following baseline assessments, participants will be randomized to either intervention (exercise, health education, socialization and group auditory rehabilitation (GAR)) or control (GAR only) groups. The intervention group will attend a local YMCA twice a week and the control group once a week. Intervention sessions will include 45 min of strengthening, balance and resistance exercises, 30 min of group walking at a self-selected pace and 60 min of interactive health education or GAR. The control group will attend 60-min GAR sessions. GAR sessions will include education about hearing, hearing technologies, enhancing communication skills, and psychosocial support. Pre-post trial data collection and measures will include: functional fitness (gait speed, 30-s Sit to Stand Test), hearing and health-related quality of life, loneliness, depression, social participation and social support. At trial end, feasibility (recruitment, randomization, retention, acceptability) and GAR will be evaluated.	Despite evidence suggesting that HL is associated with declines in functional fitness, there are no studies aimed at addressing functional fitness declines associated with the disability of HL. This pilot trial will provide knowledge about the physical, mental and social impacts on health related to HL as a disability. This will inform the feasibility of a larger RCT and preliminary evidence about the initial effects of a novel, community-based, holistic intervention addressing both the negative psychosocial and functional physical effects of HL among older adults.	
28129486	Patients with systemic sclerosis suffer severe physical limitations and psychological morbidity but their lived experience remains underrepresented and is reflected in the scarcity of evidence based patient-centered interventions. We aimed to describe patients' perspectives of systemic sclerosis to inform strategies to improve their care.Face-to-face semi-structured interviews were conducted with 30 adult patients with limited or diffuse systemic sclerosis in Australia. Transcripts were thematically analyzed using HyperRESEARCH software.	Six themes were identified: bodily malfunction (restrictive pain, debilitating physical changes, pervasive exhaustion); deprivation of social function (loss of work and career, social isolation, threat to traditional roles, loss of intimacy); disintegration of identity (stigmatizing physical changes, disassociated self-image, extinguished hopes, alone and powerless, invisibility of illness); insecurity of care (unrecognized disease, ambiguity around diagnosis and cause, information insufficiency, resigning to treatment limitations, seeking reassurance, fear of progression); avoiding the sick role (evading thoughts of sickness, protecting family, favorable comparison); and perseverance and hope (positive stoicism, optimism about treatment and monitoring, taking control of own health, pursuing alternative treatments, transcending illness through support).	Systemic sclerosis inflicts major bodily and social restrictions that crushes patients' identity and self-image. Uncertainties about the cause, diagnosis and prognosis can undermine confidence in care, leading to anxiety and therapeutic nihilism. Access to psychosocial care to support the patients' role and functioning capacity, as well as communication and education that explicitly address their concerns regarding management may potentially improve treatment satisfaction, self-efficacy, adherence and outcomes in patients with systemic sclerosis. This article is protected by copyright. All rights reserved.	
28129407	Chinese calligraphic handwriting (CCH) is a traditional art form that requires high levels of concentration and motor control. Previous research has linked short-term training in CCH to improvements in attention and memory. Little is known about the potential impacts of long-term CCH practice on a broader array of executive functions and their potential neural substrates. In this cross-sectional study, we recruited 36 practitioners with at least 5 years of CCH experience and 50 control subjects with no more than one month of CCH practice and investigated their differences in the three components of executive functions (i.e., shifting, updating, and inhibition). Valid resting-state fMRI data were collected from 31 CCH and 40 control participants. Compared with the controls, CCH individuals showed better updating (as measured by the Corsi Block Test) and inhibition (as measured by the Stroop Word-Color Test), but the two groups did not differ in shifting (as measured by a cue-target task). The CCH group showed stronger resting-state functional connectivity (RSFC) than the control group in brain areas involved in updating and inhibition. These results suggested that long-term CCH training may be associated with improvements in specific aspects of executive functions and strengthened neural networks in related brain regions.
28128812	Influenza is a viral respiratory disease capable of causing epidemics that represent a threat for global security. Mexico was the first country to notify the WHO of an outbreak of what later became the first influenza pandemic of the 21st Century, caused by the virus A(H1N1)2009. Before this event Mexico had a national pandemic influenza preparedness plan, which included seasonal influenza vaccination, stockpiles of personal protection equipment and strategic drugs, and risk communication strategies. During the epidemic, the national public health laboratory network and case surveillance systems were strengthened together with surge capacities for intensive care and delivery of antiviral drugs. Risk communication was conducted for people to comply with implemented measures regarding social distancing (workplace and school closures, household quarantine). This report describes the Mexican experience during the 2009 influenza pandemic and the lessons that this experience provides to public health preparedness for future pandemics.
28128731	Tobacco cessation training programs to treat tobacco dependence have measureable effects on patients' smoking. Tobacco consumption in low- and middle-income countries (LMICs) is high and slowly decreasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs for health professionals and organizations. Based on a previous online smoking cessation training program for hospital workers in Spain, the Fruitful Study aims to increase smoking cessation knowledge, attitudes, self-confidence, and performance interventions among health care professionals of three Spanish-speaking low- and middle-income Latin American and Caribbean (LAC) countries.The purpose of this paper is to describe the methodology and evaluation strategy of the Fruitful Study intended to adapt, implement, and test the effectiveness of an online, evidence-based tobacco cessation training program addressed to health professionals from Bolivia, Guatemala, and Paraguay.	This study will use a mixed-methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be (1) participants' attitudes, knowledge, and behaviors before and after the training; and (2) the level of implementation of tobacco control policies within the hospitals before and after the training.	To date, adaptation of the materials, study enrollment, and training activities have been completed. During the adaptation, the main mismatches were language background and content adaptation. Several aids were developed to enable students' training enrollment, including access to computers, support from technicians, and reminders to correctly complete the course. Follow-up data collection is in progress. We have enrolled 281 hospital workers. Results are expected at the beginning of 2017 and will be reported in two follow-up papers: one about the formative evaluation and the other about the summative evaluation.	There is a need to learn more about the cultural and content elements that should be modified when an online tobacco cessation training program is adapted to new contexts. Special attention should be given to the personal and material resources that could make the implementation possible. Results from the Fruitful Study may offer a new approach to adapting programs to LMICs in order to offer education solutions with the use of emerging and growing communication technologies.	
28128542	Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature.We used PRISMA guidelines and Medline to conduct this systematic review. 448 relevant articles were found. Twelve articles, all published after year 2000 were included and reviewed by two independent investigators.	Among 12 selected articles, 10762 outpatient endovascular procedures were performed and 3883 procedures were realized for arterial lower limb revascularization. Average age was 65.2. Major exclusion criteria were social isolation (no available accompanying adult for the first 24 hours, no available communication system) and high-risk patients (ASA 4 and above). During the perioperative period, no death was noted. Major hematoma rate was 0% to 3%, minor hematoma rate went from 1.6% to 20%. Conversion to in-patient status for overnight observation occurred in 0% to 16% in ten real life studies and was mostly due to complications at puncture site. Reintervention over the first month occurred in 0% to 4%. Readmission in the first month after being discharged occurred in 0% to 3.2%. Diabetes and critical limb ischemia were not related to higher complication rate.	This review indicates that outpatient endovascular procedures for PAD are safe and efficient. Guidelines are necessary to enforce patients' selection and insure high quality perioperative care.	
28128442	We assessed the use of a microswitch-based program for promoting ambulation responses by two children with multiple disabilities. The goals of the study were to: (a) evaluate the importance of the contingency between the target behavior (forward step) and the programmed consequence (preferred stimuli), (b) measure effects of the intervention on indices of happiness, and (c) assess the social validation of the procedure using 20 physiotherapists as external raters. The intervention involved the automatic delivery of preferred stimuli contingent on forward steps. Results showed that both participants improved their performance (forward steps and indices of happiness) during contingent reinforcement phases compared to baseline and noncontingent reinforcement phases. Moreover, physiotherapists rated the intervention as socially valid.
28128430	Redes neuronales de la expresion facial.Introduccion. La percepcion de caras involucra una amplia red de conexiones entre regiones corticales y subcorticales que intercambian y sincronizan informacion a traves de haces de sustancia blanca. Este preciso sistema de comunicacion puede verse afectado tanto a traves de las propias estructuras como por las vias que las conectan. Objetivos. Delimitar el sustrato neuronal que subyace a la percepcion de la expresion facial y analizar los diferentes factores que participan modulando la integridad de esta red neuronal, con el fin de proponer mejoras en los programas de rehabilitacion. Desarrollo. Cuando la compleja red de conexiones que participa en la percepcion de la expresion facial se altera por traumatismos, patologias neurodegenerativas, trastornos del desarrollo, incluso por aislamiento social o contextos negativos, se deteriora tambien la capacidad para interactuar de manera adaptativa con el entorno. Conclusiones. La posibilidad de restaurar la integridad de la red neuronal encargada del procesamiento de la expresion facial pasa por tener en cuenta diferentes variables que en mayor o menor grado se han mostrado capaces de modificar la estructura o funcionalidad de las redes neuronales, como el entrenamiento aerobico, la estimulacion magnetica transcraneal, la estimulacion electrica transcraneal y el aprendizaje, sin bien estas variables estarian condicionadas por la edad, el tipo y evolucion del trastorno o el contexto generador, lo que plantearia la necesidad de protocolos de rehabilitacion ajustados y orientados a delimitar el sustrato neuronal del deficit.	Face perception involves a broad network of connections between cortical and subcortical regions for the exchange and synchronization of information using white matter fibers. This precise communication system can be affected by the structures and the pathways that connect them.	To establish the neural substrate underlying the perception of facial expression and to analyze the different factors involved in modulating the integrity of this neural network, with the aim being to introduce improvements into rehabilitation programs.	When the complex neural network involved in the perception of facial expression is altered by trauma, neurodegenerative disorders, developmental disorders, social isolation or negative contexts, the adaptive capacity to interact with the environment also deteriorates.	Maintaining the neural network integrity responsible for processing facial expression requires considering different variables. To a greater or lesser extent, these variables modify the structure or function of neural networks, such as aerobic training, transcranial magnetic stimulation, transcranial electrical stimulation, and learning. These variables are affected by age, and the type and course of the condition or generator context, and raise the need for rehabilitation protocols that are adapted and designed to delimit the deficient neuronal substrate.	
28127576	Autism is a developmental disability characterized by atypical social interaction, interests or body movements, and communication. Our review examines the empirical status of three communication phenomena believed to be unique to autism: pronoun reversal (using the pronoun you when the pronoun I is intended, and vice versa), echolalia (repeating what someone has said), and a reduced or even reversed production-comprehension lag (a reduction or reversal of the well-established finding that speakers produce less sophisticated language than they can comprehend). Each of these three phenomena has been claimed to be unique to autism; therefore, each has been proposed to be diagnostic of autism, and each has been interpreted in autism-centric ways (psychoanalytic interpretations of pronoun reversal, behaviorist interpretations of echolalia, and clinical lore about the production-comprehension lag). However, as our review demonstrates, none of these three phenomena is in fact unique to autism; none can or should serve as diagnostic of autism, and all call into question unwarranted assumptions about autistic persons and their language development and use.
28127043	There is widespread acceptance that a significant and sustained impact on the growing global obesity burden requires implementation of a range of health policies to influence the obesity landscape. This acceptance is underpinned by the understanding that the obesity landscape is a complex interaction between the many factors that influence an individual's dietary intake and physical activity levels. Over the past decade we have seen increasing convergence in national and international recommendations on how to best improve this obesity landscape. In the past few years this has led to a noticeable increase in the implementation of these recommended national, state and local government policies. Here, we argue that to maximise the impact of population-level policies intended to improve diet and activity environments we need to see progress in a number of key areas, namely: broadening the range of environments that can be empowered to implement policy; improving our understanding of how best to combine multiple policies and interventions; and improving our understanding of the equity impact of these policies. We also argue that a key goal moving forward should be better capture and communication of the existing activities in order to more rapidly spread the uptake of these policies globally and at scale.
28126202	Racial disparities in adult flu vaccination rates persist with African Americans falling below Whites in vaccine acceptance. Although the literature has examined traditional variables including barriers, access, attitudes, among others, there has been virtually no examination of the extent to which racial factors including racial consciousness, fairness, and discrimination may affect vaccine attitudes and behaviors.We contracted with GfK to conduct an online, nationally representative survey with 819 African American and 838 White respondents. Measures included risk perception, trust, vaccine attitudes, hesitancy and confidence, novel measures on racial factors, and vaccine behavior.	There were significant racial differences in vaccine attitudes, risk perception, trust, hesitancy and confidence. For both groups, racial fairness had stronger direct effects on the vaccine-related variables with more positive coefficients associated with more positive vaccine attitudes. Racial consciousness in a health care setting emerged as a more powerful influence on attitudes and beliefs, particularly for African Americans, with higher scores on racial consciousness associated with lower trust in the vaccine and the vaccine process, higher perceived vaccine risk, less knowledge of flu vaccine, greater vaccine hesitancy, and less confidence in the flu vaccine. The effect of racial fairness on vaccine behavior was mediated by trust in the flu vaccine for African Americans only (i.e., higher racial fairness increased trust in the vaccine process and thus the probability of getting a flu vaccine). The effect of racial consciousness and discrimination for African Americans on vaccine uptake was mediated by perceived vaccine risk and flu vaccine knowledge.	Racial factors can be a useful new tool for understanding and addressing attitudes toward the flu vaccine and actual vaccine behavior. These new concepts can facilitate more effective tailored and targeted vaccine communications.	
28126155	Diabetes is one of the most challenging chronic health conditions in the current era. Diabetes-related foot problems need proper patient education, and social media could a play role to disseminate proper information.A systematic search was performed on Facebook groups using the key words "diabetes foot care", "diabetes foot", "diabetes foot management" and "podiatric care". The search resulted in 57 groups and detailed activity information was collected from those groups. Usefulness of each relevant post was determined. Regression analysis was performed to explore the factors associated with the level of usefulness of diabetes foot care-related Facebook groups.	Our search resulted in a total of 16 eligible diabetes foot care-related Facebook groups with a total of 103 eligible posts. The average number of group members for the selected groups were 265.75 with an interquartile range of 3.5-107.75. Of the total 103 timeline posts, 45.6% posts were categorized as useful, while the remaining posts were not useful. Top mentioned diabetes foot care practice was "Checking feet daily". Multivariable logistic regression analysis showed that the level of usefulness of diabetes foot care-related Facebook groups were significantly associated with the type of posts and no association was found with presence of "likes" and presence of comment.	Facebook being a widely used social networking system, patient welfare organizations, doctors, nurses and podiatrists could use this platform to provide support to educating diabetes patients and their caregivers by disseminating useful and authentic knowledge and information related to diabetes foot care.	
28126055	Voluntarily sending sexual content (e.g., photos, videos) among adolescents via the Internet and mobile phones, a phenomenon called sexting , is receiving increasing social and research attention. The aims of this study were: 1) to analyze the prevalence and trends of sexting among adolescents by gender and age and 2) to examine the personality profile of adolescents that participated in sexting.The sample consisted of 3,223 Spanish adolescents from 12 to 17 years of age (49.9% female; mean age = 14.06, SD = 1.37) who anonymously and voluntarily completed self-report questionnaires on sexting and the big five personality factors.	The overall prevalence of sexting was 13.5%. The prevalence was 3.4% at 12 years old and increased to 36.1% at 17 years of age, showing a growing and significant linear trend. Overall, no differences were found between males and females. The personality profile of those involved in sexting was characterized by higher Extraversion and Neuroticism and by lower scores in Conscientiousness and Agreeableness.	Given its high prevalence, beyond adopting a perspective based on the dangers of sexting, an educational approach that emphasizes responsible and informed use of information and communication technologies is necessary.	
28125824	Improvement in hospital transitional care has become a major national priority, although the impact on children's postdischarge outcomes is unclear.To characterize common handoff practices between hospital and primary care providers (PCPs), and test the hypothesis that common handoff practices would be associated with fewer unplanned readmissions.	This prospective cohort study enrolled randomly selected pediatric patients during an acute hospitalization at a tertiary children's hospital in 2012-2014.	Primary care and patient data were abstracted from administrative, caregiver, and PCP questionnaires on admission through 30 days postdischarge. The primary outcome was 30-day unplanned readmission to any hospital. Logistic regression assessed relationships between readmissions and 11 handoff communication practices.	We enrolled 701 children, from which 685 identified PCPs. Complete data were collected from 84% of PCPs. Communication practices varied widely--verbal handoffs occurred rarely (10.7%); PCP notification of admission occurred for 50.8%. Caregiver experience scores, using an adapted Care Transitions Measure-3, were high but were unrelated to readmissions. Thirty-day unplanned readmissions to any hospital were unrelated to most handoff practices. Having PCP follow-up appointments scheduled prior to discharge was associated with more readmissions (adjusted odds ratio, 2.20; 95% confidence interval, 1.08-4.46).	Despite their presumed value, common handoff practices between hospital providers and PCPs may not lead to reductions in postdischarge utilization for children. Addressing broader constructs like caregiver self-efficacy or social determinants is likely necessary. Journal of Hospital Medicine 2017;12:29-35.	
28125721	We study the situation where the members of a community have the choice to participate in the completion of a common task. The process of completing the task involves only costs and no benefits to the individuals that participate in this process. However, completing the task results in changes that significantly benefit the community and that exceed the participation efforts. A task completion social dilemma arises when the short-term participation costs dissipate any interest in the community members to contribute to the task completion process and therefore to obtain the benefits that result from completing the task. In this work, we model the task completion problem using a dynamical system that characterizes the participation dynamics in the community and the task completion process. We show how this model naturally allows for the incorporation of several mechanisms that facilitate the emergence of cooperation and that have been studied in previous research on social dilemmas, including communication across a network, and indirect reciprocity through relative reputation. We provide mathematical analyses and computer simulations to study the qualitative properties of the participation dynamics in the community for different scenarios.
28125452	The 2014 World Health Organization Classification of Tumors of Female Reproductive Organs endorsed the new category of seromucinous carcinoma, a neoplasm that exhibits morphologic and immunophenotypic overlap with other histotypes of ovarian carcinoma. The goal of this study was to determine whether seromucinous carcinoma was a distinct histotype by assessing its diagnostic reproducibility and comparing its molecular composition to the 5 major histotypes of ovarian carcinoma. Thirty-two tumors diagnosed as seromucinous carcinomas from 2 centers were studied. Eighteen cases were randomly selected for a review set comprising a total of 50 ovarian carcinomas of various histotypes. Morphologic histotype was independently assessed by 4 pathologists. For the 32 seromucinous carcinomas, a histotype-specific immunophenotype was assigned using a diagnostic immunohistochemical panel. Histotype-specific genotype was assigned using a combination of immunohistochemistry and targeted next-generation sequencing for somatic mutations, including genes recurrently mutated in ovarian carcinomas. There was low to modest agreement between pathologists with the reference diagnosis of seromucinous carcinoma, ranging from 39% to 56% for the 4 observers. The immunophenotype was not unique but overlapped predominantly with endometrioid and to a lesser extent with mucinous and low-grade serous carcinoma. Genomic and immunohistochemical alterations were detected in a number of target genes, including KRAS (70%), PIK3CA (37%), PTEN (19%), and ARID1A (16%); no CTNNB1 mutations were identified. Nine cases (30%) harbored concurrent KRAS/PIK3CA mutations. An endometrioid genotype was assigned to 19 cases, a low-grade serous genotype to 9, and a mucinous genotype to 1 and 3 cases were uninformative. Integrating morphology, immunophenotype, and genotyping resulted in reclassifying the seromucinous carcinomas to endometrioid 23/32 (72%), low-grade serous 8/32 (25%), and mucinous 1/32 (3%). The morphologic diagnosis of seromucinous carcinomas is not very reliable and it does not exhibit a distinct immunophenotype or genotype. The molecular features overlap mostly with endometrioid and low-grade serous carcinomas. Our data suggest the category of seromucinous carcinoma be discontinued as ancillary molecular tests can assign cases to one of the major histotypes.
28125439	Cornelia de Lange syndrome (CdLS) is a rare genetic syndrome with clinical manifestations due to multiple affected organ systems including limbs, gastrointestinal, skin, and central nervous systems. Although the genetic basis of CdLS is now uncovered, how behavioral manifestations are associated with genetic and brain differences are less well understood. The current focused review systematically describes the main behavioral observations to date in individuals with CdLS, which have a significant impact on quality of life and adaptive functioning.The CdLS behavioral phenotype includes autistic traits as a prominent feature; however, brain imaging studies, required to understand gene-brain-behavior connections in CdLS, are scarce. Moreover, autistic features in CdLS have a greater emphasis on repetitive behaviors, including self-injurious behaviors (SIB) and expressive communication deficits, different that the core social deficit seen in idiopathic autism. Current data strongly support the use of CdLS as a model disease for repetitive behaviors and associated developmental delay manifestations.	Behavioral phenotype characteristics in CdLS point to a preponderance of repetitive clinical phenomena as well as expressive verbal deficits that ought to inform specific treatment approaches in CdLS. In particular, repetitive behaviors associated with self-injury are of high negative impact on the quality of life for individuals with CdLS and their families. Treatment approaches geared to manage repetitive behaviors and self-injurious behaviors in CdLS are required in this developmental condition.	
28125422	This paper explores participatory design walks (PD walks) as a first step toward a participatory design of health information technology (HIT) aimed at tackling health inequality in a neighbourhood identified as a high-risk health area. Existing research shows that traditional methods for health promotion, such as campaigns and teaching, have little to no effect in high-risk health areas. Rather, initiatives must be locally anchored - integrated into the local culture, and based on social relationships and group activities. This paper explains how we conducted PD walks with residents and community workers in the neighbourhood and how this participatory approach supported a first step toward HIT design that tackles health inequality. This is important, as people in neighbourhoods with high health risks are not the target audience for the health technology innovation currently taking place despite the fact that this group suffers the most from health inequality and weigh most on the public healthcare services and costs. The study identifies social and cultural aspects that influence everyday health management and presents how a citizen-driven approach like PD walks, can contribute valuable insights for design of HIT. The paper provides concrete methodological recommendations on how to conduct PD walks that are valuable to HIT designers and developers who aim to do PD with neighbourhoods.
28124443	To identify the impact of a full suite of health information technology (HIT) on the relationships that support safety and quality among intensive care unit (ICU) clinicians.A year-long comparative ethnographic study of three academic ICUs was carried out. A total of 446 hours of observational data was collected in the form of field notes. A subset of these observations-134 hours-was devoted to job-shadowing individual clinicians and conducting a time study of their HIT usage.	Significant variation in HIT implementation rates and usage was noted. Average HIT use on the two "high-use" ICUs was 49 percent. On the "low-use" ICU, it was 10 percent. Clinicians on the high-use ICUs experienced "silo" effects with potential safety and quality implications. HIT work was associated with spatial, data, and social silos that separated ICU clinicians from one another and their patients. Situational awareness, communication, and patient satisfaction were negatively affected by this siloing.	HIT has the potential to accentuate social and professional divisions as clinical communications shift from being in-person to electronically mediated. Socio-technically informed usability testing is recommended for those hospitals that have yet to implement HIT. For those hospitals already implementing HIT, we suggest rapid, locally driven qualitative assessments focused on developing solutions to identified gaps between HIT usage patterns and organizational quality goals.	
28123646	The present research investigates whether spontaneous trait inferences occur under conditions characteristic of social media and networking sites: nonextreme, ostensibly self-generated content, simultaneous presentation of multiple cues, and self-paced browsing. We used an established measure of trait inferences (false recognition paradigm) and a direct assessment of impressions. Without being asked to do so, participants spontaneously formed impressions of people whose status updates they saw. Our results suggest that trait inferences occurred from nonextreme self-generated content, which is commonly found in social media updates (Experiment 1) and when nine status updates from different people were presented in parallel (Experiment 2). Although inferences did occur during free browsing, the results suggest that participants did not necessarily associate the traits with the corresponding status update authors (Experiment 3). Overall, the findings suggest that spontaneous trait inferences occur on social media. We discuss implications for online communication and research on spontaneous trait inferences.
28122648	Autism spectrum disorders (ASD) are complex neurobiological disorders that impair social interactions and communication and lead to restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. The causes of these disorders remain poorly understood, but gut microbiota, the 1013 bacteria in the human intestines, have been implicated because children with ASD often suffer gastrointestinal (GI) problems that correlate with ASD severity. Several previous studies have reported abnormal gut bacteria in children with ASD. The gut microbiome-ASD connection has been tested in a mouse model of ASD, where the microbiome was mechanistically linked to abnormal metabolites and behavior. Similarly, a study of children with ASD found that oral non-absorbable antibiotic treatment improved GI and ASD symptoms, albeit temporarily. Here, a small open-label clinical trial evaluated the impact of Microbiota Transfer Therapy (MTT) on gut microbiota composition and GI and ASD symptoms of 18 ASD-diagnosed children.MTT involved a 2-week antibiotic treatment, a bowel cleanse, and then an extended fecal microbiota transplant (FMT) using a high initial dose followed by daily and lower maintenance doses for 7-8 weeks. The Gastrointestinal Symptom Rating Scale revealed an approximately 80% reduction of GI symptoms at the end of treatment, including significant improvements in symptoms of constipation, diarrhea, indigestion, and abdominal pain. Improvements persisted 8 weeks after treatment. Similarly, clinical assessments showed that behavioral ASD symptoms improved significantly and remained improved 8 weeks after treatment ended. Bacterial and phagedeep sequencing analyses revealed successful partial engraftment of donor microbiota and beneficial changes in the gut environment. Specifically, overall bacterial diversity and the abundance of Bifidobacterium, Prevotella, and Desulfovibrio among other taxa increased following MTT, and these changes persisted after treatment stopped (followed for 8 weeks).	This exploratory, extended-duration treatment protocol thus appears to be a promising approach to alter the gut microbiome and virome and improve GI and behavioral symptoms of ASD. Improvements in GI symptoms, ASD symptoms, and the microbiome all persisted for at least 8 weeks after treatment ended, suggesting a long-term impact.	
28121094	The feedback of patient-reported outcome measures (PROMs) data is intended to support the care of individual patients and to act as a quality improvement (QI) strategy.To (1) identify the ideas and assumptions underlying how individual and aggregated PROMs data are intended to improve patient care, and (2) review the evidence to examine the circumstances in which and processes through which PROMs feedback improves patient care.	Two separate but related realist syntheses: (1) feedback of aggregate PROMs and performance data to improve patient care, and (2) feedback of individual PROMs data to improve patient care.	Aggregate – feedback and public reporting of PROMs, patient experience data and performance data to hospital providers and primary care organisations. Individual – feedback of PROMs in oncology, palliative care and the care of people with mental health problems in primary and secondary care settings.	Aggregate – providers’ responses, attitudes and experiences of using PROMs and performance data to improve patient care. Individual – providers’ and patients’ experiences of using PROMs data to raise issues with clinicians, change clinicians’ communication practices, change patient management and improve patient well-being.	Searches of electronic databases and forwards and backwards citation tracking.	Realist synthesis to identify, test and refine programme theories about when, how and why PROMs feedback leads to improvements in patient care.	Providers were more likely to take steps to improve patient care in response to the feedback and public reporting of aggregate PROMs and performance data if they perceived that these data were credible, were aimed at improving patient care, and were timely and provided a clear indication of the source of the problem. However, implementing substantial and sustainable improvement to patient care required system-wide approaches. In the care of individual patients, PROMs function more as a tool to support patients in raising issues with clinicians than they do in substantially changing clinicians’ communication practices with patients. Patients valued both standardised and individualised PROMs as a tool to raise issues, but thought is required as to which patients may benefit and which may not. In settings such as palliative care and psychotherapy, clinicians viewed individualised PROMs as useful to build rapport and support the therapeutic process. PROMs feedback did not substantially shift clinicians’ communication practices or focus discussion on psychosocial issues; this required a shift in clinicians’ perceptions of their remit.	There was a paucity of research examining the feedback of aggregate PROMs data to providers, and we drew on evidence from interventions with similar programme theories (other forms of performance data) to test our theories.	PROMs data act as ‘tin openers’ rather than ‘dials’. Providers need more support and guidance on how to collect their own internal data, how to rule out alternative explanations for their outlier status and how to explore the possible causes of their outlier status. There is also tension between PROMs as a QI strategy versus their use in the care of individual patients; PROMs that clinicians find useful in assessing patients, such as individualised measures, are not useful as indicators of service quality.	Future research should (1) explore how differently performing providers have responded to aggregate PROMs feedback, and how organisations have collected PROMs data both for individual patient care and to improve service quality; and (2) explore whether or not and how incorporating PROMs into patients’ electronic records allows multiple different clinicians to receive PROMs feedback, discuss it with patients and act on the data to improve patient care.	This study is registered as PROSPERO CRD42013005938.	The National Institute for Health Research Health Services and Delivery Research programme.	
28122403	The aim of this study was to explore the perceptions of health care among persons living with inflammatory bowel disease.The quality of care plays an important role in the life of persons with a chronic disease. To define what persons with inflammatory bowel disease perceive as high-quality care, greater focus must be placed on the individual's own perspective of living with the condition.	A qualitative exploratory study was conducted based on focus groups.	Five focus groups were conducted with adult persons living with inflammatory bowel disease, 14 men and 12 women aged 19-76 years. The interviews were performed between January-June 2014.	The perceptions of health care from the perspective of persons living with inflammatory bowel disease were summarised in two categories: 'professional attitudes of healthcare staff' and 'structure of the healthcare organisation'. Persons with inflammatory bowel disease want to be encountered with respect, experience trust and obtain information at the right time. They also expect shared decision-making, communication and to encounter competent healthcare professionals. Furthermore, the expectations on and perceptions of the structure of the healthcare organisation comprise access to care, accommodation, continuity of care, as well as the pros and cons of specialised care.	The findings show the importance of establishing a respectful and trusting relationship, facilitating healthcare staff and persons with inflammatory bowel disease to work as a team in fulfilling individual care needs - but there is room for improvement in terms of quality of care.	A person-centred approach, which places the individual and her/his family at the centre, considering them experts on their own health and enabling them to collaborate with healthcare staff, seems important to reach a high-quality healthcare organisation for patients with Inflammatory bowel disease.	
28122207	The weight of evidence points to the advertising of food affecting food consumption, especially among children. Such advertising often promotes unhealthy foods. Current policy deliberations focus on developing effective 'protective' messages to increase advertising literacy and consequent scepticism about advertising targeting children. This study examined whether incorporating a 'protective' message in an advergame promoting energy-dense snacks would reduce children's snack intake. A randomized between-subject design was conducted in the Netherlands (N = 215) and Spain (N = 382) with an advergame promoting either energy-dense snacks or nonfood products. The results showed that playing an advergame promoting energy-dense snacks increased caloric intake in both countries, irrespective of whether the 'protective' message was present or not. These results point to the limitations of 'protective' messages and advertising literacy and provide policy makers with a rationale for extending the current prohibition of food advertising to young children in the terrestrial media to online environments.
28122155	The aim of this study was to explore the support worker functions in community mental health teams for older adults in relation to roles, boundaries, supervision and training.Support workers in community mental health teams provide important help to older people with complex mental and physical health needs in their own homes. Their numbers have grown substantially in recent years, but without professional registration there is concern that boundaries with qualified practitioners are insufficiently clear and that they do not receive the support they require.	Qualitative research using interview data and thematic framework analysis investigated support workers' and registered practitioners' perspectives on roles, boundaries, supervision and training.	Semi-structured face-to-face interviews were undertaken in 2011, with 42 members of nine teams spread across England, including support workers and community mental health nurses. Coding of transcribed audio-recordings and subsequent analysis was undertaken by four researchers.	Support workers undertook diverse roles and had considerable autonomy over their duties. Participants agreed about what tasks support workers should not undertake, yet there was evidence of 'negotiated' boundaries and examples of these being breached. Lines of authority were complex, yet support workers were supported through open communication with the wider team. Training was problematic, with few courses tailored for support workers and efforts towards formal qualification hindered by low pay and time pressures.	Local and national attention is needed to prevent 'drift' into activities that both support workers and registered practitioners consider outside their remit. Barriers to training and further qualification need to be addressed.	
28121856	Despite research supporting improved psychosocial well-being, quality of life, and survival for patients undergoing postmastectomy breast reconstruction, Asian patients remain one-fifth as likely as Caucasians to choose reconstruction. This study investigates cultural factors, values, and perceptions held by Asian women that might impact breast reconstruction rates.The authors conducted semistructured interviews of immigrant East Asian women treated for breast cancer in the New York metropolitan area, investigating social structure, culture, attitudes toward surgery, and body image. Three investigators independently coded transcribed interviews, and then collectively evaluated them through axial coding of recurring themes.	Thirty-five immigrant East Asian women who underwent surgical treatment for breast cancer were interviewed. Emerging themes include functionality, age, perceptions of plastic surgery, inconvenience, community/family, fear of implants, language, and information. Patients spoke about breasts as a function of their roles as a wife or mother, eliminating the need for breasts when these roles were fulfilled. Many addressed the fear of multiple operations. Quality and quantity of information, and communication with practitioners, impacted perceptions about treatment. Reconstructive surgery was often viewed as cosmetic. Community and family played a significant role in decision-making.	Asian women are statistically less likely than Caucasians to pursue breast reconstruction. This is the first study to investigate culture-specific perceptions of breast reconstruction. Results from this study can be used to improve cultural competency in addressing patient concerns. Improving access to information regarding treatment options and surgical outcomes may improve informed decision-making among immigrant Asian women.	
28121464	Integrating uses and gratifications theory and the cognitive/communication mediation model: this study examines Chinese students' use of social media and subsequent impact on political participation. An integrative framework is proposed where media use, political expression, and political cognitions (efficacy and knowledge) play important mediating roles between audience motivations and participation. Structural equation analyses showed support for the integrated model. Guidance and social utility motivations exhibited different indirect effects on online and offline participation through social media news, discussion, and political efficacy. Entertainment motivations exhibited no direct or indirect effects. Contrary to expectations and previous literature, surveillance motivations exhibited negative direct and indirect effects on offline participation, which may be attributed to the particular Chinese social and political context. Implications of the findings are discussed.
28121245	Hearing loss is a barrier to speech and social and cognitive development. This can be especially pronounced in children living in low- and middle-income countries with limited resources.To determine the feasibility, durability and social impact of ComCare GLW solar-powered hearing aids provided for Vietnamese children with hearing impairment.	A retrospective review of data from an international, multi-discipline humanitarian visit was performed. Hearing aids were given to 28 children enrolled at the Khoai Chau Functional Rehabilitation School, Hung Yen Province, Vietnam. Device inspection and observational assessments were performed by teachers using a modified Parents' Evaluation of Aural/Oral Performance of Children and an Infant Hearing Program Amplification Benefit Questionnaire. Qualitative interviews were undertaken to assess the study aims.	Hearing aids were well tolerated for use during regular school hours. All units remained functional during the study period (12 months). Teachers noted increased student awareness and responsiveness to surrounding sounds, but the degree of response to amplification varied between children. There was no significant improvement in speech development as all subjects had prelingual deafness. Teachers felt confident in troubleshooting any potential device malfunction.	A solar-powered hearing aid may be a viable option for children in low- and middle-income countries. This study demonstrates that device distribution, maintenance and function can be established in countries with limited resources, while providing feasibility data to support future studies investigating how similar devices may improve the quality of life of those with hearing loss.	
28121173	Augmentative and alternative communication (AAC) social media research is relatively new, and is built on a foundation of research on use of the Internet and social media by people with communication disabilities. Although the field is expanding to include a range of people who use AAC, there are limitations and gaps in research that will need to be addressed in order to keep pace with the rapid evolution of social media connectivity in assistive communication technologies. In this paper, we consider the aims, scope, and methodologies of AAC social media research, with a focus on social network sites. Lack of detailed attention to specific social network sites and little use of social media data limits the extent to which findings can be confirmed. Increased use of social media data across a range of platforms, including Instagram and YouTube, would provide important insights into the lives of people who use AAC and the ways in which they and their supporters use social media. New directions for AAC social media research are presented in line with those discussed at the social media research symposium at the International Society for Augmentative and Alternative Communication in Toronto, Canada, on August 12, 2016.
28121021	Dysarthria is an acquired speech disorder following neurological injury that reduces intelligibility of speech due to weak, imprecise, slow and/or unco-ordinated muscle control. The impact of dysarthria goes beyond communication and affects psychosocial functioning. This is an update of a review previously published in 2005. The scope has been broadened to include additional interventions, and the title amended accordingly.To assess the effects of interventions to improve dysarthric speech following stroke and other non-progressive adult-acquired brain injury such as trauma, infection, tumour and surgery.	We searched the Cochrane Stroke Group Trials Register (May 2016), CENTRAL (Cochrane Library 2016, Issue 4), MEDLINE, Embase, and CINAHL on 6 May 2016. We also searched Linguistics and Language Behavioral Abstracts (LLBA) (1976 to November 2016) and PsycINFO (1800 to September 2016). To identify further published, unpublished and ongoing trials, we searched major trials registers: WHO ICTRP, the ISRCTN registry, and ClinicalTrials.gov. We also handsearched the reference lists of relevant articles and contacted academic institutions and other researchers regarding other published, unpublished or ongoing trials. We did not impose any language restrictions.	We selected randomised controlled trials (RCTs) comparing dysarthria interventions with 1) no intervention, 2) another intervention for dysarthria (this intervention may differ in methodology, timing of delivery, duration, frequency or theory), or 3) an attention control.	Three review authors selected trials for inclusion, extracted data, and assessed risk of bias. We attempted to contact study authors for clarification and missing data as required. We calculated standardised mean difference (SMD) and 95% confidence interval (CI), using a random-effects model, and performed sensitivity analyses to assess the influence of methodological quality. We planned to conduct subgroup analyses for underlying clinical conditions.	We included five small trials that randomised a total of 234 participants. Two studies were assessed as low risk of bias; none of the included studies were adequately powered. Two studies used an attention control and three studies compared to an alternative intervention, which in all cases was one intervention versus usual care intervention. The searches we carried out did not find any trials comparing an intervention with no intervention. The searches did not find any trials of an intervention that compared variations in timing, dose, or intensity of treatment using the same intervention. Four studies included only people with stroke; one included mostly people with stroke, but also those with brain injury. Three studies delivered interventions in the first few months after stroke; two recruited people with chronic dysarthria. Three studies evaluated behavioural interventions, one investigated acupuncture and another transcranial magnetic stimulation. One study included people with dysarthria within a broader trial of people with impaired communication.Our primary analysis of a persisting (three to nine months post-intervention) effect at the activity level of measurement found no evidence in favour of dysarthria intervention compared with any control (SMD 0.18, 95% CI -0.18 to 0.55; 3 trials, 116 participants, GRADE: low quality, I² = 0%). Findings from sensitivity analysis of studies at low risk of bias were similar, with a slightly wider confidence interval and low heterogeneity (SMD 0.21, 95% CI -0.30 to 0.73, I² = 32%; 2 trials, 92 participants, GRADE: low quality). Subgroup analysis results for stroke were similar to the primary analysis because few non-stroke participants had been recruited to trials (SMD 0.16, 95% CI -0.23 to 0.54, I² = 0%; 3 trials, 106 participants, GRADE: low quality).Similar results emerged from most of the secondary analyses. There was no evidence of a persisting effect at the impairment (SMD 0.07, 95% CI -0.91 to 1.06, I² = 70%; 2 trials, 56 participants, GRADE: very low quality) or participation level (SMD -0.11, 95% CI -0.56 to 0.33, I² = 0%; 2 trials, 79 participants, GRADE: low quality) but substantial heterogeneity on the former. Analyses of immediate post-intervention outcomes provided no evidence of any short-term benefit on activity (SMD 0.29, 95% CI -0.07 to 0.66, I² = 0%; 3 trials, 117 participants, GRADE: very low quality); or participation (SMD -0.24, 95% CI -0.94 to 0.45; 1 study, 32 participants) levels of measurement.There was a statistically significant effect favouring intervention at the immediate, impairment level of measurement (SMD 0.47, 95% CI 0.02 to 0.92, P = 0.04, I² = 0%; 4 trials, 99 participants, GRADE: very low quality) but only one of these four trials had a low risk of bias.	We found no definitive, adequately powered RCTs of interventions for people with dysarthria. We found limited evidence to suggest there may be an immediate beneficial effect on impairment level measures; more, higher quality research is needed to confirm this finding.Although we evaluated five studies, the benefits and risks of interventions remain unknown and the emerging evidence justifies the need for adequately powered clinical trials into this condition.People with dysarthria after stroke or brain injury should continue to receive rehabilitation according to clinical guidelines.	
28120803	Over the years, vocal matching has progressed beyond being an interesting behavioural phenomenon to one that now has relevance to a wide range of fields. In this review, we use birds and cetaceans to explain what vocal matching is, why animals vocally match and how vocal matching can be identified. We show that while the functional aspects of vocal matching are similar, the contexts in which matching is used can differ between taxa. Whereas vocal matching in songbirds facilitates mate attraction and the immediate defence of resources, in parrots and cetaceans it plays a role in the maintenance of social bonds and the promotion of behavioural synchrony. We propose criteria for defining vocal matching with the aim of stimulating more matching studies across a wider range of taxa, including those using other, non-vocal, communication modalities. Finally, we encourage future studies to explore the importance of vocal learning in the development of vocal matching, and the information it may provide to third parties in the communication network.
28120586	Evaluation of communication abilities in the elderly is crucial for activities which will be performed to improve their quality of life. A valid and reliable questionnaire is needed for assessing communication abilities. We aimed to translate and validate the speech, spatial, and qualities of hearing scale (SSQ) in Iran. The forward-backward procedure was applied to translate the questionnaire from English into Persian. After linguistic validation and pilot study, a cross-sectional study was carried out, and psychometric properties of the Iranian version of the SSQ were tested. Number of 333 elderly individuals with impaired hearing completed the questionnaire. Number 48.3% were hearing aid users and 51.7% was not. Reliability was assessed by internal consistency (Cronbach's alpha) and test-retest analysis. Exploratory factor analysis was performed for extracting factor structure of the Persian version of SSQ. Confirmatory factor analysis was performed to compare different models of factor loadings. The Mean age of participants was 62.00 years (SD=9.58 years), and the mean SSQ score was 5.1 (SD=1.2, ranged: 3.17-6.27). Reliability evaluation revealed high internal consistency and good test- retest reliability. Cronbach's alpha coefficient was 0.96 and the Pierson Correlation at test-retest analysis was 0.73 for Quality of hearing factor, 0.88 for Spatial and o.73 for Speech understanding factor. The results of exploratory factor analysis (EFA) indicated a four-factor solution for P-SSQ that jointly accounted for 52.40% of the variance observed. Confirmatory factor analysis approved the three factor solution but proposed a possible fourth factor. The Iranian version of the SSQ has acceptable psychometric properties, and it will be helpful for assessing different kinds of communication abilities in the Iranian elderly population.
28120316	For more than a century researchers have used enculturated animals-those extensively trained or reared by humans-to explore the effects of learning and environment on the capacities for linguistic abilities outside of the human line. Unfortunately, due to many controversies, the findings of these studies frequently have been dismissed or outright ignored. However, experimental exploration of the capacities of nonhumans is the only option to determine which, if any, language-associated capacities are unique to humans. Researchers continue to publish findings from language projects that move our understanding forward, including descriptions of capacities, such as gestural comprehension, declarative communication, and categorization, that are frequently considered to be specific biological adaptations.
28120137	The purpose of this article is to provide reflections about the important and exciting opportunities for cancer education career advancement and professional development. Advancement in professional, personal, and career growth for clinicians and health professionals is critical to improve quality cancer care and updated health communication with patients and families. Valuable insights from my recent 2-year term as treasurer, Board of Directors, Cancer Patient Education Network, are shared inspiring others to build their rewarding professional development. The professional leadership opportunity gave me a new energy level to be invested in rapidly changing cancer education with so many diverse cancer education professionals. Professional cancer education associations are dedicated to advancing patient-centered care through professional networks. They create welcoming environments with significant networking and mentoring opportunities. Cancer education touches many lives, and the cancer education associations strongly support new advances. I encourage early or mid-career cancer education professionals to discover how their increased interest may spark leadership and inspire participation in our cancer education professional associations.
28119586	The present study used functional near-infrared spectroscopy (fNIRS) to measure 5- to 6-month-old infants' hemodynamic response in the prefrontal cortex (PFC) to visual stimuli differing in saliency and social value. Nineteen Japanese 5- to 6-month-old infants watched video clips of Peek-a-Boo (social signal) performed by an anime character (AC) or a human, and hand movements without social signal performed by an AC. The PFC activity of infants was measured by 22-channel fNIRS, while behaviors including looking time were recorded simultaneously. NIRS data showed that infants' hemodynamic responses in the PFC generally decreased due to these stimuli, and the decrease was most prominent in the frontopolar (FP), covering medial PFC (MPFC), when infants were viewing Peek-a-Boo performed by an AC. Moreover, the decrease was more pronounced in the dorsolateral PFC (DLPFC) when infants were viewing Peek-a-Boo performed by an AC than by a human. Accordingly, behavioral data revealed significantly longer looking times when Peek-a-Boo was performed by an AC than by a human. No significant difference between Peek-a-Boo and non-Peek-a-Boo conditions was observed in either measure. These findings indicate that infants at this age may prefer stimuli with more salient features, which may be more effective in attracting their attentions. In conjunction with our previous findings on responses to self-name calling in infants of similar age, we hypothesize that the dynamic function of the MPFC and its vicinity (as part of default mode network (DMN): enhanced by self-focused stimuli, attenuated by externally focused stimuli), which is consistently observed in adults, may have already emerged in 5- to 6-month-old infants.
28119216	Recent examinations of road safety communications, including anti-speeding advertisements, have considered the differential effects of positive and negative emotional appeals on driver behaviour. However, empirical evaluations of anti-speeding messages have largely relied on measures of viewers' reported intentions to comply with speed limits and the self-reported driving behaviour of viewers post-exposure, which might not be indicative of the direct effects that these messages have on real-world driving behaviour. The current research constitutes a first empirical evaluation of different real-world anti-speeding advertisements, as measured by their effects on young drivers' speeding behaviour, using a driving simulator. Licensed drivers (N=116) aged 17-25 years completed driving measures prior to, immediately following, and 7-10days after viewing one of four social marketing advertisements. Results indicated that young drivers' average driving speeds were modestly reduced immediately after they viewed an anti-speeding advertisement that depicted social consequences for speeding and employed a positive emotional appeal when compared to an emotion-matched control advertisement; however, this effect was not found for the anti-speeding advertisement depicting a crash. Interestingly, the results based on reported intentions to reduce speeding predicted the opposite pattern of results. However, there was no evidence that the immediate changes to speeding were maintained 7-10days later, and prompts during Phase 2 did not appear to have an effect. The implications of these findings for road safety advertisements targeting young drivers are discussed.
28119156	Chemosensory anxiety signals effectively prime motor responses related to withdrawal behavior, such as the startle reflex, in adult humans. As the reproductive status strongly affects the response to social chemosignals, the current study examined whether chemosensory anxiety signals would augment the startle response in prepubertal children as it does in adults. Using cotton pads, axillary sweat was collected from 28 men while waiting for an important oral examination (anxiety condition), and during ergometer training (sport control condition). Using a constant-flow olfactometer, sweat samples and pure cotton samples (cotton control) were presented to 10 prepubertal girls aged 9-13years (M=11.25, SD=1.25) for 3000ms during inhalation. White noise bursts of 102dB(A) served as startle probes, and startle responses were recorded via electromyography of the orbicularis oculi muscle. The girls showed larger startle amplitudes to probes presented in the context of chemosensory anxiety signals as compared to a context of sport control sweat (p<0.01) as well as cotton control (p<0.05). This effect was not attributable to differences in stimulus detection rates or stimulus hedonics. The results show that in prepubertal girls, similar to adults, chemosensory anxiety signals prime defensive motor behavior. This effect appears unrelated to the odorous quality of anxiety sweat, but seems to reflect a specific preparedness to respond to the underlying social alarm signal. Thus, chemosensory communication supporting individual harm protection is independent of the reproductive status in humans.
28119084	Communication is the act of information transfer between sender and receiver. In rats, vocal communication can be studied through ultrasonic vocalizations (USV). 50-kHz USV occur in appetitive situations, most notably juvenile play, likely expressing the sender׳s positive affective state. Such appetitive 50-kHz USV serve important pro-social communicative functions and elicit social exploratory and approach behavior in the receiver. Emission of 50-kHz USV can be induced pharmacologically by the administration of psychostimulant drugs, such as amphetamine. However, it is unknown whether amphetamine affects the pro-social communicative function of 50-kHz USV in the receiver. We therefore assessed dose-response effects of amphetamine (0.0mg/kg, 0.5mg/kg, 1.0mg/kg, 2.5mg/kg, 5.0mg/kg) on pro-social ultrasonic communication on both, sender and receiver, in juvenile rats. We found an inverted U-shaped effect of amphetamine on 50-kHz USV emission, with 50-kHz USV levels being strongly enhanced by moderate doses, yet less prominent effects were seen following the highest dose. Likewise, amphetamine exerted inverted U-shaped effects on social exploratory and approach behavior induced by playback of appetitive 50-kHz USV. Social approach was enhanced by moderate amphetamine doses, but completely abolished following the highest dose. Amphetamine further dose-dependently promoted the emission of 50-kHz USV following playback of appetitive 50-kHz USV, indicating more vigorous attempts to establish social proximity. Our results support an important role of dopamine in closing a perception-and-action-loop through linking mechanisms relevant for detection and production of social vocalizations. Moreover, our approach possibly provides a new means to study mania-like aberrant social interaction and communication in animal models for bipolar disorder.
28118967	A core role of the pharmacist is to ensure safe and effective medication use. Therapeutic classes that impair alertness (e.g. sedatives or hypnotics) can pose safety concerns for the consumer when undertaking activities requiring psychomotor vigilance (e.g. driving).To explore pharmacists' perceptions and communication strategy of the risks related to alertness impairing medications in clinical practice.	In-depth semi-structured interviews explored community pharmacists' perceptions of medication-related risks, current medication provision and the feasibility of new practice tools. Interviews were digitally recorded, transcribed verbatim and analysed using Framework Analysis to identify emergent themes. A Psychometric Risk Perception Questionnaire was also used to evaluate pharmacists' perceptions across 7 common psychotropic drug classes.	Synthesis of the qualitative dataset of 30 pharmacist interviews revealed three key themes: 'Safety and Consequences of AIMs', 'Factors that Influence Risk Communication' and 'Refining Risk Communication'. Participating pharmacists were generally aware of the therapeutic classes associated with medication-related risks but were concerned about patients' level of understanding. Counselling approaches were largely dictated by perceived patient interest/experience with a medication. Concerns were centred on inter-individual pharmacokinetic differences, which could make the precise risk assignment difficult. Pharmacists also highlighted workflow limitations and the need to bring patients' attention to these resources during the clinical interaction to maximise impact.	Medication-related risk communication is a complex clinical phenomenon dictated by patients' prior experiences and the pharmacists' practice environment. Extending the evidence base in this therapeutic area and refining clinical resources are key steps towards optimising patient medication safety.	
28118933	The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw.
28118024	Medical professionals are now relying on social media platforms like Twitter to express their recommendations for the use or avoidance of products like electronic cigarettes (e-cigs), which may have long-term health consequences for users. The goal of this study is to compare how physicians from the United States and the United Kingdom talk about e-cigs on Twitter and identify the topics that these groups perceive as salient. Comparing tweets from the U.S. and U.K. will allow for a better understanding of how medical professionals from these countries differ in their attitudes toward e-cigs. This information can be also used to inform policies designed to regulate the use of e-cigs. Using a text-mining program, we analyzed approximately 3,800 original tweets sent by physicians from the U.S. and the U.K. within a 1-year time span (June 2015 through June 2016). The program clustered the tweets by topics, which allowed us to categorize the topics by importance. Both sets of tweets contained debates about the degree to which e-cigs pose a threat to health, but the U.S. tweets emphasized the dangers of e-cig use for teens, while the U.K. tweets focused more on the potential that e-cigs have to be used as a smoking cessation aid. Doctors are using Twitter to share timely information about the potential risks, benefits, and regulations associated with e-cigs. Evaluating these tweets allows researchers to collect information about topics that doctors find important and make comparisons about how medical professionals from the U.S. and the U.K. regard e-cigs.
28117594	Social network sites (SNS) are a novel social environment for college students with psychological distress to connect with their peers, but the nature and effects of these interactions are not well understood. This study reports findings from a Facebook study among 238 college students reporting nonspecific psychological distress using the K-6 scale. Behavioral data included Facebook status updates containing affect words written by participants within the past 60 days and the number of responses (comments and likes) each update received. The updates were also coded for depression symptoms. Self-report data included participants' self-presentational concerns, the affective valence of each post, effects of responses on mood, and satisfaction with the responses to and outcome of each status update. Higher psychological distress was associated with displaying depression language on Facebook, with higher self-presentational concerns, and with less satisfaction with audiences' responses and less overall satisfaction with the outcome of the interaction. These results offer a unique glimpse into the social world of college students with psychological distress through their everyday use of Facebook, and how the interplay of this novel environment and students' mental health impacts their social behaviors and interaction meaning-making on Facebook.
28117563	Clinical research faces a reproducibility crisis. Many recent clinical and preclinical studies appear to be irreproducible--their results cannot be verified by outside researchers. This is problematic for not only scientific reasons but also legal ones: patents grounded in irreproducible research appear to fail their constitutional bargain of property rights in exchange for working disclosures of inventions. The culprit is likely patent law’s doctrine of enablement. Although the doctrine requires patents to enable others to make and use their claimed inventions, current difficulties in applying the doctrine hamper or even actively dissuade reproducible data in patents. This Article assesses the difficulties in reconciling these basic goals of scientific research and patent law. More concretely, it provides several examples of irreproducibility in patents on blockbuster drugs--Prempro, Xigris, Plavix, and Avastin--and discusses some of the social costs of the misalignment between good clinical practice and patent doctrine. Ultimately, this analysis illuminates several current debates concerning innovation policy. It strongly suggests that a proper conception of enablement should take into account after-arising evidence. It also sheds light on the true purpose--and limits--of patent disclosure. And lastly, it untangles the doctrines of enablement and utility.
28116967	This paper aims to review the evidence to support the effectiveness of sympathectomy as a treatment for facial blushing in terms of relief of facial blushing, patient satisfaction, recurrence of blushing, patients regretting treatment and its associated complications.A systematic search strategy was performed in Ovid-Medline, Embase, Cochrane library and NICE. Studies reporting outcomes of sympathetic interruption in the treatment of facial blushing were retrieved.	Nine studies met the inclusion criteria with 1369 patients included in the final analysis. The age range of patients was 8 to 74 years (from 7 studies) with 56% females. Mean follow up was 21 months in 8 studies (range 6 to 30 months). The pooled proportion of patients who had good relief of facial blushing was 78.30% (95% C.I. 58.20% - 98.39%). Complete satisfaction was reported in 84.02% (95% C.I. 71.71% - 96.33%). Compensatory sweating and gustatory sweating were the commonest complications occurring in 74.18% (95% C.I. 58.10% - 90.26%) and 24.42% (95% C.I. 12.22% - 36.61%) respectively. The estimated proportion of patients regretting surgery was 6.79% (C.I 2.08% 11.50%).	Sympathetic interruption at T2 or T2-3 ganglia appears to be an effective treatment for facial blushing. However, lack of randomized trials comparing sympathetic interruption with non-surgical methods of treatment and heterogeneity of included studies with respect to assessment of outcome measures preclude strong evidence and definitive recommendations.	
28116774	Primary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities.To identify proposals to approach HP in the context of primary care according to health-care users aged 45-75 years, key community informants and primary care centre (PCC) workers.	Descriptive-interpretive qualitative research with 276 participants from 14 PCC of seven Spanish regions. A theoretical sampling was used for selection. A total of 25 discussion groups, two triangular groups and 30 semi-structured interviews were carried out. A thematic interpretive contents analysis was carried out.	Participants consider that HP is not solely a matter for the health sector and they emphasize intersectoral collaboration. They believe that it is important to strengthen community initiatives and to create a healthy social environment that encourages greater responsibility and participation of health-care users in decisions regarding their own health and better management of public services and resources. HP, care in the community and demedicalization should be priorities for PHC. Participants propose organizational changes in the PCC to improve HP. PCC workers are aware that HP falls within the scope of their responsibilities and propose to increase their training, motivation, competences and knowledge of the social environment. Informants emphasize that HP should be person-centred approach and empathic communication. HP activities should be appealing, ludic and of proven effectiveness.	According to a socio-ecological and intersectoral model, PHC services must get actively involved in HP together with community and through outreach interventions.	
28116636	We sought to explore clinical factors associated with successful transition from Assertive Community Treatment to less intensive clinical services. Mixed-method observational follow up study of veterans discharged from three VA-affiliated ACT teams to less intensive clinical services. Of the 240 veterans in ACT, 9% (n = 21) were discharged during the study period. Among the 11 of 21 discharged veterans who enrolled in the follow up study, reason for discharge, designated by the veteran's primary clinician at the time of discharge, predicted outcomes (p = 0.02) at 9 months, with "disengagement" as a reason for discharge predicting poorer outcomes. Six of 11 veterans experienced poor outcomes at 9 months, including incarceration and substance use relapse. ACT clinicians rarely discharge clients. Many clients may experience negative clinical events following ACT discharge, and clients may be difficult to follow post-discharge. Client disengagement from ACT may indicate higher likelihood of poor outcomes following discharge to less intensive clinical services.
28115912	High levels of work-related stress, burnout, job dissatisfaction, and poor health are common within the nursing profession. A comprehensive understanding of nurses' psychosocial work environment is necessary to respond to complex patients' needs. The aims of this study were threefold: (1) To retest and confirm two structural equation models exploring associations between practice environment and work characteristics as predictors of burnout (model 1) and engagement (model 2) as well as nurse-reported job outcome and quality of care; (2) To study staff nurses' and nurse managers' perceptions and experiences of staff nurses' workload; (3) To explain and interpret the two models by using the qualitative study findings.This mixed method study is based on an explanatory sequential study design. We first performed a cross-sectional survey design in two large acute care university hospitals. Secondly, we conducted individual semi-structured interviews with staff nurses and nurse managers assigned to medical or surgical units in one of the study hospitals. Study data was collected between September 2014 and June 2015. Finally, qualitative study results assisted in explaining and interpreting the findings of the two models.	The two models with burnout and engagement as mediating outcome variables fitted sufficiently to the data. Nurse-reported job outcomes and quality of care explained variances between 52 and 62%. Nurse management at the unit level and workload had a direct impact on outcome variables with explained variances between 23 and 36% and between 12 and 17%, respectively. Personal accomplishment and depersonalization had an explained variance on job outcomes of 23% and vigor of 20%. Burnout and engagement had a less relevant direct impact on quality of care (≤5%). The qualitative study revealed various themes such as organisation of daily practice and work conditions; interdisciplinary collaboration, communication and teamwork; staff nurse personal characteristics and competencies; patient centeredness, quality and patient safety. Respondents' statements corresponded closely to the models' associations.	A deep understanding of various associations and impacts on studied outcome variables such as risk factors and protective factors was gained through the retested models and the interviews with the study participants. Besides the softer work characteristics - such as decision latitude, social capital and team cohesion - more insight and knowledge of the hard work characteristic workload is essential.	
28115459	To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly.Qualitative study of interviews.	A fall prevention clinic in Calgary, Alta.	Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them.	Participants' stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients' additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed.	The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues.	The addition of patient narratives to clinical assessments offers clinicians an understanding of patients' perspectives, which can be used to better engage patients in rehabilitation.	
28114769	In this study, we developed and tested a common factors feedback (CFF) system. The CFF system was designed to provide ongoing feedback to clients and therapists about client ratings of three common factors: (a) outcome expectations, (b) empathy, and (c) the therapeutic alliance. We evaluated the CFF system using randomized, clinical trial (RCT) methodology.Clients were 79 undergraduates who reported mild, moderate, or severe depressive symptoms at screening and pretreatment assessments. These clients were randomized to either: (a) treatment as usual (TAU) or (b) treatment as usual plus the CFF system (TAU + CFF). Both conditions entailed 5 weekly sessions of evidence-based therapy delivered by doctoral students in clinical psychology. Clients completed measures of common factors (i.e., outcome expectations, empathy, therapeutic alliance) and outcome at each session. Clients and therapists in TAU + CFF received feedback on client ratings of common factors at the beginning of Sessions 2 through 5. When surveyed, clients and therapists indicated that that they were satisfied with the CFF system and found it useful. Multilevel modeling revealed that TAU + CFF clients reported larger gains in perceived empathy and alliance over the course of treatment compared with TAU clients. No between-groups effects were found for outcome expectations or treatment outcome. These results imply that our CFF system was well received and has the potential to improve therapy process for clients with depressive symptoms. (PsycINFO Database Record	
28114681	The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits?This study used a phenomenological qualitative design. The researchers conducted 2 in-depth, semistructured interviews with 8 SLPs who specialized in AAC and self-identified as primarily working with children.	Four major themes emerged from the data: area of assessment, method of assessment, evaluation preparation, and parent education. Each major theme contained multiple subthemes and categories within those subthemes.	Participants discussed similar areas of assessment for both cases, indicating that some aspects of AAC assessment are universal. However, the specific aspects of what they were assessing and how they went about assessing them differed between the 2 cases. The results of the current study provide an outline of an assessment protocol for children with complex communication needs.	

28114376	Increasing numbers of young people with perinatally acquired HIV are surviving to adulthood. When they come of age, they leave pediatric services in which they were followed and have to be transferred to the adult health care system. Difficulties in adaptation to adult care and the numbers of young people lost to follow up after transfer to adult care have been reported. This transition phase and their retention in adult care are crucial in maintaining the clinical status of these young with HIV in adulthood. Our study aimed to explore how HIV professionals working in adult care perceive and adapt their practices to young people in transition.Qualitative interviews were conducted with 18 health and social services professionals in hospitals or patient associations in France. A thematic analysis was conducted.	Adult care professionals were found to be making a distinction between these young people and their patients who were infected during adulthood. On the basis of the healthcare teams' experience, a simplified categorization of these young people into four levels can be used: those "who have everything good"; those who have some deficiencies that must be addressed; those "who have everything bad"; and those lost to follow up. Professionals interviewed highlighted the difficulties they encountered with young people in transition. Three types of problematic situations were identified: problems of acceptance of the disease; communication problems; and problems of disorientation in the new care environment.	Despite the lack of specific training or national policy recommendations for the integration of young people with perinatally acquired HIV into adult services, all the adult healthcare teams interviewed tried to adapt their practice to this population. The results suggested that professional involvement during transition should depend on the characteristics of the patient, not be limited to a single transition model and that a dedicated structure for transition care is not appropriate for all young people.	
28114262	Spouses' ability to care for survivors can be particularly challenging because patients and spouses are interdependent and mutually influence one another. Family functioning such as family cohesion and communication may play a primary role in improving the health-related quality of life (HRQOL) of couples, given that cancer can influence family dynamics.The aims of this study were to investigate the mediating effect of family communication on the relationship between family cohesion and HRQOL and examine the moderating effect of sex on this relationship among cancer survivor-spouse dyads.	A total of 91 cancer survivors with a diagnosis of breast, colorectal, or prostate cancer and their spouses were recruited from the University Hospital Registry in Cleveland, Ohio. The dyadic data were analyzed using structural equation modeling with the actor-partner interdependence mediation model.	Findings demonstrated that the spouses' own perceived family communication mediated the associations between their own family cohesion and physical HRQOL and between the survivors' family cohesion and physical HRQOL. The spouse actor effects between family communication and HRQOL significantly differed by sex.	Enhancing family cohesion and communication within the family can improve the spouses' HRQOL. Findings regarding sex differences serve as a rationale for gender-based approaches to improving HRQOL in survivorship care in the family context.	Couple- and/or family-based interventions should be designed to enhance family cohesion and improve family communication skills for effective adjustments within couples and families. Supportive care within the family context can be promoted to address the diverse challenges of survivorship care.	
28114092	Telepsychiatry was introduced in the early 1950's for the provision of mental health services from a distance. In 1990 the progress made in telecommunications technologies caused a significant expansion in telepsychiatry services. It can refer to store and forward technologies, interactive technologies, remote monitoring technologies and it is applied to contribute to the lift of restrictions placed on providing mental health services. Restrictions may exist due to geographic isolation, lack of specialized services, high cost of moving patients etc. The positive cost-benefit analysis and the reliability of diagnosis and efficacy of interventions through telepsychiatry have been documented in various research papers referring to a wide range of contexts such as prisons, remote areas, general and psychiatric hospitals. Since 2003 the Mobile Mental Health Unit of South- Eastern (SE) Cyclades has been using videoconferencing in order to provide mental health services in thirteen islands. This area shares many of the characteristics of remote areas such as residential dispersion, lack of mental health services and frequent lack of access to services in urban centers. Telepsychiatry in conjunction with physical presence of professionals was launched by the Mobile Mental Health Unit in order to provide assistance to the evaluation of patients, to therapeutic interventions, to medicine prescription, to crisis intervention, to psychoeducation of patients and their families and to the implementation of educational and administrative activities . The use of existing technology in combination with the development of human resources has enabled continuity of care, crisis intervention and avoidance of involuntary hospitalization for a significant number of persons. Moreover, it has improved cooperation and coordination between the interdisciplinary team and local authorities and agencies. When professionals located in different parts are collaborating via telepsychiatry it is necessary to ensure that they have immediate and simultaneous access to data concerning the patient. This need is served by the electronic medical record that facilitates access to patient records, improves the quality of care, reduces the probability of making wrong decisions and contributes to the promotion of research and service evaluation. KLIMAKA's electronic medical record contains more than ten thousand cases of which 4544 are related to individuals served by the Mobile Mental Health Unit during the years 2003-2010. This article presents the basic functions and parameters of the electronic medical record, the applications of telepsychiatry in the whole range of services provided by the scientific staff and provides information on how human and technology resources are distributed to the branches of the Mobile Mental Health Unit of SE Cyclades.
28114071	Individuals with autism are often characterized by impairments in communication, reciprocal social interaction and explicit expression of their affective states. In conventional techniques, a therapist adjusts the intervention paradigm by monitoring the affective state e.g., anxiety of these individuals for effective floor-time-therapy. Conventional techniques, though powerful, are observation-based and face resource limitations. Technology-assisted systems can provide a quantitative, individualized rehabilitation platform. Presently-available systems are designed primarily to chain learning via aspects of one's performance alone restricting individualization. Specifically, these systems are not sensitive to one's anxiety. Our presented work seeks to bridge this gap by developing a novel VR-based interactive system with Anxiety-Sensitive adaptive technology. Specifically, such a system is capable of objectively identifying and quantifying one's anxiety level from real-time biomarkers, along with performance metrics. In turn it can adaptively respond in an individualized manner to foster improved social communication skills. In our present research, we have used Virtual Reality (VR) to design a proof-of-concept application that exposes participants to social tasks of varying challenges. Results of a preliminary usability study indicate the potential of our VR-based Anxiety-Sensitive system to foster improved task performance, thereby serving as a potent complementary tool in the hands of therapist.
28113949	Molecular communication (MC) is a new paradigm for developing communication systems that exchanges information through the transmission and reception of molecules. One proposed model for MC is using bacteria to carry information encoded into DNA plasmids, and this is termed bacterial nanonetworks. However, a limiting factor in the models that have been studied so far is the environment considered only in ideal conditions with a single population. This is far from realistic in natural environments, where bacteria co-exist in multiple populations of same and different species, resulting in a very complex social community. This complex community has social interactions that include cooperation, cheating, as well as competition. In this paper, the effects of these social interactions on the information delivery in bacterial nanonetworks are studied in terms of delay, attenuation and data rate. The numerical results show that the cooperative behavior of bacteria improves the performance of delay and attenuation leading to a higher data rate, and this performance can be degraded once their behavior switches towards cheating. The competitive social behavior shows that the performance can degrade delay as well as attenuation leading to slower data rates, as the population with the encoded DNA plasmids are prevented from reaching the receiver. The analysis of social interactions between the bacteria will pave the way for efficient design of bacterial nanonetworks enabling applications such as intra-body sensing, drug delivery, and environmental control against pollution and biological hazards.
28113672	The aging population with its concomitant medical conditions, physical and cognitive impairments, at a time of strained resources, establishes the urgent need to explore advanced technologies that may enhance function and quality of life. Recently, robotic technology, especially socially assistive robotics has been investigated to address the physical, cognitive, and social needs of older adults. Most system to date have predominantly focused on one-on-one human robot interaction (HRI). In this paper, we present a multi-user engagement-based robotic coach system architecture (ROCARE). ROCARE is capable of administering both one-on-one and multi-user HRI, providing implicit and explicit channels of communication, and individualized activity management for long-term engagement. Two preliminary feasibility studies, a one-on-one interaction and a triadic interaction with two humans and a robot, were conducted and the results indicated potential usefulness and acceptance by older adults, with and without cognitive impairment.
28112589	Although the use of telepractice in speech-language therapy for assessment purposes is well documented, its effectiveness and potential for rehabilitation in poststroke aphasia remain largely unknown. The purpose of this study was to investigate the effectiveness of a remotely delivered synchronous pragmatic telespeech language therapy for improving functional communication in aphasia.A pre-/post-test design was chosen in which each participant was his or her own control. Using a telerehabilitation platform and software (Oralys TeleTherapy) based on the Promoting Aphasics' Communicative Effectiveness (PACE) approach, 20 participants with chronic poststroke aphasia received 9 speech therapy sessions over a 3-week period.	Teletreatment with the PACE pragmatic rehabilitation approach led to improvements in functional communication, marked by (a) an increase in communication effectiveness, reflecting significantly improved autonomy in functional communication; (b) a decrease in communication exchange duration, meaning that the treatment made communication faster and more efficient; (c) a decrease in the number of communication acts, meaning that, after treatment, less information was needed to be efficiently understood by the communication partner; and (d) an increase in the number of different communication strategies used, meaning that the treatment fostered the use of a variety of alternative communication modes.	This study provides additional arguments about the benefits of telerehabilitation for poststroke patients with aphasia. It showed that multimodal language therapy delivered through synchronous telerehabilitation had positive effects on functional communication in chronic aphasia.	
28112551	To describe the choice-making abilities of girls and women with Rett syndrome.Females with Rett syndrome registered with the Australian Rett Syndrome Database with a pathogenic MECP2 mutation were included in this study. Video clips showing choice making in 64 females at a median age of 11.6 years (range 2.3-35.6 years) were analysed. Video clips were coded for the location and nature of the choice-making interaction, and the actions of the communication partner and female with Rett syndrome.	The majority (82.8%, 53/64) of females made a choice, most using eye gaze. Just under half (24/53) used one modality to communicate their choice, 52.8% used two modalities and one used three modalities. Of those who made a choice, 50% did so within 8 s. The length of time to make a choice did not appear to vary with age. During choice making, 57.8% (37/64) of communication partners used language and gestures, 39.1% (25/64) used only language and two used language, gestures and symbols within the interaction.	The provision of adequate time allowing for a response and observation for the use of multiple modalities could promote effective choice making in females with Rett syndrome. Implications for Rehabilitation The provision of adequate time allowing for a response will promote effective choice making in girls and women with Rett syndrome. Although almost all girls and women with Rett syndrome used eye gaze to indicate their choice, communication partners also need to recognise and respond to other communication modalities that are sometimes used like body movements.	
28112476	A number of interventions have been undertaken to develop and promote social networks among community-dwelling older adults. However, it has been difficult to examine the effects of these interventions, because of problems in assessing interactions. The present study was designed to quantitatively measure and visualize face-to-face interactions among elderly participants in an exercise program. We also examined relationships among interactional variables, personality and interest in community involvement, including interactions with the local community.Older adults living in the same community were recruited to participate in an exercise program that consisted of four sessions. We collected data on face-to-face interactions of the participants by using a wearable sensor technology device.	Network analysis identified the communication networks of participants in the exercise program, as well as changes in these networks. Additionally, there were significant correlations between the number of people involved in face-to-face interactions and changes in both interest in community involvement and interactions with local community residents, as well as personality traits, including agreeableness.	Social networks in the community are essential for solving problems caused by the aging society. We showed the possible applications of face-to-face interactional data for identifying core participants having many interactions, and isolated participants having only a few interactions within the community. Such data would be useful for carrying out efficient interventions for increasing participants' involvement with their community. Geriatr Gerontol Int 2017; ••: ••-••.	
28111901	Eavesdropping has evolved in many predator-prey relationships. Communication signals of social species may be particularly vulnerable to eavesdropping, such as pheromones produced by ants, which are predators of termites. Termites communicate mostly by way of substrate-borne vibrations, which suggest they may be able to eavesdrop, using two possible mechanisms: ant chemicals or ant vibrations. We observed termites foraging within millimetres of ants in the field, suggesting the evolution of specialised detection behaviours. We found the termite Coptotermes acinaciformis detected their major predator, the ant Iridomyrmex purpureus, through thin wood using only vibrational cues from walking, and not chemical signals. Comparison of 16 termite and ant species found the ants-walking signals were up to 100 times higher than those of termites. Eavesdropping on passive walking signals explains the predator detection and foraging behaviours in this ancient relationship, which may be applicable to many other predator-prey relationships.
28111564	Facial expressions constitute a rich source of non-verbal cues in face-to-face communication. They provide interlocutors with resources to express and interpret verbal messages, which may affect their cognitive and emotional processing. Contrarily, computer-mediated communication (CMC), particularly text-based communication, is limited to the use of symbols to convey a message, where facial expressions cannot be transmitted naturally. In this scenario, people use emoticons as paralinguistic cues to convey emotional meaning. Research has shown that emoticons contribute to a greater social presence as a result of the enrichment of text-based communication channels. Additionally, emoticons constitute a valuable resource for language comprehension by providing expressivity to text messages. The latter findings have been supported by studies in neuroscience showing that particular brain regions involved in emotional processing are also activated when people are exposed to emoticons. To reach an integrated understanding of the influence of emoticons in human communication on both socio-cognitive and neural levels, we review the literature on emoticons in three different areas. First, we present relevant literature on emoticons in CMC. Second, we study the influence of emoticons in language comprehension. Finally, we show the incipient research in neuroscience on this topic. This mini review reveals that, while there are plenty of studies on the influence of emoticons in communication from a social psychology perspective, little is known about the neurocognitive basis of the effects of emoticons on communication dynamics.
28110905	In this study researchers are trying to analyse the personality factors related to social skills in nurses who work in: Intensive Care Units, ICU, and Hospitalisation units. Both groups are from the Madrid Health Service (SERMAS).The present investigation has been developed as a descriptive transversal study, where personality factors in ICU nurses (n=29) and those from Hospitalisation units (n=40) were compared. The 16PF-5 questionnaire was employed to measure the personality factors associated with communication skills.	The comparison of the personality factors associated to social skills, communication, in both groups, show us that nurses from ICU obtain in social receptivity: 5,6 (A+), 5,2 (C-), 6,2 (O+), 5,1 (H-), 5,3 (Q1-), and emotional control: 6,1 (B+), 5,9 (N+). Meanwhile the data doesn't adjust to the expected to emotional and social expressiveness, emotional receptivity and social control, there are not evidence.	The personality factors associated to communication skills in ICU nurses are below those of hospitalisation unit nurses. The present results suggest the necessity to develop training actions, focusing on nurses from intensive care units to improve their communication social skills.	
28110883	Parent-reporting is needed to examine Quality of Life (QoL) of children with cerebral palsy (CP) across all severities. This study examines whether QoL changes between childhood and adolescence, and what predicts adolescent QoL.SPARCLE is a European cohort study of children with CP, randomly sampled from population databases. Of 818 8-12-year-olds joining the study, 594 (73%) were revisited as 13-17-year-olds. The subject of this report is the 551 (316 boys, 235 girls) where the same parent reported QoL on both occasions using KIDSCREEN-52 (transformed Rasch scale, mean 50, SD 10 per domain). Associations were assessed using linear regression.	Between childhood and adolescence, average QoL reduced in six domains (1.3-3.8 points, p<0.01) and was stable in three (Physical wellbeing, Autonomy, Social acceptance). Socio-demographic factors had little predictive value. Childhood QoL was a strong predictor of all domains of adolescent QoL. Severe impairments of motor function, IQ or communication predicted higher adolescent QoL on some domains; except that severe motor impairment predicted lower adolescent QoL on the Autonomy domain. More psychological problems and higher parenting stress in childhood and their worsening by adolescence predicted lower QoL in five and eight domains respectively; contemporaneous pain in seven domains. The final model explained 30%-40% of variance in QoL, depending on domain.	In general, impairment severity and socio-demographic factors were not predictors of lower adolescent QoL. However, pain, psychological problems and parenting stress were predictors of lower adolescent QoL in most domains. These are modifiable factors and addressing them may improve adolescent QoL.	
28110866	To examine the associations between weight status and structural and functional dimensions of social relations among 11- to 15-year-old girls and boys.Analyses were based on cross-sectional data from the Danish contribution to the international Health Behavior in School-aged Children study 2010. The study population (n = 4,922) included students in the fifth, seventh, and ninth grade from a representative sample of Danish schools. Multinomial logistic regression analyses were used to study the associations between weight status and social relations, supported by a conceptual framework for the study of social relations.	Among girls, overweight/obese weight status was associated with spending less time with friends after school compared to normal-weight status (0 days/week: odds ratio: 6.25, 95% confidence interval: 2.18-17.95, 1 day/week: 2.81, 1.02-7.77, 2 days/week: 3.27, 1.25-8.56, 3 days/week: 3.32, 1.28-8.61, and 4 days/week: 3.23, 1.17-8.92, respectively vs. 5 days/week). Among girls, overweight/obese weight status was associated with being bullied (2.62, 1.55-4.43). Among boys, overweight/obese weight status was associated with infrequent (1 to 2 days vs. every day) communication with friends through cellphones, SMS messages, or Internet (1.66, 1.03-2.67). In the full population, overweight/obese weight status was associated with not perceiving best friend as a confidant (1.59, 1.11-2.28). No associations were found between weight status and number of close same-sex and opposite-sex friends, mother/father as confidant, and perceived classmate acceptance.	This study shows that overweight/obese adolescents have higher odds of numerous poor social relations than their normal-weight peers both in terms of structural and functional dimensions of social relations.	
28110546	HIV-related stigma in the wider community compounds the suffering of people living with HIV (PLWH) and hampers effective HIV prevention and care. This study examines the level of public stigma toward PLWH in Hong Kong and associated social-cultural factors. A telephone survey was conducted in June-July 2016 with 1080 Chinese adults aged 18-94 randomly selected from the general population. The results indicate substantial degree of public stigma toward PLWH. Overall, 58.1% of the participants endorsed at least one statement indicating negative social judgment of PLWH. Over 40% attributed HIV infections to irresponsible behaviors and nearly 30% perceived most PLWH as promiscuous. About 20% considered HIV to be a punishment for bad behavior and believed that PLWH should feel ashamed of themselves. These statistics indicate that HIV-related stigma among the general Hong Kong population had no noticeable reduction in a decade but is lower than that among rural and urban populations in China. Our findings suggest that the lower stigma in Hong Kong may be linked to higher education levels rather than Hongkongers' more Westernized outlook. The results of a multiple regression analysis showed that education level (β = -.19), homophobia (β = .30), and conformity to norms (β = .14) were independent predictors of HIV-related stigma but not age, income, or cultural orientations. By differentiating between associated social-cultural factors, this study provides a more nuanced understanding of the layered nature of HIV-related stigma: not broadly grounded in religion or Chinese culture but stemming from more specific social-cultural beliefs - perceptions of norm violation and negative attitudes toward homosexuality, which were not mutually exclusive. These findings have implications for HIV-related stigma reduction by providing evidence for the importance of addressing homophobia. Existing HIV publicity activities should be re-examined for inadvertent contribution to the stigmatization process - particularly press conferences and prevention campaigns that reinforce negative stereotypes of gay/bisexual men and PLWH.
28110237	This paper explores the proposal that there is a close link between counterfactual thinking and lying. Both require the imagination of alternatives to reality and we describe four studies which explore this link. In Study 1 we measured individual differences in both abilities and found that individuals with a tendency to generate counterfactual thoughts were also more likely to generate potential lies. Studies 2 and 3 showed that counterfactual availability influences people's ability to come up with lies and the extent to which they expect others to lie. Study 4 used a behavioural measure of deception to show that people tend to lie more in situations also known to elicit counterfactual thoughts. Overall, the results show that the imagination of alternatives to the past plays an important role in the generation of lies. We discuss the implications for the fields of counterfactual thinking and deception.
28109659	Most spider species are solitary, and among the few social interactions among them, resource competition between females has received little attention. We discovered that females of the feather-legged spider Uloborus plumipes invade the orb webs of conspecifics and compete for webs. Following observations in the wild, intruder-defender interactions were studied in a terrarium and in controlled laboratory experiments. We found that contests for orb webs occurred spontaneously between adult females. Competitive interactions in U. plumipes were characterized by an escalation of ritualized behaviors. In 27% of the contests the winner was determined by interactions at a distance, which involved behaviors that caused vibratory signaling on the web. The remaining interactions escalated to physical contact, and in 78% of these a fight occurred between the contestants. Using multivariate logistic regression we determined the factors that predicted the outcome of the contests: (i) Web ownership did not give the defender a competitive advantage. (ii) The difference in physical size between the competing spiders was the most important predictor for the outcome of web contests. (iii) Independent of body size, the display of certain behaviors, specifically the ability to reach the hub before the contestant and the frequency of attacks, increased the probability of winning. (iv) Winning or losing a fight did not affect the chances of winning subsequent contests. The interactions reported here provide a promising approach to investigate communication in spiders and to test theoretical models of intraspecific competition.
28109320	Celebrities are highly influential people whose actions and decisions are watched and often emulated by wide audiences. Many celebrities have used their prominent social standing to offer medical advice or endorse health products, a trend that is expected to increase. However, the extent of the impact that celebrities have in shaping the public's health-related knowledge, attitudes, behaviors, and status is unclear. This systematic review seeks to answer the following questions: (1) Which health-related outcomes are influenced by celebrities? (2) How large of an impact do celebrities actually have on these health-related outcomes? (3) Under what circumstances do celebrities produce either beneficial or harmful impacts?Ten databases were searched, including MEDLINE, EMBASE, PsycINFO, PubMed, CINAHL, Communication Complete, Sociological Abstracts, Social Sciences Citation Index, Journals @ Scholars Portal, and ProQuest Dissertations & Theses A&I. Two reviewers conducted title and abstract screening and full-text screening to identify primary studies that employed empirical methods (either quantitative or qualitative) to examine celebrities' impact on health-related knowledge, attitudes, behaviors, or status outcomes.	The results of this review will contribute to our understanding of celebrity influences and how to design positive evidence-based celebrity health promotion activities. In addition, these findings can help inform the development of media reporting guidelines pertaining to celebrity health news and provide guidance to public health authorities on whether and how to respond to or work with celebrities.	PROSPERO CRD42015019268.	
28109189	Adolescents observe and imitate people to whom they are associated in their social context, and the normative factors sent out by reference groups are crucial determinants of their decision to smoke. The aim of the study is to investigate how adolescents' smoking changes when they are exposed to factors of pro-smoking normative influence by parents and peers, and how age moderate this relation. A cross sectional survey collected data from 5657 students, aged between 11 and 14, from public and private middle schools in the Italian region of Switzerland (Ticino) on their smoking habits, perceived parents' and peers' approval and smoking.Multinomial logistic regression show that, as adolescents get older, more of the pro-smoking factors come from peers and parents, the higher the risk gets of being a "heavy smoker" has compared against having no experience with smoking. Living in a context with no factor of normative influence toward smoking play a protective role against smoking, and this effect becomes more important than more harmful the smoking behavior in question is. Furthermore, peers' descriptive norms are more influential for adolescents to become "light" and "heavy smokers", while smoking being approved by peers is important for adolescents to become accustomed to smoking.	Findings support the different influence of parents' and peers' norms on adolescents' smoking, and highlight the importance of peers' model behavior as the most important factor influencing smoking during adolescence. Such results have implications for programs that aim to prevent or reduce smoking in early adolescence when friendship choice starts to become crucial.	
28108929	Extramarital partnerships exacerbate high HIV prevalence rates in many communities in sub-Saharan Africa. We explored contextual risk factors and suggested interventions to reduce extramarital partnerships among couples in the fishing communities on Lake Victoria, Kenya. We conducted 12 focus group discussions with 9-10 participants each (N = 118) and 16 in-depth interviews (N = 16) with fishermen and their spouses. Couples who participated were consented and separated for simultaneous gender-matched discussions/interviews. Interview topics included courtship and marriage, relationship and sexual satisfaction, extramarital relationships and how to intervene on HIV risks. Coding, analysis, and interpretation of the transcripts followed grounded theory tenets that allow analytical themes to emerge from the participants. Our results showed that extramarital partnerships were perceived to be widespread and were attributed to factors related to sexual satisfaction such as women needing more foreplay before intercourse, discrepancies in sexual desire, and boredom with the current sexual repertoire. Participants also reported that financial and sociophysical factors such as family financial support and physical separation, contributed to the formation of extramarital partnerships. Participants made suggestions for interventions that reduce extramarital partnerships to minimize HIV risks at the community, couple, and individual level. These suggestions emphasized improving community education, spousal communication, and self-evaluation for positive behavior change. Future studies can draw upon these findings as a basis for designing community-owned interventions that seek to reduce community-level HIV risk through a reduction in the number of sexual partners.
28108877	Although it is well established that HIV-related stigma, depression, and lack of social support are negatively associated with health-related quality of life (HRQoL) among people living with HIV (PLH), no studies to date have examined how these psychosocial factors interact with each other and affect HRQoL among incarcerated PLH. We, therefore, incorporated a moderated mediation model (MMM) to explore whether depression mediates the effect of HIV-related stigma on HRQoL as a function of the underlying level of social support. Incarcerated HIV-infected men with opioid dependence (N = 301) were recruited from the HIV units in Kajang prison in Malaysia. Participants completed surveys assessing demographic characteristics, HIV-related stigma, depression, social support, and HRQoL. Results showed that the effect of HIV-related stigma on HRQoL was mediated via depression (a1:β = 0.1463, p < 0.001; b1:β = -0.8392, p < 0.001), as demonstrated by the two-tailed significance test (Sobel z = -3.8762, p < 0.001). Furthermore, the association between social support and HRQoL was positive (β = 0.4352, p = 0.0433), whereas the interaction between HIV-related stigma and depression was negatively associated with HRQOL (β = -0.0317, p = 0.0133). This indicated that the predicted influence of HIV-related stigma on HRQoL via depression had negative effect on HRQoL for individuals with low social support. The results suggest that social support can buffer the negative impact of depression on HRQoL and highlights the need for future interventions to target these psychosocial factors in order to improve HRQoL among incarcerated PLH.
28108642	OBJECTIVE : To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. Qualitative study.	 One academically affiliated primary care practice serving older adults with CNCP in New York City. SUBJECTS : Thirteen older adults (age 65-85 years) with CNCP on chronic opioid therapy, that is, continuous use of opioids for at least six months. METHODS : One researcher conducted one-on-one telephone interviews with participants, and two researchers analyzed the transcribed data using descriptive analysis. A nurse and a physician researcher iteratively critiqued and approved the results. RESULTS : Participants provided opinions as to the effects that smartphones may have on medication management and communications with their providers. Smartphones can benefit older adults by supporting interactions with the health care system such as more effective scheduling and coordinating prescribing practices with local pharmacies. Participants expressed difficulties with isolation due to CNCP and posited that smartphones could provide a means for social support. Specifically, smartphones should support older adult needs to effectively communicate pain experiences with personal contacts and caregivers, as well as health care providers. Based on these results, we provide suggestions that can inform future smartphone interventions for older adults with CNCP.	 Smartphones that focus on supporting medication management, enhancing communication with providers, and facilitating connectedness within social networks to reduce feelings of isolation may help to improve CNCP outcomes in older adults.	
28108053	Graphic health warnings (GHWs) on cigarette packages present an important tobacco control opportunity, particularly for vulnerable populations suffering a disproportionate tobacco burden. One mechanism by which GHWs may influence smoking outcomes is by prompting interpersonal discussions within health discussion networks (the set of personal contacts with whom an individual discusses health issues).The study examined the association between GHW-prompted conversations within health discussion networks and key tobacco-related outcomes, with attention to valence and content of the discussions.	Between August 2013 and April 2014, we recruited 1200 individuals from three communities in Massachusetts, emphasizing recruitment of individuals of low socioeconomic position (SEP) and members of other selected vulnerable groups. Respondents were exposed to the nine GHWs proposed by the FDA in 2011, asked a series of questions, and assessed at follow-up a few weeks later.	A total of 806 individuals were included in this analysis. About 51% of respondents reported having a health discussion network, with significantly lower reports among African-Americans and Hispanics compared to Whites. Around 70% of respondents (smokers and nonsmokers) with health discussion networks reported having one or more conversations about the GHWs with network members, the bulk of which were negative and focused on warning others about smoking. For smokers, we found a small but positive association between the percentage of network conversations that were negative and reports of quit attempts.	The results point to a potential mechanism by which GHWs may impact tobacco-related outcomes, prompting further inquiry into the role of health discussion networks (and discussion networks, more broadly) in tobacco control among low SEP individuals.	
28107154	Human trafficking is a global human rights issue with long-range health consequences about which physicians are largely uneducated. Medical schools are uniquely positioned to address this gap. All future physicians, regardless of specialty, must learn to identify victims and refer them to trauma-informed treatment. Research and advocacy are needed to address the lack of rigorously evaluated curricula in this area, impact policy, and improve services for victims of this heinous form of exploitation.
28107027	This goal of this study was to assess the initial feasibility and efficacy of a play-based intervention targeting executive functions (EF) and parent-child relationships in preschoolers compared with an active control group. Preschoolers with EF deficits (M age = 3.7 ± 0.47, predominantly White boys) and their parents were randomized to intervention (n = 36) or active control (n = 32) conditions. Child performance on EF tasks, parent and masked teacher ratings of EF and behavior, and masked clinician ratings of severity were collected at baseline and at 3 and 6 months postbaseline. Partial eta-squared effect sizes at .02 or higher comparing performance across the two groups was considered evidence of meaningful, albeit small, intervention effects. Intervention effects were observed for parent ratings of inattention, hyperactivity/impulsivity, and number/severity of problems experienced in various home situations, teacher ratings of severity of problems in various school situations, parent and teacher ratings of overall impairment, and clinician ratings of impairment. Intervention effects for functional improvements were maintained at the 6-month follow-up. No effect of the intervention was observed on the objective EF measures, although parent ratings of emotional control were improved for children in the intervention group. An intervention utilizing play-based activities targeting EF, when administered in a structured way by parents, is a promising approach for improving behavior in preschoolers with self-regulation deficits. More work is needed to investigate potential impact on EF and to disentangle mechanisms of action. It may be that the intervention's focus on the structure and quality of parent-child interactions is a mediator of outcomes, rather than improved EFs.
28106811	Hearing impairment may affect children's communication skills, social development, and educational achievement. Little is known about the prevalence of hearing impairment among Chinese children. Data were taken from the 2006 second China National Survey on Disability (CNSD). Hearing impairment was defined as moderate (41-60 dB HL), severe (61-80 dB HL), profound (81-90 dB HL), or complete (>91 dB HL). Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI). A weighted number of 567,915 hearing impairment children were identified, yielding a prevalence of 17.49 per 10,000 people (95% CI: 16.90-18.08), with prevention or treatment options possible for 64.6% of hearing impairment children. The main causes of hearing impairment were hereditary, tympanitis, and drug intoxication. Illiteracy in one or both parents (mother: OR = 1.388, 95% CI: 1.125-1.714, p < 0.0001; father: OR = 1.537, 95% CI: 1.152-2.049, p < 0.0001 relative to no school or primary school), annual family income lower than national average (OR = 1.323, 95% CI: 1.044-1.675, p = 0.0203, relative to higher than national average), household size larger than three people (OR = 1.432, 95% CI: 1.164-1.762, p = 0.0007, relative to smaller than three people) and single-mother family (OR = 2.056, 95% CI: 1.390-3.042, p = 0.0176, relative to intact family) were the independence risk factors for hearing impairment among Chinese children. Lower annual family income, male children, larger household size, single-mother family, and lower levels of maternal and paternal education were independent risk factors for hearing impairment for Chinese children. Further studies on hearing impairment prevention and the relationship between parental social factors and the risk of hearing impairment are needed.
28106596	In today's life, social media offer new working ways. People are increasingly expanding interactions from face-to-face meetings to online ways of communication, networking, searching, creating and sharing information, and furthermore taking care of patients/citizens via tweeting care, Facebook care, blogging care, vlogging care, infotainment care, gamification-care, infographic care, for instance. This chapter discusses the utilisation of social media in the healthcare domain including nursing education, practice and research. When in the current healthcare era, social media is used effectively and purposefully, it can give all of us a greater choice in how we live, how we take care of our health and how we learn and build both our professional competences and produce evidence-based, qualified data. Nurses need continuous education and proper tools to take the most of the benefits of social media, not forgetting privacy and ethical issues. This use of social media in professional nursing generates the need for new competences.
28105776	The purpose of this study was to determine the roles, expectations and problems of patient companions and to develop solutions to the difficulties encountered by the nurses, patients and their companions. A qualitative approach with semi-structured face-to-face interviews was used during May and June 2014 to collect data. A convenience sample of participants was selected from the nurses, patients and their companions. Content analysis was used for the data. The results of this study revealed that the need for companions is important to the current Turkish healthcare system, but it has many drawbacks. As companions are witness to a patient's declining health and family, social and financial problems, their role should be to support their patients emotionally or socially, but they should not perform medical tasks. Therefore, the agencies responsible for managing the use of patient companions should regularly review its function by communicating often with the patients and their caregivers. Open communication between patient companions and all those responsible for patient care could improve the present difficulties which exist.
28105638	Cancer care continues to stress the US healthcare system with increases in life expectancy, cancer prevalence, and survivors' complex needs. These challenges are compounded by socioeconomic, racial, and cultural disparities that are associated with poor clinical outcomes. One innovative and resource-wise strategy to address this demand on the system is expanded use of telehealth. This paradigm has the potential to decrease healthcare and patient out-of-pocket costs and improve patient adherence to recommended treatment and/or surveillance.
28105548	Despite the expansion of early intervention approaches for young children with ASD, investigators have struggled to identify measures capable of assessing social communication change in response to these interventions. Addressing recent calls for efficient, sensitive, and reliable social communication measures, the current paper outlines the refinement and validation of the Social Communication Checklist (SCC). We discuss two small studies exploring the psychometric properties of the SCC and the SCC-R (revised Social Communication Checklist), including sensitivity to change, inter-rater reliability, and test-retest reliability, in two samples of children with ASD and one sample of typically-developing children. Results indicate this measure is reliable, sensitive to change after a brief social communication intervention, and strongly related to well-established measures of social communicative functioning.
28105001	Autism spectrum disorders (ASDs) are a group of complex neurodevelopmental conditions that present in early childhood and have a current estimated prevalence of about 1 in 68 US children, 1 in 42 boys. ASDs are heterogeneous, and arise from epigenetic, genetic and environmental origins, yet, the exact etiology of ASDs still remains unknown. Individuals with ASDs are characterized by having deficits in social interaction, impaired communication and a range of stereotyped and repetitive behaviors. Currently, a diagnosis of ASD is based solely on behavioral assessments and phenotype. Hundreds of diverse ASD susceptibility genes have been identified, yet none of the mutations found account for more than a small subset of autism cases. Therefore, a genetic diagnosis is not yet possible for the majority of the ASD population. The susceptibility genes that have been identified are involved in a wide and varied range of biological functions. Since the genetics of ASDs is so diverse, information on genome function as provided by transcriptomic data is essential to further our understanding. Gene expression studies have been extremely useful in comparing groups of individuals with ASD and control samples in order to measure which genes (or group of genes) are dysregulated in the ASD group. Transcriptomic studies are essential as a key link between measuring protein levels and analyzing genetic information. This review of recent autism gene expression studies highlights genes that are expressed in the brain, immune system, and processes such as cell metabolism and embryology. Various biological processes have been shown to be implicated with ASD individuals as well as differences in gene expression levels between different types of biological tissues. Some studies use gene expression to attempt to separate autism into different subtypes. An updated list of genes shown to be significantly dysregulated in individuals with autism from all recent ASD expression studies will help further research isolate any patterns useful for diagnosis or understanding the mechanisms involved. The functional relevance of transcriptomic studies as a method of classifying and diagnosing ASD cannot be underestimated despite the possible limitations of transcriptomic studies.
28104987	To investigate the health-related quality of life (HRQoL) of patients suffering with idiopathic inflammatory bowel disease (IBD).The Greek validated version of the Short Inflammatory Bowel Disease Questionnaire was used for evaluating the quality of life of IBD patients. The questionnaire was distributed to 100 consecutive patients suffering from IBD and presenting for a clinic appointment at the endoscopy unit of Larnaca General Hospital during the period from October to November 2012. The criteria for participating in this study were constituted by the documented diagnosis of either ulcerative colitis (UC) or Crohn's disease (CD) after endoscopy and histologic examination at least 6 months before the study, adult patients (18 years old or older), the capability of verbal communication and the patient's written consent for attending this study. The majority of the questionnaires were completed by a nurse practitioner who specializes in IBD patient care.	Regarding the physical dimension in patients with UC, males scored significantly higher than females (4.2 vs 3.4, P = 0.023). Higher scores were also observed in UC patients younger than 35 or older than 50 years (4.0 and 4.2 vs 3.2, respectively, P = 0.021). The psychological dimension revealed similar results in patients with UC, with males, and older ages scoring higher (5.0 vs 3.0, P = 0.01 and 4.7 vs 2.7, P < 0.5, respectively), whereas regarding CD higher scores were observed in married compared to unmarried (3.83 vs 2.33, P = 0.042). No statistical differences in any parameters in the social dimension were observed. Regarding the treatment of, patients with CD, overall higher scores were observed when treated with biological factors compared to standard therapy in all dimensions but with statistical significant difference in the social dimension (5.00 vs 3.25, P = 0.045).	The study reveals a negative impact of IBD on HRQoL. Increased risks are age and gender in patients with UC and family status in patients with CD.	
28104577	Little is understood about the determinants of symptom expression in individuals with fibromyalgia syndrome (FMS). While individuals with FMS often report environmental influences, including weather events, on their symptom severity, a consistent effect of specific weather conditions on FMS symptoms has yet to be demonstrated. Content analysis of a large number of messages by individuals with FMS on Twitter can provide valuable insights into variation in the fibromyalgia experience from a first-person perspective.The objective of our study was to use content analysis of tweets to investigate the association between weather conditions and fibromyalgia symptoms among individuals who tweet about fibromyalgia. Our second objective was to gain insight into how Twitter is used as a form of communication and expression by individuals with fibromyalgia and to explore and uncover thematic clusters and communities related to weather.	Computerized sentiment analysis was performed to measure the association between negative sentiment scores (indicative of severe symptoms such as pain) and coincident environmental variables. Date, time, and location data for each individual tweet were used to identify corresponding climate data (such as temperature). We used graph analysis to investigate the frequency and distribution of domain-related terms exchanged in Twitter and their association strengths. A community detection algorithm was applied to partition the graph and detect different communities.	We analyzed 140,432 tweets related to fibromyalgia from 2008 to 2014. There was a very weak positive correlation between humidity and negative sentiment scores (r=.009, P=.001). There was no significant correlation between other environmental variables and negative sentiment scores. The graph analysis showed that "pain" and "chronicpain" were the most frequently used terms. The Louvain method identified 6 communities. Community 1 was related to feelings and symptoms at the time (subjective experience). It also included a list of weather-related terms such as "weather," "cold," and "rain."	According to our results, a uniform causal effect of weather variation on fibromyalgia symptoms at the group level remains unlikely. Any impact of weather on fibromyalgia symptoms may vary geographically or at an individual level. Future work will further explore geographic variation and interactions focusing on individual pain trajectories over time.	
28104546	This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality.Six position statements and guidelines issued by the Indian Society for Critical Care Medicine and the Indian Association of Palliative Care from 2005 till 2015 were examined. The present study reflects upon the recommendations suggested by these texts.	Although the policy documents conform to the universally set norms of introducing palliative and end-of-life care in intensive care units, they hardly suit Indian reality. The study illustrates local complexities that are not addressed by the policy documents. This include difficulties faced by intensivists and physicians in arriving at a consensus decision, challenges in death prognostication, hurdles in providing compassionate care, providing "culture-specific" religious and spiritual care, barriers in effective communication, limitations of documenting end-of-life decisions, and ambiguities in defining modalities of palliative care. Moreover, the policy documents largely dismiss special needs of elderly patients.	The article suggests the need to reexamine policies in terms of their attainability and congruence with Indian reality.	
28103746	Recently, several event-related potential (ERP) studies investigated the impact of sender attributions on language-based social feedback processing. Results showed very early responses to the social context, while interactions or effects of emotional content started later. However, in these studies, sender attribution was varied across blocks, possibly inducing unspecific, anticipatory effects. Here, who was giving feedback was disclosed simultaneously with the decision itself. Participants' ERPs differentiated between attributed senders starting with the early posterior negativity. P3 and late positive potential (LPP) amplitudes were also enlarged for the "human sender". Emotion effects occurred in the P3 and LPP time windows. Further, we found an interaction on the P3: "Human" emotional feedback was selectively amplified. Source analysis localized enhanced processing of "human"-generated feedback in visual areas from around 300 ms after feedback onset and from 400 ms also in temporal regions. Enhancement of "human" emotional feedback resulted from increased activations in the left visual word form area. These findings highlight that decoding who is giving feedback precedes content processing, both in blocked and in randomly alternating situations. Further, in quasi-realistic social contexts, processing of emotional content is selectively amplified. Finally, involvement of semantic language processing structures indicates reintegration of words in a salient context.
28103711	The quality of perimortem care received by patients who died at our hospitals was unknown.To describe the quality of hospital care experienced in the last week of life, as perceived by decedents' families.	Telephone survey that included established measures and investigator-developed content.	Large, tertiary care center known for high-quality, cost-effective care.	Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year.	None.	Participant perceptions of the decedent's care, including symptom management, personal care, communication, and care coordination.	Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents' anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents' illness (29%), and receiving contradictory or confusing information (33%).	Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.	
28103638	Acquired brain injury (ABI) can result in impairments in motor function, language, cognition, and sensory processing, and in emotional disturbances, which can severely reduce a survivor's quality of life. Music interventions have been used in rehabilitation to stimulate brain functions involved in movement, cognition, speech, emotions, and sensory perceptions. An update of the systematic review published in 2010 was needed to gauge the efficacy of music interventions in rehabilitation for people with ABI.To assess the effects of music interventions for functional outcomes in people with ABI. We expanded the criteria of our existing review to: 1) examine the efficacy of music interventions in addressing recovery in people with ABI including gait, upper extremity function, communication, mood and emotions, cognitive functioning, social skills, pain, behavioural outcomes, activities of daily living, and adverse events; 2) compare the efficacy of music interventions and standard care with a) standard care alone, b) standard care and placebo treatments, or c) standard care and other therapies; 3) compare the efficacy of different types of music interventions (music therapy delivered by trained music therapists versus music interventions delivered by other professionals).	We searched the Cochrane Stroke Group Trials Register (January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 6), MEDLINE (1946 to June 2015), Embase (1980 to June 2015), CINAHL (1982 to June 2015), PsycINFO (1806 to June 2015), LILACS (1982 to January 2016), and AMED (1985 to June 2015). We handsearched music therapy journals and conference proceedings, searched dissertation and specialist music databases, trials and research registers, reference lists, and contacted relevant experts and music therapy associations to identify unpublished research. We imposed no language restriction. We performed the original search in 2009.	We included all randomised controlled trials and controlled clinical trials that compared music interventions and standard care with standard care alone or combined with other therapies. We examined studies that included people older than 16 years of age who had ABI of a non-degenerative nature and were participating in treatment programmes offered in hospital, outpatient, or community settings. We included studies in any language, published and unpublished.	Two review authors independently extracted data and assessed the risk of bias of the included studies. We contacted trial researchers to obtain missing data or for additional information when necessary. Where possible, we presented results for continuous outcomes in meta-analyses using mean differences (MDs) and standardised mean differences (SMDs). We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted a sensitivity analysis to assess the impact of the randomisation method.	We identified 22 new studies for this update. The evidence for this update is based on 29 trials involving 775 participants. A music intervention known as rhythmic auditory stimulation may be beneficial for improving the following gait parameters after stroke. We found a reported increase in gait velocity of 11.34 metres per minute (95% confidence interval (CI) 8.40 to 14.28; 9 trials; 268 participants; P < 0.00001; moderate-quality evidence). Stride length of the affected side may also benefit, with a reported average of 0.12 metres more (95% CI 0.04 to 0.20; 5 trials; 129 participants; P = 0.003; moderate-quality evidence). We found a reported average improvement for general gait of 7.67 units on the Dynamic Gait Index (95% CI 5.67 to 9.67; 2 trials; 48 participants; P < 0.00001). There may also be an improvement in gait cadence, with a reported average increase of 10.77 steps per minute (95% CI 4.36 to 17.18; 7 trials; 223 participants; P = 0.001; low-quality evidence).Music interventions may be beneficial for improving the timing of upper extremity function after stroke as scored by a reduction of 1.08 seconds on the Wolf Motor Function Test (95% CI -1.69 to -0.47; 2 trials; 122 participants; very low-quality evidence).Music interventions may be beneficial for communication outcomes in people with aphasia following stroke. Overall, communication improved by 0.75 standard deviations in the intervention group, a moderate effect (95% CI 0.11 to 1.39; 3 trials; 67 participants; P = 0.02; very low-quality evidence). Naming was reported as improving by 9.79 units on the Aachen Aphasia Test (95% CI 1.37 to 18.21; 2 trials; 35 participants; P = 0.02). Music interventions may have a beneficial effect on speech repetition, reported as an average increase of 8.90 score on the Aachen Aphasia Test (95% CI 3.25 to 14.55; 2 trials; 35 participants; P = 0.002).There may be an improvement in quality of life following stroke using rhythmic auditory stimulation, reported at 0.89 standard deviations improvement on the Stroke Specific Quality of Life Scale, which is considered to be a large effect (95% CI 0.32 to 1.46; 2 trials; 53 participants; P = 0.002; low-quality evidence). We found no strong evidence for effects on memory and attention. Data were insufficient to examine the effect of music interventions on other outcomes.The majority of studies included in this review update presented a high risk of bias, therefore the quality of the evidence is low.	Music interventions may be beneficial for gait, the timing of upper extremity function, communication outcomes, and quality of life after stroke. These results are encouraging, but more high-quality randomised controlled trials are needed on all outcomes before recommendations can be made for clinical practice.	

28103199	Susac syndrome is characterised by the triad of encephalopathy with or without focal neurological signs, branch retinal artery occlusions and hearing loss. Establishment of the diagnosis is often delayed because the triad is complete only in a minority of patients at disease onset. This leads to a critical delay in the initiation of appropriate treatment. Our objective was to establish criteria for diagnosis of either definite or probable Susac syndrome.The establishment of diagnostic criteria was based on the following three steps: (1) Definition of a reference group of 32 patients with an unambiguous diagnosis of Susac syndrome as assessed by all interdisciplinary experts of the European Susac Consortium (EuSaC) team (EuSaC cohort); (2) selection of diagnostic criteria, based on common clinical and paraclinical findings in the EuSaC cohort and on a review of the literature; and (3) validation of the proposed criteria in the previously published cohort of all Susac cases reported until 2012.	Integrating the clinical presentation and paraclinical findings, we propose formal criteria and recommend a diagnostic workup to facilitate the diagnosis of Susac syndrome. More than 90% of the cases in the literature fulfilled the proposed criteria for probable or definite Susac syndrome. We surmise that more patients could have been diagnosed with the recommended diagnostic workup.	We propose diagnostic criteria for Susac syndrome that may help both experts and physicians not familiar with Susac syndrome to make a correct diagnosis and to prevent delayed treatment initiation.	
28103179	Cyberbullying is a common byproduct of the digital revolution with serious consequences to victims. Unfortunately, there is a dearth of empirically based methods to confront it. This study used social cognitive theory to design and test an intervention message aimed at persuading college students to abstain from retaliation, seek social support, save evidence, and notify authorities-important victim responses identified and recommended in previous research. Using a posttest-only control group design, this study tested the effectiveness of an intervention message in changing college students' perceived susceptibility to and perceived severity of cyberbullying as well as their self-efficacy, response efficacy, attitudes, and behavioral intentions toward each recommended response in future episodes of cyberbullying. Results indicated that the intervention message caused participants in the experimental condition to report significantly higher susceptibility, but not perceived severity, to cyberbullying than those in the control condition. The intervention message also caused expected changes in all outcomes except self-efficacy for not retaliating and in all outcomes for seeking social support, saving evidence, and notifying an authority. Implications for message design and future research supporting evidence-based anti-cyberbullying health communication campaigns are discussed.
28102267	Self-organized regular vegetation patterns are widespread and thought to mediate ecosystem functions such as productivity and robustness, but the mechanisms underlying their origin and maintenance remain disputed. Particularly controversial are landscapes of overdispersed (evenly spaced) elements, such as North American Mima mounds, Brazilian murundus, South African heuweltjies, and, famously, Namibian fairy circles. Two competing hypotheses are currently debated. On the one hand, models of scale-dependent feedbacks, whereby plants facilitate neighbours while competing with distant individuals, can reproduce various regular patterns identified in satellite imagery. Owing to deep theoretical roots and apparent generality, scale-dependent feedbacks are widely viewed as a unifying and near-universal principle of regular-pattern formation despite scant empirical evidence. On the other hand, many overdispersed vegetation patterns worldwide have been attributed to subterranean ecosystem engineers such as termites, ants, and rodents. Although potentially consistent with territorial competition, this interpretation has been challenged theoretically and empirically and (unlike scale-dependent feedbacks) lacks a unifying dynamical theory, fuelling scepticism about its plausibility and generality. Here we provide a general theoretical foundation for self-organization of social-insect colonies, validated using data from four continents, which demonstrates that intraspecific competition between territorial animals can generate the large-scale hexagonal regularity of these patterns. However, this mechanism is not mutually exclusive with scale-dependent feedbacks. Using Namib Desert fairy circles as a case study, we present field data showing that these landscapes exhibit multi-scale patterning-previously undocumented in this system-that cannot be explained by either mechanism in isolation. These multi-scale patterns and other emergent properties, such as enhanced resistance to and recovery from drought, instead arise from dynamic interactions in our theoretical framework, which couples both mechanisms. The potentially global extent of animal-induced regularity in vegetation-which can modulate other patterning processes in functionally important ways-emphasizes the need to integrate multiple mechanisms of ecological self-organization.
28102112	Decades of research have documented how sex workers worldwide, particularly female sex workers (FSWs), shoulder a disproportionate burden of the HIV epidemic. In India, although a substantial progress has been made in controlling the epidemic, its prevalence among FSWs and the Devadasis (also called traditional sex workers) in northern Karnataka is still significantly high. On the other hand, much of the HIV prevention research has focused on their mapping and size estimation, typologies, bio-behavioural surveillance, condom use and other prevention technologies. In this article, drawing on critical theoretical perspectives, secondary historical sources and in-depth interviews, we unravel wider social, cultural and political economic complexities surrounding the lives of Devadasis, and specifically illuminate the moral pragmatics that shed light on their entry into sex trade and vulnerability to HIV. Findings from this research are extremely important since while much is known about Devadasis in social sciences and humanities, relatively little is known about the complexities of their lives within public health discourses related to HIV. Our work has direct implications for ongoing HIV prevention and health promotion efforts in the region and beyond.
28101929	The aim of the study was to evaluate taste disorders in patients receiving chemotherapy and to assess the impact of dysgeusia on patients' health-related quality of life (HRQOL). A total of 289 patients with a diagnosis of malignant solid or haematological cancer undergoing chemotherapy completed a questionnaire assessing dysgeusia and HRQOL. Sixty-four per cent of patients developed dysgeusia after and during chemotherapy. A statistically significant correlation was found between type of cancer and dysgeusia (p = .012), moreover a statistically significant association was found between type of chemotherapy and occurrence of dysgeusia (p = .031). Patients with dysgeusia had a worse overall HRQOL than those who did not have dysgeusia, and the association between HRQOL and dysgeusia was also statistically significant (p = .003). Patients with dysgeusia had a higher probability of having a worse HRQOL (p = .002). In line with previous studies, we observed a significant correlation between chemotherapy and dysgeusia. Furthermore, this study found that cancer patients with dysgeusia have a lower quality of life. In particular the domains "role," "social aspect," "nausea-vomiting" and "appetite" are most influenced by dysgeusia. Improving the communication and information to patients considered at higher risk of developing dysgeusia can have a positive impact on patients' quality of life.
28101878	This article examines the interaction of nonprofit and private actors with the traditional bureaucratic structures of government in central Pennsylvania&s recovery from hurricane Irene and tropical storm Lee. That effort relied heavily on private and nonprofit organizations as drivers of the response and recovery. The author maps the organizations involved in the recovery effort and explores the impact of the recovery effort on those organizations. A social network analysis was conducted and complemented with follow-up interviews with key actors. The network analysis reveals weak communication between sectors and a reliance on nonprofits to deliver services; interviews uncover the challenges of intersectoral collaboration. The author addresses the successes and limitations of the means by which a network of nonprofit efforts were coordinated with federal and state relief efforts and draw lessons for improving future practices. The author finds that this case deviates from theory in several ways that complicated community response and recovery. In particular, the challenges of developing and maintaining a recovery network while simultaneously delivering services placed great strain on several organizations, as well as on the fledgling network as a whole.
28101829	Autism Spectrum Disorder (ASD) is a neuro-developmental disorder commonly seen in children. It is characterized by age inappropriate, impaired social communication and the presence of stereotypic behavior. This disorder is hypothesized to result from cerebral dysfunction arising from a complex interaction between genetic, epigenetic and environmental factors. ASD should be suspected in children failing ASD specific screening tests, in the presence of red flags in social, language and/or play domains, in children with developmental or language delay, abnormal behavior, poor school performance or in those who are at high risk. Comprehensive assessment comprises of a step-wise approach that includes taking a detailed history, performing a holistic examination and observing the child closely in relation to play, social interaction and behavior. Diagnosis is established by application of the diagnostic criteria for ASD of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM V). The degree of severity, intellectual and language impairment and presence of other illnesses should be specified. Functional assessment identifies an individual's strengths and weaknesses. All these are important to formulate a customized intervention plan along with the family. The goal is to build up skills enabling optimal and as far as possible normal functioning while simultaneously reducing maladaptive behavior. This is achieved by a multi-disciplinary team comprising of various personnel experienced in tackling issues in ASD related to their respective areas of expertise. Intervention is primarily non-pharmacological, based on behavioral modification strategies. Drugs are only indicated in the reduction of target symptoms refractory to behavioral intervention. Although there is no cure, timely and appropriate intervention can improve the quality of life significantly.
28101115	Objective: To determine marital satisfaction and its influencing factors among fertile and infertile women in Shahroud. Materials and methods: In this comparative study, 1528 participants (511 infertile and1017 fertile women) were evaluated using Enrich Marital Satisfaction Scale. Data were analyzed using chi-square and t-test. Results: A total of 1402 participants (78.7%) had high marital satisfaction. The results show that no significant differences exist between marital satisfaction, marital communication, conflict resolution and idealistic distortion in fertile and infertile women. However, a significant difference was observed between marital satisfaction, and job, spouse's job and income in fertile and infertile groups, but the place of residence, education, spouse's education and fertility status showed no significant difference. Conclusion: Results showed that infertility does not reduce marital satisfaction. Since marital satisfaction is moderate in both groups, sex education for people bound to marry and sexual counseling for couples can lead to improved sexual satisfaction.
28101077	In joint action, multiple people coordinate their actions to perform a task together. This often requires precise temporal and spatial coordination. How do co-actors achieve this? How do they coordinate their actions toward a shared task goal? Here, we provide an overview of the mental representations involved in joint action, discuss how co-actors share sensorimotor information and what general mechanisms support coordination with others. By deliberately extending the review to aspects such as the cultural context in which a joint action takes place, we pay tribute to the complex and variable nature of this social phenomenon.
28100957	The uptake of various telehealth technologies to deliver health care services at a distance is expanding; however more knowledge is needed to help understand vital components for success in using telehealth in different work settings. This study was part of a larger trial designed to investigate the effect of an interactive telemedicine platform. The platform consisted of a web based ulcer record linked to a mobile phone to provide care for people with diabetic foot ulcers in outpatient clinics in specialist hospital care in collaboration with primary health care. The aim of this qualitative study was to identify perceptions of health care professionals in different working settings with respect to facilitators to engagement and participation in the application of telemedicine.Ten focus groups were conducted with health care professionals and leaders in Western Norway between January 2014 and June 2015 using Interpretive Description, an applied qualitative research strategy.	Four key conditions for success in using telemedicine as a new technology in diabetes foot care were identified: technology and training that were user-friendly; having a telemedicine champion in the work setting; the support of committed and responsible leaders; and effective communication channels at the organizational level.	Successful larger scale implementation of telemedicine must involve consideration of complex contextual and organizational factors associated with different work settings. This form of new care technology in diabetes foot care often involves health care professionals working across different settings with different management systems and organizational cultures. Therefore, attention to the distinct needs of each staff group seems an essential condition for effective implementation.	
28100830	Ideas spread across social networks, but not everyone is equally positioned to be a successful recommender. Do individuals with more opportunities to connect otherwise unconnected others-high information brokers-use their brains differently than low information brokers when making recommendations? We test the hypothesis that those with more opportunities for information brokerage may use brain systems implicated in considering the thoughts, perspectives, and mental states of others (i.e. 'mentalizing') more when spreading ideas. We used social network analysis to quantify individuals' opportunities for information brokerage. This served as a predictor of activity within meta-analytically defined neural regions associated with mentalizing (dorsomedial prefrontal cortex, temporal parietal junction, medial prefrontal cortex, /posterior cingulate cortex, middle temporal gyrus) as participants received feedback about peer opinions of mobile game apps. Higher information brokers exhibited more activity in this mentalizing network when receiving divergent peer feedback and updating their recommendation. These data support the idea that those in different network positions may use their brains differently to perform social tasks. Different social network positions might provide more opportunities to engage specific psychological processes. Or those who tend to engage such processes more may place themselves in systematically different network positions. These data highlight the value of integrating levels of analysis, from brain networks to social networks.
28100720	An audience can have a profound effect on the dynamics of communicative interactions. As a result, non-human primates often adjust their social decision-making strategies depending on the audience composition at a given time. Here we sought to test how the unique vocal behaviour of multiple audience members affected decisions to communicate. To address this issue, we developed a novel experimental paradigm in which common marmosets directly interacted with multiple 'virtual monkeys' (VMs), each of whom represented an individual marmoset with distinct vocal behaviour. This active social signalling paradigm provided subjects an opportunity to interact with and learn about the behaviour of each VM in the network and apply this knowledge in subsequent communicative decisions. We found that subjects' propensity to interact with particular VMs was determined by the behaviour of each VM in the audience and suggests that marmoset social decision-making strategies are highly adaptive to nuances of the immediate communication network.
28099125	A new MenACWY conjugate meningococcal vaccination programme was introduced in Northern Ireland (NI) in August 2015, for 13-18 year olds, as well as for first-time university entrants up to 25 years. This reflected the response made by Public Health England, due to the recent rapid increase of meningococcal group W (MenW) disease and on advice of the UK Joint Committee on Vaccination and Immunisation (JCVI). The aims of this study were to evaluate (i) the uptake of the MenACWY vaccine among first-time university students, (ii) vaccine and meningitis awareness, (iii) optimal communication modalities via a multidisciplinary team (MDT) model and (iv) current international vaccination policies relating to non-UK students. A survey was completed by 1210 students, 868 first-time freshers and 342 non-freshers, from healthcare-related, non-healthcare-related and engineering/computing faculties. The survey included an anonymous questionnaire and consented students were aged 17-50 years with a 2:3 ratio of male:female. Vaccine uptake amongst 18-year-old students was 90.7% and 87.3% in female and male cohorts, respectively, falling to 72.1% and 67.7% (19-year cohort) and 32.7% and 39.6% (20- to 25-year cohort) in males and females, respectively. Students reported that posters, clinics and talks were the preferred methods of communication and not social media. There was general lack of awareness of the signs/symptoms of meningitis and approximately 30% of students falsely believed that administration of the MenACWY vaccine excluded the risk of contracting meningitis. Overall, there was a successful vaccination campaign; however, there was a lack of meningitis awareness. Due to differing international meningococcal vaccination schedules, international students enrolling at UK universities need to be informed about current UK policies. For the successful introduction of any vaccination programme amongst university students, it is fundamental that a MDT is established to inform and deliver such a programme in an efficient and timely manner.
28098954	Play therapy is a nursing intervention employed in multidisciplinary approaches to develop the social, emotional, and behavioral skills of children. In this study, we aim to determine the effects of play therapy on the social, emotional, and behavioral skills of pre-school children through the nursing process.A single-blind, prospective, randomized controlled study was undertaken. The design, conduct, and reporting of this study adhere to the Consolidated Standards of Reporting Trials (CONSORT) guidelines.	The participants included 4- to 5-year-old kindergarten children with no oral or aural disabilities and parents who agreed to participate in the study. The Pre-school Child and Family Identification Form and Social Competence and the Behavior Evaluation Scale were used to gather data. Games in the play therapy literature about nursing diagnoses (fear, social disturbance, impaired social interactions, ineffective coping, anxiety), which were determined after the preliminary test, constituted the application of the study.	There was no difference in the average scores of the children in the experimental and control groups in their Anger-Aggression (AA), Social Competence (SC), and Anxiety-Withdrawal (AW) scores beforehand (t = 0.015, p = .988; t = 0.084, p = .933; t = 0.214, p = .831, respectively). The difference between the average AA and SC scores in the post-test (t = 2.041, p = .045; t = 2.692, p = .009, respectively), and the retests were statistically significant in AA and SC average scores in the experimental and control groups (t = 4.538, p = .000; t = 4.693; p = .000, respectively). In AW average scores, no statistical difference was found in the post-test (t = 0.700, p = .486), whereas in the retest, a significant difference was identified (t = 5.839, p = .000).	Play therapy helped pre-school children to improve their social, emotional, and behavioral skills. It also provided benefits for the children to decrease their fear and anxiety levels, to improve their communication and coping skills, and to increase their self-esteem.	The study concluded that play therapy helps develop the social, emotional, and behavioral skills of pre-school children. It has also helped children lower their fear and anxiety levels, improve their communication and coping skills, and promote their self-esteem. Pediatric nurses are recommended to include play therapy in their profession and in the nursing process.	
28098772	Tracking people's behaviors is a main category of cyber physical social sensing (CPSS)-related people-centric applications. Most tracking methods utilize camera networks or sensors built into mobile devices such as global positioning system (GPS) and Bluetooth. In this article, we propose a non-intrusive wireless fidelity (Wi-Fi)-based tracking method. To show the feasibility, we target tracking people's access behaviors in Wi-Fi networks, which has drawn a lot of interest from the academy and industry recently. Existing methods used for acquiring access traces either provide very limited visibility into media access control (MAC)-level transmission dynamics or sometimes are inflexible and costly. In this article, we present a passive CPSS system operating in a non-intrusive, flexible, and simplified manner to overcome above limitations. We have implemented the prototype on the off-the-shelf personal computer, and performed real-world deployment experiments. The experimental results show that the method is feasible, and people's access behaviors can be correctly tracked within a one-second delay.
28098508	Suicide is a leading cause of death for college-aged youth, and university counseling centers (UCC) strive to educate students about mental health issues and available campus services. The current research evaluates a college campus social norms campaign that used both peer and celebrity sources to promote help seeking among college students as a suicide prevention strategy. Postcampaign surveys of this quasi-experiment (n = 391) revealed that compared to students in the control neighborhood condition, students exposed to the campaign messages in the experimental neighborhood conditions were more likely to perceive students would refer a friend to the UCC and more likely to visit the UCC for a mental health concern. Students living in the intervention neighborhood with a peer message source reported a greater willingness to refer friends to the UCC compared to those who lived in the celebrity and control neighborhoods. Regardless of condition, students who reported seeing UCC messages reported greater effects than those who reported not viewing the messages (e.g., greater intentions to seek help and to talk to others about the UCC). Results of this study are discussed within a social norms framework and support the need for continued exposure to campaign messages to impact health outcomes.
28098505	Families with a child with cancer face significant emotional and psychosocial stressors. The frequency of childhood cancer is increasing in Lebanon with more than 282 children diagnosed each year. This condition is reported to evoke a range of challenging emotions for parents, yet no studies have been conducted on the facilitating and hindering factors that affect Lebanese parents coping with a child with cancer.The purpose of the study was to gain an in-depth understanding of factors facilitating and hindering coping methods of Lebanese parents with a child with cancer.	The study followed purposeful sampling and saturation principles in which 12 parents (mother or father) of a child were interviewed. Data were analyzed following the Utrecht School of phenomenology.	Helpful and harmful experiences emerged through the coding process. The enabling factors were social/family support; talking about it; strong religious beliefs; and the communication style of health workers. On the other hand, the deterring factors were the waiting time and the hospital stay; changes in the couple's relationship; and sibling rivalry.	These results could be used as the basis for additional research aimed at developing a structured approach to care that endorses the coping processes of Lebanese parents with a child with cancer.	Nursing and medical staff need to be conscious of parents' coping strategies and their impact on family dynamics and the relationship between the family and the health care team.	
28097516	Despite a wealth of knowledge about the neural mechanisms behind emotional facial expression processing, little is known about how they relate to individual differences in social cognition abilities. We studied individual differences in the event-related potentials (ERPs) elicited by dynamic facial expressions. First, we assessed the latent structure of the ERPs, reflecting structural face processing in the N170, and the allocation of processing resources and reflexive attention to emotionally salient stimuli, in the early posterior negativity (EPN) and the late positive complex (LPC). Then we estimated brain-behavior relationships between the ERP factors and behavioral indicators of facial identity and emotion-processing abilities. Structural models revealed that the participants who formed faster structural representations of neutral faces (i.e., shorter N170 latencies) performed better at face perception (r = -.51) and memory (r = -.42). The N170 amplitude was not related to individual differences in face cognition or emotion processing. The latent EPN factor correlated with emotion perception (r = .47) and memory (r = .32), and also with face perception abilities (r = .41). Interestingly, the latent factor representing the difference in EPN amplitudes between the two neutral control conditions (chewing and blinking movements) also correlated with emotion perception (r = .51), highlighting the importance of tracking facial changes in the perception of emotional facial expressions. The LPC factor for negative expressions correlated with the memory for emotional facial expressions. The links revealed between the latency and strength of activations of brain systems and individual differences in processing socio-emotional information provide new insights into the brain mechanisms involved in social communication.
28096429	Animals that use vocal signals to communicate often compensate for interference and masking from background noise by raising the amplitude of their vocalisations. This response has been termed the Lombard effect. However, despite more than a century of research, little is known how quickly animals can adjust the amplitude of their vocalisations after the onset of noise. The ability to respond quickly to increases in noise levels would allow animals to avoid signal masking and ensure their calls continue to be heard, even if they are interrupted by sudden bursts of high-amplitude noise. We tested how quickly singing male canaries (Serinus canaria) exhibit the Lombard effect by exposing them to short playbacks of white noise and measuring the speed of their responses. We show that canaries exhibit the Lombard effect in as little as 300 ms after the onset of noise and are also able to increase the amplitude of their songs mid-song and mid-phrase without pausing. Our results demonstrate high vocal plasticity in this species and suggest that birds are able to adjust the amplitude of their vocalisations very rapidly to ensure they can still be heard even during sudden changes in background noise levels.
28096051	This article describes a qualitative research study using a semi-structured interview process to describe barriers surrounding medication access, use, and adherence for recently discharged patients of a federally qualified health center. Common themes which emerged were: 1) Team assumptions regarding patient plans to access or appropriately use discharge medications negatively impact adherence; 2) Unmet expectation for care coordination between primary care physician (PCP) and hospital; 3) Disconnect between patients and health care workers leads to disengagement; and 4) Lack of personal contact hinders access to services.
28095941	Our aim was to explore preparation for the end of life (EoL) and life closure among persons with advanced metastatic lung cancer. Understanding quality of life through the lens of preparation and completion is important since the trajectory of lung cancer can be relatively short, often leading to application of cancer-directed therapies near death without the opportunity for advance planning or palliative care. Clinical research is needed to understand the kinds of distress specific to older adults with advanced lung cancer that are amendable to palliative care interventions.We employed an exploratory cross-sectional design to examine psychosocial and existential concerns among a purposive sample (N = 30) of advanced lung cancer patients using the "end-of-life preparation" and "life completion" subscales of the Quality of Life at the End of Life (QUAL-E) questionnaire. Nonparametric methods were employed to analyze preparation, completion, global quality of life (QoL), and the associations among depressive symptoms, preparation, completion, and global QoL.	Higher scores on life completion were associated with better global QoL, and with items related to transcendence, communicative acts, and interpersonal relationships demonstrating important contributions. The perception of being a future burden on family members was the greatest concern within the preparation domain. Depressive symptoms were not associated with preparation, completion, or global QoL.	Psychosocial and existential issues contribute to QoL at the EoL among older adults with late-stage lung cancer during cancer-directed therapy, concurrent care, and hospice. The role of preparation, especially self-perceived burden, merits further research early on in the oncological setting. The preparation and life completion subscales of the QUAL-E are feasible clinical tools for facilitating dyadic communication about sensitive topics in the palliative care setting.	
28095888	Patients seeking treatment may be assumed to prefer a psychiatrist who suggests a new treatment with confidence and optimism. Yet, this might not apply uniformly to all patients. In this study, we tested the hypothesis that new patients prefer psychiatrists who present treatments optimistically, whilst patients with longer-term experience of mental health care may rather prefer more cautious psychiatrists.In an experimental study, we produced video-clips of four psychiatrists, each suggesting a pharmacological and a psychological treatment once with optimism and once with caution. 100 'new' patients with less than 3 months experience of mental health care and 100 'long-term' patients with more than one year of experience were shown a random selection of one video-clip from each psychiatrist, always including an optimistic and a cautious suggestion of each treatment. Patients rated their preferences for psychiatrists on Likert type scales. Differences in subgroups with different age (18-40 vs. 41-65 years), gender, school leaving age (≤16 vs. >16 years), and diagnosis (ICD 10 F2 vs. others) were explored.	New patients preferred more optimistic treatment suggestions, whilst there was no preference among long-term patients. The interaction effect between preference for treatment presentations and experience of patients was significant (interaction p-value = 0.003). Findings in subgroups were similar.	In line with the hypothesis, psychiatrists should suggest treatments with optimism to patients with little experience of mental health care. However, this rule does not apply to longer-term patients, who may have experienced treatment failures in the past.	
28095838	Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation.This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia. The control condition is pre-intervention usual practice for at least six months before each site implements the intervention. The COMFORT intervention consists of six elements: family conversations regarding offers for organ donation to be led by a "designated requester"; family offers for donation are deferred to the designated requester; the offer of donation is separated from the end-of-life discussion that death is inevitable; it takes place within a structured family donation conversation using a "balanced" approach. Designated requesters may be intensivists, critical care nurses or social workers prepared by attending the three-day national "Family Donation Conversation" workshops, and the half-day NSW Simulation Program. The design is pre-post intervention to compare rates of family consent for organ donation six months before and under the intervention. Each ICU crosses from using the control to intervention condition after the site initiation visit. The primary endpoint is the consent rate for deceased organ donation calculated from 140 eligible next of kin families. Secondary endpoints are health professionals' adherence rates to core elements of the intervention; identification of predictors of family donation decision; and the proportion of families who regret their final donation decision at 90 days.	The pragmatic design of this study may identify 'what works' in usual clinical settings when requesting organ donation in critical care areas, both in terms of changes in practice healthcare professionals are willing and able to adopt, and the effect this may have on desired outcomes. The findings of this study will be indicative of the potential benefits of the intervention and be relevant and transferrable to clinical settings in other states and countries.	
28095722	Multi-state population-based studies exploring the racial/ethnic differences in the prevalence and correlates of postpartum depression (PPD), which affects 10-20% of women in the US, are rare. The aim of this study was to examine the racial/ethnic disparities in the relationship between antenatal stressful life events and PPD among US women and to explore whether antenatal health care provider communication on perinatal depression was associated with a lower risk.Data from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS) were used. For each racial/ethnic group, the distribution of PPD was compared according to different levels of the stressors and socio-demographic, pre-pregnancy, antenatal, delivery, and neonatal characteristics. Multivariable logistic regression analyses were performed with PPD as the outcome and all variables that were significant in bivariate analyses as predictors.	Eleven percent of 87,565 women met the criteria for PPD with the prevalence ranging from 7.9% among Asian/Pacific Islanders to 14% among American Indian/Alaska Natives. Irrespective of race/ethnicity, having many bills to pay and having more than usual arguments with husband/partner were risk factors for PPD. Among non-Hispanic black (NHB) women, having a husband/partner who did not want the pregnancy was associated with PPD (adjusted odds ratio [aOR]: 1.47; 95% confidence interval [CI]: 1.14, 1.90), and among non-Hispanic whites (NHWs), drug/drinking problems of someone close was associated with PPD (aOR: 1.37; 95% CI: 1.21, 1.55). Provider communication was inversely associated with PPD among NHWs (aOR: 0.77; 95% CI: 0.69, 0.85) and NHBs (aOR: 0.74; 95% CI: 0.60, 0.93).	The protective effect of provider communication on PPD suggests the benefit of a simple conversation about perinatal depression during antenatal care. Furthermore, risk factors for PPD varied by race/ethnicity suggesting that these vulnerabilities should be taken into consideration in identifying women at-risk for PPD.	
28095705	Individuals with autism spectrum disorder demonstrate narrative (i.e. storytelling) difficulties which can significantly impact their ability to form and maintain social relationships. However, existing research has not comprehensively documented these impairments in more open-ended, emotionally evocative situations common to daily interactions. Computational linguistic measures offer a promising complement to traditional hand-coding methods of narrative analysis and in this study were applied together with hand coding of narratives elicited with emotionally salient scenes from the Thematic Apperception Test. In total, 19 individuals with autism spectrum disorder and 14 typically developing controls were asked to tell stories about six images from the Thematic Apperception Test. Both structural and qualitative aspects of narrative were assessed using a hand-coding system and Latent Semantic Analysis, an automated computational measure of semantic similarity. Individuals with autism spectrum disorder demonstrated significant difficulties with the use of complex syntax to integrate their narratives and problems explaining characters' intentions. These and other key narrative skills were strongly related to narrative competence scores derived from Latent Semantic Analysis, which also distinguished the autism spectrum disorder group from controls. Together, results underscore key narrative impairments in autism spectrum disorder and support the promise of Latent Semantic Analysis as a valuable tool for the quantitative assessment of complex language abilities.
28095617	The vertebrate hindbrain includes neural circuits that govern essential functions including breathing, blood pressure and heart rate. Hindbrain circuits also participate in generating rhythmic motor patterns for vocalization. In most tetrapods, sound production is powered by expiration and the circuitry underlying vocalization and respiration must be linked. Perception and arousal are also linked; acoustic features of social communication sounds-for example, a baby's cry-can drive autonomic responses. The close links between autonomic functions that are essential for life and vocal expression have been a major in vivo experimental challenge. Xenopus provides an opportunity to address this challenge using an ex vivo preparation: an isolated brain that generates vocal and breathing patterns. The isolated brain allows identification and manipulation of hindbrain vocal circuits as well as their activation by forebrain circuits that receive sensory input, initiate motor patterns and control arousal. Advances in imaging technologies, coupled to the production of Xenopus lines expressing genetically encoded calcium sensors, provide powerful tools for imaging neuronal patterns in the entire fictively behaving brain, a goal of the BRAIN Initiative. Comparisons of neural circuit activity across species (comparative neuromics) with distinctive vocal patterns can identify conserved features, and thereby reveal essential functional components.
28095604	Alouatta species utter the most powerful primate vocalizations in the Neotropics and are well-known for their loud and long-lasting male howling bouts. However, the diversity of acoustic structures used in these howling bouts, as well as in non-howling contexts, and the relative contribution of the different group members to the entire vocal repertoire, needed to be explored further. This report provides the first detailed description of the vocal repertoire of black howler monkeys (Alouatta pigra), focusing on acoustic structures and contexts of emission of both loud and soft calls as well as on the contribution rate of males and females to the different call types. Three free-ranging social groups of black howler monkeys living in Palenque National Park, Mexico were monitored. We identified twelve acoustically discriminable call types, eight described previously and four described here for the first time. A few call types were systematically emitted either isolated or during howling bouts, but most of them could be heard in both calling contexts. Three call types were emitted only by females and two only by males. Adult males' call rates (for the seven shared call types) were higher than those of females but only when considering calls emitted within howling bouts. Our contextual analysis enabled us to divide call types into potential functional categories, according to their degree of contribution, to intra-group versus inter-group interactions and to neutral-positive versus negative situations. We then discussed how socio-ecological factors, notably sex differences in social behaviors, may explain the variability found in the vocal repertoire of this species and compared our findings with the literature on other primate species.
28095432	The huge proportion of child marriage contributes to high rates of pregnancies among adolescent girls in Bangladesh. Despite substantial progress in reducing maternal mortality in the last two decades, the rate of adolescent pregnancy remains high. The use of skilled maternal health services is still low in Bangladesh. Several quantitative studies described the use of skilled maternal health services among adolescent girls. So far, very little qualitative evidence exists about attitudes and practices related to maternal health. To fill this gap, we aimed at exploring maternal health care-seeking behavior of adolescent girls and their experiences related to pregnancy and delivery in Bangladesh.A prospective qualitative study was conducted among thirty married adolescent girls from three Upazilas (sub-districts) of Rangpur district. They were interviewed in two subsequent phases (2014 and 2015). To triangulate and validate the data collected from these married adolescent girls, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with different stakeholders. Data analysis was guided by the Social-Ecological Model (SEM) including four levels of factors (individual, interpersonal and family, community and social, and organizational and health systems level) which influenced the maternal health care-seeking behavior of adolescent girls. While adolescent girls showed little decision making-autonomy, interpersonal and family level factors played an important role in their use of skilled maternal health services. In addition, community and social factors and as well as organizational and health systems factors shaped adolescent girls' maternal health care-seeking behavior.	In order to improve the maternal health of adolescent girls, all four levels of factors of SEM should be taken into account while developing health interventions targeting adolescent girls.	
28095313	Social anxiety disorder (SAD) is characterized by negatively biased perception of social cues and deficits in emotion regulation. While negatively biased perception is thought to maintain social anxiety, emotion regulation represents an ability necessary to overcome both biased perception and social anxiety. Here, we used laughter as a social threat in a functional magnetic resonance imaging (fMRI) study to identify cerebral mediators linking SAD with attention and interpretation biases and their modification through cognitive emotion regulation in the form of reappraisal. We found that reappraisal abolished the negative laughter interpretation bias in SAD and that this process was directly mediated through activation patterns of the left dorsolateral prefrontal cortex (DLPFC) serving as a cerebral pivot between biased social perception and its normalization through reappraisal. Connectivity analyses revealed reduced prefrontal control over threat-processing sensory cortices (here: the temporal voice area) during cognitive emotion regulation in SAD. Our results indicate a central role for the left DLPFC in SAD which might represent a valuable target for future research on interventions either aiming to directly modulate cognitive emotion regulation in SAD or to evaluate its potential as physiological marker for psychotherapeutic interventions relying on emotion regulation.
28095117	This study sought to investigate parents' needs and preferences for school-based asthma support in Saudi Arabian primary schools.Semi-structured qualitative interviews were conducted in the period between November 2015 and February 2016, with a convenience sample that comprised Saudi parents and carers of children with asthma. Recruitment of participants was primarily driven through Saudi primary schools; passive snowballing and social networks were used to boost participation rates further. Interviews were audio-recorded, transcribed verbatim, translated and data were thematically organised using a latent content analysis approach.	Twenty interviews were conducted. Six themes emerged from the interviews and were grouped into three major categories: (1) general asthma management issues; (2) school-based asthma management issues; and (3) communication dissatisfaction. Participants expressed concern at schools' social and physical environments and a lack of confidence in the ability of schools to manage their child's asthma, especially when their child was ill. Most of the participants advocated for staff training and school community engagement to improve the management of asthma in Saudi primary schools.	This research clearly describes a need for school-based asthma support, including asthma-related policies, procedures and education on asthma and first aid in Saudi primary schools.	
28095058	Supporting interaction in inclusive settings between students with complex communication needs (CCN) and their peers requires careful planning and support. We used a multiple-probe-across-participants design to investigate the efficacy of collaborative planning and peer support arrangements to increase peer interaction in inclusive classrooms. Participants were four middle school students with CCN who had an intellectual disability and used an iPad with Proloquo2Go as augmentative and alternative communication (AAC). Educational teams comprised of a special educator, general educator, paraprofessional, and speech-language pathologist participated in collaborative planning for the intervention. For all four students, the intervention substantially increased communication to and from their peers. AAC use increased for one student. We offer implications for research and practice on supporting social interaction in general education settings.
28094822	Autism is characterized by impairment in reciprocal communication and speech, repetitive behaviors, and social communication. The genetic and environmental factors play roles in the pathogenesis of autism. It was recently shown that the genes involved in the folate/homocysteine pathway may be risk factors for autistic children. One of the genes that may be the risk factor for autism is Methionine synthase (MTR). MTR is responsible for the regeneration of methionine from homocysteine. The aim of this study was to analyze the association of MTR A2756G gene polymorphism (rs1805087) and the risk of autism in a population in northern Iran. The prevalence of MTR A2756G polymorphism was determined in 108 children with autism and 130 controls in northern Iran. Genotypes and allele frequencies were determined in patients and controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The prevalence of genotype frequencies of AA, AG and GG in autistic children were 57.41%, 22.22% and 20.37%, respectively, while in controls were 61.54%, 32.31% and 6.15%, respectively. There was significant difference between the MTR polymorphism distribution in control and patient groups. The prevalence of allele frequencies of A and G in autistic children were 0.69 and 0.31, respectively and in controls were 0.78 and 0.22, respectively (P=0.03). The MTR G allele conferred a 1.6-fold increased risk to autism relative to the A allele (95% CI=1.06-2.41, P=0.02). The present study suggests that the G allele of MTR A2756G polymorphism is associated with an increased risk of autism.
28094664	While the increasing number of people surviving cancer is promising, the long-term health effects warrant broad, innovative interventions. We investigated the feasibility and acceptability of a 24-week intervention called 'Active Book Club' comprising audio book listening, pedometer walking and supervised book club meetings.An exploratory and descriptive design was applied. Qualitative data included baseline and post-intervention focus group interviews as well as post-intervention individual interviews. The study also included data on retention, attendance, and adherence. Seventeen self-referred cancer survivors with various oncological and sociodemographic backgrounds were included.	Eight (47%) participants completed the entire intervention. Their median attendance at the book club meetings was eight [interquartile range (IQR) 6-9] of nine possible, and they reached the walking step goal in a median of 11 (IQR 7-12) of the first 12 weeks, and seven (IQR 1-10) of the last 12 weeks. The qualitative analysis revealed five themes including: Motivation and expectations (i.e. reasons for enrollment), Attentive listening (i.e. experiences of the audio book format), Affected by the story (i.e. experiences of the content of the books), Group involvement (i.e. experiences of the book club meetings) and Walking regularly (i.e. experiences of the walking program). Overall, findings revealed that while audio books may bring new meaning to physical activity and serve as a relief from own concerns, certain stories may affect some individuals negatively. The substantial dropout rate, however, suggested that modification is necessary and that patient involvement in choice of literature may be critical to enhance acceptability.	The 'Active Book Club' represents a novel psychosocial intervention potentially supporting physical activity adoption and mental health in cancer survivors. However, several issues related to feasibility and acceptability including choice of literature genre, format and supervision of book club meetings need to be considered before larger scale clinical trials are initiated.	
28094557	To collect in-depth information regarding cigarette initiation interactions in the early smoking experimentation among male youth in China, twenty focus groups with male teenagers (N = 165) were conducted. Focus group discussions indicated a high prevalence of cigarette initiation among peers, and such initiation often translated into immediate smoking. Of the identified cigarette initiation appeals, "face" and normative pressure appeals were the most difficult to reject. Upon first initiation attempts, more teenagers accepted cigarettes than rejected them. The reasons behind both cigarette initiation and acceptance primarily related to facilitating social interaction. Upon being rejected, initiating teenagers (agents) who insisted on offering cigarettes often gained compliance. Profiles of peer agents were constructed in this study. Key practical implications suggest simultaneously prioritizing efforts to reduce cigarette initiation and encouraging cigarette refusal.
28093798	This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations.
28093756	The Japanese expression 'Mottainai!' can be translated as 'What a waste!' or 'Don't be wasteful!' However, mottainai means much more than that. It expresses a sense of concern or regret for whatever is wasted because its intrinsic value is not properly utilized. Buddhism and Japan's indigenous religion, Shinto, are integral to the Japanese psyche, accordingly the other-than-human world is also experienced and lived in daily life. In the Japanese worldview everything in nature is endowed with spirit, every individual existence is dependent on others and all are connected in an ever-changing world. Mottainai offers a glimpse of the anima mundi inherent in this worldview. This contrasts with our anthropocentric Zeitgeist, which manifests outwardly as environmental crisis and inwardly as fixation upon social interactions, especially through communication technologies, to the exclusion of all else. Jung's statement, 'The decisive question for man is: Is he related to something infinite or not? That is the telling question of his life', has never been more pertinent. Encounters beyond the human world could be understood as touching this 'something infinite', and the apparent benefits of such experiences in the analytical process are illustrated with clinical vignettes from the author's practice.
28093379	There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports the intentions of the World Health Organization (WHO) to have integrated people-centered care.To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care, and embraces the use of digital technology.	The overall research method was inspired by action research and used an agile, iterative approach. In 2012, a living lab was established in a Danish municipality which allowed for the freedom of redesigning health care processes. As the first step, a wide group of stakeholders was gathered to create a layout for the reorganization of services and development of technology, based on established principles for innovative management of people with chronic conditions. The next three steps were (1) a proof of concept in 2012, (2) a pilot study, and (3) a feasibility study from 2013 to 2015, in which a total of 93 chronic obstructive pulmonary disease (COPD) patients were enrolled. Citizens were provided a tablet-based solution for remote follow-up and communication purposes, and access to a 24/7 response and coordination center that coordinated both virtual and face-to-face support for COPD management. In step five the initial model was extended with elements that support continuity of care. Beginning in the autumn of 2013, 1102 frail elderly individuals were included and offered two additional services: an outgoing acute medical team and a local subacute bed function.	Based on the findings from the iterative process, and evolving technology and workflow solutions, we propose a robust and feasible model that can provide a framework for developing solutions to support an active life with one or more LTCs. The resulting Epital Care Model (ECM) consists of six stages, and serves as a template for how a digitally-enhanced health service can be provided based on patients' medical needs. The model is designed to be a proactive, preventive, and monitoring health care system that involves individuals in the management of their own health conditions.	The ECM is in accordance with WHO's framework for integrated people-centered health services, and may serve as a framework for the development of new technologies and provide a template for future reorganization.	
28093278	Schizophrenia patients have impaired performance and abnormal brain activation during facial emotion recognition, which may represent a marker of genetic liability to schizophrenia. However, it remains unclear whether the impairment is specific to recognizing emotion from faces or is instead attributable to more generalized dysfunction. The current study aimed to distinguish between specific and generalized neural dysfunction underlying impaired facial emotion recognition in schizophrenia and examine associations with genetic liability. Twenty-eight schizophrenia patients, 27 nonpsychotic first-degree relatives, and 27 community controls underwent functional magnetic resonance imaging while making judgments about either the emotion or age of emotional faces. Patients had performance deficits during the emotion and age discrimination conditions compared to relatives and controls, while relatives had intact performance. Patients had hypoactivation compared to controls across conditions, mainly in medial prefrontal cortex. Unlike controls, patients demonstrated a failure to recruit the dorsomedial prefrontal cortex, a region involved in social cognition and decision-making, and relatives had a pattern of recruitment intermediate between patients and controls. Compared to controls, relatives had greater deactivation of regions associated with the default mode network, and patients had similar findings during age discrimination. The common patterns of performance deficits and activation abnormalities during emotion and age discrimination in schizophrenia suggest that generalized cognitive impairment, notably in social cognition and decision-making, contributes to impaired facial emotion recognition. Similar functional activation patterns in relatives, despite intact performance, suggest that brain activation may represent a more sensitive marker of genetic liability than behaviour. Hyperdeactivation of default mode network regions in relatives may represent cognitive inefficiency, or compensatory mechanisms that help maintain intact performance.
28093239	Social communication impairment has been implicated in various mental health disorders. The primary aim of this review paper is to summarize the extant research on the development and application of technologies to address social communication deficits, conceptualized according to the four constructs outlined by the NIMH's Research Domain Criteria (RDoC), transdiagnostically in children and adolescents. An exhaustive and systematic search yielded 69 peer-reviewed articles meeting all inclusion criteria (i.e., used technology, applied the technology to target impairment in at least one of four constructs of social communication, included a child or adolescent samples). We found limited use of technology for exploration of impairment in reception of non-facial communication, compared to the other social communication constructs. In addition, there has been an overwhelming focus on social communication impairment in children and adolescents with Autism Spectrum Disorder (ASD), with relatively few studies evaluating technology application in other clinical populations. Implications for future directions for technological interventions to treat social communication impairments transdiagnostically are discussed.
28092316	Newborn screening programs provide testing for all newborns born in this country for conditions that can potentially cause death or disability. Currently each state is responsible for its programs and the number of disorders screened varies from state to state. The current universal recommended metabolic screening panel may include 32 to 58 disorders. Expansion of the programs has impacted the role of nurses in the neonatal intensive care units (NICUs). Nurses are responsible for facilitating the screening process, educating the family, and assisting with follow-up. In addition, they are the first-line defense for emotional, spiritual, and social support.To review of the expansion of this program over time and discuss challenges the NICU nurse encounters.	Research literatures along with the national recommendation by governmental and professional agencies were reviewed to obtain evidence on current practice recommendations.	NICU nurses face several challenges with the expansion of newborn screening programs. This includes gaining knowledge to answer questions posed by empowered parents and educate them appropriately; ensuring quality of the process that minimizes errors and optimal communication; and, addressing ethical concerns about the storage and subsequent use of specimens. New and ongoing research can measure and ensure provision of quality services provided through the NICUs globally.	
28092296	There are many challenges to health, functioning, and participation for children with Down syndrome; yet, the quality-of-life (QOL) domains important for this group have never been clearly articulated. This study investigated parental observations to identify QOL domains in children with Down syndrome and determined whether domains differed between children and adolescents.The sample comprised 17 families whose child with Down syndrome was aged 6 to 18 years. Primary caregivers took part in semistructured telephone interviews to explore aspects of their child's life that were satisfying or challenging. Qualitative thematic analysis was implemented using a grounded theory framework to identify domains. The coded data set was divided into 2 groups (childhood and adolescence) at 3 age cut points to observe whether differences existed between the coded domains and domain elements: (1) 6 to 11 years with 12 to 18 years; (2) 6 to 13 years with 14 to 18 years; and (3) 6 to 15 years with 16 to 18 years.	Eleven domains were identified: physical health, behavior and emotion, personal value, communication, movement and physical activity, routines and predictability, independence and autonomy, social connectedness and relationships, variety of activities, nature and outdoors, and access to services. No differences in domains and domain elements were identified across childhood and adolescence.	Our data form a preliminary framework from which to design investigations of the child's perspectives on life quality and suggest a range of necessary supports and services.	
28092186	Background and aims Excessive use of social networking sites (SNS) has recently been conceptualized as a behavioral addiction (i.e., "disordered SNS use") using key criteria for the diagnosis of substance dependence and shown to be associated with a variety of impairments in psychosocial functioning, including an increased risk of problem drinking. This study sought to characterize associations between "disordered SNS use" and attitudes towards alcohol, drinking motives, and adverse consequences resulting from alcohol use in young adults. Methods Undergraduate students (n = 537, 64.0% female, mean age = 19.63 years, SD = 4.24) reported on their use of SNSs and completed the Alcohol Use Disorders Identification Test, Temptation and Restraint Inventory, Approach and Avoidance of Alcohol and Drinking Motives Questionnaires, and Drinker Inventory of Consequences. Results Respondents meeting previously established criteria for "disordered SNS use" were significantly more likely to use alcohol to cope with negative affect and to conform to perceived social norms, reported significantly more conflicting (i.e., simultaneous positive and negative) attitudes towards alcohol, and had experienced significantly more, and more frequent adverse consequences from drinking in their inter- and intrapersonal, physical, and social functioning, compared to individuals without problems related to SNS use. Discussion and conclusions Findings add to an emerging body of literature suggesting a link between excess or maladaptive SNS use and problems related to alcohol in young adults and point to emotion dysregulation and coping motives as potential shared risk factors for substance and behavioral addictions in this demographic.
28091344	Autism spectrum disorders (ASDs) are pervasive and multifactorial neurodevelopmental conditions, characterized by impairments in social communication and interaction, and restricted, repetitive patterns of behaviour, interests or activities. Treatment options to ameliorate symptoms of ASDs are limited. Heterogeneity complicates the quest for personalized medicine in this population. Our aim was to investigate if there are baseline characteristics of patients that moderate response or trial design features that impede the identification of efficacious interventions for ASDs.Literature searches of EMBASE, MEDLINE and PsycINFO identified 43 studies for qualitative assessment of baseline characterization of participants and 37 studies for quantitative analysis of moderators of treatment response. Criteria included blinded randomized controlled trials (RCTs) in paediatric ASD, with at least 10 participants per arm or 20 overall, of oral treatments, including pharmacological interventions and dietary supplements.	Random-effects meta-analysis of 1997 participants (81% male) identified three moderators associated with an increase in treatment response: trials located in Europe and the Middle-East; outcome measures designated primary status; and the type of outcome measure. Inconsistent reporting of baseline symptom severity and intellectual functioning prevented analysis of these variables. Qualitative synthesis of baseline characteristics identified at least 31 variables, with only age and gender reported in all trials. Biological markers were included in six RCTs.	Few trials reported adequate baseline characteristics to permit detailed analysis of response to treatment. Consideration of geographical location, baseline severity and intellectual function is required to ensure generalizability of results. The use of biological markers and correlates in ASD trials remains in its infancy. There is great need to improve the application of baseline characterization and incorporation of biological markers and correlates to permit selection of participants into homogeneous subgroups and to inform response to treatment in ASD.	
28090084	Vocalizations of human infants undergo dramatic changes across the first year by becoming increasingly mature and speech-like. Human vocal development is partially dependent on learning by imitation through social feedback between infants and caregivers. Recent studies revealed similar developmental processes being influenced by parental feedback in marmoset monkeys for apparently innate vocalizations. Marmosets produce infant-specific vocalizations that disappear after the first postnatal months. However, it is yet unclear whether parental feedback is an obligate requirement for proper vocal development. Using quantitative measures to compare call parameters and vocal sequence structure we show that, in contrast to normally raised marmosets, marmosets that were separated from parents after the third postnatal month still produced infant-specific vocal behaviour at subadult stages. These findings suggest a significant role of social feedback on primate vocal development until the subadult stages and further show that marmoset monkeys are a compelling model system for early human vocal development.
28089766	This communication examines the expanding phenotypes of the MECP2 C-terminal atypical Rett syndromes in males and their affected carrier mothers.We describe three males with normal karyotypes who presented with congenital evolving complex neurodevelopmental encephalopathies with multifaceted symptomatology of hypotonia, epilepsy, ataxia, spasticity, movement disorders, behavioral issues, severe intellectual impairment, and communication skills, and a protracted regression phase followed by stabilization. These phenotypes did not prompt us to identify atypical Rett syndrome early in childhood.	Genetic analysis identified the two brothers with C-terminal truncation and the third male with C-terminal missense mutations. These mutations were inherited from their mothers, both of whom had incompletely characterized modest intellectual, mental health, social, and gastrointestinal impairments. Neither was independently able to care properly for their son(s).	Mutations of the MECP2 gene should be considered early in males with hypotonia, developmental delay, profound intellectual impairment, and seizures, associated with a mother with psychosocial, cognitive, and gastrointestinal impairments. Counseling and supporting mildly affected mothers requires both medical and social efforts.	
28089714	Being touched is known to affect emotion, and even a casual touch can elicit positive feelings and affinity. Psychophysiological studies have recently shown that tactile primes affect visual evoked potentials to emotional stimuli, suggesting altered affective stimulus processing. As, however, these studies approached emotion from a purely unidimensional perspective, it remains unclear whether touch biases emotional evaluation or a more general feature such as salience. Here, we investigated how simple tactile primes modulate event related potentials (ERPs), facial EMG and cardiac response to pictures of facial expressions of emotion. All measures replicated known effects of emotional face processing: Disgust and fear modulated early ERPs, anger increased the cardiac orienting response, and expressions elicited emotion-congruent facial EMG activity. Tactile primes also affected these measures, but priming never interacted with the type of emotional expression. Thus, touch may additively affect general stimulus processing, but it does not bias or modulate immediate affective evaluation.
28088616	Problems in fairly allocating welfare and health resources are very often located in the spaces where citizens interact directly with state workers. This study draws on observations of doctor-patient encounters in disability assessments for the South African disability grant (DG) to examine how doctor-patient interactions and patient agency shape social welfare allocation in a context of high poverty and inequality. Data were gathered via interviews with healthcare workers and observations of doctor-patient interactions in twelve clinics and three hospitals in the Western Cape province between October 2013 and August 2014. Twenty-four doctors were interviewed, of whom seventeen were observed conducting a total of 216 consultations with patients. Two training sessions of DG assessors were also observed. Findings show that interactions between doctors and patients are sites of negotiation and contestation over rights to social assistance. Claimants' understanding of disability differed from biomedical and bureaucratic definitions. Patients attempted to influence doctors' decisions through narratives of suffering and performances of disability. Others used verbal or physical abuse as a form of protest against perceived unfair treatment. To defend themselves from these pressures and maintain authority in these interactions, doctors employed coping strategies that distanced and objectified claimants. This resulted in strained doctor-patient relationships and made the DG system confusing to the public. This demonstrates the importance of considering trust, power dynamics and the exercise of agency by both patients and providers in understanding policy implementation.
28088259	In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana.In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.	Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana.	In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.	
28087544	To synthesis the qualitative studies of children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).Systematic review and meta-ethnography.	CFS/ME is an important disabling illness, with uncertain cause and prognosis. As a result, children with CFS/ME can find themselves living with greater uncertainty and stigma, exacerbating the impact of the condition. There is a growing body of qualitative research in CFS/ME, yet there has been no attempt to systematically synthesis the studies involving children.	Studies exploring the experiences of children diagnosed with CFS/ME, published or unpublished, using qualitative methods were eligible. MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched as well as grey literature, reference lists and contacting authors. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography.	Ten studies involving 82 children with CFS/ME aged 8-18 were included. Our synthesis describes four third-order constructs within children's experiences: (1) disruption and loss: physical, social and the self; (2) barriers to coping: suspension in uncertainty, problems with diagnosis and disbelief; (3) facilitators to coping: reducing uncertainty, credible illness narratives, diagnosis and supportive relationships and (4) hope, personal growth and recovery. CFS/ME introduces profound biographical disruption through its effects on children's ability to socialise, perform school and therefore how they see their future. Unfamiliarity of the condition, problems with diagnosis and felt stigma prevent children from forming a new illness identity. Children adopt coping strategies such as building credible explanations for their illness.	Physical, social, emotional and self-dimensions of life should be included when treating and measuring outcomes from healthcare in paediatric CFS/ME. There is a need for greater recognition and diagnosis of childhood CFS/ME, specialist advice on activity management and improved communication between health and education providers to help children cope with their condition.	
28087123	Conversational entrainment, the natural tendency for people to modify their behaviors to more closely match their communication partner, is examined as one possible mechanism modulating the prevalence of vocal fry in the speech of young American women engaged in spoken dialogue.Twenty young adult female American English speakers engaged in two spoken dialogue tasks-one with a young adult female American English conversational partner who exhibited substantial vocal fry and one with a young adult female American English conversational partner who exhibited quantifiably less vocal fry. Dialogues were analyzed for proportion of vocal fry, by speaker, and two measures of communicative success (efficiency and enjoyment).	Participants employed significantly more vocal fry when conversing with the partner who exhibited substantial vocal fry than when conversing with the partner who exhibited quantifiably less vocal fry. Further, greater similarity between communication partners in their use of vocal fry tracked with higher scores of communicative efficiency and communicative enjoyment.	Conversational entrainment offers a mechanistic framework that may be used to explain, to some degree, the frequency with which vocal fry is employed by young American women engaged in spoken dialogue. Further, young American women who modulated their vocal patterns during dialogue to match those of their conversational partner gained more efficiency and enjoyment from their interactions, demonstrating the cognitive and social benefits of entrainment.	
28086967	The evidence-based practice profile (EBP2) questionnaire assesses students' self-reported knowledge, behaviour and attitudes related to evidence-based practice. The aim of this study was to translate and cross-culturally adapt EBP2 into Norwegian and to evaluate the reliability, validity and responsiveness of the Norwegian version.EBP2 was translated and cross-culturally adapted using recommended methodology. Face validity and feasibility were evaluated in a pilot on bachelor students and health and social workers (n = 18). Content validity was evaluated by an expert panel. Nursing students (n = 96), social educator students (n = 27), and health and social workers (n = 26) evaluated the instrument's measurement properties. Cronbach's alpha was calculated to determine internal consistency. Test-retest reliability was evaluated using the intra-class correlation coefficient (ICC) and standard error of measurement (SEM). Discriminative validity was assessed by independent sample t test. A confirmatory factor analysis (CFA) was performed to assess the structural validity of a five-factor model (Relevance, Sympathy, Terminology, Practice and Confidence) using the comparative fit index (CFI) and the root mean square error of approximation (RMSEA). A priori hypotheses on effect sizes and P values were formulated to evaluate the instrument's responsiveness.	The forward-backward translation was repeated three times before arriving at an acceptable version. Eleven of 58 items were re-worded. Face validity and content validity were confirmed. Cronbach's alpha was 0.90 or higher for all domains except Sympathy (0.66). ICC ranged from 0.45 (Practice) to 0.79 (Terminology) and SEM from 0.29 (Relevance) to 0.44 (Practice). There was a significant mean difference between exposure and no exposure to EBP for the domains Relevance, Terminology and Confidence. The CFA did not indicate an acceptable five-factor model fit (CFI = 0.69, RMSEA = 0.09). Responsiveness was as expected or better for all domains except Sympathy.	The cross-culturally adapted EBP2-Norwegian version was valid and reliable for the domains Relevance, Terminology and Confidence, and responsive to change for all domains, except Sympathy. Further development of the instrument's items are needed to enhance the instruments reliability for the domains Practice and Sympathy.	
28086857	Intimate partner violence (IPV) is a significant public health issue that affects 1 in 3 women globally and a similarly large number of women in Nepal. Over the past decade, important policy and programmatic steps have been taken to address violence against women in Nepal. There remains a dearth of evidence on the effectiveness of primary violence prevention strategies. The Change Starts at Home study begins to fill this gap by utilizing a multi-component social behaviour change communication (SBCC) strategy involving a radio drama and community mobilization to shift attitudes, norms and behaviours that underpin IPV perpetration in Nepal.The study uses a concurrent mixed-methods design. The quantitative aspect of the evaluation is a pair-matched, repeated cross-sectional 2-armed, single-blinded cluster trial (RCT: N = 36 clusters, 1440 individuals), comparing a social behaviour change communication (SBCC) strategy to radio programming alone for its impact on physical and / or sexual IPV at the end of programming (12 months' post-baseline) and 6-months post the cessation of project activities (18-months post baseline). The qualitative aspects of the design include several longitudinal approaches to understand the impact of the intervention and to examine mechanisms of change including in-depth interviews with participants (N = 18 couples), and focus group discussions with community leaders (N = 3 groups), and family members of participants (N = 12 groups). Treatment effects will be estimated with generalized logistic mixed models specified to compare differences in primary outcome from baseline to 12-month follow-up, and baseline to 18-months follow-up in accordance with intention-to-treat principles.	The study rigorously evaluates the effectiveness of a promising strategy to prevent IPV. The results of the trial will be immediately useful for governmental, nongovernmental, and donor funded programs targeting partner violence or social norms that underpin it. Findings of the study will also contribute to global knowledge on the effectiveness of media and community engagement as a primary prevention strategy for IPV.	
28086839	Researchers considering children's traditional ecological knowledge (TEK) highlighted the importance of examining children's daily activities as empirical contexts for its acquisition. Many of them evaluated children's TEK acquisition linearly as gain or loss, and paid less attention to the adaptive nature of this knowledge system and the social relationships arising from its acquisition processes. This study approaches children's TEK acquisition considering these abovementioned aspects. I utilize pastoral Maasai girls' firewood collection as a case study, and analyze the personal, interpersonal and cultural institutional aspects of girls' Ethnobotanical knowledge (EK) acquisition within this chore.Participant observation and unstructured interviews were used for data collection. I joined 12 girls (6 to 15 years old) on day trips for firewood collection, and documented their participation and performance during this chore. I observed interactions among girls and between girls and women concerning this activity, and investigated girls' perceptions of local wood species via their descriptions. I also informally interviewed 15 women, between 20 and 80 years old on their evaluation of the wood species to be used as firewood.	Current diet change and gender-age roles in chore participation in Maasai society require females to continually participate in firewood collection. Within this social context, girls intensively participated in day trips of firewood collection during the long-term vacation in the dry season. They collected a sizable amount from 24 plant species, and generated EK through personal sensual experiences, such as fragrance, hardness, and heaviness of different wood species. They acquired local taxonomy and terminology of different wood species, and learned others preferences for wood species used as fuel through interpersonal communication. These personal and interpersonal aspects, together with current diet change and division of labor within gender-age roles in Maasai society, provide EK with multi-dimensional meanings in current subsistence strategies.	Results of this study show that girls acquired EK with multi-dimensional meanings through daily firewood collection, which cannot be only evaluated in a linear manner. Future studies focused on children's TEK acquisition should consider the personal, interpersonal, and cultural institutional aspects of this adaptive knowledge system and children's roles within it.	
28086787	Due to the popularity of public service announcements (PSAs), as well as the broader health and social harms associated with illicit drug use, this study sought to investigate how drug prevention messages found in the Government of Canada's DrugsNot4Me campaign were understood, experienced, and engaged with among a group of street-involved young people in Vancouver, Canada.Qualitative interviews were conducted with 25 individuals enrolled in the At-Risk Youth Study, and a thematic analysis was conducted.	Findings indicate that the campaign's messages neither resonated with "at-risk youth", nor provided information or resources for support. In some cases, the messaging exacerbated the social suffering experienced by these individuals.	This study underscores the importance of rigorous evaluation of PSAs and the need to consider diverting funds allocated to drug prevention campaigns to social services that can meaningfully address the structural drivers of drug-related harms among vulnerable youth populations.	
28085541	Multimodal curricular assessment after adding standardized patient (SP) actor-based simulation to an advance care planning (ACP) facilitator training course and development of a formative feedback tool.ACP represents a highly valued service requiring more and better trained facilitators.	Participants were primarily nurses and social workers in a large multisite health system. The course included a precourse video demonstration of ACP, traditional lectures, and four 30-minute simulations with SPs. Knowledge was tested with a multiple choice question (MCQ) test. In addition to standard postcourse/postsimulation evaluations, learners were surveyed pre/post/30-90 days delayed for self-perceived confidence. A linear mixed-effects model was used to analyze changes over time. Trained faculty rated performance in simulations with an observational mini-clinical examination (mini-CEX)-type rating form with a checklist, global competency, and global communication rating. Inter-rater reliability (IRR) was calculated on randomly selected paired ratings.	Sixty-seven individuals consented to participate. MCQ scores improved from 83% ± 10% to 92% ± 8% (p < 0.001). Paired learner surveys of self-confidence across six domains were available for 65 pre, 65 post, and 40 delayed with a mean positive change on a 0 to 10 point scale from pre-post (2.32 ± 1.65; p < 0.001) and predelayed (2.34 ± 1.96; p < 0.001) time frames. For the faculty observation ratings of simulation performance, the average raw agreement for critical actions was 82% and IRR was 0.71.	Learner feedback and self-assessment suggest that actor-based simulation contributed to improved confidence in conducting ACP. The mini-CEX observation form is adequate for formative feedback, with further testing needed to make judgments of competence.	
28085084	Integrating wireless sensor network (WSN) into the emerging computing paradigm, e.g., cyber-physical social sensing (CPSS), has witnessed a growing interest, and WSN can serve as a social network while receiving more attention from the social computing research field. Then, the localization of sensor nodes has become an essential requirement for many applications over WSN. Meanwhile, the localization information of unknown nodes has strongly affected the performance of WSN. The received signal strength indication (RSSI) as a typical range-based algorithm for positioning sensor nodes in WSN could achieve accurate location with hardware saving, but is sensitive to environmental noises. Moreover, the original distance vector hop (DV-HOP) as an important range-free localization algorithm is simple, inexpensive and not related to the environment factors, but performs poorly when lacking anchor nodes. Motivated by these, various improved DV-HOP schemes with RSSI have been introduced, and we present a new neural network (NN)-based node localization scheme, named RHOP-ELM-RCC, through the use of DV-HOP, RSSI and a regularized correntropy criterion (RCC)-based extreme learning machine (ELM) algorithm (ELM-RCC). Firstly, the proposed scheme employs both RSSI and DV-HOP to evaluate the distances between nodes to enhance the accuracy of distance estimation at a reasonable cost. Then, with the help of ELM featured with a fast learning speed with a good generalization performance and minimal human intervention, a single hidden layer feedforward network (SLFN) on the basis of ELM-RCC is used to implement the optimization task for obtaining the location of unknown nodes. Since the RSSI may be influenced by the environmental noises and may bring estimation error, the RCC instead of the mean square error (MSE) estimation, which is sensitive to noises, is exploited in ELM. Hence, it may make the estimation more robust against outliers. Additionally, the least square estimation (LSE) in ELM is replaced by the half-quadratic optimization technique. Simulation results show that our proposed scheme outperforms other traditional localization schemes.
28084607	In the USA, levels of emotional well-being among cancer survivors remain low. Social media is recognized as important to improve their emotional well-being. However, little is known about social mechanisms that underlie the impact of health-related social media in cancer care. This study proposed a moderated mediation model to signify a pathway linking social media use to emotional well-being.Four-hundred and fifty-nine cancer survivors identified through the 2013 US-based Health Information National Trends Survey were included for data analysis. First, structural equation modeling was conducted to examine the path from social media use to emotional well-being, mediated by patient activation. Second, hierarchical regression was performed to test the moderation effect of emotion management. Last, a normal theory-based approach was used to explore the final moderated mediation model.	The effect of health-related social media use on emotional well-being was completely mediated by patient activation. Also, emotion management positively moderated the effect of patient activation on emotional well-being. Last, emotion management positively moderated the mediation pathway from health-related social media use to patient activation, and finally, to emotional well-being.	Health-related social media, by itself, is not sufficient to bring about improvement in cancer survivors' emotional well-being. Patient activation and emotion management play a significant role.	In future interventions designed to improve cancer survivors' emotional health, health practitioners should not only encourage cancer survivors to use social media for health purposes, but also activate them in the course of care, and improve their emotion self-management skills.	
28084154	Stigma is a major problem in schizophrenia, and the most effective way to reduce it is to provide information. But literature lacks studies evaluating long-term efficacy of mass communication.This is a pilot study to assess if a brief intervention (TV report) may have long-term effects.	Assessing stigma scores from subjects before and after seeing a vignette.	We found that the social distance and restriction to patients not only fell after a brief intervention but also kept lower after 1 and 3 months.	We conclude that even brief intervention may create persistent impact in reducing discrimination.	
28084140	To help the growing number of cancer survivors deal with the challenges of cancer survivorship, survivorship care plans (SCPs) were recommended by the Institute of Medicine (IOM) in 2006. The SCP is a formal document that contains both a tailored treatment summary and a follow-up care plan. Since the IOM recommendation 10 years ago, the implementation in daily clinical practice is minimal. Several studies have investigated the effects of SCPs on patient-reported outcomes and oncology and primary care providers (PCPs), but the quantity and quality of these studies are limited.The first four randomized trials comparing SCP delivery with usual care failed to show a positive effect on satisfaction with information provision, satisfaction with care, distress or quality of life. SCPs did improve the amount of information provided and communication of PCPs with medical specialists and patients. A recent small trial that changed the focus from SCP as primarily an information delivery intervention to a behavioral intervention did observe positive effects on self-reported health, lower social role limitations and a trend towards greater self-efficacy. Gaps in knowledge about SCPs include uncertainty about content and length of the SCP; whether it should be delivered online or on paper; the timing and frequency of delivery; which health care provide should deliver SCP care. Finally, cost-effectiveness of SCP interventions has received limited attention.	Currently, there is not enough evidence to warrant large-scale implementation of SCPs, or to abandon SCPs altogether. Emphasis on the SCP process and survivor engagement, supporting self-management may be an important way forward in SCP delivery. Whether this is beneficial and cost-effective on the long term and among different groups of cancer survivors needs further investigation.	
28084134	An increasing need exists for suitable measures to evaluate treatment outcome in adolescents. YP-CORE is a pan-theoretical brief questionnaire developed for this purpose, but it lacks studies in different cultures or languages.To explore the acceptability, factor structure, reliability, validity, and sensitivity to change of the Finnish translation of YP-CORE.	The study was conducted at the Department of Adolescent Psychiatry, Helsinki University Central Hospital. A Finnish translation was prepared by a team of professionals and adolescents. A clinical sample of 104 patients was asked to complete the form together with BDI-21 and BAI, and 92 of them filled the forms again after a 3-month treatment. Analysis included acceptability, confirmatory factor analysis, internal and test-re-test reliability, concurrent validity, influence of gender and age, and criteria for reliable change.	YP-CORE was well accepted, and the rate of missing values was low. Internal consistency (α = 0.83-.92) and test-re-test reliability were good (r = 0.69), and the results of CFA supported a one-factor model. YP-CORE showed good concurrent validity against two widely used symptom-specific measures (r = 0.62-0.87). Gender had a moderately strong effect on the scores (d = 0.67), but the effect of age was not as evident. The measure was sensitive to change, showing a larger effect size (d = 0.55) than in the BDI-21 and BAI (d = 0.31-0.50).	The results show that the translation of YP-CORE into Finnish has been successful, the YP-CORE has good psychometric properties, and the measure could be taken into wider use in clinical settings for outcome measurement in adolescents.	
28084112	Verbal fluency tests are often used as part of an assessment battery to investigate children's lexical knowledge as well as executive function skills. To date, however, issues surrounding consistency of measurement cloud comparisons across studies, with the developmental performance of Australian-English speaking children also currently lacking. This study tracked verbal fluency development as measured by two semantic fluency tasks that included coding of fluency, clustering and switching type responses.Participants included 355 typically developing Australian-English speaking children (4-10 years) and 46 young adults. Total fluency was determined by the number of words produced for each category (Animals or Food), minus repetitions and rule violations. Semantic clusters (words generated within a subcategory) were coded while switches between single words or subcategories were differentiated and coded as either hard or cluster switches.	Fluency showed consistent improvement over age. Cluster Switches and Hard Switches showed some evidence of a plateau in performance relative to fluency, but in opposite direction. Other measures showed no strong trends over age. Results were similar for both semantic categories.	Our results highlight the rich information available within a semantic fluency task and the importance of differentiating hard and cluster switches in paediatric samples.	
28083982	Halitosis is caused by volatile sulphur compounds including methyl mercaptan (CH3 SH) in the oral cavity and is a serious problem that limits interpersonal social communication. The aim of study was to evaluate the effects of reuterin-related compounds (RRCs) on halitosis-related periodontopathic bacteria in vitro.RRC-01, RRC-02 and RRC-03 (32 and 64 μg ml-1 ) in culture media containing Fusobacterium nucleatum JCM8523 and Porphyromonas gingivalis ATCC33277 were used. The effects of RRCs on CH3 SH production and detectable odour by F. nucleatum and P. gingivalis were examined by CH3 SH production assay and organoleptic test, respectively. The number of bacterial cells was also measured using an ATP assay. In P. gingivalis treated with RRCs, the expression of mgl gene, which is responsible for CH3 SH production, was examined by qRT-PCR.	CH3 SH production and the score of detectable odour from F. nucleatum and P. gingivalis culture media containing RRCs were significantly lower than that without RRCs (P < 0.05). The expression of mgl gene in P. gingivalis was significantly downregulated by RRC-01 (P < 0.01), but not by RRC-02 or RRC-03.	RRCs are potent oral care products for preventing halitosis via reducing CH3 SH production.	
28083927	Corn Soy Blend (CSB) porridge is commonly prepared with oil for treatment of moderate acute malnutrition (MAM). A recent review recommended that 30 g of oil be used with 100 g of CSB to increase energy density and micronutrient absorption. This study assessed the effectiveness and cost-effectiveness of program changes aimed at achieving that target oil:CSB ratio in prepared porridge. Caregivers of children in MAM supplementary feeding programs were assigned to three groups: a control group received monthly rations of 1 L oil, 8 kg CSB in bulk, and social and behavior change communication (SBCC); intervention groups received 2.6 L oil, 8 kg CSB provided either in bulk (Group 1) or four 2-kg packages with printed messages (Group 2), and enhanced SBCC emphasizing the target oil:CSB ratio. Compared to the control, both intervention groups had higher mean added oil per 100 g CSB (18 g, p < 0.01, and 13 g, p= 0.04, higher in groups 1 and 2, respectively), and greater odds of meeting or exceeding the target ratio (28.4, p< 0.01, and 12.7, p= 0.02, in groups 1 and 2, respectively). Cost per caregiver reaching the target ratio was most favorable in Group 1 ($391 in Group 1, $527 in Group 2, and $1,666 in the control). Enhanced SBCC combined with increased oil ration resulted in increased use of oil in CSB porridge in a supplementary feeding program. Modified packaging did not improve effectiveness. However, both interventions were more cost-effective than standard programming.
28083845	Lower participation rates in cancer genetic counseling are observed among different ethnic minorities. The goal of our study is to gain insight into determinants of Turkish and Moroccan patients' participation in breast cancer genetic counseling and DNA testing, from the point of view of healthcare professionals and patients. Questionnaire-based telephone interviews about awareness, perceptions, and reasons for (non-) participation in cancer genetic counseling were conducted with 78 Dutch breast cancer patients from Turkish and Moroccan descent. The interviews were held in Arabic, Berber, Turkish, or Dutch by bilingual research assistants. Additionally, 14 breast cancer patients participated in one of two focus group meetings, and two focus groups were held with 11 healthcare professionals. SPSS and QSR Nvivo were used to examine the quantitative and qualitative data, respectively. Half of the total group of patients (N = 78) and 79% of patients eligible for genetic counseling and testing (N = 33) were aware of the possibility of genetic counseling. The most important determinants for nonparticipation in genetic counseling were experienced difficulties in patient-doctor communication, cultural factors (e.g., social norms), limited health literacy, limited knowledge of the family cancer history, and anxiety about cancer. Religious beliefs and knowing personal and family members' breast cancer risks were motives to obtain genetic counseling. Despite the fact that our study showed that Moroccan and Turkish women reported several personal motives to obtain genetic counseling and testing (GCT), patients and healthcare professionals experience significant language and health literacy difficulties, which make it harder to fully access health care such as genetic counseling and testing.
28083832	Male circumcision (MC) significantly reduces HIV acquisition among men, leading WHO/UNAIDS to recommend high HIV and low MC prevalence countries circumcise 80% of adolescents and men age 15-49. Despite significant investment to increase MC capacity only 27% of the goal has been achieved in Zimbabwe. To increase adoption, research to create evidence-based messages is greatly needed. The Integrated Behavioral Model (IBM) was used to investigate factors affecting MC motivation among adolescents. Based on qualitative elicitation study results a survey was designed and administered to a representative sample of 802 adolescent boys aged 13-17 in two urban and two rural areas in Zimbabwe. Multiple regression analysis found all six IBM constructs (2 attitude, 2 social influence, 2 personal agency) significantly explained MC intention (R2 = 0.55). Stepwise regression analysis of beliefs underlying each IBM belief-based construct found 9 behavioral, 6 injunctive norm, 2 descriptive norm, 5 efficacy, and 8 control beliefs significantly explained MC intention. A final stepwise regression of all the significant IBM construct beliefs identified 12 key beliefs best explaining intention. Similar analyses were carried out with subgroups of adolescents by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group. This study demonstrates the application of theory-driven research to identify evidence-based targets for the design of effective MC messages for interventions to increase adolescents' motivation. Incorporating these findings into communication campaigns is likely to improve demand for MC.
28083724	In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency.
28083091	Social living ultimately depends on coordination between group members, and communication is necessary to make this possible. We suggest that this might have been the key selection pressure acting on the evolution of language in humans and use a behavioural coordination model to explore the impact of communication efficiency on social group coordination. We show that when language production is expensive but there is an individual benefit to the efficiency with which individuals coordinate their behaviour, the evolution of efficient communication is selected for. Contrary to some views of language evolution, the speed of evolution is necessarily slow because there is no advantage in some individuals evolving communication abilities that much exceed those of the community at large. However, once a threshold competence has been achieved, evolution of higher order language skills may indeed be precipitate.
28081554	This research aims to assess the nature and extent of alcohol marketing through sport sponsorship over a summer of televised sport in New Zealand.Frequency analysis of New Zealand television broadcasts of five international sporting events during the summer of 2014-2015. Broadcasts were analysed to identify the percentage of time when alcohol brands were visible during game-play. The number of independent alcohol brand exposures was recorded.	Alcohol brands were observed during every televised event. Audiences were exposed to between 1.6 and 3.8 alcohol brand exposures per minute. Alcohol brands were visible between 42 and 777 times across the games examined. For three out of the five events alcohol brands were visible for almost half of the game.	Alcohol sponsorship was prevalent in international sport on New Zealand television. Given the popularity of broadcast sport, especially with children, there is an urgent need for regulation of alcohol sponsorship of sport. There are viable models of alcohol sponsorship replacement but their implementation requires the will of both sporting organisations and politicians. This research adds weight to arguments to implement recommendations to remove all alcohol sponsorship of sport.	

28081302	Head and neck cancer (HNC) encompasses a diverse group of tumors, and thus providing appropriate and tailored information to patients before, during, and after treatment is a challenge. The objective of the current study was to characterize the experience and unmet needs of patients with HNC with regard to information and support provision.A 28-question, cross-sectional survey was completed by patients treated for HNC at 1 of 4 institutions in New South Wales, Australia (Chris O'Brien Lifehouse and Liverpool, Westmead, and Wollongong hospitals). It consisted of the adapted Kessler Psychological Distress Scale and questions assessing information quality, quantity, and format.	A total of 597 patients responded. The mean age of the patients was 58 years (range, 21-94 years) with 284 men and 313 women (1:1.1). The majority of patients reported information concerning the disease process (76%), prognosis (67%), and treatment (77%) was sufficient, and approximately 50% reporting having received little or no information regarding coping with stress and anxiety. A substantial percentage of patients reported receiving minimal information concerning psychosexual health (56%) or the availability of patient support groups (56%). The majority of patients preferred access to multiple modes of information delivery (72%), with the preferred modality being one-on-one meetings with a health educator (37%) followed by internet-based written information (19%).	Patients with HNC are a diverse group, with complex educational and support needs. Patients appear to be given information regarding survivorship topics such as psychological well-being, patient support groups, and psychosexual health less frequently than information concerning disease and treatment. Verbal communication needs to be reinforced by accessible, well-constructed, written and multimedia resources appropriate to the patient's educational level. Cancer 2017;123:1949-1957. © 2017 American Cancer Society.	
28081117	This study aims to elucidate the intricate interplay between public attention and public emotion toward multiple social issues. A theoretical framework is developed based on three perspectives including endogenous affect hypothesis, affect transfer hypothesis, and affective intelligence theory. Large-scale longitudinal data with 265 million tweets on five social issues are analyzed using a time series analytical approach. Public attention on social issues can influence public emotion on the issue per se. Social issues interact with one another to attract public attention in both cooperative and competitive ways. Instead of a direct transfer from public emotion to public attention, the public emotion toward a social issue moderates the interaction between the issue and other issue(s).
28080261	This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB).Participants included healthy, primarily English-speaking Hispanic (n = 93; Hispanic-English), primarily Spanish-speaking Hispanic (n = 93; Hispanic-Spanish), and English speaking Non-Hispanic white (n = 93; NH white) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses.	Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH whites on demographically unadjusted NIHTB-CB Fluid Composite scores (ps < .01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p = .001), processing speed (p = .003), and working memory (p < .001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group.	On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated.	
28080152	Propagation of political ideologies in social networks has shown a substantial impact on voting behavior. Both the contents of the messages (the ideology) and the politicians' influence on their online audiences (their followers) have been associated with such an impact. In this study we evaluate which of these factors exerted a major role in deciding electoral results of the 2015 Colombian regional elections by evaluating the linguistic similarity of political ideologies and their influence on the Twitter sphere. The electoral results proved to be strongly associated with tweets and retweets and not with the linguistic content of their ideologies or politicians' followers in Twitter. Finally, suggestions for new ways to analyze electoral processes are discussed.
28080149	This study examined preferences and ascriptions of human control for avatars associated with positive and negative language. An avatar is a graphical representation of an individual user in a virtual world. Users form judgments of other virtual world users based on the appearance and behavior of their avatars in the absence of physical cues. In particular, users have previously displayed sensitivity toward anthropomorphism and verbal behavior of avatars they encounter within virtual environments. Thus far, investigations of language in online and virtual spaces have been limited to specific contexts. University student participants and Amazon Mechanical Turk workers were shown two avatars. Each pair consisted of two out of three possible appearances: a tiger, a male, or a female. Each avatar was aligned with a different text introduction: one containing words of positive emotional valence and the other of negative emotional valence. Participants from both samples preferred avatars associated with positive language, regardless of appearance, but participants did not ascribe human control of an avatar based on either emotional valance or appearance. Significant differences for reported preferences and likeability demonstrate the salience of emotive language as a social cue even in short text introductions for avatars. These findings suggest that those we like and want to be around in virtual environments might not necessarily align with whom we view as human.
28080085	Emotion expression is critical for the communication of important social information, such as emotional states and behavioral intentions. However, people tend to vary in their level of emotional expression. This meta-analysis investigated the relationships between levels of emotion expression and suppression, and social and interpersonal outcomes. PsycINFO databases, as well as reference lists were searched. Forty-three papers from a total of 3,200 papers met inclusion criteria, allowing for 105 effect sizes to be calculated. Meta-analyses revealed that greater suppression of emotion was significantly associated with poorer social wellbeing, including more negative first impressions, lower social support, lower social satisfaction and quality, and poorer romantic relationship quality. Furthermore, the expression of positive and general/nonspecific emotion was related to better social outcomes, while the expression of anger was associated with poorer social wellbeing. Expression of negative emotion generally was also associated with poorer social outcomes, although this effect size was very small and consisted of mixed results. These findings highlight the importance of considering the role that regulation of emotional expression can play in the development of social dysfunction and interpersonal problems. (PsycINFO Database Record
28079875	A neonatal illness severity score, The Score for Neonatal Acute Physiology-II (SNAP-II), predicts neurodevelopmental impairments at two years of age among children born extremely preterm. We sought to evaluate to what extent SNAP-II is predictive of cognitive and other neurodevelopmental impairments at 10 years of age.In a cohort of 874 children born before 28 weeks of gestation, we prospectively collected clinical, physiologic and laboratory data to calculate SNAP-II for each infant. When the children were 10 years old, examiners who were unaware of the child's medical history assessed neurodevelopmental outcomes, including neurocognitive, gross motor, social and communication functions, diagnosis and treatment of seizures or attention deficit hyperactivity disorder (ADHD), academic achievement, and quality of life. We used logistic regression to adjust for potential confounders.	An undesirably high SNAP-II (⩾30), present in 23% of participants, was associated with an increased risk of cognitive impairment (IQ, executive function, language ability), adverse neurological outcomes (epilepsy, impaired gross motor function), behavioral abnormalities (attention deficit disorder and hyperactivity), social dysfunction (autistic spectrum disorder) and education-related adversities (school achievement and need for educational supports. In analyses that adjusted for potential confounders, Z-scores ⩽-1 on 11 of 18 cognitive outcomes were associated with SNAP-II in the highest category, and 6 of 18 were associated with SNAP-II in the intermediate category. Odds ratios and 95% confidence intervals ranged from 1.4 (1.01, 2.1) to 2.1 (1.4, 3.1). Similarly, 2 of the 8 social dysfunctions were associated with SNAP-II in the highest category, and 3 of 8 were associated with SNAP-II in the intermediate category. Odds ratios and 95% confidence intervals were slightly higher for these assessments, ranging from 1.6 (1.1, 2.4) to 2.3 (1.2, 4.6).	Among very preterm newborns, physiologic derangements present in the first 12 postnatal hours are associated with dysfunctions in several neurodevelopmental domains at 10 years of age. We are unable to make inferences about causality.	
28079726	In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems.This article contains the Charter on Professionalism for Health Care Organizations, as well as the process and rationale for its development. For hospitals and hospital systems to effectively care for patients, maintain a healthy workforce, and improve the health of populations, they must attend to the four domains addressed by the Charter: patient partnerships, organizational culture, community partnerships, and operations and business practices. Impacting the social determinants of health will require collaboration among health care organizations, government, and communities.Transitioning to the model hospital described by the Charter will challenge historical roles and assumptions of both its leadership and staff. While the Charter is aspirational, it also outlines specific institutional behaviors that will benefit both patients and workers. Lastly, this article considers obstacles to implementing the Charter and explores avenues to facilitate its dissemination.
28079721	Retention in care is the most challenging step along the HIV care continuum. Many patients who engage in care and achieve viral suppression have care interruptions, characterized by moving in and out of care ("churn"). Poor retention has clinical consequences and contributes to new HIV transmissions, but how to predict or prevent it remains elusive. This study sought to understand the relationship between individual- and structural-level barriers, and poor retention for persons living with HIV/AIDS in Atlanta, GA.We administered a survey, through interviews, with HIV-infected patients continuously retained in care for 6 years ("continuously retained," n = 32) and patients with recent gaps in care ("unretained" n = 27). We assessed individual-level protective factors for successful engagement (self-efficacy, resilience, perceived social support, and disclosure), risk factors for poor engagement (substance use, mental illness, and stigma), and structural/systemic-level barriers (financial and housing instability, transportation, food insecurity, communication barriers, and incarceration history). Chi-square and Mann-Whitney U tests were used to compare the 2 populations.	Both continuously retained and unretained populations had high rates of prior viral suppression but few unretained patients were virologically suppressed upon return to care (11%). Younger age, crack cocaine use, food insecurity, financial instability, housing instability, and phone number changes in the past year were significantly more likely to be present in the unretained population.	Our findings suggest the need for targeted risk assessment tools to predict the highest-risk patients for poor retention whereby public health interventions can be directed to those individuals.	
28078763	Discharge communication is an important aspect of high-quality emergency care. This study addresses the gap in knowledge on how to describe discharge communication in a paediatric emergency department (ED).The objective of this feasibility study was to develop and test a coding scheme to characterize discharge communication between health-care providers (HCPs) and caregivers who visit the ED with their children.	The Pediatric Emergency Discharge Interaction Coding Scheme (PEDICS) and coding manual were developed following a review of the literature and an iterative refinement process involving HCP observations, inter-rater assessments and team consensus.	The coding scheme was pilot-tested through observations of HCPs across a range of shifts in one urban paediatric ED.	Overall, 329 patient observations were carried out across 50 observational shifts. Inter-rater reliability was evaluated in 16% of the observations. The final version of the PEDICS contained 41 communication elements.	Kappa scores were greater than .60 for the majority of communication elements. The most frequently observed communication elements were under the Introduction node and the least frequently observed were under the Social Concerns node. HCPs initiated the majority of the communication.	Pediatric Emergency Discharge Interaction Coding Scheme addresses an important gap in the discharge communication literature. The tool is useful for mapping patterns of discharge communication between HCPs and caregivers. Results from our pilot test identified deficits in specific areas of discharge communication that could impact adherence to discharge instructions. The PEDICS would benefit from further testing with a different sample of HCPs.	
28078566	Traditional cognitive assessment in neurological conditions involving physical disability is often prevented by the presence of verbal-motor impairment; to date, an extensive motor-verbal-free neuropsychological battery is not available for such purposes. We adapted a set of neuropsychological tests, assessing language, attentional abilities, executive functions and social cognition, for eye-tracking (ET) control, and explored its feasibility in a sample of healthy participants. Thirty healthy subjects performed a neuropsychological assessment, using an ET-based neuropsychological battery, together with standard "paper and pencil" cognitive measures for frontal (Frontal Assessment Battery-FAB) and working memory abilities (Digit Sequencing Task) and for global cognitive efficiency (Montreal Cognitive Assessment-MoCA). Psychological measures of anxiety (State-Trait Anxiety Inventory-Y-STAI-Y) and depression (Beck Depression Inventory-BDI) were also collected, and a usability questionnaire was administered. Significant correlations were observed between the "paper and pencil" screening of working memory abilities and the ET-based neuropsychological measures. The ET-based battery also correlated with the MoCA, while poor correlations were observed with the FAB. Usability aspects were found to be influenced by both working memory abilities and psychological components. The ET-based neuropsychological battery developed could provide an extensive assessment of cognitive functions, allowing participants to perform tasks independently from the integrity of motor or verbal channels. Further studies will be aimed at investigating validity and usability components in neurological populations with motor-verbal impairments.
28077966	This study examined the pathways by which destructive and constructive marital conflict leading to social skills development in preschool children, are mediated through negative and positive parenting practices.Mothers of 2931 Japanese children, aged 5-6 years, completed self-report questionnaires regarding their marital relationship (the Quality of co-parental communication scale) and parental practices (the Alabama parenting questionnaire). The children's teachers evaluated their social skills using the Social skills scale.	Path analyses revealed significant direct paths from destructive marital conflict to negative parenting practices and lower scores on the self-control component of social skills. In addition, negative parenting practices mediated the relationship between destructive marital conflict and lower scores on cooperation, self-control, and assertion. Our analyses also revealed significant direct paths from constructive marital conflict to positive parenting practices, and higher scores on cooperation and assertion. Positive parenting practices mediated the relationship between constructive marital conflict and higher scores on self-control and assertion.	These findings suggest that destructive and constructive marital conflict may directly and indirectly influence children's social skills development through the mediation of parenting practices.	
28077910	The First Mediterranean Seminar on Science Writing, Editing & Publishing (SWEP 2016) was held in Sarajevo, Bosnia & Herzegovina from 2nd to 3rd December 2016. It was organized by Academy of Medical Sciences of Bosnia and Herzegovina, running concurrent sessions as part of its Annual Meeting titled " "Days of AMNuBiH - Theory and Practice in Science Communication and Scientometrics". Hotel Bosnia in the city centre was the chosen venue. On the first day, nineteen presentations on various issues of science writing and publication ethics were delivered by speakers from Croatia, Serbia, Macedonia, Albania, Bosnia & Herzegovina and the UK (Asim Kurjak, Milivoj Boranić, Doncho Donev, Osman Sinanović, Miro Jakovljević, Enver Zerem, Dejan Milošević, Silva Dobrić, Srećko Gajović, Izet Mašić, Armen Yuri Gasparyan, Šekib Sokolović, Nermin Salkić, Selma Uzunović, Admir Kurtčehajić, Edin Begić and Floreta Kurti). Each presentation had a take-home message for novice and seasoned authors, encountering numerous problems in non-Anglophone research environment. Lecturers, who were internationally recognized editors of regional journals, generously shared their experience of adhering to the best ethical guidance. Elegant presentations by Srećko Gajović (Editor-in-Chief of the Croatian Medical Journal) and Armen Yuri Gasparyan (past Chief Editor of the European Science Editing) showcased their accomplishments that strengthened ties between authors from all over the world. Gasparyan reflected on educational resources of editorial associations, such as the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE), and called not just to declare the adherence to, but also to enforce their ethical guidance in daily practice. Editors of Medical Archives, Croatian Medica Journal, Vojnosanitetski Pregled, Psychiatria Danubina, Acta Informatica Medica, Materia Socio-Medica, The Donald School Journal of Ultrasound in Obstretics and Gynecology, Acta Medica Saliniana and Medicinski Glasnik presented their editorial strategies aimed at attracting best authors and resolving problems with authorship, conflicts of interest, and plagiarism. Topical education on science writing and editing was considered as an inseparable part of continuing professional development in biomedicine. Armen Yuri Gasparyan (UK) was offered an opportunity to interact with more than 70 participants, attending the SWEP 2016 on the second day. The lecturer talked about author contributions, disclosures of conflicts of interests, plagiarism of ideas and words, research performance and impact indicators, and targeting ethical journals. Topics were presented in a way to help non-Anglophone authors, reviewers and editors avoid common ethical problems. Dr Gasparyan stressed the importance of regularly arranging such meetings across Balkan and Mediterranean countries to eradicate plagiarism and other forms research misconduct. The organizers of the SWEP 2016 awarded selected keynote speakers with certificates of lifetime achievement in journal editing, and decided to run the Seminar annually with support of Balkan and Mediterranean editors and publishers. The SWEP 2016 marked a turning point in the process of regional developments since all attending editors opted for nurturing enthusiasm of the organizers and launching the Mediterranean Association of Science Editors and Publishers (MASEP). The Seminar was a great success with its impressive scientific and social activities. It attracted more than 100 students, researchers, editors, and publishers from Bosnia & Herzegovina and neighbouring countries. Proceedings, in the form of short reports, were published in Acta Informatica Medica and archived in PubMed Central. New friendships were forged between regional experts in editing and young specialists during those unforgettable two days of intensive discussions and informal interactions (a-y).
28077345	Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts).The objectives of our study were as follows: (1) assess clinicians' and adolescents' views on using an e-monitoring tool and to use this information to help shape the development of the tool and (2) assess clinician experiences with a fully developed version of the tool that was implemented in their clinical service.	A descriptive qualitative study using semistructured focus groups was conducted in New Zealand. In total, 7 focus groups included clinicians (n=50) who worked in primary care, and 3 separate groups included adolescents (n=29). Clinicians were general practitioners (GPs), school guidance counselors, clinical psychologists, youth workers, and nurses. Adolescents were recruited from health services and a high school. Focus groups were run to enable feedback at 3 phases that corresponded to the consultation, development, and postimplementation stages. Thematic analysis was applied to transcribed responses.	Focus groups during the consultation and development phases revealed the need for a simple e-monitoring registration process with guides for end users. Common concerns were raised in relation to clinical burden, monitoring risk (and effects on the therapeutic relationship), alongside confidentiality or privacy and technical considerations. Adolescents did not want to use their social media login credentials for e-monitoring, as they valued their privacy. However, adolescents did want information on seeking help and personalized monitoring and communication arrangements. Postimplementation, clinicians who had used the tool in practice revealed no adverse impact on the therapeutic relationship, and adolescents were not concerned about being e-monitored. Clinicians did need additional time to monitor adolescents, and the e-monitoring tool was used in a different way than was originally anticipated. Also, it was suggested that the registration process could be further streamlined and integrated with existing clinical data management systems, and the use of clinician alerts could be expanded beyond the scope of simply flagging adolescents of concern.	An e-monitoring tool was developed in consultation with clinicians and adolescents. However, the study revealed the complexity of implementing the tool in clinical practice. Of salience were privacy, parallel monitoring systems, integration with existing electronic medical record systems, customization of the e-monitor, and preagreed monitoring arrangements between clinicians and adolescents.	
28077195	The integration of new knowledge into clinical practice continues to lag behind discovery. The use of Free Open Access Medical education (FOAM) has disrupted communication between emergency physicians, making it easy for practicing clinicians to interact with colleagues from around the world to discuss the latest and highest impact research. FOAM has the potential to decrease the knowledge translation gap, but the concerns raised about its growing influence are 1) research that is translated too quickly may cause harm if its findings are incorrect; 2) there is little editorial oversight of online material; and 3) eminent online individuals may develop an outsized influence on clinical practice. We propose that new types of scholars are emerging to moderate the changing landscape of knowledge translation: 1) critical clinicians who critically appraise research in the same way that lay reviewers critique restaurants; 2) translational teachers adept with these new technologies who will work with researchers to disseminate their findings effectively; and 3) interactive investigators who engage with clinicians to ensure that their findings resonate and are applied at the bedside. The development of these scholars could build on the promise of evidence-based medicine by enhancing the appraisal and translation of research in practice.
28077170	Traumatic brain injury (TBI) survivors often report difficulties with understanding and producing paralinguistic cues, as well as understanding and producing basic communication tasks. However, a large range of communicative deficits in this population cannot be adequately explained by linguistic impairment. The review examines prosodic processing performance post-TBI, its relationship with injury severity, brain injury localization, recovery and co-occurring psychiatric or mental health issues post-TBI METHODS: A systematic review using several databases including MEDLINE, EMBASE, Cochrane, LLBA (Linguistics and Language Behaviour Abstract) and Web of Science (January 1980 to May 2015), as well as a manual search of the cited references of the selected articles and the search cited features of PubMed was performed. The search was limited to comparative analyses between individuals who had a TBI and non-injured individuals (control). The review included studies assessing prosodic processing outcomes after TBI has been formally diagnosed. Articles that measured communication disorders, prosodic impairments, aphasia, and recognition of various aspects of prosody were included. Methods of summary included study characteristics, sample characteristics, demographics, auditory processing task, age at injury, brain localization of the injury, time elapsed since TBI, reports between TBI and mental health, socialization and employment difficulties. There were no limitations to the population size, age or gender. Results were reported according to the PRISMA guidelines. Two raters evaluated the quality of the articles in the search, extracted data using data abstraction forms and assessed the external and internal validity of the studies included using STROBE criteria. Agreement between the two raters was very high (Cohen's kappa = .89, P < 0.001). Results are reported according to the PRISMA guidelines.A systematic review of 5212 records between 1980 and 2015 revealed 206 potentially eligible studies and 8 case-control studies (3 perspective and 5 retrospective) met inclusion and exclusion criteria for content and quality. Performance on prosodic processing tasks was found to be impaired among all participants with a history of TBI (ages ranged from 8 to 70 years old), compared to those with no history of TBI, in all eight studies examined. Compared with controls, individuals with a history of TBI had statistically significantly slower reaction time in identifying emotions from prosody and impaired processing of prosodic information that is muffled, non-sense, competing, or in conflict (prosody versus semantics). Heterogeneous findings on correlations between specific brain locations and prosodic processing impairment were reported. Psychiatric issues, employment status or social integration post-TBI were scarcely reported but, when reported, they co-occurred with a history of TBI and prosodic impairments.	The current review confirms the relationship between impaired prosodic processing and history of TBI. Future studies should collect and report comprehensive details about severity of TBI, location of brain injury and time elapsed since injury, as they could key influence factors to the extent of prosodic processing impairments and recovery from auditory processing impairments post-TBI. The exploration of prosodic processing tasks as a possible neuropsychological marker of TBI diagnosis and recovery is warranted.	
28076659	Water reuse can serve as a sustainable alternative water source for urban areas. However, the successful implementation of large-scale water reuse projects depends on community acceptance. Because of the negative perceptions that are traditionally associated with reclaimed water, water reuse is often not considered in the development of urban water management plans. This study develops a simulation model for understanding community opinion dynamics surrounding the issue of water reuse, and how individual perceptions evolve within that context, which can help in the planning and decision-making process. Based on the social amplification of risk framework, our agent-based model simulates consumer perceptions, discussion patterns, and their adoption or rejection of water reuse. The model is based on the "risk publics" model, an empirical approach that uses the concept of belief clusters to explain the adoption of new technology. Each household is represented as an agent, and parameters that define their behavior and attributes are defined from survey data. Community-level parameters-including social groups, relationships, and communication variables, also from survey data-are encoded to simulate the social processes that influence community opinion. The model demonstrates its capabilities to simulate opinion dynamics and consumer adoption of water reuse. In addition, based on empirical data, the model is applied to investigate water reuse behavior in different regions of the United States. Importantly, our results reveal that public opinion dynamics emerge differently based on membership in opinion clusters, frequency of discussion, and the structure of social networks.
28075713	This study was a 2-phase activist research project aimed at co-creating a prototype pedagogical model for working with youth from socially vulnerable backgrounds in a sport context. This article addresses the learning aspirations (learning outcomes) that emerged when we created spaces for youth to develop strategies to manage the risks they face in their community.This study took place in a socially and economically disadvantaged neighborhood in a Brazilian city where we worked with a group of 17 boys aged 13 to 15 years old, 4 coaches, a pedagogic coordinator, and a social worker. During a 6-month period, we collected multiple sources of data including field journal entries/observations (38) and audio records of youth work sessions (18), coaches' work sessions (16), combined coaches and youth work sessions (3), and meetings between the lead and the 2nd author for debriefing and planning sessions (36).	By using an activist approach, 4 learning aspirations emerged: becoming responsible/committed, learning from mistakes, valuing each other's knowledge, and communicating with others.	Findings suggest there is a need for more sports programs that start from young people's concrete needs and life situations and look to create places for youth to see alternative possibilities and take action.	
28075655	To review the qualitative literature on experiences of and preferences for end-of-life care of people with cancer aged 16-40 years (young adults) and their informal carers. A systematic review using narrative synthesis of qualitative studies using the 2006 UK Economic and Social Research Council research methods program guidance. Seven electronic bibliographic databases, two clinical trials databases, and three relevant theses databases were searched from January 2004 to October 2015. Eighteen articles were included from twelve countries. The selected studies included at least 5% of their patient sample within the age range 16-40 years. The studies were heterogeneous in their aims, focus, and sample, but described different aspects of end-of-life care for people with cancer. Positive experiences included facilitating adaptive coping and receiving palliative home care, while negative experiences were loss of "self" and nonfacilitative services and environment. Preferences included a family-centered approach to care, honest conversations about end of life, and facilitating normality. There is little evidence focused on the end-of-life needs of young adults. Analysis of reports including some young adults does not explore experience or preferences by age; therefore, it is difficult to identify age-specific issues clearly. From this review, we suggest that supportive interventions and education are needed to facilitate open and honest communication at an appropriate level with young people. Future research should focus on age-specific evidence about the end-of-life experiences and preferences for young adults with cancer and their informal carers.
28075089	Autism spectrum disorder is characterized by difficulty with social communication and restricted, repetitive patterns of behavior, interest, or activities. The Diagnostic and Statistical Manual of Mental Disorders, 5th ed., created an umbrella diagnosis that includes several previously separate conditions: autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. There is insufficient evidence to recommend screening for autism spectrum disorder in children 18 to 30 months of age in whom the disorder is not suspected; however, there is a growing body of evidence that early intensive behavioral intervention based on applied behavior analysis improves cognitive ability, language, and adaptive skills. Therefore, early identification of autism spectrum disorder is important, and experts recommend the use of a validated screening tool at 18- and 24-month well-child visits. Medications can be used as adjunctive treatment for maladaptive behaviors and comorbid psychiatric conditions, but there is no single medical therapy that is effective for all symptoms of autism spectrum disorder. Prognosis is heavily affected by the severity of diagnosis and the presence of intellectual disability. Children with optimal outcomes receive earlier, more intensive behavioral interventions and less pharmacologic treatment.
28074991	Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students.To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile.	Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding.	Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers.	According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.	
28074356	Individuals with autism spectrum disorder (ASD) often exhibit increased anxiety, even in non-stressful situations. We investigate general anxiousness (anxiety trait) and responses to stressful situations (anxiety state) in 22 adolescents with ASD and 32 typically developing controls. We measured trait anxiety with standardized self- and parent-reported questionnaires. We used a Biopac system to capture state anxiety via skin conductance responses, mean heart rate and heart rate variability during high- and low-anxiety tasks. Results reveal higher trait anxiety in adolescents with ASD (p < 0.05) and no group difference in state anxiety. Increased parent-reported trait anxiety may predict decreased state anxiety during high-stress conditions. Together, these findings suggest that higher trait anxiety may result in dampened physical responses to stress.
28073816	To examine how information and communication technology (ICT) access and use are conceptually incorporated in the Successful Aging 2.0 framework.Using data from the 2011 National Health and Aging Trends Study (N = 6,476), we examined how ICT access and use for different purposes are associated with social engagement (i.e., informal and formal social participation) by gender. Weighted logistic regression analyses were performed.	Findings revealed that men were more likely to access and use ICT than women. ICT access was positively associated with all types of women's social engagement, but only with men's informal social participation. Information technology (IT) use for health matters was positively associated with formal social participation for women and with informal social participation for men. IT use for personal tasks was negatively associated with formal social participation for older adults. Communication technology use was positively associated with formal and informal social participation for women and men.	This study supports the expansion of the successful aging model by incorporating ICT access and use. Further, it assists in the identification of specific technologies that promote active engagement in later life for women and men.	
28073727	The scientific literature about disabled people has stressed their high exposure to social exclusion and marginalization, linked to ways of thinking and representations about them. In the area of HIV/AIDS, this marginalization, which results in higher levels of self-stigmatization and especially in inequalities in prevention, continues to put disabled people at high risk of HIV infection. The current study, conducted with a socioepidemiological and behavioral approach, included 317 people with hearing disabilities, recruited through purposive sampling combined with a snowball approach. Participants, after providing informed consent in accordance with the declaration of Helsinki, completed a questionnaire and underwent HIV screening. The results showed a high rate of early sexual intercourse and a high prevalence of HIV, associated with their many risk factors and vulnerability. The analysis also revealed that social marginalization, erroneous beliefs, lack of communication and more generally of appropriate prevention adapted to them, a high rate of multiple partners, a low rate of condom use, psychosexual violence, and difficulties in negotiating social relations, particularly those of sexual relations, are the principal factors of vulnerability and risk.
28073306	Using data from a national survey of South Koreans, this study explores the role of science communication in enhancing three different forms of scientific knowledge ( factual, procedural, and subjective). We first assess learning effects, looking at the extent to which citizens learn science from different channels of communication (interpersonal discussions, traditional newspapers, television, online newspapers, and social media). We then look into the knowledge gap hypothesis, investigating how different communication channels can either widen or narrow the gap in knowledge between social classes. Television was found to function as a "knowledge leveler," narrowing the gap between highly and less educated South Koreans. The role of online newspapers in science learning is pronounced in our research. Reading newspapers online indicated a positive relationship to all three measures of knowledge. Contrary to the knowledge-leveling effect of television viewing, reading online newspapers was found to increase, rather than decrease, the gap in knowledge. Implications of our findings are discussed in detail.
28072832	This study sought to identify factors associated with objectively assessed exercise behavior in Chinese patients with early-stage cancer. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University Medical College and the Nantong Tumor Hospital. One-way ANOVA, Pearson Chi-square tests and regression analysis were employed to identify the correlations between physical exercise and the measured factors. The results showed that occupation type (χ2 = 14.065; p = 0.029), monthly individual monthly income level (χ2 = 24.795; p = 0.003), BMI (χ2 = 15.709; p = 0.015) and diagnosis (χ2 = 42.442; p < 0.000) were significantly correlated with the subjects self-reported exercise with different frequency per week. Differences in the frequency of exercise were associated with different degrees of reported Benefit Finding (BF) (F = 24.651; p < 0.000), communication with doctors (F = 15.285; p < 0.000), medical coping modes (F = 45.912; p < 0.000), social support (F = 2.938; p = 0.030), depression (F = 6.017; p < 0.000), and quality of life (F = 12.288; p < 0.000). Multiple regression analysis showed that 1.6%-6.4% of the variance in five variables, excluding social support and optimism could be explained by exercise. Our results indicated that benefit finding, medical coping modes, communication with doctors, social support, depression and quality of life were significantly correlated with exercise. The variance in several psychosocial factors (benefit finding, medical coping modes, the communication with doctors, depression and quality of life) could be explained by exercise. Psychosocial factors should be addressed and examined over time when evaluating the effect of physical exercise that is prescribed as a clinically relevant treatment.
28070688	Background Recommendations call for the inclusion of both patient and provider input in the redesign of prescription labels. Pharmacist opinions on prescription warning labels are important because they are the health providers who would eventually distribute and explain the revised labels during medication counseling. They may be the first health provider to notice a patient's misunderstanding on how to safely use their prescription medications. Objectives To explore the perspectives of patients and pharmacists on five newly designed PWLs, and examine if there were similarities and differences between patients' and pharmacists' perspectives. Setting Private room in Wisconsin. Methods A descriptive study using semi-structured 60-min face-to-face individual interviews with patients and pharmacists explored patients and pharmacists' feedback on five newly designed PWLs. Patients who were 18 years and older, spoke English, and took a prescription medication and pharmacists who filled prescriptions in an ambulatory setting participated in the study. The patient and pharmacist perspectives on the words (content), picture and color (cosmetic appearance), and placement of warning instructions on the pill bottle (convenience) was based on a label redesign framework. Qualitative content analysis was done. Main outcome measure Patient and pharmacist perspectives on the newly designed PWLs. Results Twenty-one patients and eight pharmacists practicing in an academic medical center outpatient setting (n = 5) or retail pharmacy (n = 3) participated. All patients and pharmacists wanted the PWLs positioned on the front of the pill bottle but not the side of the bottle or warning instructions embedded into the main prescription label. Other similarities included participants preferring: (1) pictures closely depicting the instructions and (2) the use of yellow highlighting on the PWL to draw attention to it. There were differences in patient and pharmacist perspectives regarding the addition of 'Warning' to the instruction on the PWL with the patient preference to include the word 'Warning'. Pharmacists thought some PWL pictures had racial stereotypes, but this feedback was never mentioned by patients. Conclusions Patients and pharmacists had different preferences for PWL design changes to improve understandability. Pharmacist preferences did not always correspond with patient preferences. However, patients and pharmacists generally agreed on the preferred location of the PWL on the pill bottle and the use of color for drawing patients' attention.
28069667	It is increasingly recognized that some patients self-manage in the context of social networks rather than alone. Consumer health information technology (IT) designed to support socially embedded self-management must be responsive to patients' everyday communication practices. There is an opportunity to improve consumer health IT design by explicating how patients currently leverage social media to support health information communication.The objective of this study was to determine types of health information communication patterns that typify Facebook users with chronic health conditions to guide consumer health IT design.	Seven hundred participants with type 2 diabetes were recruited through a commercial survey access panel. Cluster analysis was used to identify distinct approaches to health information communication both on and off Facebook. Analysis of variance (ANOVA) methods were used to identify demographic and behavioral differences among profiles. Secondary analysis of qualitative interviews (n = 25) and analysis of open-ended survey questions were conducted to understand participant rationales for each profile.	Our analysis yielded 7 distinct health information communication profiles. Five of 7 profiles had consistent patterns both on and off Facebook, while the remaining 2 demonstrated distinct practices, with no health information communication on Facebook but some off Facebook. One profile was distinct from all others in both health information communication practices and demographic composition. Rationales for following specific health information communication practices were categorized under 6 themes: altruism, instrumental support, social support, privacy and stigma, convenience, and Facebook knowledge.	Facebook has been widely adopted for health information communication; This study demonstrates that Facebook has been widely adopted for health information communication. It also shows that the ways in which patients communicate health information on and off Facebook are diverse.	
28069321	Multiple studies have identified consumers' difficulty correctly interpreting risk information provided about prescription drugs, whether in printed format or online. This study's purpose was to explore whether consumers can distinguish between prescription drug precautions and side effects presented on brand-name drug websites.Participants (n=873) viewed fictitious drug websites that presented both precautions and side effects for one of four drugs, and they completed a survey assessing recall and comprehension. We coded open-ended recall data to identify whether drug precautions were mentioned and, if so, how they were interpreted.	Approximately 15% of participants mentioned at least one drug precaution. The majority (59.7%) misinterpreted precautions as potential side effects. Participants who misinterpreted precautions rated the drugs as significantly more likely to cause side effects than participants who accurately interpreted the precautions. Age, education, literacy, and other factors did not appear to predict precaution interpretation.	At least some consumers are likely to interpret precautions on drug websites as potential side effects, which might affect consumer preferences, treatment decisions, and medication safety.	Healthcare providers should be aware of this potential confusion, assess patients' understanding of precautions and potential side effects, and address any misunderstandings.	
28069317	obstetric and midwifery literature continually emphasise incidence and consequence of obesity in pregnancy. However, they offer less consensus on how best to support women who are obese. Therefore, this study explores in depth the lived experience of women who have a Body Mass Index (BMI) ≥30kg/m². This exploration provides a bio-psycho-social understanding of the lived experience of women to identify how best to support them throughout their childbirth experience.an Interpretative Phenomenological Analysis (IPA) design was adopted for this qualitative study. Purposive sampling of participants was conducted on the postnatal wards of a maternity hospital in the Republic of Ireland. In total, 15 participants volunteered to take part in semi-structured interviews conducted at six to ten weeks postnatally. Data were analysed utilising the IPA framework.	the results indicate that participants were conscious of the problematics of communicating obesity in pregnancy. The narrative data revealed an unconscious collusion between healthcare professionals and women as they navigate obesity related conversations. The behaviours related to unconscious collusion are incorporated in the sub-ordinate themes; 'just recorded and that's all', 'but what's eating healthy? 'pussy footing around' and 'I hate that word obesity.	the findings highlight a lack of information received by participants from healthcare professionals regarding increased BMI or weight management. The data suggests that healthcare professionals appeared to collude with women to avoid challenging discussions regarding obesity. This may be related to avoidance on participants' part and/or may be linked with healthcare professionals' reluctance to communicate issues relating to increased BMI. Although participants were generally unhappy with the communication skills of health professionals, they readily acknowledged the sensitive nature of obesity related communications. The findings provide healthcare professionals with an important insight into issues of effective communication and obesity related healthcare promotion from the woman's perspective in order to enhance provision of appropriate health information and maternity care to women who have an increased BMI.	
28069155	Oncology health professionals (HPs) are increasingly required to care for patients from minority backgrounds. Yet many HPs have not had formal training in how to communicate effectively in culturally diverse settings. More information is needed about the challenges that oncology HPs face in communicating with minority patients to inform the content of formal training programs. This qualitative study aimed to identify oncology nurses' and oncologists' individual experiences and challenges in communicating with patients from minority backgrounds.Thirty-eight oncology HPs (21 oncology nurses, 12 medical oncologists, and 5 radiation oncologists) were interviewed individually or in focus groups about their experiences communicating with patients from minority backgrounds. The interviews were audio taped and analysed thematically.	The majority of participants (82%) reported varying degrees of uncertainty and discomfort regarding working with minority patients, with many barriers to communication encountered. Participants perceived that minority patients received less emotional support than majority group patients. They experienced challenges in balancing beliefs about patient autonomy with cultural differences regarding the role of the family. Strategies employed by participants to facilitate interactions included: modifying speech, taking more time in consultations, rapport building, and using nonverbal techniques.	Oncology HPs encounter many linguistic and cultural barriers when communicating with minority patients. They need formal training tailored to developing culturally competent communication. Oncology nurses and oncologists could benefit from formal communication skills training focused upon cultural competence during their career development programs.	
28068156	In the clinical setting, previous studies have shown personalized risk assessment and communication improves risk perception and motivation. We evaluated an online health calculator that estimated and presented six different measures of life expectancy/mortality based on a person's sociodemographic and health behavior profile. Immediately after receiving calculator results, participants were invited to complete an online survey that asked how informative and motivating they found each risk measure, whether they would share their results and whether the calculator provided information they need to make lifestyle changes. Over 80% of the 317 survey respondents found at least one of six healthy living measures highly informative and motivating, but there was moderate heterogeneity regarding which measures respondents found most informative and motivating. Overall, health age was most informative and life expectancy most motivating. Approximately 40% of respondents would share the results with their clinician (44%) or social networks (38%), although the information they would share was often different from what they found informative or motivational. Online personalized risk assessment allows for a more personalized communication compared to historic paper-based risk assessment to maximize knowledge and motivation, and people should be provided a range of risk communication measures that reflect different risk perspectives.
28067586	Real-time videoconferencing technology such as clinical video telehealth (CVT) offers a means to reach patient populations who face limited access to healthcare. The Veterans Health Administration has invested in CVT to improve care access for U.S. military veterans with spinal cord injuries and disorders (SCI/D); however, no studies have assessed the factors that influence implementation of this technology in clinical practice for individuals with SCI/D.Guided by a sociotechnical perspective, the purpose of this study was to identify factors that influence implementation of CVT for veterans with SCI/D.	We conducted semistructured telephone interviews with 40 healthcare providers who use CVT to deliver services to veterans with SCI/D.	Factors related to workflow and communication were widely reported as implementation barriers. Coordinating logistics for CVT appointments was challenging, and effective communication between CVT team members across facilities was considered crucial. Providers also cited factors related to technical infrastructure, people, and organizational features, including the need for appropriate equipment, space, personnel, and support for using CVT equipment.	The implementation of CVT in the care of veterans with SCI/D was influenced by an interrelated set of social and technical factors. Key among them were social factors related to people, workflow, and communication, given that CVT supports healthcare teams interacting remotely in real time.	CVT implementation requires teams working together to negotiate a complex, distributed process across multiple sites. Such complexity places a premium on teamwork and communication among healthcare teams before, during, and after a CVT encounter.	
28066306	Facial expression recognition (FER) is an important aspect of effective interpersonal communication. In order to explore whether the development of FER was delayed in hearing impaired children, 44 child participants completed labeling, and matching tasks to identify four basic emotions (happiness, sadness, anger, and fear). Twenty-two participants had either a cochlear implant (CI) or a hearing aid (HA) while 22 had normal hearing and participants were matched across conditions by age and gender. The results showed that children with a CI or HA were developmentally delayed not only in their emotion-labeling (verbal) tasks but also in their emotion-matching (nonverbal) tasks. For all participants, the emotion-labeling task was more difficult than the emotion-matching task. Additionally, the relative difficulty of recognizing four different emotional expressions was similar between verbal and nonverbal tasks.
28066303	Autism Spectrum Disorder (ASD) is characterized by difficulties with social interaction and communication, which manifest at school especially in less structured situations such as recess. Recess provides opportunities for relationship with peers in a natural context, for which students with ASD may not be equipped with the necessary skills to use without support. Using a single-case design, we evaluated an intervention applied in recess to improve the social interaction skills of a student with high-functioning ASD mediated by his peers without ASD, in second grade of elementary school. This intervention includes different strategies to initiate the peers without ASD, using direct instruction, modeling, and social reinforcement carried out in the recess setting. After 14 sessions, changes were observed in the rates of initiating and responding to interactions, and a negative trend in the percentage of time that the student maintained low-intensity interactions or was alone. Teachers and family perceived improvements in social skills, more peer acceptance, and increase in the frequency and duration of social interactions. This intervention can help teachers to apply research-based practices to improve some social interaction skills in high-functioning students with autism in inclusive school environments.
28066284	Smart phones are ubiquitous in everyday life and are having a major impact on work, education, social relationships and modes of communication. Children are the fastest growing population of smart phone users, with use often focusing around internet access, e.g., 1 in 3 internet users in the UK are under 18 years of age. Despite their widespread use, relatively little is known about the factors that underpin children's use. The home is a significant ecological context of development and recent research has highlighted the importance of the home environment in promoting and supporting the development of both safe and unsafe online behavior. Yet the importance of these influences currently remains relatively unrecognized. Therefore, in this paper we present a narrative review of evidence examining parental practices concerning digital communication technologies and applications, with a particular focus on smartphones, and how they relate to the use of technology by their children. Emerging evidence to date indicates that two important factors are at play. Firstly, parental technology use is closely related to that of their child. Secondly, that despite parents frequently voiced concerns about the nature and extent of their child's mobile phone use, parents themselves often engage in a number of unsafe internet behaviors and excessive phone use in the home environment. Our review identifies two crucial lines of enquiry that have yet to be comprehensively pursued by researchers in the field: firstly, the adoption of a psychological perspective on children's emergent behaviors with mobile devices and secondly, the influential role of context. Given parental concerns about the possible negative impact of technologies, parental awareness should be raised about the influence of their behavior in the context of internet safety along with the adoption of good digital literacy practices. It is anticipated that a comprehensive characterization of the associated contextual factors influencing smartphone use will serve as a catalyst for debate, discussion, and future research.
28066202	Numerous animal species emit vocalizations in response to various social stimuli. The neural basis of vocal communication has been investigated in monkeys, songbirds, rats, bats, and invertebrates resulting in deep insights into motor control, neural coding, and learning. Mice, which recently became very popular as a model system for mammalian neuroscience, also utilize ultrasonic vocalizations (USVs) during mating behavior. However, our knowledge is lacking of both the behavior and its underlying neural mechanism. We developed a novel method for head-restrained male mice (HRMM) to interact with non-restrained female mice (NRFM) and show that mice can emit USVs in this context. We first recorded USVs in a free arena with non-restrained male mice (NRMM) and NRFM. Of the NRMM, which vocalized in the free arena, the majority could be habituated to also vocalize while head-restrained but only when a female mouse was present in proximity. The USVs emitted by HRMM are similar to the USVs of NRMM in the presence of a female mouse in their spectral structure, inter-syllable interval distribution, and USV sequence length, and therefore are interpreted as social USVs. By analyzing the vocalizations of NRMM, we established criteria to predict which individuals are likely to vocalize while head fixed based on the USV rate and average syllable duration. To characterize the USVs emitted by HRMM, we analyzed the syllable composition of HRMM and NRMM and found that USVs emitted by HRMM have a higher proportion of USVs with complex spectral representation, supporting previous studies showing that mice social USVs are context dependent. Our results suggest a way to study the neural mechanisms of production and control of social vocalization in mice using advanced methods requiring head fixation.
28066177	Autism spectrum disorders (ASD) comprise a number of heterogeneous neurodevelopmental diseases characterized by core behavioral symptoms in the domains of social interaction, language/communication and repetitive or stereotyped patterns of behavior. In utero exposure to valproic acid (VPA) has evolved as a highly recognized rodent ASD model due to the robust behavioral phenotype observed in the offspring and the proven construct-, face- and predictive validity of the model. The number of parvalbumin-immunoreactive (PV+) GABAergic interneurons has been consistently reported to be decreased in human ASD subjects and in ASD animal models. The presumed loss of this neuron subpopulation hereafter termed Pvalb neurons and/or PV deficits were proposed to result in an excitation/inhibition imbalance often observed in ASD. Importantly, loss of Pvalb neurons and decreased/absent PV protein levels have two fundamentally different consequences. Thus, Pvalb neurons were investigated in in utero VPA-exposed male ("VPA") mice in the striatum, medial prefrontal cortex (mPFC) and somatosensory cortex (SSC), three ASD-associated brain regions. Unbiased stereology of PV+ neurons and Vicia Villosa Agglutinin-positive (VVA+) perineuronal nets, which specifically enwrap Pvalb neurons, was carried out. Analyses of PV protein expression and mRNA levels for Pvalb, Gad67, Kcnc1, Kcnc2, Kcns3, Hcn1, Hcn2, and Hcn4 were performed. We found a ∼15% reduction in the number of PV+ cells and decreased Pvalb mRNA and PV protein levels in the striatum of VPA mice compared to controls, while the number of VVA+ cells was unchanged, indicating that Pvalb neurons were affected at the level of the transcriptome. In selected cortical regions (mPFC, SSC) of VPA mice, no quantitative loss/decrease of PV+ cells was observed. However, expression of Kcnc1, coding for the voltage-gated potassium channel Kv3.1 specifically expressed in Pvalb neurons, was decreased by ∼40% in forebrain lysates of VPA mice. Moreover, hyperpolarization-activated cyclic nucleotide-gated channel (HCN) 1 expression was increased by ∼40% in the same samples from VPA mice. We conclude that VPA leads to alterations that are brain region- and gene-specific including Pvalb, Kcnc1, and Hcn1 possibly linked to homeostatic mechanisms. Striatal PV down-regulation appears as a common feature in a subset of genetic (Shank3B-/-) and environmental ASD models.
28065201	Humans exhibit extensive large-scale cooperation, of a form unprecedented in the natural world. Here I suggest that this cooperation arises in our species alone because of our uniquely potent capacities for social learning, imitation and teaching, combined with the co-evolutionary feedbacks that these capabilities have generated on the human mind. Culture took human populations down evolutionary pathways not available to non-cultural species, either by creating conditions that promoted established cooperative mechanisms, such as indirect reciprocity and mutualism, or by generating novel cooperative mechanisms not seen in other taxa, such as cultural group selection. In the process, gene-culture co-evolution seemingly generated an evolved psychology, comprising an enhanced ability and motivation to learn, teach, communicate through language, imitate and emulate, as well as predispositions to docility, social tolerance, and the sharing of goals, intentions and attention. This evolved psychology is entirely different from that observed in any other animal, or that could have evolved through conventional selection on genes alone.
28065195	The goals of the present targeted review on maternal and child overweight and obesity were to: (i) understand the current situation in low- and middle-income countries (LMIC) with regard to recent trends and context-specific risk factors; and (ii) building off this, identify entry points for leveraging existing undernutrition programmes to address overweight and obesity in LMIC. Trends reveal that overweight and obesity are a growing problem among women and children in LMIC; as in Ghana, Kenya, Niger, Sierra Leone, Tanzania and Zimbabwe, where the prevalence among urban women is approaching 50 %. Four promising entry points were identified: (i) the integration of overweight and obesity into national nutrition plans; (ii) food systems (integration of food and beverage marketing regulations into existing polices on the marketing of breast-milk substitutes and adoption of policies to promote healthy diets); (iii) education systems (integration of nutrition into school curricula with provision of high-quality foods through school feeding programmes); and (iv) health systems (counselling and social and behaviour change communication to improve maternal diet, appropriate gestational weight gain, and optimal infant and young child feeding practices). We conclude by presenting a step-by-step guide for programme officers and policy makers in LMIC with actionable objectives to address overweight and obesity.
28064558	Hyperlexic-like reading (defined as word decoding much better than comprehension) has been associated with autism spectrum disorder (ASD). Here we study correlates of a hyperlexic-like reading style (HPL) in ADHD, a condition known to co-occur both with reading difficulties and ASD.We compared 10 girls with an ADHD diagnosis plus HPL with 26 with ADHD minus HPL.	Girls with HPL scored marginally lower in reading comprehension but did not differ from non-HPL girls in IQ, vocabulary, or in the severity of ADHD ratings. However, in addition to scoring much better on word decoding, HPL readers also displayed higher levels of social-communication deficits on the ADOS-G and the ADI-R. Moreover, correlation analysis in the full sample revealed an association between increasing autistic features and word reading.	The study underscores the heterogeneity of reading skills in ADHD, and shows the relevance of subclinic autistic features for understanding this variability.	
28064513	Although many cross-sectional studies have examined bullying experiences and correlated factors among adolescents in schools, relatively little is known about the extent to which bullying roles are stable or fluid over time. This short-term quantitative longitudinal study in Vietnam examined temporal patterns and predictors of bullying roles over an academic year. A total of 1424 middle and high school students aged 12-17 years completed two anonymous, self-administered questionnaires six months apart in 2014 and 2015. Young people were classified into different bullying roles as follow: not-involved (38.9%), victims only (24%), bullies only (6.6%), and bully-victims (40.4%) across the two times. About 60% of all surveyed students experienced bullying either as victim, bully, or bully-victim during the year. Of these students, nearly three in four indicated unstable bullying roles over time. Multivariate multinomial logistic regressions indicated factors ranging from individual (age, gender, and mental health) to family (social support, parental supervision and monitoring, witnessing parental violence, and conflict with siblings), school (perceived social support, teachers' attempt to stop bullying at school), and peers (social support, students' attempt to stop bullying at school) have significant associations with levels of bullying involvement. Implications for bullying prevention programs nationally and internationally are discussed.
28064027	The available opinions regarding participation do not appear to be applicable to adults with visual and severe or profound intellectual disabilities (VSPID). Because a clear definition and operationalization are lacking, it is difficult for support professionals to give meaning to participation for adults with VSPID.The purpose of the present study was to develop a definition and operationalization of the concept of participation of adults with VSPID.	Parents or family members, professionals, and experts participated in an online concept mapping procedure. This procedure includes generating statements, clustering them, and rating their importance. The data were analyzed quantitatively using multidimensional scaling and qualitatively with triangulation.	A total of 53 participants generated 319 statements of which 125 were clustered and rated. The final cluster map of the statements contained seven clusters: (1) Experience and discover; (2) Inclusion; (3) Involvement; (4) Leisure and recreation; (5) Communication and being understood; (6) Social relations; and (7) Self-management and autonomy. The average importance rating of the statements varied from 6.49 to 8.95. A definition of participation of this population was developed which included these seven clusters.	The combination of the developed definition, the clusters, and the statements in these clusters, derived from the perceptions of parents or family members, professionals, and experts, can be employed to operationalize the construct of participation of adults with VSPID. This operationalization supports professionals in their ability to give meaning to participation in these adults. Future research will focus on using the operationalization as a checklist of participation for adults with VSPID.	
28063604	Seeking proximity to another person immediately expresses affiliative intentions. These are highly relevant after experiencing social exclusion. Through a novel task, the current study investigated the relation between proximity and observed ostracism during early childhood. A sample of 64 children (Mage=58months) first watched priming videos either depicting ostracism or not. Subsequently, children saw four seats of varying distances from an interactant's seat and chose where to sit. Children who observed social exclusion selected seats with higher proximity. The results suggest that young preschoolers can immediately express the threatened need to belong by literally getting closer to even a stranger after witnessing ostracism. The task provides new opportunities to test reactions to social exclusion during early childhood.
28063395	Impaired social functioning is a hallmark of major psychiatric disorders. The purpose of this study was to detect a disorder-specific factor of social dysfunction among patients with major psychiatric disorders (PSY), including schizophrenia (SCZ), bipolar disorder (BIP) and major depressive disorder (MDD). Social functioning was assessed in patients with SCZ (n=80), BIP (n=27) or MDD (n=29) and healthy controls (HC, n=68) using the Social Functioning Scale (SFS). Compared to HC, the SCZ, BIP and MDD patient groups showed lower total SFS scores. No differences in the total scores for social functioning were observed between patient groups. We next investigated seven subscales of the SFS among PSY and observed significant diagnostic effects on all subscales of the SFS. Notably, patients with SCZ have poorer interpersonal communication than patients with MDD. Furthermore, the poorer interpersonal communication score was significantly correlated with an increase in schizotypal personality traits, as assessed by the Schizotypal Personality Questionnaire (SPQ) in HC. Although there were no differences in overall social functioning among PSY, disorder-specific factors, such as interpersonal communication, were evident in SCZ. The correlation between poor interpersonal communication and the increase in schizotypal traits suggests that poor interpersonal communication may be an intermediate phenotype of SCZ.
28062310	The role of various forms of social support (including the mere presence of another person) in pain has been studied in children and younger adults, but parallel studies involving older persons have not been conducted. In this investigation, older adults (N = 100) took part in a series of experimental pain tasks in each of the following conditions: alone, in the presence of a stranger, and in the presence of a family member. Indices of pain (threshold, tolerance, intensity, unpleasantness, facial expressions) and facial expressions of emotion were analyzed. Facial expressions of pain and happiness were more prominent when a family member was present. In the presence of a stranger, pain was reported as less unpleasant and facial expressions of fear were more frequent. In examining sex differences, male participants reported higher pain tolerance and female participants displayed more prominent facial expressions of pain. Moreover, facial expressions of neutral states and happiness were more frequent among female participants, whereas facial expressions of anger were more frequent among male participants. Results show that the presence of others influences the experience and expression of pain in older persons.We showed that the presence of others influences the experience and expression of pain in older adults. The presence of a family member increases nonverbal pain expressiveness whereas the presence of a stranger results in decreased self-reported pain unpleasantness.	
28061777	Instant messaging applications have the potential to improve and facilitate communication between hospital doctors and students, hence generating and improving learning opportunities. This study aims to demonstrate the feasibility and acceptability of instant messaging communication to supplement medical education for medical students whilst on clinical attachment.A total of 6 WhatsApp Messenger (WhatsApp Inc.) groups were created for medical students on clinical attachment. These were used to provide communication within Problem Based Learning (PBL) groups for a duration of 8 weeks. The frequency and type of communication were recorded. Students' opinions were evaluated through a structured interview process at the end of the study period. A thematic analysis was performed on the content of the instant messaging groups and on the results of the structured interviews.	All of the participants were active in their respective messaging groups (19 students and 6 tutors). A total of 582 messages, 22 images and 19 webpage links were sent. Thematic analysis on content of the instant messaging groups identified the following themes: organisational, educational and social. Thematic analysis on the content of interviews identified themes such as the ease of use of instant messaging, benefit of instant messaging to foster understanding and learning, and the ability to access recorded discussions.	The findings of this study illustrate a method by which communication within PBL groups can be facilitated by the use of instant messaging. The results indicate the feasibility and acceptability of WhatsApp Messenger in supplementing PBL teaching for medical students, and provides a framework for studies to investigate use amongst larger cohorts of students.	
28061039	According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach.African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software.	Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media.	Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.	
28060872	Early multisensory perceptual experiences shape the abilities of infants to perform socially-relevant visual categorization, such as the extraction of gender, age, and emotion from faces. Here, we investigated whether multisensory perception of gender is influenced by infant-directed (IDS) or adult-directed (ADS) speech. Six-, 9-, and 12-month-old infants saw side-by-side silent video-clips of talking faces (a male and a female) and heard either a soundtrack of a female or a male voice telling a story in IDS or ADS. Infants participated in only one condition, either IDS or ADS. Consistent with earlier work, infants displayed advantages in matching female relative to male faces and voices. Moreover, the new finding that emerged in the current study was that extraction of gender from face and voice was stronger at 6 months with ADS than with IDS, whereas at 9 and 12 months, matching did not differ for IDS versus ADS. The results indicate that the ability to perceive gender in audiovisual speech is influenced by speech manner. Our data suggest that infants may extract multisensory gender information developmentally earlier when looking at adults engaged in conversation with other adults (i.e., ADS) than when adults are directly talking to them (i.e., IDS). Overall, our findings imply that the circumstances of social interaction may shape early multisensory abilities to perceive gender.
28060675	To examine the effectiveness of a health promotion flyer to increase awareness of breast cancer risk and physical activity as a risk reduction strategy in young adult women.Young adult women (N = 123) viewed one of five health promotion flyers online and then completed measures of perceived breast cancer risk (PR) and perceived informativeness (PI) and a qualitative thought-listing activity.	Differences were observed in PI such that the control and low risk/low information messages were significantly less informative than the others. Qualitative analyses revealed two general themes: message content and flyer design. Additional analyses of the flyer design comments revealed four sub-themes: negative thoughts about the image, positive thoughts about the image, misunderstanding breast cancer risk information, and social comparison. Exploratory analyses controlling for message type indicated that image appraisal predicted PI such that those who commented on the image found the flyer to be less informative.	Results suggest that the flyer was informative but did not impact young women's breast cancer risk perceptions. Additionally, the image may have distracted young women from the intended message. Evaluating the acceptability of images used in health promotion materials is recommended before testing the effectiveness of the intervention.	
28060582	Entertainment-education is an effective health communication strategy that combines or embeds educational messages into entertainment programs to bring about social and behavior change. For years, scholars have considered how entertainment-education works. Some contemporary theories posit that entertainment-education does not engender behavior change directly but does so through mediating variables. This study adds to the literature on this topic by exploring the direct relationship between exposure and social norms instead of their relationship through behavior as a mediator. Novel to this study is the use of encoded exposure, a continuous and recognition-based measure of exposure that includes ever watching, recall, involvement, and dose in its operationalization. Using cross-sectional data from Kyunki … Jeena Issi Ka Naam Hai, an entertainment-education program in India, this exploratory analysis indicates a positive and significant relationship between encoded exposure and social norms. How can this finding be applied to future programs? Questions remain, and replication is needed, but if it is not essential to go through behavior in order to change social norms, then implications emerge for the theory and practice of entertainment-education.
28059570	This study examined proposed direct and mediating relationships in the Structural Influence Model (SIM) of Communication within the chronic disease context. Using data from the Annenberg National Health Communication Survey (N = 14,472), we tested the potential mediating roles of information seeking, information scanning, and social capital between social determinants of health and four chronic disease risk behaviors: exercise level, fruit and vegetable intake, cigarette smoking, and excessive alcohol use. Information seeking, information scanning, and social capital received support as potential mediators. Our results are largely consistent with predictions of the SIM and highlight the important role of communication in reducing health risks and increasing healthy behaviors.
28059565	This study examined the effects of an anti-smoking campaign that employs a crowdsourcing method with a social networking service. Drawing upon social capital scholarship and the expression effect research paradigm in eHealth systems, the study also investigated the roles of social trust and community life satisfaction in the social media campaign that has a specific geographical boundary. To that end, we conducted an experiment using a two-group pretest-posttest design. We randomly assigned 201 participants to two conditions: "campaign message reception only" as a control group and "message reception and expression" as a treatment group in which participants fully engaged in the campaign process by sharing their own campaign ideas with other participants. Findings revealed that social trust and community life satisfaction interacted with the treatment condition to positively affect persuasive intentions, but in distinct ways. Social trust moderated the effect of the message reception and interaction condition on participants' willingness to encourage community members to stop smoking. In contrast, community life satisfaction moderated the effect of the treatment condition on encouraging others to comply with the community's anti-smoking policy. These results provide theoretical and practical implications related to the roles of social capital in geographically defined social media campaigns.
28059553	This study offers an analysis of how healthy and risky behaviors are discussed on an emerging social media platform. We sought to understand what behaviors are communicated and if they are encouraged or discouraged. We completed a content analysis of messages (n = 3,776) posted to Yik Yak captured three times a day on 4 days of the week across two separate weeks. We analyzed messages to determine the category of the behavior, an appraisal of the behavior, and normative voting feedback. Our results show that risky behaviors were discussed with greater frequency and received more user votes than healthy behaviors. Exposure to these messages could influence other students' perceptions of norms associated with these risky behaviors. We suggest further research to determine how Yik Yak may affect normative perceptions on college campuses.
28059460	Dynamic face cues can be very salient, as when observing sudden shifts of gaze to a new location, or a change of expression from happy to angry. These highly salient social cues influence judgments of another person during the course of an interaction. However, other dynamic cues, such as pupil dilation, are much more subtle, affecting judgments of another person even without awareness. We asked whether such subtle, incidentally perceived, dynamic cues could be encoded in to memory and retrieved at a later time. The current study demonstrates that in some circumstances changes in pupil size in another person are indeed encoded into memory and influence judgments of that individual at a later time. Furthermore, these judgments interact with the perceived trustworthiness of the individual and the nature of the social context. The effect is somewhat variable, however, possibly reflecting individual differences and the inherent ambiguity of pupil dilation/constriction.
28058104	Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment. The report highlights the crucial role of early diagnosis and subsequent chemotherapy in avoiding amputation. We particularly focused critical and emotional aspects related to the communication about the leg amputation with the patient and his family.
28057875	What are some of the challenges of working in a fertility clinic?The most frequently mentioned challenges were workload (e.g. high time pressure) and patient-related sources (e.g. unrealistic expectations).	One study showed a too high workload, worry about handling human material and low success rates were main stressors in fertility clinics.	An online open-ended survey inviting participants to respond to seven questions was distributed to 5902 members of the European Society for Human Reproduction and Embryology (ESHRE, October 2010). Questions asked participants to describe the top three factors that made (i) their work stressful (hereafter 'Work stressors') and (ii) working with patients difficult (hereafter 'Perceived sources of difficulties'), and (iii) to choose from these factors which top three issues they would be willing to attend a workshop to resolve (hereafter 'Workshops'). A qualitative content analysis using inductive coding for each question was used to extract meaningful themes from the text replies, at three levels of increasing abstraction (lower and higher categories, general themes).	The final sample comprised 526 respondents (8.9% participation rate). Respondents were predominantly clinicians (41.3%, n = 216) or embryologists (35.5%, n = 186) from European countries (73.0%, n = 386).	The number of text replies generated for each question was 1421, 1208 and 907 for the 'Work Stressors', 'Perceived sources of difficulties' and 'Workshop' questions, respectively. The most often reported higher-order categories of Work Stressors were 'Time and Workload' (61.6%, e.g. time pressure), 'Organisation, Team and management issues' (60.4%, e.g. team conflicts) and 'Job content and work environment' (50.3%, e.g. burdensome administration). For 'Perceived sources of difficulties' these were 'Patient-related sources' (66.7%, e.g. unrealistic expectations), 'Communication and Counselling with patients' (33.7%, e.g. strained information giving) and 'Misinformation and lack of knowledge' (27.8%, e.g. Dr Google). Finally, the topics participants would be willing to address in Workshops were 'Communicating and Counselling with Patients' (24.9%), 'Dealing with Patient-related sources' (19.6%) and 'Clinical topics' (19.6%). Three general themes emerged. First, a theme of 'time and time trade-offs' expressed the oft-mentioned need to trade-off time spent on one activity (e.g. managing patient demands) against another activity (e.g. clinical workload, administration) with stress level dependent on the efficacy of trading-off. Second, the theme of 'multifactorial causes' of challenging patient interactions that embodied the many sources of difficulties working with patients. What staff would be willing to address in workshops was indicated by the final general theme of 'a little of everything', which linked to the need for multiple workshops addressing the multifactorial nature of challenges in fertility clinics.	Only about 10% of members receiving the survey participated. The work was limited to the stressful and difficult aspects of working in fertility clinics, which may give a more negative impression than if questions about the rewards and benefits had also been included.	The nature of stressors and difficulties of working in a fertility clinic are consistent with models of occupational stress and patient complexity. Specialized psychologists, management consultants and other occupational experts could assist fertility teams in overcoming many of the challenges. More research is required on the effect of encountered work stressors and perceived sources of difficulties in working with patients on staff and patient outcomes.	None declared.	
28057835	Distributed social learning may occur at many temporal and spatial scales, but it rarely adds up to a stable culture. Cultures vary in stability and diversity (polymorphism), ranging from chaotic or drifting cultures, through cumulative polymorphic cultures, to stable monolithic cultures with high conformity levels. What features can sustain polymorphism, preventing cultures from collapsing into either chaotic or highly conforming states? We investigate this question by integrating studies across two quite separate disciplines: the emergence of song cultures in birds, and the spread of public opinion and social conventions in humans. In songbirds, the learning process has been studied in great detail, while in human studies the structure of social networks has been experimentally manipulated on large scales. In both cases, the manner in which communication signals are compressed and filtered - either during learning or while traveling through the social network - can affect culture polymorphism and stability. We suggest a simple mechanism of a shifting balance between converging and diverging social forces to explain these effects. Understanding social forces that shape cultural evolution might be useful for designing agile communication systems, which are stable and polymorphic enough to promote gradual changes in institutional behavior.
28057830	The concerted responses of eusocial insects to environmental stimuli are often referred to as collective cognition at the level of the colony. To achieve collective cognition, a group can draw on two different sources: individual cognition and the connectivity between individuals. Computation in neural networks, for example, is attributed more to sophisticated communication schemes than to the complexity of individual neurons. The case of social insects, however, can be expected to differ. This is because individual insects are cognitively capable units that are often able to process information that is directly relevant at the level of the colony. Furthermore, involved communication patterns seem difficult to implement in a group of insects as they lack a clear network structure. This review discusses links between the cognition of an individual insect and that of the colony. We provide examples for collective cognition whose sources span the full spectrum between amplification of individual insect cognition and emergent group-level processes.
28057827	Social behaviour emerges from the local environment but is constrained by the animal's life history and its evolutionary lineage. In this perspective, we consider the genus Drosophila and provide an overview of how these constraints can shape how individuals interact. Our focus is restricted to visual and chemical signals and how their use varies across species during courtship - currently the only social behaviour well-studied across many Drosophila species. We broadly categorize species into four climatic groups - cosmopolitan, tropical, temperate and arid - which serve as discussion points as we review comparative behavioural and physiological studies and relate them to the abiotic conditions of a species environment. We discuss how the physiological and behavioural differences among many fly species may reflect life history differences as much as, or even more than, differences in phylogeny. This perspective serves not only to summarize what has been studied across drosophilids, but also to identify questions and outline gaps in the literature worth pursuing for progressing the understanding of behavioural evolution in Drosophila.
28057048	Studying the effect on functioning of the emergency department of disasters with a potential impact on staff members themselves usually involves table top and simulated patient exercises. Computerized virtual reality simulations have the potential to configure a variety of scenarios to determine likely staff responses and how to address them without intensive utilization of resources. To decide whether such studies are justified, we determined whether a novel computer simulation has the potential to serve as a valid and reliable model of on essential function in a busy ED.Ten experienced female ED triage nurses (mean age 51) mastered navigating a virtual reality model of triage of 4 patients in an ED with which they were familiar, after which they were presented in a testing session with triage of 6 patients whose cases were developed using the Emergency Severity Index to represent a range of severity and complexity. Attitudes toward the simulation, and perceived workload in the simulation and on the job, were assessed with questionnaires and the NASA task load index. Z-scores were calculated for data points reflecting subject actions, the time to perform them, patient prioritization according to severity, and the importance of the tasks. Data from questionnaires and scales were analyzed with descriptive statistics and paired t tests using SPSS v. 21. Microsoft Excel was used to compute a correlation matrix for all standardized variables and all simulation data.	Nurses perceived their work on the simulation task to be equivalent to their workload on the job in all aspects except for physical exertion. Although they were able to work with written communications with the patients, verbal communication would have been preferable. Consistent with the workplace, variability in performance during triage reflected subject skill and experience and was correlated with comfort with the task. Time to perform triage corresponded to the time required in the ED and virtual patients were prioritized appropriately according to severity.	This computerized simulation appears to be a reasonable accurate proxy for ED triage. If future studies of this kind of simulation with a broader range of subjects that includes verbal communication between virtual patients and subjects and interactions of multiple subjects, supports the initial impressions, the virtual ED could be used to study the impact of disaster scenarios on staff functioning.	
28056643	The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women's misconceptions of contraceptive side-effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.
28056642	Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care.To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods.	Qualitative focus groups.	Volunteers from a large teaching hospital were purposively sampled.	Five focus groups were conducted with 25 hospital volunteers (aged 19-80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to 'refresh' training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each.	Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals.	
28056556	To better understand adolescents experiencing peer victimization, ostracism, and emotional health problems, this study aimed to describe a cohort of middle school students identified as having school peer-related social difficulties as 2 groups: those with mental health diagnoses (MHDs; n = 17) and those without diagnoses (n = 8). Participants were administered a test battery to examine communication ability, social responsiveness, social activity, ostracism, victimization, and emotional health. Results showed that adolescents with MHDs, relative to those without, scored significantly lower on measures of communication ability, social responsiveness, and social activity but similarly on measures of victimization, ostracism, and internalizing/externalizing factors. Results suggest that adolescents with and without MHDs can endure ostracism and peer victimization to a similar extent. Because ostracism and victimization have serious morbidity in adolescents, physicians and caregivers must look for signs in all adolescents, irrespective of MHD. Recommendations for appropriate primary care management are discussed.
28056381	The evaluation of adaptive behavior is informative in children with attention-deficit/hyperactivity disorder (ADHD) or specific learning disorders (SLD). However, the few investigations available have focused only on the gross level of domains of adaptive behavior.To investigate which item subsets of the Vineland-II can discriminate children with ADHD or SLD from peers with typical development.	Student's t-tests, ROC analysis, logistic regression, and linear discriminant function analysis were used to compare 24 children with ADHD, 61 elementary students with SLD, and controls matched on age, sex, school level attended, and both parents' education level.	Several item subsets that address not only ADHD core symptoms, but also understanding in social context and development of interpersonal relationships, allowed discrimination of children with ADHD from controls. The combination of four item subsets (Listening and attending, Expressing complex ideas, Social communication, and Following instructions) classified children with ADHD with both sensitivity and specificity of 87.5%. Only Reading skills, Writing skills, and Time and dates discriminated children with SLD from controls.	Evaluation of Vineland-II scores at the level of item content categories is a useful procedure for an efficient clinical description.	
28056078	Early-life social isolation has profound effects on adult social competence. This is often expressed as increased aggression or inappropriate displays of courtship-related behaviors. The social incompetence exhibited by isolated animals could be in part due to an altered ability to participate in communicatory exchanges. House mice (Mus musculus) present an excellent model for exploring this idea, because social isolation has a well-established influence on their social behavior, and mice engage in communication via multiple sensory modalities. Here, we tested the prediction that social isolation during early life would influence ultrasonic vocalizations (USVs) emitted by adult male mice during same-sex social encounters. Starting at three weeks of age, male mice were housed individually or in social groups of four males for five weeks, after which they were placed in one of three types of paired social encounters. Pair types consisted of: two individually housed males, two socially housed males, or an individually housed and a socially housed male ("mixed" pairs). Vocal behavior (USVs) and non-vocal behaviors were recorded from these 15-minute social interactions. Pairs of mice consisting of at least one individually housed male emitted more and longer USVs, with a greater proportional use of USVs containing frequency jumps and 50-kHz components. Individually housed males in the mixed social pairs exhibited increased levels of mounting behavior towards the socially housed males. Mounting in these pairs was positively correlated with increased number and duration of USVs as well as increased proportional use of spectrally more complex USVs. These findings demonstrate that USVs are part of the suite of social behaviors influenced by early-life social isolation, and suggest that altered vocal communication following isolation reflects reduced social competence.
28054827	This article presents the revised consensus criteria for the diagnosis of frontotemporal dysfunction in amyotrophic lateral sclerosis (ALS) based on an international research workshop on frontotemporal dementia (FTD) and ALS held in London, Canada in June 2015. Since the publication of the Strong criteria, there have been considerable advances in the understanding of the neuropsychological profile of patients with ALS. Not only is the breadth and depth of neuropsychological findings broader than previously recognised - - including deficits in social cognition and language - but mixed deficits may also occur. Evidence now shows that the neuropsychological deficits in ALS are extremely heterogeneous, affecting over 50% of persons with ALS. When present, these deficits significantly and adversely impact patient survival. It is the recognition of this clinical heterogeneity in association with neuroimaging, genetic and neuropathological advances that has led to the current re-conceptualisation that neuropsychological deficits in ALS fall along a spectrum. These revised consensus criteria expand upon those of 2009 and embrace the concept of the frontotemporal spectrum disorder of ALS (ALS-FTSD).
28054430	Over the last decade, the concept of the "complex patient" has not only been more widely used in multidisciplinary healthcare teams and across various healthcare disciplines, but it has also become more vacuous in meaning. The uptake of the concept of the "complex patient" spans across disciplines, such as medicine, nursing, and social work, with no consistent definition. We review the chronological evolution of this concept and its surrogate terms, namely "comorbidity," "multimorbidity," "polypathology," "dual diagnosis," and "multiple chronic conditions." Drawing on key principles of concept clarification, we highlight disciplinary usage in the literature published between 2005 and 2015 in health sciences, attending to overlaps and revealing nuances of the complex patient concept. Finally, we discuss the implications of this concept for practice, research, and theory.
28054349	Within Western cultural traditions, the idea that parents should talk about the death of their child with each other is deeply rooted. However, across bereaved parent couples there are wide variations in communication about their grief with each other. In this study, we explored the experiences of bereaved couples related to the process of talking and not talking. We used a thematic coding approach to analyze 20 interviews with 26 bereaved parents (11 interviewed as couples, four as individuals). Four main meanings emerged out of our analysis: not talking because of the inadequacy and pointlessness of words in grief, not talking as a way to regulate emotions in daily life, not talking as an expression of a personal, intimate process, and not talking because the partner has the same loss but a different grief process. In addition, we found that the process of talking and not talking can partly be understood as an emotional responsive process on an intrapersonal and interpersonal level. In this process partners search for a bearable distance from their own grief and their partner's, and attune with their relational context. A better understanding of this process is sought in a dialectical approach, emphasizing the value of both talking and not talking in a tense relationship with each other. Implications for clinical work are described.
28053979	Introduction. This study investigated views of mothers from disadvantaged urban and regional areas (i.e., beyond major capital cities) as potential end users of child active play and screen time behaviour change interventions, with a focus on text messaging and web-based delivery platforms. Methods. Thirty-two mothers (22 urban; 10 regional) were interviewed. Purpose-designed questions covered topics regarding mothers' preferences for accessing and receiving information related to parenting and child active play and screen time. Data from transcribed interviews were analysed to identify responses and key themes. Results. Mothers reported frequently accessing parenting- and child-related information online. Regional mothers reported seeking information by talking with other people less frequently than urban mothers and seemed to have a stronger preference for receiving information online. There were few differences between responses from low and high educated mothers. The majority of mothers reported that they would be happy to receive text messages containing information about active play and screen time and that they would find a dedicated website with this information useful. Conclusions. Mothers in this study held favourable views on the potential of receiving information via new communication technologies. Future interventions targeting socioeconomically disadvantaged mothers may benefit from delivering intervention messages via these technologies.
28053833	After a piece of information is put into a network, its fate depends on the behaviors of the nodes of the network; nodes that are equipped with the hardware and software of the age of information and are more powerful than any time in the past. This study suggests that a useful research for communication, marketing and advertising would be one that looks for patterns in the reactions of the nodes toward different pieces of information.This study has used Facebook to see how people have reacted to different types of messages in terms of liking, sharing and commenting. Rather than looking for universal, generalizable patterns we have tried to examine the practicality of the proposed method. The practical aspect of the study comes after a short theoretical discussion on the issue of flow of information in a digital world. The results revealed dozens of significant relations between the examined variables.	This study, its theoretical discussion and results suggest that it would be practical to study the relations between the characteristics of Facebook messages and the type of reactions (liking, sharing and commenting) that they attract.	
28053659	Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network.After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding.	We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.	

28052774	Network meta-analysis (NMA) has become a popular method to compare more than two treatments. This scoping review aimed to explore the characteristics and methodological quality of knowledge synthesis approaches underlying the NMA process. We also aimed to assess the statistical methods applied using the Analysis subdomain of the ISPOR checklist.Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, and Cochrane Database of Systematic Reviews from inception until April 14, 2015. References of relevant reviews were scanned. Eligible studies compared at least four different interventions from randomised controlled trials with an appropriate NMA approach. Two reviewers independently performed study selection and data abstraction of included articles. All discrepancies between reviewers were resolved by a third reviewer. Data analysis involved quantitative (frequencies) and qualitative (content analysis) methods. Quality was evaluated using the AMSTAR tool for the conduct of knowledge synthesis and the ISPOR tool for statistical analysis.	After screening 3538 citations and 877 full-text papers, 456 NMAs were included. These were published between 1997 and 2015, with 95% published after 2006. Most were conducted in Europe (51%) or North America (31%), and approximately one-third reported public sources of funding. Overall, 84% searched two or more electronic databases, 62% searched for grey literature, 58% performed duplicate study selection and data abstraction (independently), and 62% assessed risk of bias. Seventy-eight (17%) NMAs relied on previously conducted systematic reviews to obtain studies for inclusion in their NMA. Based on the AMSTAR tool, almost half of the NMAs incorporated quality appraisal results to formulate conclusions, 36% assessed publication bias, and 16% reported the source of funding. Based on the ISPOR tool, half of the NMAs did not report if an assessment for consistency was conducted or whether they accounted for inconsistency when present. Only 13% reported heterogeneity assumptions for the random-effects model.	The knowledge synthesis methods and analytical process for NMAs are poorly reported and need improvement.	
28052329	We highlight key components of emerging academic structures in global health nursing and explain how this investment can expand nursing's broader engagement in global health policy development.Engaging nursing in global health policy development is vital to ensure the scale-up of effective health programmes. Globally, nurses promote development of interprofessional healthcare teams who are responsible for translating sound global health policy and evidence-based programming into practice. However, the role of nurses within policy forums and on influential decision-making bodies within the global health space remains limited, which reinforces suboptimal global health policy implementation.	Investment in globally engaged academic structures is an important way to expand participation of nursing in global health policy development.	A review of the current knowledge and substantive findings related to academic structures promoting global health nursing was conducted, and included a directed search of institutional websites, related grey and peer-reviewed literature, and communication with top-tier schools of nursing in the United States, to identify specific developments in global health nursing academic structures.	Effective academic structures promoting global health nursing include a framework of four critical components - Research, Education, Policy and Partnership. Academic structure type and core activities vary depending on institutional priorities.	Increasingly, global health research, driven by individual nursing investigators, is expanding; however, in order to translate these advances into expanded involvement in global health policy development, academic structures within schools of nursing need to systematically expand educational opportunities, bolster research capacity and promote partnership with policymakers.	
28051933	As a highly social species, humans are equipped with a powerful tool for social communication-the face. Although seemingly simple, the human face can elicit multiple social perceptions due to the rich variations of its movements, morphology, and complexion. Consequently, identifying precisely what face information elicits different social perceptions is a complex empirical challenge that has largely remained beyond the reach of traditional methods. In the past decade, the emerging field of social psychophysics has developed new methods to address this challenge, with the potential to transfer psychophysical laws of social perception to the digital economy via avatars and social robots. At this exciting juncture, it is timely to review these new methodological developments. In this article, we introduce and review the foundational methodological developments of social psychophysics, present work done in the past decade that has advanced understanding of the face as a tool for social communication, and discuss the major challenges that lie ahead.
28051336	We investigated online diffusion of information, spread of fear, and perceived risk of infection to Middle East Respiratory Syndrome (MERS) as cases of MERS spread rapidly and dozens of fatalities occurred in South Korea in May-June of 2015. This study retrieved 8,671,695 MERS-related online documents from May 20 to June 18, 2015, from 171 Korean online channels and analyzed such documents by using multilevel models and data mining with Apriori algorithm association analysis. We used R software (version 3.2.1) for the association analysis data mining and visualization. Buzz with negative emotions (i.e., anxiety or fear) was more prevalent in online discussion boards, Twitter, and online cafes than news sites and blogs. News buzz (b = 0.21, p < 0.001), but not rumor buzz (b = 0.06, p = 0.308), was associated with positive MERS emotions (i.e., being calm or composed). The mention of eating immunity-boosting food in the news led to a 94 percent chance of a positive MERS emotion and that such a chance of showing a positive emotion was 4.75 times higher than that without such a mention (support of 0.001, confidence of 0.94, and lift of 4.75). Even with the same precautionary messages that were disseminated, they yielded the opposite emotional reactions to people depending on the channel through which the messages were communicated. In the face of a novel and highly contagious disease such as MERS, the government must deploy a response system that includes provision and dissemination of reliable information and inhibits online diffusion of false information.
28050947	HIV remains an intractable public health concern in the USA, with infection rates notably concentrated among Black gay and bisexual men. Status disclosure by HIV-positive individuals can be an important aspect of risk reduction but doing so poses dilemmas concerning privacy, stigma and self-protection, especially among populations subjected to multiple types of stigmatisation. Understanding the factors related to the disclosure process can help to inform prevention efforts. Using exploratory in-depth interviews, this qualitative study examines the disclosure process among a sample of twenty HIV-positive Black gay and bisexual men (mean age = 40) recruited through a non-profit health centre in a mid-western city in the USA. Data were analysed using a thematic analysis approach with HIV-disclosure as an a priori sensitising concept. Fears of stigma and secondary disclosure within social networks were critical barriers to talking about HIV with sexual partners and disclosure decisions involved a complex process centred on three primary themes: degree of sexual risk, partner type and perceived partner trustworthiness. The unique combinations of these contextual factors resulted in increased or decreased likelihood of disclosure. A conceptual model explicating a potential process by which these contextual factors influence disclosure decisions is presented.
28050944	Palliative care is considered an integral part of oncology and communicating this with patients is an unavoidable task for oncologists. This contribution investigated to what extent communication skills for communicating palliative care with patients are trained in the formal academic training program in medical oncology in Flanders, Belgium. The programme is based on the recommendations for a Global Core Curriculum in Medical Oncology, developed by The American Society of Clinical Oncology (ASCO) together with the European Society for Medical Oncology (ESMO).For this qualitative study, data were collected using document analysis from the ESMO/ASCO recommendations and the documents of the Flanders' medical oncology programme complemented with interviews with Flemish medical oncology trainees.	Few recommendations for training communication skills to communicate about palliative care were found in the ASMO/ASCO recommendations and even less in the Flanders' programme documents. Trainees are mainly exposed to palliative care communication during the clinical practice of their training. Only very few lectures or seminars are devoted to palliative care and even less on communication about palliative care. They reported several barriers to communicate about palliative care.	This study revealed promising developments for the training of Flemish medical oncologists to discuss palliative care. However, there is still a need for more theoretical training on palliative care complemented with communication skills trainings. Communication training in general needs to be fully integrated as a core skill within the medical curriculum at large and should be promoted as lifelong learning and competency development.	
28050218	Targeting overlapping behavioral phenotypes in neurogenetic disorders can help elucidate gene-behavior relationships. Fragile X syndrome (FXS) and autism spectrum disorder (ASD) have been studied as a model for this approach, and important areas of phenotypic overlap and divergence have been documented. However, few studies have examined how the manifestation of ASD-related phenotypes in FXS may change over development, a question which has important implications for conceptualizing shared etiologies of these disorders and their constituent phenotypes. The goal of this study was to characterize ASD phenotypes in boys and girls with FXS across development, as well as to compare individual component phenotypes among boys with FXS and boys with idiopathic ASD (ASD-O) over time.Sixty-five boys and girls with FXS and 19 boys with ASD-O completed a battery of diagnostic, cognitive, and language assessments at two time points (mean 2.5 years apart). Nonparametric tests assessed changes in diagnostic classification in FXS over time, and hierarchical linear modeling and repeated measures assessed changes in individual ASD symptoms in FXS over time. Additionally, ANCOVAs compared ASD symptom severity and component phenotypes in boys with FXS-O, FXS-ASD, and ASD-O at both time points.	Overall, ASD symptom manifestation for children with FXS significantly increased over time, and developmental predictors varied based on the domain of symptoms assessed. The greatest degree of overlap was observed between boys with FXS-ASD and ASD-O in the domain of reciprocal social communication across time points, whereas boys with ASD-O demonstrated greater impairment in restricted and repetitive behaviors at the later time point.	ASD symptoms increased in FXS with age, and social language impairment emerged as a potential core shared feature of FXS and ASD that may help elucidate underlying molecular genetic variation related to phenotypic variance, and aid intervention planning for subgroups of children showing distinct phenotypes. Results highlight the value of a developmental perspective, and longitudinal data in particular, in evaluating shared behavioral phenotypes across genetic conditions, lending insight into underlying cognitive, neural, and genetic mechanisms associated with key developmental phenotypes in ASD and FXS.	
28050217	Early research has documented that young children show an increased interest toward objects that are verbally labeled by an adult, compared to objects that are presented without a label. It is unclear whether the same phenomenon occurs in neurodevelopmental disorders affecting social development, such as autism spectrum disorder (ASD) and Williams syndrome (WS).The present study used a novel eye-tracking paradigm to determine whether hearing a verbal label increases the salience of novel objects in 35 preschoolers with ASD, 18 preschoolers with WS, and 20 typically developing peers.	We found that typically developing children and those with WS, but not those with ASD, spent significantly more time looking at objects that are verbally labeled by an adult, compared to objects that are presented without a label.	In children without ASD, information accompanied by the speaker's verbal label is accorded a "special status," and it is more likely to be attended to. In contrast, children with ASD do not appear to attribute a special salience to labeled objects compared to non-labeled objects. This result is consistent with the notion that reduced responsivity to pedagogical cues hinders social learning in young children with ASD.	
28049573	More people are living after a diagnosis of cancer than ever before and now account for around 5% of the US population. The specialty of cancer survivorship has been developing and growing since the mid-1980s, but the term survivor is open to debate by people living with cancer and those caring for them. Regardless of the term used, many ongoing physical, psychological, and social needs affect quality of life for people who are living with cancer and those who have survived the disease. Survivors prefer to have these needs addressed by their oncologist but also want their primary care provider to have a role. However, survivors also believe there are communication and coordination barriers between care providers. The existing method for delivering cancer care is becoming unsustainable and is not adequately configured to deliver high-quality cancer care to this growing population in the USA, especially when confronted with projected health-care shortages by 2020. In this Series paper, we define the term cancer survivor, discuss survivors' ongoing needs and preferences for care over time, and consider the implications for delivering coordinated cancer care in the USA.
28049279	The leading cause of death in children in developing countries is protein-energy malnutrition. In Viet Nam, 25.9% of children under 5 experience stunted growth and 6.6% are moderately wasted. Iron deficiency anaemia and vitamin A deficiency contribute to these and other malnutrition conditions.Given these factors, more evidence based approaches are required to improve understanding of current attitudes, opinions and behaviours of mothers with young children, in order to operationalise social marketing of nutrition commodities in Viet Nam.	A literature review supported a rapid assessment and response method involving semi-structured interviews with 77 stakeholders and focus group discussions with 80 program beneficiaries from four geographic locations in the north and south of Viet Nam. Discussion agendas were developed to address key program issues with grounded theory utilized for data analysis.	Data analysis highlighted challenges and opportunities within the six Ps of social marketing: Supply and demand side issues included: cost and the quality of products, the limited scale of interventions and promotional activities. Policy issues identified related to current policies that inhibited the broader promotion and distribution of micronutrient products, and opportunities for improved dialogue with policy partners. Partnerships further emphasized the need for public private partnerships to support the social change process.	Implications for theory, policy, and practice indicates that rapid assessment and response is a cost-effective, pragmatic method of public health research, in resource constrained settings, to explore policies and behaviours amenable to change and build stakeholder engagement in the program.	
28049225	The Journal Impact Factor (JIF) is a single citation metric, which is widely employed for ranking journals and choosing target journals, but is also misused as the proxy of the quality of individual articles and academic achievements of authors. This article analyzes Scopus-based publication activity on the JIF and overviews some of the numerous misuses of the JIF, global initiatives to overcome the 'obsession' with impact factors, and emerging strategies to revise the concept of the scholarly impact. The growing number of articles on the JIF, most of which are in English, reflects interest of experts in journal editing and scientometrics toward its uses, misuses, and options to overcome related problems. Solely displaying values of the JIFs on the journal websites is criticized by experts as these average metrics do not reflect skewness of citation distribution of individual articles. Emerging strategies suggest to complement the JIFs with citation plots and alternative metrics, reflecting uses of individual articles in terms of downloads and distribution of related information through social media and networking platforms. It is also proposed to revise the original formula of the JIF calculation and embrace the concept of the impact and importance of individual articles. The latter is largely dependent on ethical soundness of the journal instructions, proper editing and structuring of articles, efforts to promote related information through social media, and endorsements of professional societies.
28046044	Patients' perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient's perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver's perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients' demographic information and the caregiver's perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes 'disease / treatment', 'treatment procedure related instructions', 'preparation for examination', 'positive reinforcement / reassurance', and 'family / social history' from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme 'Positive reinforcement / reassurance': 'number of related words' (p = 0.002), 'number of related utterances' (p = 0.001), 'percentage of the related words in total number of words' (p = 0.005), 'percentage of the related utterances in total number of utterances' (p = 0.035) and 'percentage of time spent in total time duration' (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver's involvement, such as clinicians' mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians' communication skills for improving patients' clinical experiences and treatment satisfaction.
28044197	Domestic chickens are members of an order, Aves, which has been the focus of a revolution in our understanding of neuroanatomical, cognitive, and social complexity. At least some birds are now known to be on par with many mammals in terms of their level of intelligence, emotional sophistication, and social interaction. Yet, views of chickens have largely remained unrevised by this new evidence. In this paper, I examine the peer-reviewed scientific data on the leading edge of cognition, emotions, personality, and sociality in chickens, exploring such areas as self-awareness, cognitive bias, social learning and self-control, and comparing their abilities in these areas with other birds and other vertebrates, particularly mammals. My overall conclusion is that chickens are just as cognitively, emotionally and socially complex as most other birds and mammals in many areas, and that there is a need for further noninvasive comparative behavioral research with chickens as well as a re-framing of current views about their intelligence.
28044064	Difficulties in social communication are part of the phenotypic overlap between autism spectrum disorders (ASD) and schizophrenia. Both conditions follow, however, distinct developmental patterns. Symptoms of ASD typically occur during early childhood, whereas most symptoms characteristic of schizophrenia do not appear before early adulthood. We investigated whether overlap in common genetic influences between these clinical conditions and impairments in social communication depends on the developmental stage of the assessed trait. Social communication difficulties were measured in typically-developing youth (Avon Longitudinal Study of Parents and Children, N⩽5553, longitudinal assessments at 8, 11, 14 and 17 years) using the Social Communication Disorder Checklist. Data on clinical ASD (PGC-ASD: 5305 cases, 5305 pseudo-controls; iPSYCH-ASD: 7783 cases, 11 359 controls) and schizophrenia (PGC-SCZ2: 34 241 cases, 45 604 controls, 1235 trios) were either obtained through the Psychiatric Genomics Consortium (PGC) or the Danish iPSYCH project. Overlap in genetic influences between ASD and social communication difficulties during development decreased with age, both in the PGC-ASD and the iPSYCH-ASD sample. Genetic overlap between schizophrenia and social communication difficulties, by contrast, persisted across age, as observed within two independent PGC-SCZ2 subsamples, and showed an increase in magnitude for traits assessed during later adolescence. ASD- and schizophrenia-related polygenic effects were unrelated to each other and changes in trait-disorder links reflect the heterogeneity of genetic factors influencing social communication difficulties during childhood versus later adolescence. Thus, both clinical ASD and schizophrenia share some genetic influences with impairments in social communication, but reveal distinct developmental profiles in their genetic links, consistent with the onset of clinical symptoms.Molecular Psychiatry advance online publication, 3 January 2017; doi:10.1038/mp.2016.198.
28044047	Previous studies identified associations between maternal obesity and childhood neurodevelopment, but few examined paternal obesity despite potentially distinct genetic/epigenetic effects related to developmental programming.Upstate KIDS (2008-2010) recruited mothers from New York State (excluding New York City) at ∼4 months postpartum. Parents completed the Ages and Stages Questionnaire (ASQ) when their children were 4, 8, 12, 18, 24, 30, and 36 months of age corrected for gestation. The ASQ is validated to screen for delays in 5 developmental domains (ie, fine motor, gross motor, communication, personal-social functioning, and problem-solving ability). Analyses included 3759 singletons and 1062 nonrelated twins with ≥1 ASQs returned. Adjusted odds ratios (aORs) and 95% confidence intervals were estimated by using generalized linear mixed models accounting for maternal covariates (ie, age, race, education, insurance, marital status, parity, and pregnancy smoking).	Compared with normal/underweight mothers (BMI <25), children of obese mothers (26% with BMI ≥30) had increased odds of failing the fine motor domain (aOR 1.67; confidence interval 1.12-2.47). The association remained after additional adjustment for paternal BMI (1.67; 1.11-2.52). Paternal obesity (29%) was associated with increased risk of failing the personal-social domain (1.75; 1.13-2.71), albeit attenuated after adjustment for maternal obesity (aOR 1.71; 1.08-2.70). Children whose parents both had BMI ≥35 were likely to additionally fail the problem-solving domain (2.93; 1.09-7.85).	Findings suggest that maternal and paternal obesity are each associated with specific delays in early childhood development, emphasizing the importance of family information when screening child development.	
28042974	The Vineland Adaptive Behavior Scales use parental report to examine communication and social skills in children with typical and atypical development, and exhibit high reliability when compared against overall direct testing. However, findings are mixed comparing Vineland communication/language scores with experimenter-administered tests of language.The current study breaks new ground in comparing Vineland reports with direct observation of children's speech by (a) individual items and (b) level of child functioning, focusing on usage of wh-questions, verb tenses, negation, pronouns and noun-verb combinations. Both 'high-verbal' (HV) and 'middle-verbal' (MV) children with ASD are included, as well as a language-matched TD group.	The results revealed that parent report on the Vineland varies in accuracy of capturing the production of grammatical items by young children with ASD and TD children. While parents' assessment of their child's production of noun-verb combinations and 'who/why' was highly accurate, children's production of pronouns was under-rated by parents. Additionally, parents of HV children also under-rated their child's production of past regular verbs.	Underestimation of these grammatical elements could lead to mistaken conclusions about their development in ASD or in individual children.	
28042850	The unsafe use and misuse of pesticides in China are major threats to farmers' health and the environment. The purpose of this study is to evaluate small-scale farmers' practices with regard to pesticide use and identify the determinants of their behavior in Anqiu County, China. The results show that the frequency of pesticide application by local farmers is high and that the improper disposal of pesticides after use is common in the study area. Although most farmers felt that they were at some degree of risk when using pesticides, farmers were found to overuse pesticides in the study area. The probability of pesticide overuse significantly decreased with farmers' risk perceptions, willingness to reduce pesticide use, better social relationships, and strict government monitoring. The perception of risk can thus be an important element in education and communication efforts.
28042538	Autism is a neurodevelopmental disorder characterized by difficulty in verbal and non-verbal communication, impaired social interaction, and restricted and repetitive behavior. It has been recently introduced as a multigenic disorder with significant epigenetic effects on its pathology. Recently, epigenetic silencing of retinoic acid receptor- related orphan receptor alpha (RORα) gene (which has an essential role in neural tissue development) was shown to have occurred in autistic children due to methylation of its promoter region. This may thus explain a significant part of the molecular pathogenesis of autism. Therefore, we aimed to confirm this finding by implementing a case-control (experimental) study in the population of Isfahan.The methylation status of a 136 bp sequence of a GpG island (encompassing 13 CpG sites) in the RORA promoter region (positions -200 to -64) as an experimental study was examined in the lymphocyte cells of 30 autistic children after sodium bisulfite treatment using the melting curve analysis-methylation (MCA-Meth) assay compared with normal children. Also, quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) analysis was used to estimate the level of mRNA transcripts and to evaluate MCA-Meth analysis results.	This study revealed no methylation in the examined promoter regions in both autistic and normal children, with the melting curve of all studied samples being comparable to that of the non-methylated control. The results of MCA-Meth analysis were also consistent with qRT-PCR results. We therefore observed no significant difference in the levels of RORα transcripts in the blood lymphocytes between autistic and healthy children.	The methylation of the RORA promoter region may not be considered as a common epigenetic risk factor for autism in all populations. Hence, the molecular pathogenesis of autism remains unclear in the population investigated.	
28041818	After the evacuation from Africa to Western hospitals of several international workers with the Ebola virus disease, the first case of contagion outside Africa occurred in Madrid, Spain. A nursing care assistant who had attended a missionary repatriated from Sierra Leone contracted the disease. On October 7th 2014, the patient arrived at the University Hospital La Paz-Carlos III in Madrid. She remained in the hospital for 30 days, 25 of which were in strict isolation in a negative pressure room with air lock anteroom; personal protective equipment was required. During the last five days, the patient was moved to a standard room. Protection measures were used in accordance with the Hospital Occupational Health Department. According to its evolution, we differentiate three phases with specific care demands which were conditioned by the risk of transmission, forcing extreme measures of prevention. The largest numbers of direct interventions fall within the realm of the nursing profession. It is essential that specialized units with regular training be created for highly contagious diseases. In addition, this and other cases should be analyzed from the point of view of nursing, to allow standardized care. We also recognize the importance of managing communication to prevent social unrest and stigmatization of staff.
28041806	Multiple and complex health, social, and environmental factors threaten the school success of children living with HIV. Little is known about interventions to overcome these threats to school success. We aimed to identify the number and types of recommendations from hospital-generated neurodevelopmental exams and school-generated evaluations, Individual Education Plans (IEP), and 504 Plans for adaptations in the classroom for students with HIV infection. We also compared recommendations suggested by both neurodevelopmental exams and IEPs or 504 Plans. Data were derived from the clinic records of 31 school-age children. Content analysis yielded 358 recommendations in 11 categories. Findings highlighted a lack of communication between the clinic and schools.
28041647	Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) decrease life expectancy for affected patients. The aim was to describe the perceptions of received information regarding diagnosis, treatment and management, as well as social support and coping perceived by patients with PAH or CTEPH.A descriptive, national cohort survey that included patients from all PAH-centres in Sweden. A quantitative methodology was employed where all patients received three questionnaires, QLQ-INFO25, Mastery Scale and Social Network & Support Scale.	The response rate was 74% (n=325), mean age 66±14years, 71% were female and 69% were diagnosed with PAH and 31% with CTEPH. Sixty percent of respondents were satisfied with the received information and felt it was helpful. Best experiences were of information in the areas of medical tests (70%) and the disease (61%). Forty-five percent wanted more information. Men described their social network as more accessible than women (p=0.004). Those living alone had a lower coping ability.	Despite a high level of satisfaction with the received information, almost half of the patients wanted more information.	Regular repeating or giving new information should be an ongoing process in the care of patients at the PAH-centres.	
28040991	Augmentative and alternative communication (AAC) interventions have been shown to be effective in supporting children with autism spectrum disorder (ASD) to communicate, particularly to request preferred items and activities. The aim of this systematic review was to examine the effectiveness of AAC interventions in supporting children to produce a broader range of communicative functions and determine the extent to which these interventions have been evaluated beyond immediate effectiveness to address maintenance, generalization, and social validity. A systematic search and application of inclusion criteria yielded 30 interventions that focused on communication functions beyond object requests. In many of the studies, flaws detracted from the certainty of evidence, and maintenance, generalization, and/or social validity were not addressed. Further research is needed to evaluate the extent to which AAC interventions can support children with ASD to communicate using a variety of communication functions, as well as to demonstrate sustained, transferable, and meaningful change.
28040801	Children with autism spectrum disorder (ASD) often struggle with social skills, including the ability to perceive emotions based on facial expressions. Research evidence suggests that many individuals with ASD can perceive emotion in music. Examining whether music can be used to enhance recognition of facial emotion by children with ASD would inform development of music therapy interventions.The purpose of this study was to investigate the influence of music with a strong emotional valance (happy; sad) on children with ASD's ability to label emotions depicted in facial photographs, and their response time.	Thirty neurotypical children and 20 children with high-functioning ASD rated expressions of happy, neutral, and sad in 30 photographs under two music listening conditions (sad music; happy music). During each music listening condition, participants rated the 30 images using a 7-point scale that ranged from very sad to very happy. Response time data were also collected across both conditions.	A significant two-way interaction revealed that participants' ratings of happy and neutral faces were unaffected by music conditions, but sad faces were perceived to be sadder with sad music than with happy music. Across both conditions, neurotypical children rated the happy faces as happier and the sad faces as sadder than did participants with ASD. Response times of the neurotypical children were consistently shorter than response times of the children with ASD; both groups took longer to rate sad faces than happy faces. Response times of neurotypical children were generally unaffected by the valence of the music condition; however, children with ASD took longer to respond when listening to sad music.	Music appears to affect perceptions of emotion in children with ASD, and perceptions of sad facial expressions seem to be more affected by emotionally congruent background music than are perceptions of happy or neutral faces.	

28040718	The "shared-care model" for patients with cancer involves care coordination between primary care providers (PCPs) and oncologists, with the goal of optimizing survivorship care. However, a high proportion of adolescent and young adult (AYA) cancer survivors do not have a PCP. Study objectives were to increase the percentage of AYAs with a PCP documented in the electronic medical record (EMR) via the use of a best practice advisory (BPA) or "stopgap" intervention; to increase communication between providers by the number of routed clinic notes; and to assess oncology providers' attitudes/beliefs about the model and intervention.Data were collected for the 6 months before implementation of the BPA to determine the percentage of AYAs with a PCP and the number of notes routed to providers (time point 1 [T1]). The same data were collected at time point 2 (T2) after the BPA had been implemented for 6 months. Oncology providers participated in an education video module and an online survey at T1 and a survey at T2.	At T1, 47.1% of 756 AYAs had a documented PCP in the EMR. At T2, the percentage increased to 55.1% (P<.002). The number of routed notes did not change significantly from T1 to T2. Providers that completed the intervention survey agreed/strongly agreed that the shared-care model is a desirable model of care (T1 = 86%; T2 = 93%) and that a BPA is useful for facilitating PCP referrals (T1 = 76%; T2 = 39%).	This BPA is feasible for increasing the percentage of AYAs with a PCP documented in the EMR and could potentially lead to increased PCP referral and communication among providers for the benefit of long-term survivorship care. Providers generally agree with the shared-care model; however, the BPA implementation requires modification.	
28040487	The Gulf toadfish (Opsanus beta) has a fully functional ornithine urea cycle (O-UC) that allows it to excrete nitrogenous waste in the form of urea. Interestingly, urea is excreted in a pulse across the gill that lasts 1-3h and occurs once or twice a day. Both the stress hormone, cortisol, and the neurotransmitter, serotonin (5-HT) are involved in the control of pulsatile urea excretion. This and other evidence suggests that urea pulsing may be linked to toadfish social behavior. The hypothesis of the present study was that toadfish urea pulses can be triggered by waterborne chemical cues from conspecifics. Our findings indicate that exposure to seawater that held a donor conspecific for up to 48h (pre-conditioned seawater; PC-SW) induced a urea pulse within 7h in naïve conspecifics compared to a pulse latency of 20h when exposed to seawater alone. Factors such as PC-SW intensity and donor body mass influenced the pulse latency response of naïve conspecifics. Fractionation and heat treatment of PC-SW to narrow possible signal candidates revealed that the active chemical was both water-soluble and heat-stable. Fish exposed to urea, cortisol or 5-HT in seawater did not have a pulse latency that was significantly different than seawater alone; however, ammonia, perhaps in the form of NH4Cl, was found to be a factor in the pulse latency response of toadfish to PC-SW and could be one component of a multi-component cue used for chemical communication in toadfish. Further studies are needed to fully identify the chemical cue as well as determine its adaptive significance in this marine teleost fish.
28039893	Breast cancer affects mostly older women but there are no guidelines especially devoted to adjuvant chemotherapy for this population. In this context, this study was carried out in a population-based cohort of French elderly women with breast cancer, to check adherence to the existing national guidelines according to the women's age, taking into account the evolution of the situation over time for women requiring chemotherapy. Between October 2006 and December 2008, all consecutive women included in the French Health registry for a biopsy-proven primary nonmetastatic breast cancer, aged 65-80 years at diagnosis, and living in South Eastern France, were asked to participate in a cohort study. Medical information was collected from physicians. The study population was restricted to the 223 women who were recommended adjuvant chemotherapy according to national guidelines. Those who received chemotherapy were compared to those who did not receive this treatment. Among these 223 women 55% had received chemotherapy. Only three women refused the treatment. Less than 8% have had a geriatric assessment before treatment decision and only two were proposed to participate in a clinical trial. After adjustment for comorbidity score, tumor characteristics, socio-demographic characteristics, and year of diagnosis, increasing patient age was independently associated with decreased guideline concordance for adjuvant chemotherapy. Women aged 75-80 years received chemotherapy more than four times less often than women aged 65-74 years. However, the percentage of women who received chemotherapy increased from 33% to 58% between 2006 and 2008, in parallel with the setting up of Onco-Geriatric Coordination Units in the area. In France, chronological age remains a barrier to receive chemotherapy for older breast cancer women but the establishment of a formal collaboration between oncologists and geriatricians seems to be an effective way to improve care delivery in this population.
28039845	perinatal mental health is an important public health issue and consideration must be given to care provision for effective support and care of women in the perinatal period.to synthesise primary research on midwives' perceived role in Perinatal Mental Health (PMH).	integrative review.	Whittemore and Knafl's (2005) framework was employed. A systematic search of the literature was completed. Studies were included if they met the following criteria: primary qualitative, quantitative and mixed methods research studies published in peer reviewed journals between January 2006 to February 2016, where the population of interest were midwives and the outcomes of interest were their perceived role in the management of women with PMH problems. The methodological quality of studies was assessed using the relevant CASP (Critical Appraisal Skills Programmes, 2014) criteria for quantitative and qualitative research studies. Data extraction, quality assessment and thematic analysis were conducted.	a total of 3323 articles were retrieved and 22 papers were included in the review (15 quantitative, 6 qualitative and one mixed method study). The quality of the studies included was good overall. Two overarching themes emerged relating to personal and professional engagement. Within personal engagement four sub themes are presented: knowledge, skills, decision making and attitude. Within professional engagement four themes are presented: continuous professional development, organisation of care, referral, and support.	the findings indicate midwives require continuous professional development opportunities that address knowledge, attitudes to PMH, communication and assessment skills. However educational and training support in the absence of appropriate referral pathways and support systems will have little benefit.	
28039823	High rates of comorbidity are found among eating disorder (ED) patients, which may negatively affect treatment outcome and prognosis. However, there is a shortage of studies in Spain using clinician administered interviews to assess rates of comorbidity among these patients, particularly in adolescents. This study aimed to evaluate Axis I psychiatric diagnoses in adolescent patients with an ED and to compare them with patients with a distinct disorder with adolescent onset, substance use disorder (SUD) patients. Considering that maternal psychological distress is another factor involved in ED prognosis, a secondary aim was to examine the relationship between patient's psychological variables and maternal distress (depression and anxiety). The cross-sectional study included 50 ED patients, 48 SUD patients, and their mothers. More than half of the patients received a diagnosis for a comorbid disorder. Internalizing problems were more common among EDs and externalizing disorders were the most common comorbidities among SUDs, similar to findings from other countries. Maternal distress was associated with higher levels of depression and symptom severity in patients. No differences in distress were found between mothers of patients with a comorbid diagnosis and those without. Elevated anxiety or depression in mothers did not increase the likelihood of patients having a particular primary diagnosis. In short, while both ED and SUD patients presented high rates of comorbidity, the types of comorbid diagnoses were specific to each group. Assessing for the presence of comorbid disorders and targeting maternal psychological distress may guide treatment interventions and improve patient prognosis.
28039559	Concerned partners (CPs) of military service members and veterans with alcohol misuse face significant help-seeking barriers. We adapted the Community Reinforcement and Family Training (CRAFT) intervention into a 4-session web-based intervention (WBI) called Partners Connect. The program aims to help the CP increase their own well-being, teach the CP how to manage his/her behavior (e.g., communication) toward their partner, and identify ways the CP can help their partner reduce drinking and seek treatment. We recruited CPs through social media, and then tested the feasibility and acceptance of the WBI by conducting qualitative interviews and post-WBI session surveys after their WBI sessions. CPs (n = 12) spontaneously reported improvements in communication and more effective management of their partner's drinking due to skills learned. They discussed how the online approach can help overcome barriers to seeking in-person help. This WBI fills an important gap in clinical services for military and veteran CPs and CPs in the general population who may not otherwise seek in-person counseling.
28039032	The aim of this study was to assess whether specific title characteristics could influence the likelihood of being included in the "Altmetric Top 100."We conducted a 1:2 matched case-control study with the cases being the health care articles included in the "Altmetric Top 100" lists (2013-2015) matched through a random computerized procedure with two health care articles published in the same journal and year. For each title, we extracted the number of characters in the title, the number of uncommon words, and whether the title was declarative. Conditional logistic regression was used to estimate odds ratio (OR) with 95% confidence intervals adjusted for a prespecified baseline confounder (open access).	One hundred eight "Medical and health sciences" articles were retrieved in the 2013-2015 "Altmetric Top 100" and matched to 216 control articles. Titles of the "Altmetric Top 100" articles were 102.6 characters (±42) long, included 3.4 (±2.0) uncommon words, and 29.6% (32/108) were "declarative." Titles of the matched articles were 109.3 characters (±37.1) long, included 4.7 (±2.4) uncommon words, and 21.8% (47/216) were "declarative." After multivariate adjustment, declarative titles with a lower number of uncommon words were significantly more represented in the Altmetric list, with declarative titles having 2.8 times the odds of being in the top list (OR: 2.8; 95% confidence interval: 1.2, 6.4). For each additional uncommon word in the title, there was a 1.4 increase in the odds of being a non-Altmetric Top 100 article (1.4; 1.2-1.6).	An easy-to-understand, informative title may help bridge the gap between scholar and social media dissemination.	
28038875	The rubber boom across much of Southeast Asia has led to environmental destruction, and the resultant crash in the price of rubber has destabilised livelihoods. We investigated the necessary factors required to enable a transition towards a more sustainable model for rubber cultivation in Southwest China (i.e. the 'greening' of rubber cultivation), using a framework for the integrative study of multiple aspects in complex land use issues. We present findings from stakeholder interviews and a stakeholder workshop, and discuss their relevance within and beyond Southwest China. The current focus of researchers and development practitioners tends to be on finding technical solutions to address unsustainable rubber cultivation practices. However, stakeholder consultations revealed that the key barriers were more social: low levels of trust and knowledge exchange between stakeholder groups and fragmented visions about the future of the landscape. It is very important to continue the economic prosperity initially brought by rubber, but, without improved communication between government and researchers and smallholder farmers, this will be very difficult to achieve. A wider landscape perspective is needed to address issues in rubber cultivation to avoid repeating the same problems of cash crop boom and bust experienced with other crops, most notably bananas. We conclude that more effort should be put into developing mechanisms that integrate technical knowledge, enhance social relationships, and present a forum for reconciling - or at least acknowledging - the differing needs, knowledge, and objectives of different groups, and transcending the power dynamics between smallholder farmers and government and researchers.
28036341	Adequate community knowledge about malaria is crucial in order to improve prevention by reducing exposure to the disease. Malaria is a major cause of morbidity and mortality among children of less than five years of age in Equatorial Guinea. However, information concerning the accuracy of community knowledge is insufficient. This study aimed at assessing the depth of caregivers' knowledge of malaria, their beliefs and attitudes about this disease, and their socioeconomic determinants in the Bata district of Equatorial Guinea.A cross-sectional study was conducted in the district of Bata, involving 440 houses selected from 18 rural villages and 26 urban neighbourhoods. A combined "Malaria Knowledge Score" was generated based on caregivers' knowledge about transmission, symptoms, prevention, the treatment of children, and best place to seek treatment. Multivariate logistic regressions analyses were performed to assess those factors that are associated with knowledge about malaria.	A total of 428 caregivers were interviewed; 255 (59.6%) and 173 (40.4%) lived in urban and rural areas respectively. Significant differences between rural and urban households were observed in caregivers' malaria knowledges and beliefs. Almost 42% of urban and 65% of rural caregivers were unaware as to how malaria is transmitted (OR = 2.69; 95% CI: 1.78-4.05). Together with rurality, the factors most significantly associated with the Malaria Knowledge were the level of education of the caregiver and the socioeconomic status of the household.	Improvements in educational programs are needed to empower the most vulnerable households such that they can pro-actively implement malaria control measures. This could be achieved by a comprehensive communication strategy aimed at changing individual and community behaviours, and delivered by suitably trained community health workers and indoor residual spraying personnel.	
28036004	This paper reviews the state-of-the-art in sensing technologies that are relevant for Autism Spectrum Disorder (ASD) screening and therapy. This disorder is characterized by difficulties in social communication, social interactions, and repetitive behaviors. It is diagnosed during the first three years of life. Early and intensive interventions have been shown to improve the developmental trajectory of the affected children. The earlier the diagnosis, the sooner the intervention therapy can begin, thus, making early diagnosis an important research goal. Technological innovations have tremendous potential to assist with early diagnosis and improve intervention programs. The need for careful and methodological evaluation of such emerging technologies becomes important in order to assist not only the therapists and clinicians in their selection of suitable tools, but to also guide the developers of the technologies in improving hardware and software. In this paper, we survey the literatures on sensing technologies for ASD and we categorize them into eye trackers, movement trackers, electrodermal activity monitors, tactile sensors, vocal prosody and speech detectors, and sleep quality assessment devices. We assess their effectiveness and study their limitations. We also examine the challenges faced by this growing field that need to be addressed before these technologies can perform up to their theoretical potential.
28035240	The transition from high school to post-secondary education and work is difficult for adolescents on the autism spectrum. Transition planning can be an effective way of supporting adolescents on the autism spectrum to prepare for leaving school and to succeed in obtaining employment; however, there is a need for an autism-specific transition planning program with proven effectiveness. This paper describes a trial protocol for evaluating the Better OutcOmes & Successful Transitions for Autism (BOOST-A™); an online interactive program that empowers adolescents on the autism spectrum to plan their transition from school to further study, training, or employment.The trial will involve adolescents on the autism spectrum in high school and their parents, who will be alternately assigned to a control group (regular practice) or an intervention group (using the BOOST-A™). The BOOST-A™ was developed using the PRECEDE-PROCEED model, and is based on the self-determination model, and the strengths- and technology-based approaches. It involves participants completing a series of online modules. The primary outcome will be self-determination, because high self-determination has been linked to successful transition to employment among adolescents on the autism spectrum. Secondary outcomes will include domain-specific self-determination, career planning and exploration, quality of life, and environmental support. Data will be obtained from questionnaires completed by the adolescent on the autism spectrum and their parent/s. Data collection will take place at baseline (Time point 1) and 12 months later (Time point 2).	This trial will provide evidence of the effectiveness of the BOOST-A™ to assist adolescents on the autism spectrum to successfully transition from school. Trial registration #ACTRN12615000119594.	
28034801	Thyroid hormones are important for the development of the central nervous system. Since the fetal thyroid gland is not functioning until mid-gestation, transport of maternal thyroid hormones across the placenta is essential during the early phases of gestation. Maternal thyroid deficiency has been associated with a higher incidence of neurodevelopmental disorders in the newborns. The relationship between maternal hypothyroidism and the onset of autism spectrum disorders (ASD) in the offspring, however, is still debated. To address this issue, we used a validated animal model of prenatal hypothyroidism based on the administration of the thyroid peroxidase inhibitor methimazole (MMI, 0.02g/100ml in tap water) to rat dams from gestational day 9 up to delivery. The offspring was tested in behavioral tasks during infancy (PNDs 5, 9, 13) and adolescence (PND 35-40) to capture some of the core and associated symptoms of ASD. MMI-exposed pups were able to vocalize as controls when separated from the nest, and showed intact social discrimination abilities in the homing behavior test. At adolescence, the offspring from both sexes did not show an anxious-phenotype in the elevated plus maze and showed intact object recognition. However, MMI-exposed male rats showed increased novelty-directed exploratory behaviors: they solicited their partner to play more and showed more interest for novel rather than familiar objects compared to control rats. Our results show that prenatal MMI-induced hypothyroidism does not cause in the rat offspring behaviors that resemble core and associated ASD symptoms, like deficits in communication and social interaction and anxiety.
28034626	Autism spectrum disorders (ASD) affect millions of children worldwide, and are characterized by impairment in social interaction and communication, and specific repetitive behavioral patterns. Growing evidence highlights a role of toll-like receptors (TLRs) in the pathogenesis of ASD. Specifically, TLR-4 activation has been shown to be associated with increased pro-inflammatory cytokines as well as autistic symptoms in offspring. NADPH oxidase (NOX-2) derived reactive oxygen species (ROS) have also been shown to play pathogenic role under inflammatory conditions. However, the role of TLR-4 in the regulation of NOX-2 derived ROS has not been explored in ASD, particularly in T cells. Therefore, this study explored TLR-4 and NOX-2 related signaling in peripheral T cells of ASD patients (n=35) and age-matched typically developing children (n=30). In this study, we find that ASD individuals have increased TLR-4 expression on T cells which is associated with increased NOX-2 expression and ROS generation as compared to typically developing children. Moreover, activation of TLR-4 on T cells by lipopolysaccharide (LPS) in vitro leads to enhanced generation of NOX-2 derived ROS via nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) pathway. These data support a link between T cell TLR-4 activation and NOX-2/ROS upregulation in ASD patients. Our study has implications in the context of neuroinflammation observed in ASD patients as ROS may lead to amplification and perpetuation of inflammation both in the periphery and central nervous system. Our data also suggest that therapeutic targeting of TLR-4 signaling may lead to reduction in inflammation of ASD patients.
28034408	Various online applications and service has led to the development of online health communities (OHCs), which in addition to the peer-to-peer communication offer patients and other users also interaction with health professionals. While the benefits and challenges of patients and other users' participation in OHCs have been extensively studied, a thorough examination of how health professionals as moderators (i.e., those who provide clinical expertise to patients and other users in OHCs) experience participation in OHCs is lacking.The aim of this study is to explore the main benefits and challenges of health professional moderators' participation in the OHCs.	The study undertakes an exploratory qualitative study, with in-depth semi-structured interviews with health professional moderators (n=7) participating in the largest OHC in Slovenia, Med.Over.Net. The data was analysed using inductive thematic analysis approach and principles of grounded theory.	Four themes of health professional moderators' experiences were identified: (a) benefits of addressing OHC users' health-related needs, (b) challenges of addressing OHC users' health-related needs, (c) health professional moderators' benefits, and (d) health professional moderators' challenges.	This small study demonstrates that health professional participating in OHCs as moderators perceive themselves as facilitators of patients and other OHC's users empowering processes and outcomes, in which OHC's users improve their health literacy, develop skills, expand their social support, and gain other important resources necessary when dealing with health-related issues. Health professional moderator's role, however, also involves several duties, responsibilities and limitations that are often experienced as difficulties in providing patients and other users with adequate counselling and online medical service. OHCs also represent an important terrain for personal and professional empowerment of health professional moderators, although the presence of disempowering processes also needs to be noted.	

28033714	Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.
28033503	Social networking sites (SNS) are especially attractive for adolescents, but it has also been shown that these users can suffer from negative psychological consequences when using these sites excessively. We analyze the role of fear of missing out (FOMO) and intensity of SNS use for explaining the link between psychopathological symptoms and negative consequences of SNS use via mobile devices. In an online survey, 1468 Spanish-speaking Latin-American social media users between 16 and 18 years old completed the Hospital Anxiety and Depression Scale (HADS), the Social Networking Intensity scale (SNI), the FOMO scale (FOMOs), and a questionnaire on negative consequences of using SNS via mobile device (CERM). Using structural equation modeling, it was found that both FOMO and SNI mediate the link between psychopathology and CERM, but by different mechanisms. Additionally, for girls, feeling depressed seems to trigger higher SNS involvement. For boys, anxiety triggers higher SNS involvement.
28033486	ADHD is, I argue, an impairment in sense of time and a matter of difference in rhythm; it can be understood as a certain being in the world, or more specifically, as a disruption in the experience of time and a state of desynchronization and arrhythmia. Through excerpts of interviews with adults diagnosed with ADHD and observations, I illustrate how impairment in time is manifested in an embodied experience of being out of sync. I suggest that the experience of ADHD is characterized as 1) an inner restlessness and bodily arrhythmia; 2) an intersubjective desynchronization between the individual and its surroundings; and 3) a feeling of lagging behind socially due to difficulties in social skills. In closing, I argue that an increasingly accelerating society is augmenting the experience of being out of sync rather than eliminating it.
28033485	Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children.In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries. The focus group transcripts were analyzed using open and focused coding methodology.	The focus groups and subsequent analysis demonstrated that pediatric IMG residents' socialization to their home culture impacts their transition to practice in the United States; they must adjust not only to a U.S. culture, different from their own, but also to the culture of medicine in the United States. We identified the following new acculturation themes: understanding the education system and family structure, social determinants of health, communication with African American parents, contraception, physician handoffs, physicians' role in prevention, adolescent health, and physicians' role in child advocacy. We further highlight the acculturation challenges faced by pediatric IMG residents and offer brief recommendations for the creation of a deliberate acculturation curriculum for pediatric IMG residents. Insight: Residency training is a unique period in physicians' personal and professional development and can be particularly challenging for IMGs. There is a significant gap in the identified acculturation needs and the current curricula available to IMG residents who care for children.	
28033341	In the past five years, several scientific articles have claimed that the increase some countries have registered in suicide rates since 2008 is somehow related to the economic crisis. Other research has suggested that the impact of specific economic problems on the probability of suicidal behavior is often mediated by other individual-level factors, mainly psychological and physical, whose negative influence is exacerbated by reductions in the availability of health and social care during an economic crisis. On the basis of almost 1,000 cases of suicide collected by the Institute of Forensic Medicine in the province of Milan, this article aims at testing whether suicidal probability during an economic crisis is influenced by the interaction between an individual's employment status and the presence of psychological or physical disease. Using a binary logistic regression model, this article demonstrates that the likelihood of suicide during an economic crisis is three times higher for persons affected by a severe disease, either physical or psychological, than for people who are not affected (OR = 3.156; 95% CI = 1.066-9.339; p = 0.38). Neither employment status nor the interaction between employment status and health status contributed to the difference between the suicide rate before and during the economic crisis.
28033199	Prioritizing self-transcendent values such as family and friends more than nontranscendent values such as wealth and privilege is associated with lower stress response. In this study, we tested whether having self-transcendent values can reduce specific responses in the brain in the context of potentially threatening health communications.Sedentary adults (N = 67) who would likely feel threatened by health messages that highlight the risk of sedentary behavior were recruited. Participants indicated the degree to which they prioritize self-transcendent values more than nontranscendent values. Using functional magnetic resonance imaging, participants' neural responses to health messages were assessed within neural regions implicated in threat responses, including bilateral amygdala and anterior insula (AI).	A tendency to prioritize self-transcendent more than nontranscendent values was associated with lower reactivity during exposure to health messages within anatomically defined regions of left amygdala (t(55) = -2.66, p = .010, 95% confidence interval [CI] = -0.08 to -0.01), right amygdala (t(55) = -2.22, p = .031, 95% CI = -0.06 to 0.0), and left AI (t(55) = -2.17, p = .034, 95% CI = -0.04 to 0.0), as well as a mask functionally defined to be associated with "threat" using an automated meta-analysis (t(55) = -2.04, p = .046, 95% CI = -0.05 to 0.0). No significant effect was obtained within the right AI (t(55) = -1.38, p = .17, 95% CI = -0.04 to .01). These effects were partially enhanced by reinforcing important values through self-affirmation, remained significant after accounting for self-reported social connection, and were specific to health message processing (versus generic self-related information).	Attenuated neural reactivity to potentially threatening health messages may be a novel way that prioritizing self-transcendent values could lead to positive health behaviors.	
28032896	To examine whether a novel videoconference that connects an interdisciplinary hospital-based team with clinicians at postacute care sites improves interprofessional communication and reduces medication errors.Prospective cohort.	One tertiary care medical center and eight postacute care sites.	Hospital-based providers (hospitalists, geriatricians, pharmacists, social workers, medical trainees, and subspecialists) and postacute care clinicians.	All patients discharged to eight postacute care sites were discussed in a weekly videoconference.	Preliminary data including demographic characteristics of the patients discussed, postacute care provider satisfaction survey results, and data on medication errors are reported.	Over 2 years, 907 patients were discussed; 84.6% were discussed with staff at subacute skilled nursing facilities and the remainder with clinicians at one long-term acute care facility. They had an average hospital length of stay of 6.8 days. Postacute care providers felt that the videoconference enhanced communication and provided much-needed access to information and hospital staff. Of the 106 pharmacy discrepancies identified, 16% involved an omission of a medication.	As increasing numbers of older adults are discharged to postacute care facilities, they face high-risk care transitions. Extension for Community Healthcare Outcomes-Care Transitions (ECHO-CT) facilitates interdisciplinary communication between hospital and postacute care providers, who normally have minimal interaction. Preliminary data suggests that ECHO-CT may improve the transitions of care processes between these sites.	
28032775	This research demonstrates that individual differences in the implicit power motive (i.e., the concern with impact, influence, and control) moderate how African Americans communicate with White Americans in challenging intergroup dialogues. In a study with African American participants we find that the higher their implicit power motive, the more they use an affiliation strategy to communicate with a White American partner in a conversation context that evokes the history of slavery (Study 1). In a study with White American participants we find that, in the same conversation context, they are more engaged (i.e., open, attentive, and motivated) if they receive an affiliation message rather than a no-affiliation message from an African American partner (Study 2). In interracial dyads we find that African American participants' implicit power motives moderate how much they intend to signal warmth to a White American discussion partner, how much they display immediacy behaviors and use affiliation imagery in the discussion, and with what level of engagement White American participants respond (Study 3). High but not low implicit power African Americans thus employ a communication strategy-expressing affiliation and warmth-that can be effective for engaging White Americans with uncomfortable, race-identity-relevant topics. (PsycINFO Database Record
28032560	Undergoing surgery always involves various risks of complications, often depending on the type of surgery. Because of complications, a second surgical intervention, a reoperation, must occasionally be done, which in turn often causes an extended hospital stay, a longer recovery phase, greater suffering for the patient, and higher health care costs. Even though complications after general surgery are relatively common, little is known regarding patient experience of a reoperation. Knowledge of this could impact on care models in the future. The aim of this study was to describe patients' experience of acute, unplanned reoperation during a planned hospital stay.A purposive sampling strategy was used, and 16 patients were included, all who had undergone acute unplanned reoperation during a planned hospital stay. Semi-structured interviews were used to collect data, and a content analysis with an inductive approach was used for data analysis.	The analysis resulted in two main themes: (1) health professionals' importance, having its foundation in categories trust and information, and (2) reaction, based on the categories anxiety and sadness.	Unplanned reoperation caused psychological, social, and existential reactions. Health care professionals were perceived as important because good communication, accurate information, their presence, and creating feelings of confident and safe care were meaningful factors for the patients as they managed the situation.	
28032470	This paper seeks to highlight the benefits of prioritizing moderate African communitarian principles as partly demonstrated in the HIV prevention strategies implemented in Uganda in the late 1980s. Pertinent lessons could be drawn so as to achieve the HIV prevention targets envisioned in the post-2015 development era. Communitarianism emphasizes the importance of communities as part of healthy human existence. Its core ethical values include the virtues of generosity, compassion, and solidarity. Persuasion through communication, consensus through dialogue, and the awareness and commitment to responsibilities towards other members of the community, are chief practices relied upon to achieve appropriate social behaviour. All these elements signify individual rootedness in communities and contribute to the healthy existence of its members. Communitarianism is usually classified as either authoritarian/radical or responsive/moderate, depending on the primacy given to either community interests or the individual will and rights. Moderate communitarianism recognizes the individual's capacity for moral reasoning, virtue and free choice. The ensuing form of society is deemed more ethical as it relies on education in the virtues, moral persuasion and informal social controls, without stifling individual identity, agency, and capacity for self-determination. If moderate African communitarianism, in particular, can to a certain extent be associated with the significant aspects of Uganda's HIV prevention strategies in the stated period, then its present-day relevance for HIV prevention and other public health interventions may be emphasized accordingly. This applies especially in view of the ongoing efforts to achieve a balance between individual and collective interests in bioethics.
28032454	Both human and nonhuman primate adults use infant-directed facial and vocal expressions across many contexts when interacting with infants (e.g., feeding, playing). This infant-oriented style of communication, known as infant-directed speech (IDS), seems to benefit human infants in numerous ways, including facilitating language acquisition. Given the variety of contexts in which adults use IDS, we hypothesized that IDS supports learning beyond the linguistic domain and that these benefits may extend to nonhuman primates. We exposed 2.5-month-old rhesus macaque infants (N = 15) to IDS, adult-directed speech (ADS), and a non-social control (CTR) during a video presentation of unrelated stimuli. After a 5- or 60-minute delay, infants were shown the familiar video side-by-side with a novel video. Infants exhibited a novelty preference after the 5-minute delay, but not after the 60-minute delay, in the ADS and CTR conditions, and a novelty preference in the IDS condition only after the 60-minute delay. These results are the first to suggest that exposure to IDS affects infants' long-term memory, even in non-linguistic animals.
28032414	In 2012 the Intelligibility in Context Scale (ICS) was published as a parent-report screening assessment that considers parents' perceptions of their children's functional intelligibility with a range of communication partners that differ in levels of authority and familiarity in real-life situations. To date, the ICS has been translated into 60 languages (including German).To evaluate the psychometric properties of the German translation of the ICS ( = ICS-G), especially its reliability and validity, using four objective measures of speech sound disorder (SSD) severity: percentage of consonants correct (PCC); percentage of initial consonants correct (PICC); percentage of vowels correct (PVC); and percentage of phonemes correct (PPC).	Children who were typically developing (TD) and children with SSD (n = 181; 90 males, 81 females; mean age = 4.18 years, SD = 0.79 years, range = 3;0-5;11 years) were recruited through 13 kindergartens and 15 speech-language pathologists (SLPs) in Germany. All children's parents completed the ICS-G. To obtain an insight into the severity of SSD (n = 30), children's speech skills were assessed with PLAKSS-II. For the analysis of test-retest reliability the ICS-G was re-administered with a subsample of parents (n = 36) after 1 week.	The ICS-G had high internal consistency (α = .95, p < .001) and high test-retest reliability (r = .998, p < .001). The ICS-G total scores and item scores for both samples showed significant correlations, indicating good construct validity. Analyses revealed low but significant correlations with external factors (e.g., age, social class). Criterion validity was established through significant correlations between the ICS-G and scores for PCC (r = .43), PICC (r = .43), PVC (r = .62) and PPC (r = .47). The discriminatory ability of the ICS-G was indicated by significantly higher mean scores for the TD group (mean = 4.49, SD = 0.47) than the SSD group (mean = 3.97, SD = 0.63).	The overall good psychometric properties of the ICS-G support its use by SLPs for clinical and research purposes with German-speaking children.	
28032306	Culturally-based risk behavior prevention programs for American Indian elementary school children are sparse. Thus a group of American Indian educators collaborated in the creation of a program that helps children make healthy decisions based on their cultural and traditional value system. In this paper the effectiveness of Lakota Circles of Hope (LCH), an elementary school culturally-based prevention program was studied and evaluated. Three cohorts of fourth and fifth graders participated in a mixed methods quasi-experimental evaluative research design that included focus groups and surveys prior to and following the intervention. Five research questions regarding the program's impact on students' self-esteem and self-efficacy, Lakota identity, communication, conflict resolution and risk behaviors were addressed in this study. Participants were compared to non-participants in three American Indian reservation school sites. Educators completed a survey to record their observations and feedback regarding the implementation of the program within their respective school sites. The study provides preliminary evidence that, when delivered with fidelity, LCH contributes to statistically significant changes in risk behaviors, Lakota identity, respect for others, and adult and parent communication. A two-way multivariate analysis of variance with post hoc analysis of data collected from the LCH participants (N = 1392) were used to substantiate a significant increase in respect for others and a decrease in risk behaviors which included alcohol, tobacco, and substance use at the 0.10 alpha level. Significant positive improvements in parent and adult communication and an increased Lakota identity at the 0.01 alpha level were obtained. There were no significant differences in self-esteem and conflict resolution from pre to post intervention and in comparison with non LCH participating students.
28032050	This study aims to estimate the prevalence of medical information discrepancies between dental and medical records of cardiac patients at AlHada Armed Forces Hospital in Taif and to identify the factors contributing to these information discrepancies.The study applied a descriptive retrospective medical and dental records review of a stratified proportional sample of 289 cardiac patients, which was extracted from 1154 cardiac patients who visited both the cardiology and dental clinics at the AlHada Armed Forces Hospital between 2007 and June 2012. Data were analyzed using the Statistical Package for the Social Sciences version 19.	The main results of this study are the following: The mean and standard deviation of patient's age was 56 ± 16.9, female patients represented 47.8% of the study population. A total of 78.5% of dental records were documented by dental residents whereas 48.4% of the dentists had more than 6 years of experience. Two hundred and seventy-nine (96.5%) of the 289 dental records had medical information discrepancies compared to the corresponding medical records. One hundred percent of systemic lupus erythematosus and rheumatic fever cases were not documented in the dental records followed by 93% of medications, 92% of stroke, and 88.5% of hyperlipidemia, whereas the least prevalent were cardiac disease (26%) and diabetes mellitus (22.2%).	Approximately 75% of the patients who directly or indirectly accessed the dental services showed discrepancies. The researcher concludes that critical information gaps exist between dental and medical records that mostly attributed to system level problems. A well-established model for efficient communication among medical and dental care providers caring for cardiac patients does not appear to exist. The absence of such a model can threaten the overall health of patients.	
28031629	Although 80% of the deaths worldwide occur in middle- and low-income countries such as India, there is less awareness of end-of-life care (EOLC) for people with chronic, serious, progressive, or advanced life-limiting illnesses, including dementia. EOLC involves good communication, clinical decision-making, liaison with medical teams and families, comprehensive assessment of and specialized interventions for physical, psychological, spiritual, and social needs of patients and their caregivers. The psychiatrist can play a significant role in each of the above domains in EOLC. The current trends in India are examined, including ambiguities between EOLC and euthanasia. Future directions include formulating a national EOLC policy, providing appropriate services and training. The psychiatrist should get involved in this process, with major responsibilities in providing good quality EOLC for patients with both life-limiting physical illnesses and severe mental disorders, supporting their caregivers, and ensuring dignity in death.
28031344	Upcoming KDIGO guidelines for the evaluation of living kidney donors are expected to move towards a personal risk-based evaluation of potential donors. We present the age and sex-specific lifetime risk of renal replacement therapy (RRT) for end-stage renal disease in 10 European countries.We defined lifetime risk of RRT as the cumulative incidence of RRT up to age 90 years. We obtained RRT incidence rates per million population by 5-year age groups and sex using data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, and used these to estimate the cumulative incidence of RRT, adjusting for competing mortality risk.	Lifetime risk of RRT varied from 0.44% to 2.05% at age 20 years and from 0.17% to 1.59% at age 70 years across countries, and was twice as high in men as in women. Lifetime RRT risk decreased with age, ranging from an average of 0.77% to 0.44% in 20- to- 70-year-old women, and from 1.45% to 0.96% in 20- to- 70-year-old men. The lifetime risk of RRT increased slightly over the past decade, more so in men than in women. However, it appears to have stabilized or even decreased slightly in more recent years.	The lifetime risk of RRT decreased with age, was lower in women as compared with men of equal age and varied considerably throughout Europe. Given the substantial differences in lifetime risk of RRT between the USA and Europe, country-specific estimates should be used in the evaluation and communication of the risk of RRT for potential living kidney donors.	
28031301	Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component-which UNICEF refers to as communication for development (C4D)-of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. This article describes the lessons learned about social mobilization and community engagement in the emergency response to the Ebola outbreak, with a particular focus on UNICEF's C4D work in Guinea, Liberia, and Sierra Leone. The lessons emerged through an assessment conducted by UNICEF using 4 methods: a literature review of key documents, meeting reports, and other articles; structured discussions conducted in June 2015 and October 2015 with UNICEF and civil society experts; an electronic survey, launched in October and November 2015, with staff from government, the UN, or any partner organization who worked on Ebola (N = 53); and key informant interviews (N = 5). After triangulating the findings from all data sources, we distilled lessons under 7 major domains: (1) strategy and decentralization: develop a comprehensive C4D strategy with communities at the center and decentralized programming to facilitate flexibility and adaptation to the local context; (2) coordination: establish C4D leadership with the necessary authority to coordinate between partners and enforce use of standard operating procedures as a central coordination and quality assurance tool; (3) entering and engaging communities: invest in key communication channels (such as radio) and trusted local community members; (4) messaging: adapt messages and strategies continually as patterns of the epidemic change over time; (5) partnerships: invest in strategic partnerships with community, religious leaders, journalists, radio stations, and partner organizations; (6) capacity building: support a network of local and international professionals with capacity for C4D who can be deployed rapidly; (7) data and performance monitoring: establish clear C4D process and impact indicators and strive for real-time data analysis and rapid feedback to communities and authorities to inform decision making. Ultimately, communication, community engagement, and social mobilization need to be formally placed within the global humanitarian response architecture with proper funding to effectively support future public health emergencies, which are as much a social as a health phenomenon.
28031028	Collaborative care is an increasingly popular approach for improving quality of care for people with mental health problems through an intensified and structured collaboration between primary care providers and health professionals with specialized psychiatric expertise. Trials have shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing collaborative care for patients with anxiety and depression.We developed a comprehensive search strategy in cooperation with a research librarian and performed a search in five databases (EMBASE, PubMed, PsycINFO, ProQuest, and CINAHL). All authors independently screened titles and abstracts and reviewed full-text articles. Studies were included if they were published in English and based on the original qualitative data on the implementation of a collaborative care intervention targeted at depression or anxiety in an adult patient population in a high-income country. Our subsequent analysis employed the normalization process theory (NPT).	We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care providers was found to be critical but sometimes difficult. Enablers included physician champions, reimbursement for extra work, and feedback on the effectiveness of collaborative care. The social and professional skills of the care managers seemed critical for integrating collaborative care in the primary health care clinic. Day-to-day implementation was also found to be facilitated by the care managers being located in the clinic since this supports regular face-to-face interactions between physicians and care managers.	The following areas require special attention when planning collaborative care interventions: effective educational programs, especially for care managers; issues of reimbursement in relation to primary care providers; good systems for communication and monitoring; and promoting face-to-face interaction between care managers and physicians, preferably through co-location. There is a need for well-sampled, in-depth qualitative studies on the implementation of collaborative care in settings outside the USA and the UK.	
28029354	Depression is a highly prevalent mental illness that is associated with high rates of morbidity and functional impairment. At the psychiatric unit of the University Hospital of Strasbourg, France, we have developed an open group that combines psychoeducation and cognitive-behavior therapy (CBT), the information, discovery, exchange and mobilization for depression group (IDEM-depression). IDEM-depression is composed of 17 thematic, structured, and independent sessions, which address different aspects of depression (i.e., rumination, pharmacological treatments). Because of its flexible format, patients with varying degrees of depression severity (from remission up to severe depressive symptoms) and whose depression might be bipolar or unipolar, are able to participate in the group. Thus, the group is well suited to a large number of patients with major depression. In the present study we aimed at describing the IDEM-depression group and presenting results regarding patients' overall satisfaction, assessed via two self-report questionnaires (the Client Satisfaction Questionnaire, the CSQ-8, and the IDEM ad hoc questionnaire), as well as its effect on mood following each session assessed via a visual analog scale (VAS) ranging from 0 up to 100.Sixty-five patients participated in 50 sessions of the IDEM-depression group in two hospitals in Alsace. 61% of the patients had bipolar disorder, and 41% of them were inpatients. Sessions took place on a weekly basis, lasted 2hours and were proposed by a CBT-trained clinical psychologist. Patients were asked to fill-out the VAS at the beginning and at the end of each session. Moreover, they were asked to fill-out the CSQ-8 and the IDEM ad hoc questionnaire when they left the group. Other than one session ("yoga and mindfulness"), all the sessions (16 out of 17) were structured on a Powerpoint© presentation. During the first hour information was given regarding the topic (i.e., rumination), and a shared CBT conceptualization of the topic was formulated by the participants and the psychologist. For most sessions, the first hour was therefore communication and information-based, whereas during the second hour participants were asked to participate in in-session behavioral experiments and/or to evaluate specific aspects of their behavior (thoughts, emotions, activity, mindful behavior) during the last few days. The therapist manual and the slides for each session are available via e-mail to the first author.	Regarding the results, self-reported mood on the VAS was compared between the onset (225 VAS) and the end (225 VAS) of each session. Overall, results suggest that self-reported mood is significantly improved following the participation in sessions (t=-5. 87, P<0.001). Moreover, mean results on the CSQ-8 suggest that patients are highly satisfied with the group (M=24.46, SD=6.42). Among them, 82% reported a moderate-high satisfaction with the group. On the IDEM ad hoc questionnaire, patients reported an overall high satisfaction level regarding (i) the content of sessions, (ii) the duration of sessions, (iii) the frequency of sessions, (iv) how much they felt they could express themselves during sessions. In the qualitative comments of this questionnaire, patients reported that the group helped them to gain an understanding of the mechanisms involved in depression; to feel less isolated and guilty; and to learn about specific psychotherapeutic tools (i.e., mindfulness) and to try to implement them.	Our results suggest that an IDEM-depression group is well suited to a wide-array of clinical pictures associated with depression (varying severity, bipolar or unipolar, inpatients and outpatients). This is probably due to its open-group format which is particularly well-adapted to the dynamic symptomatology associated with major depression, and may stimulate decentering in patients who have different levels of severity of symptoms but participate in the same session. Moreover, its impact on mood improvement, and the high satisfaction level reported by patients, seem to be related to its CBT and psychoeducation-based content on the one hand, which has shown its efficacy in depression. On the other hand, IDEM's structured open-group format might have also contributed to the improvement in mood and the overall good satisfaction reported by patients, through the social support provided by the group, improved feeling of self-efficiency, and its effect on stigmatization. Thus, IDEM-depression group is an efficacious, flexible, low-cost, and easy to implement (in different clinical settings) psychotherapeutic option for major depression.	
28028676	Autonomic dysfunctions are part of a spectrum of non-motor symptoms in Parkinson's disease (PD) patients. The aim of the study was to assess the prevalence of autonomic dysfunctions and their influence on the quality of life (QoL) in PD patients, adjusted for age, sex, disease duration and motor symptoms. Patients were evaluated for motor function (Unified Parkinson's Disease Rating Scale, UPDRS part III), disease stage (Hoehn and Yahr scale, H&Y scale), autonomic dysfunction (Scales for Outcomes in Parkinson's disease, Autonomic, SCOPA-AUT) and QoL (Parkinson's Disease Questionnaire-39, PDQ-39). Urinary, gastrointestinal and sexual autonomic dysfunctions were most frequently reported, while the most severe symptoms were reported for sexual and urinary systems. Age and motor symptoms did not correlate with autonomic dysfunction, while disease duration correlated with cardiovascular dysfunction. There were sex differences on the thermoregulation subscale. All types of autonomic dysfunction influenced QoL, mostly gastrointestinal and thermoregulatory dysfunctions, except for sexual one. Many aspects of QoL (activity of daily living, emotion, cognitive functions, communication and social support) except for stigma and mobility were affected by autonomic dysfunctions. Age, disease duration, sex and motor symptoms were not found to affect global QoL scores, but had detrimental effects on different PDQ-39 dimensions. Autonomic dysfunctions influence QoL in more aspects than motor symptoms, age, disease duration and sex. Patients tend to be more stigmatized with motor than non-motor symptoms.
28028128	Adolescent electronic cigarette ("e-cigarette") use tripled in recent years, yet little is known about the school-level correlates of teenage e-cigarette use, harm and risk perceptions, or pre-use intentions to use.Multilevel regression and 2014 National Youth Tobacco Survey data were used to assess school-level e-cigarette prevalence and person-level e-cigarette use as well as age at initiation and frequency of use (among initiates), expectations for future use (among abstainers); and perceived e-cigarette addictivity and harm.	Lifetime use was higher among students in medium- (odds ratio[OR]=2.30, 95% confidence interval[CI]=1.82, 2.89) and high- (OR=4.66, 95% CI=3.67, 5.90) versus low-use schools. Past 30-day-use followed a similar pattern. Multilevel ordinal logistic models revealed that initiates from high-use schools reported more days of use in the past month (OR=2.25, 95% CI=1.52, 3.33) and higher age-at-first-use (OR=1.45, 95% CI=1.08, 2.00) than students at lowuse schools. Expectations for future use were higher among abstainers from medium- and highuse versus low-use schools, and among all students, perceived addictivity and harm caused by ecigarettes were lower in medium- and high- versus low-use schools.	School context is associated with multiple dimensions of e-cigarette use, pre-use intentions, and perceptions of e-cigarette health risks.	The current study demonstrates a link between school prevalence of e-cigarette use and studentlevel use, as well as perceived risks of e-cigarette use, age of initiation and frequency of use among users, and intentions to use among abstainers. Health communication and prevention initiatives should target school social environments to promote nicotine abstinence and a culture of health.	

28027338	Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes.To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience.	Randomized clinical trial at a single VA facility. Among 583 eligible high-need outpatients whose health care costs or hospitalization risk were in the top 5% for the facility, 150 were randomly selected for ImPACT; the remaining 433 received standard PACT care.	The ImPACT multidisciplinary team addressed health care needs and quality of life through comprehensive patient assessments, intensive case management, care coordination, and social and recreational services.	Primary difference-in-difference analyses examined changes in health care costs and acute and extended care utilization over a 16-month baseline and 17-month follow-up period. Secondary analyses estimated the intervention's effect on ImPACT participants (using randomization as an instrument) and for patients with key sociodemographic and clinical characteristics. ImPACT participants' satisfaction and activation levels were assessed using responses to quality improvement surveys administered at baseline and 6 months.	Of 140 patients assigned to ImPACT, 96 (69%) engaged in the program (mean [SD] age, 68.3 [14.2] years; 89 [93%] male; mean [SD] number of chronic conditions, 10 [4]; 62 [65%] had a mental health diagnosis; 21 [22%] had a history of homelessness). After accounting for program costs, adjusted person-level monthly health care expenditures decreased similarly for ImPACT and PACT patients (difference-in-difference [SE] -$101 [$623]), as did acute and extended care utilization rates. Among respondents to the ImPACT follow-up survey (n = 54 [56% response rate]), 52 (96%) reported that they would recommend the program to others, and pre-post analyses revealed modest increases in satisfaction with VA care (mean [SD] increased from 2.90 [0.72] to 3.16 [0.60]; P = .04) and communication (mean [SD] increased from 2.99 [0.74] to 3.18 [0.60]; P = .03).	Intensive outpatient care for high-need patients did not reduce acute care utilization or costs compared with standard VA care, although there were positive effects on experience among patients who participated. Implementing intensive outpatient care programs in integrated settings with well-established medical homes may not prevent hospitalizations or achieve substantial cost savings.	
28027009	Adopting a social network analysis approach, the present study examined social capital and network dynamics of online support seeking and support provision in a depression forum. We constructed a depression forum network by mapping out all of the users and the reply ties among them. The findings showed a consistently reciprocal pattern between users' replies sent to others and replies received from others. Forum users' bridging social capital was positively associated with the source diversity of their received replies and negatively associated with the average length of their received replies. Furthermore, forum users' bonding social capital was positively associated with the average length of their received replies and negatively associated with the source diversity of their received replies.

28026981	Intimate partnerships are discouraged during early recovery, despite research that highlights their capacity to be resources for change.This study seeks to provide descriptions of intimate partnerships and how such partnerships challenge and/or support minimizing HIV sex-risk among participants in continuing care for cocaine addiction in order to inform substance use programming.	Forty-two recorded continuing care counseling sessions of 33 people who discussed HIV sex-risk behavior were transcribed and analyzed using thematic analysis. This sample was derived from a larger randomized controlled trial that looked at the impact of a continuing care intervention for people with cocaine use problems.	Although participants expressed the desire for a primary intimate partnership, casual intimate partnerships that often involved HIV sex-risk behavior were more prevalent. Challenges to having a primary intimate partner included the belief that intimate partnerships do not support recovery, difficulty in developing friendships with women among heterosexual men, and the ubiquity of drug use and sex work in home environments with limited economic opportunity. Despite these challenges, some participants reported having primary intimate partners that supported their recovery through open communication.	Clinicians providing substance use interventions can consider encouraging components of intimate partnerships that support recovery. In addition, the strong environmental influence on individual HIV sex-risk behavior should be considered in delivering any substance use intervention.	
28025709	Communication between patients and professionals is one major aspect of the support offered to cancer patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) has developed a cancer-specific instrument for the measurement of different issues related to the communication between cancer patients and their health care professionals.Questionnaire development followed the EORTC QLG Module Development Guidelines. A provisional questionnaire was pre-tested (phase III) in a multicenter study within ten countries from five cultural areas (Northern and South Europe, UK, Poland and Taiwan). Patients from seven subgroups (before, during and after treatment, for localized and advanced disease each, plus palliative patients) were recruited. Structured interviews were conducted. Qualitative and quantitative analyses have been performed.	One hundred forty patients were interviewed. Nine items were deleted and one shortened. Patients' comments had a key role in item selection. No item was deleted due to just quantitative criteria. Consistency was observed in patients' answers across cultural areas. The revised version of the module EORTC QLQ-COMU26 has 26 items, organized in 6 scales and 4 individual items.	The EORTC COMU26 questionnaire can be used in daily clinical practice and research, in various patient groups from different cultures. The next step will be an international field test with a large heterogeneous group of cancer patients.	
28024436	Regulatory frameworks around the world mandate that health and social care professional education programs graduate practitioners who have the competence and capability to practice effectively in interprofessional collaborative teams. Academic institutions are responding by offering interprofessional education (IPE); however, there is as yet no consensus regarding optimal strategies for the assessment of interprofessional learning (IPL). The Program Committee for the 17th Ottawa Conference in Perth, Australia in March, 2016, invited IPE champions to debate and discuss the current status of the assessment of IPL. A draft statement from this workshop was further discussed at the global All Together Better Health VIII conference in Oxford, UK in September, 2016. The outcomes of these deliberations and a final round of electronic consultation informed the work of a core group of international IPE leaders to develop this document. The consensus statement we present here is the result of the synthesized views of experts and global colleagues. It outlines the challenges and difficulties but endorses a set of desired learning outcome categories and methods of assessment that can be adapted to individual contexts and resources. The points of consensus focus on pre-qualification (pre-licensure) health professional students but may be transferable into post-qualification arenas.
28024279	The use of puppets in health care is emerging as a mode of simulation that combines elements of engaging with the child through play whilst at the same time providing education. This review examines the impact when nurses use play therapy or puppets as a simulation modality in nursing education and in the clinical paediatric nursing environment. Electronic search was conducted using CINAHL, PubMed, Scopus, Web of Science and PsycINFO data bases, between 1980 and January 2015 with the combinations of play therapy; puppetry; nursing education; nursing; simulation; health professionals and puppets. Twelve articles were identified that highlight the use of puppet simulation in the education of nursing students and children in the healthcare environment. Puppet modelling and puppet simulation is predominantly adopted in the areas of health education and specifically diabetes education. Identified gaps in the use of puppet simulation in nursing, nurse education and puppet simulation as a three-way communication process; thus identifying the need for further research on puppet simulation and its application and benefits in nursing and nurse education.
28019640	At present there are about 47.5 million people suffering from different types of dementia and by 2030 this number should reach 75.6 million. This obviously brings about serious social and economic burden for people suffering from any kind of dementia.The purpose of this article is to explore only semantic dementia (SD) as one of the forms of frontotemporal dementia (FTD) and provide the latest information on its diagnosis and treatment which play a significant role in the maintenance of quality of life of both patients and their caregivers. Especially unimpaired communication is one of the key factors in the relationship between the patients and their caregivers.	The methods used for this mini review include a method of literature review of available sources found in the world's acknowledged databases such as Web of Science, PubMed, Springer and Scopus from the period of 2010 up to the present time; and a method of comparison and evaluation of the selected studies.	The findings of this mini review show that FTD, respectively SD, is a serious neurodegenerative disorder which has fatal consequences for the affected patients. In addition, the findings also indicate that there are not many possibilities of pharmacological treatment for semantic dementia and therefore more attention should be paid to alternative, non-pharmacological approaches.	Although semantic dementia is a relatively rare neurodegenerative disorder if compared with other types of dementia, it has an irreversible impact on patient's and his/her caregiver's life in terms of quality.	
28018841	This study evaluated the effect of a 12-week social marketing intervention conducted in 2012 promoting 1% milk use relying on paid advertising. Weekly milk sales data by type of milk (whole, 2%, 1%, and nonfat milk) were collected from 80 supermarkets in the Oklahoma City media market, the intervention market, and 66 supermarkets in the Tulsa media market (TMM), the comparison market. The effect was measured with a paired t-test. A mixed segmented regression model, controlling for the contextual difference between supermarkets and data correlation, identified trends before, during, and after the intervention. Results show the monthly market share of 1% milk sales changed from 10.0% to 11.5%, a 15% increase. Evaluating the volume sold, the monthly mean number of gallons of 1% milk sold increased from 890.5 gal (SD = 769.8) per supermarket from before the intervention to 1070.7 gal (SD = 922.5) following the intervention (t(79) = 9.4, p = 0.000). Moreover, average weekly sales of 1% milk were stable prior to the intervention (b = - 0.2 gal/week, 95% CI [- 0.6 gal/week, 0.3 gal/week]). During each additional week of the intervention, 1% milk sales increased by an average of 4.1 gal in all supermarkets (95% CI [3.5 gal/week, 4.6 gal/week]). Three months later, albeit attenuated, a significant increase in 1% milk sales remained. In the comparison market, no change in the market share of 1% milk occurred. Paid advertising, using the principles of social marketing, can be effective in changing an entrenched and habitual nutrition habit.
28018692	Sudden hearing loss in the only hearing ear cases are rarely published in the English literature; most of the cases are idiopathic. It is an otologic emergency needing urgent treatment. Delayed diagnosis can interfere with patient's social life with interrupting the verbal communication. In this case report we presented a 33-year-old female patient having sudden sensorineural hearing loss in the only hearing ear diagnosed as bilateral large vestibular aqueduct syndrome.
28017847	Little is known about the specific behavioral exchanges that occur on a day-to-day basis between dyads of common bottlenose dolphins (Tursiops truncatus). This study assesses the proportion of time dyads spend in proximity (within ∼2m) and the proportion of time spent in affiliative, agonistic, or socio-sexual contexts within and between age/sex dolphin pairings to better understand their social relationships. Observations of bottlenose dolphins housed at the Roatan Institute of Marine Sciences provided 10.5h of underwater footage from which to examine association coefficients and inter-individual interactions. These data suggest similar patterns to previous studies on bottlenose dolphins: mother-calf dyads shared the highest coefficients of association, followed by male-male, female-female, and male-female dyads. Four classes of association coefficients were defined for the population including low, medium, medium-high and high. This study is the first to quantitatively assess association patterns concurrently with affiliative, agonistic, and socio-sexual behaviors for bottlenose dolphins. The predominant relationships were affiliative.
28017179	Motivational interviewing (MI) is often incorporated into screening, brief intervention, and referral to treatment (SBIRT) interventions in critical care settings to address alcohol and other drug use. However, cognitive status has been linked to differential response to MI sessions in emergency department (ED) settings. The current study examined one possible explanation for this differential response: whether higher versus lower mental status impacts patient response to clinician statements during MI sessions conducted in an ED. Participants were 126 patients receiving an MI-based single-session alcohol brief intervention, and 13 therapists who provided treatment. Participants completed a mental status exam (MSE) as part of the screening process. Intervention sessions were audio-taped, and transcribed and coded using the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003). The MISC 2.0 coded therapist behaviors that are related to the use of motivational interviewing, and patient language reflecting movement toward (change talk) or away from (sustain talk) changing personal alcohol use. Overall, patients responded in a similar manner to therapist MI behaviors regardless of high versus low level of mental functioning at the time of the intervention. Group differences emerged on patient response to only three specific therapist skills: giving information, open questions, and complex reflection. Thus, the differential effects of SBIRT in critical care settings do not appear to be a result of differences in the therapist and patient communication process.
28013441	Unlike such cognitive impairments as autism and schizophrenia, the speech pattern in obsessive-compulsive disorder (OCD) has largely remained underrepresented. We examined the pragmatic competence of OCD-affected individuals under two variant modes: pragmatic recognition and pragmatic production. In the recognition phase, the informants completed a discourse completion test around two speech acts of request and apology (20 high power distance situations). The production phase was carried out through an interview during which the informants' communication behaviors were rated on the basis of the Orion's pragmatic language skills checklist (OPLS) subscales. No significant difference was observed between the normal and OCD groups in terms of pragmatic recognition. Moreover, considering the OPLS subscales, although the normal controls significantly outperformed in non-verbal communication and expressive skills, the overall pragmatic production ability of the two groups was statistically alike. The results are discussed in relation to the two competing disorders of autism and social anxiety.
28013039	Gaze plays a pivotal role in human communication, especially for coordinating attention. The ability to guide the gaze orientation of others forms the backbone of joint attention. Recent research has raised the possibility that gaze following behaviors could induce liking. The present study seeks to investigate this hypothesis. We designed two physically different human avatars that could follow the gaze of users via eye-tracking technology. In a preliminary experiment, 20 participants assessed the baseline appeal of the two avatars and confirmed that the avatars differed in this respect. In the main experiment, we compared how 19 participants rated the two avatars in terms of pleasantness, trustworthiness and closeness when the avatars were following their gaze versus when the avatar generated gaze movements autonomously. Although the same avatar as in the preliminary experiment was rated more favorably, the pleasantness attributed to the two avatars increased when they followed the gaze of the participants. This outcome provides evidence that gaze following fosters liking independently of the baseline appeal of the individual.
28012682	To describe the impact of genetic information on Alzheimer's disease (AD) risk communication to patients with mild cognitive impairment (MCI) and their visit companions.Participants of the fourth REVEAL Study trial were randomized to receive AD risk assessments with or without genotype results. We coded 79 audio recorded risk disclosure sessions with the Roter Interaction Analysis System. Multilevel analyses explored differences in communication when disclosed risks were based on age and MCI diagnosis alone or in addition to APOE genotype status.	The addition of genotype results diminished the patient-centered nature of the sessions (p<0.001). When ε4 positive relative to ε4 negative results were disclosed, visit companions were more verbally active (p<0.05), disclosed more medical information (p<0.05), were more positive verbally and non-verbally (p<0.05) and were more proactive in setting the visit agenda (p<0.05).	Delivery of complex genetic risk information reduces the patient-centeredness of disclosure sessions. Visit companions are more actively engaged in session communication when patients are at increased genetic risk for AD.	AD risk discussions can be improved by supporting the positive role of visit companions and addressing the challenges inherent in the delivery of complex genetic information in a patient-centered manner.	
28012678	To elicit widowed fathers' perspectives on which domains of parenting-related communication they consider most important for dying parents to discuss at the end of life (EOL).Two hundred seventy nine fathers widowed by cancer completed a survey about their own depression and bereavement symptoms, their wife's illness, and EOL parental communication priorities. Chi square and Fisher's exact tests and logistic regression were used to evaluate relationships between maternal EOL characteristics and fathers' responses to parenting-related EOL communication priorities.	Fathers identified raising children in a manner that reflected maternal wishes, whether/how to talk with children about their mother's death, and how the mother wanted to be remembered as the most important EOL communication domains. Fathers who reported that their dying wives were worried about the children were more likely to prioritize raising children in ways that reflect her wishes (p=0.01). Other EOL characteristics were not associated with communication domains.	Communicating with children and maintaining emotional connection with the deceased parent are important priorities for bereaved fathers who lost a spouse to cancer.	Health care providers working with seriously ill parents may improve family outcomes by supporting communication at the EOL between co-parents.	
28012612	Since its beginning, research about cognitive representation of our bodies has debated over multiple representations models. Furthermore, recent years have seen a rise in the study of body representation disorders and related impairments. However, why human beings manifest so many deficits is still a mystery. Considering human evolution, frontal brain regions are well known for their changes in dimensions and connections. Less known is that parietal and temporal lobes encountered similar changes. These areas, especially in the right hemisphere, are crucial for body representation. Our hypothesis is that evolution of these areas determined a more varied and widespread cross wiring between the temporal and parietal lobes, increasing their communication pathways and their reciprocal influence. As such, these connections could lead to an increased probability of interconnected body and emotional disorders in humans. The prediction of this hypothesis is that all body representation disorders have an associated emotional component and vice versa. Evidence supporting the interconnection between emotional and body representation disorders derives from psychiatric diseases such as eating disorders. This hypothesis opens up new directions to understand body representation and points towards innovative solutions for the clinical treatments of body representation/emotional impairments.
28012522	Hearing impairment is a common type of sensory loss in children. Studies indicate that children with hearing impairment are deficient in social, cognitive and communication skills. This study compared the intelligence quotients of first- and second-generation deaf children with cochlear implants. This research is causal-comparative. All 15 deaf children investigated had deaf parents and were selected from Baqiyatallah Cochlear Implant Center. The 15 children with cochlear implants were paired with similar children with hearing parents using purposive sampling. The findings show that the Hotelling trace of multivariate analysis of variance (F = 6.78, p < 0.01, ηP2 = 0.73) was significant. The tests of between-subjects effects for second-generation children was significantly higher than for first-generation children for all intelligence scales except knowledge. It can be assumed that second-generation children joined their family in the use of sign language as the primary experience before a cochlear implant. The use of sign language before cochlear implants is recommended.
28012519	To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system.Retrospective database review of all otolaryngology surgical procedures performed in a tertiary pediatric hospital system over one academic year (July 2012-June 2013). All otolaryngology surgical procedures were reviewed, encompassing 8478 procedures on 5711 patients. The attending otolaryngologist assigned surgical scheduling category (SSCS) at the time of case booking based on an institution specific guidelines. The guidelines are as follow: Category I was assigned to American Society of Anesthesiologists physical status classification (ASA) I/II patients, designating them appropriate for institution's suburban ambulatory surgery centers; Category II was ASA I/II patients with social or transportation issues; Category III was ASA I/II patients who required case coordination with other medical or surgical departments; Category IV was reserved for patients of any ASA class whom the surgeon designated to be of a higher complexity.	8478 total procedures analyzed with 7198 having complete records. 48% were Category I, 13.6% were Category II, 1.9% were Category III and 36.5% were Category IV. The ASA were 34.7% ASA I, 50% ASA II, 13.39% ASA III, and 1.9% ASA IV. Although the largest proportion of patients were ASA II (50%), 39.6% of all ASA II were Category IV. Category IV was split into 54.2% ASA II and 34% ASA III and shows that peri-operative surgical concerns were not encompassed by the ASA system.	This surgical categorization system streamlines surgical scheduling in a tertiary pediatric hospital system, particularly with respect to the designation of cases as ambulatory surgery center or main operating room appropriate. The case mix complexity is also readily apparent, enhancing recognition of the coordination and attention required for the perioperative management of high complexity patients. The SSCS helps convey concerns not addressed by ASA physical status alone.	
28012447	Evidence shows that the government of Papua New Guinea is failing to provide basic services in health to the majority of its people. Local non-government organisations (NGOs), partnered with international NGOs, are attempting to fill this gap. With limited resources, these small Indigenous organisations must focus much of their effort on training that supports self-reliance as the main strategy for communities to improve their quality of life. This project explored the training content and methodology of Touching The Untouchables (TTU), a small Indigenous NGO based in Goroka, Eastern Highlands Province, that has trained a network of village volunteers in health promotion and safe motherhood.<br />Village life imposes multiple demands, from self-sufficiency in food to maintaining law and order. There are established attitudes about power and dependence, referred to as 'cargo thinking'. Cargo thinking stands as a barrier to the necessity of self-reliance, and requires training strategies that seek to empower participants to create change from their own initiative. Empowerment is understood as oriented towards individual people taking collective action to improve their circumstances by rectifying disparities in social power and control. To achieve self-reliance, empowerment is necessarily operational on the levels of person, community and society.<br />In addition to being operational on all three levels of empowerment, the training content and methodology adopted and developed by TTU demonstrate that empowering practice in training employs approaches to knowledge that are evidence-based, reflexive, contextual and skill-based. Creating knowledge that is reflexive and exploring knowledge about the broader context uses special kinds of communicative tools that facilitate discussion on history, society and political economy. Furthermore, training methodologies that are oriented to empowerment create settings that require the use of all three types of communication required for cooperative action: dramaturgical, normative and teleological communication.<br />The success of TTU's training content and methodology demonstrates that creating the conditions for achieving collective self-reliance through empowerment is a necessary part of primary health promotion in Papua New Guinea, and that underlying the success of empowerment oriented training are definable types of knowledge and communication.
28012388	Degradation and loss of biodiversity and ecosystem services pose major challenges in simplified agricultural landscapes. Consequently, best management practices to create or restore habitat areas on field edges and other marginal areas have received a great deal of recent attention and policy support. Despite this, remarkably little is known about how landholders (farmers and landowners) learn about field edge management practices and which factors facilitate, or hinder, adoption of field edge plantings. We surveyed 109 landholders in California's Sacramento Valley to determine drivers of adoption of field edge plantings. The results show the important influence of landholders' communication networks, which included two key roles: agencies that provide technical support and fellow landholders. The networks of landholders that adopted field edge plantings included both fellow landholders and agencies, whereas networks of non-adopters included either landholders or agencies. This pattern documents that social learning through peer-to-peer information exchange can serve as a complementary and reinforcing pathway with technical learning that is stimulated by traditional outreach and extension programs. Landholder experience with benefits and concerns associated with field edge plantings were also significant predictors of adoption. Our results suggest that technical learning, stimulated by outreach and extension, may provide critical and necessary support for broad-scale adoption of field-edge plantings, but that this alone may not be sufficient. Instead, outreach and extension efforts may need to be strategically expanded to incorporate peer-to-peer communication, which can provide critical information on benefits and concerns.
28011807	Drinking has adverse impacts on health, well-being, education and social outcomes for adolescents. Adolescents in England are among the heaviest drinkers in Europe. Recently, the proportion of adolescents who drink alcohol has fallen, although consumption among those who do drink has actually increased. This trial seeks to investigate how effective and efficient an alcohol brief intervention is with 11-15 years olds to encourage lower alcohol consumption.This is an individually randomised two-armed trial incorporating a control arm of usual school-based practice and a leaflet on a healthy lifestyle (excl. alcohol), and an intervention arm that combines usual practice with a 30 min brief intervention delivered by school learning mentors and a leaflet on alcohol. At least 30 schools will be recruited from four regions in England (North East, North West, London, Kent and Medway) to follow-up 235 per arm. The primary outcome is total alcohol consumed in the last 28 days, using the 28 day Timeline Follow Back questionnaire measured at the 12-month follow-up. The analysis of the intervention will consider effectiveness and cost-effectiveness. A qualitative study will explore, via 1:1 in-depth interviews with (n=80) parents, young people and school staff, intervention experience, intervention fidelity and acceptability issues, using thematic narrative synthesis to report qualitative data.	Ethical approval was granted by Teesside University. Dissemination plans include academic publications, conference presentations, disseminating to local and national education departments and the wider public health community, including via Fuse, and engaging with school staff and young people to comment on whether and how the project can be improved.	ISRCTN45691494; Pre-results.	
28011063	Prior research has found that the protective effect of parental engagement on adolescent smoking behaviors may be weaker if parents smoke. We examine parental influence on adolescent smoking using a social learning theory framework. We hypothesize that adolescents are more likely to mimic parental smoking behavior if they perceive parents as being more engaged and if the parent is the same gender of the adolescent.Hypotheses were tested using a diverse sample of 6,998 adolescents who were followed for seven waves (grades 6-12). Adolescent gender, time-stable and time-varying effects of parental engagement, adolescent perceptions of parental smoking, and interactions among the effects of these variables are tested using multilevel mediation models. We use a traditional measure of past 3-month adolescent smoking and a novel measure of smoking identity.	Parental smoking was associated with a developmental increase in adolescent smoking and time-stable and time-varying parental engagement protected against adolescent smoking, whereas maternal engagement and smoking exerted independent and opposite effects with no moderation and time-stable paternal engagement moderated the effects of perceived paternal smoking on adolescent smoking outcomes. Parental smoking was more strongly associated with adolescent smoking outcomes when adolescent gender was congruent with parent gender.	Even when parents smoke, parental engagement confers protection. Protective effects of engagement may be enhanced among parents who smoke through increased antismoking communication, particularly as adolescents reach the legal smoking age.	
28009723	With the increasing incidence of individuals diagnosed with autism spectrum disorders, there is a need to develop programs to support them throughout their lifespan but research in adulthood support is still scarce. This article aims to provide an up-to-date review of the research on the core characteristics of autism spectrum disorder (ASD), social attainments, and efforts to improve their outcomes.The core social communication impairments continue into adulthood among persons with ASD, but the restrictive, repetitive patterns of behavior and activities have received less attention. Adults with ASD experience more behavioral and emotional regulation issues than their peers. In terms of social attainments, adults with ASD have a greater tendency to be overeducated for their jobs and have a lower employment rate. They are also more likely to live with their parents. Interventions make a positive impact upon social communication skills and employment.	Future research could focus on the repetitive behavior of adults with ASD. Likewise, interventions examining the extent to which repetitive behavior and interests can be managed, as well as the degree to which they can be supported in their community access, living arrangements, as well as family quality of life can be further conducted.	
28009344	Major depressive disorder causes more human suffering than any other disease affecting humankind. It has a high prevalence and it is predicted that it will be among the three leading causes of disease burden by 2030. The prevalence of depression, all of its social and personal costs, and its recurrent characteristics, put heavy constraints on the ability of the public healthcare system to provide sufficient support for patients with depression. In this research, a model for continuous monitoring and tracking of depression in both short-term and long-term periods is presented. This model is based on a new qualitative reasoning approach.This paper describes the patient assessment unit of a major depression monitoring system that has three modules: a patient progress module, based on a qualitative reasoning model; an analysis module, based on expert knowledge and a rules-based system; and the communication module. These modules base their reasoning mainly on data of the patient's mood and life events that are obtained from the patient's responses to specific questionnaires (PHQ-9, M.I.N.I. and Brugha). The patient assessment unit provides synthetic and useful information for both patients and physicians, keeps them informed of the progress of patients, and alerts them in the case of necessity.	A set of hypothetical patients has been defined based on clinically possible cases in order to perform a complete scenario evaluation. The results that have been verified by psychiatrists suggest the utility of the platform.	The proposed major depression monitoring system takes advantage of current technologies and facilitates more frequent follow-up of the progress of patients during their home stay after being diagnosed with depression by a psychiatrist.	
28009249	The paper addresses recent advances in memory manipulation from the perspective of the four key pillars of neuroethics: the self, social policy, neurotechnology, and education and outreach. We provide examples for each pillar, assess their neuroethical implications, and conclude with a call for an ethics framework that is specifically tailored for the ethical challenges of memory manipulation.
28009014	As the result of recent progress in technology of communication robot, robots are becoming an important social partner for humans. Behavioral synchrony is understood as an important factor in establishing good human-robot relationships. In this study, we hypothesized that biasing a human's attitude toward a robot changes the degree of synchrony between human and robot. We first examined whether eyeblinks were synchronized between a human and an android in face-to-face interaction and found that human listeners' eyeblinks were entrained to android speakers' eyeblinks. This eyeblink synchrony disappeared when the android speaker spoke while looking away from the human listeners but was enhanced when the human participants listened to the speaking android while touching the android's hand. These results suggest that eyeblink synchrony reflects a qualitative state in human-robot interactions.
28008747	The aim of this study was to gain insight into the experience of moral distress within the aged care workforce. The objective of this study was to use and validate an existing instrument to measure moral distress within the aged care setting.Moral distress, a phenomenon associated with worker satisfaction and retention, is common within nursing. Instruments to measure moral distress exist; however, there are no validated instruments to measure moral distress within an aged care setting.	An existing instrument, the Moral Distress Scale (Revised) was identified and amended. Amendments were subject to expert review for face and content validity. Data were collected from aged care nurses working in residential and community aged care, in Australia. Reliability was assessed using Cronbach's alpha with exploratory factor analysis undertaken for construct validity.	106 participants completed the survey, 93 (87.7%) identified as female and 13 (12.3%) male. Participants ranged in age from 21 to 73 years, with a mean time working in nursing of 20.6 years. The frequency component of the instrument demonstrated an alpha of 0.89, the intensity component 0.95 and the instrument as a whole 0.94. Three factors were identified and labelled as: Quality of Care, Capacity of Team and Professional Practice. Mean scores indicate a low occurrence of moral distress, but this distress, when experienced, was felt with a moderate level of intensity. Primary causes of moral distress were insufficient staff competency levels, poor quality care because of poor communication and delays in implementing palliation.	The instrument demonstrates validity and reliability within the Australian aged care setting. Further analysis with larger populations is required to support these findings.	Australian aged care workers do experience moral distress. They suffer adverse consequences of this distress and quality of care is negatively impacted. This newly validated instrument can be used to quantify the occurrence of moral distress and to inform targeted interventions to reduce the occurrence and intensity of the experience.	
28008684	Dental issues are more prevalent for Aboriginal Australians, especially those living in rural/remote locations, but distribution of clinicians is favoured towards metropolitan areas and are not always culturally competent. This study aimed to document the experiences of dental clinicians who relocated to rural/remote communities to provide dental services to Aboriginal communities in an effort to redress these gaps.Clinicians working in a new rural/remote dental service strategy to Aboriginal communities in Northern NSW.	Qualitative semi-structured face-to-face interviews and reflective diaries were analysed qualitatively.	Relocating dental clinicians and their support team.	Three major themes emerged: Theme one: Mastering the clinical environment through professional experiences: Increasing professional capabilities, clinical environment, valuing team work and gaining community respect. Theme two: Development and growth of the individual through personal and social experiences: culture shock, developing cultural competence, social impact, economic cost and personal adjustments and growth. Theme three: An overarching sense of achievement and advice to new clinicians.	Relocation to rural and remote communities to provide health services is a complex but rewarding process. Providing personal and professional support, to relocating clinicians resulted in an overall positive experience for the participants, where they increased their professional skills and developed personally. Living and working in the community increased their cultural competence. Barriers were overcome through effective communication, flexibility and teamwork. Funding for rural placements, such as these, is critical for rural and remote health services and should include long-term appropriate funding for mentoring and support.	
28008576	Objectives/Purpose: Alcohol drinking and tobacco smoking pose high health risks for the unborn child. Even though routine testing during the course of pregnancy facilitates early intervention, addressing substance use in pregnancy seems to be more difficult. The aim of the study was to identify barriers to addressing pregnant patients' cigarette and alcohol use. Methods: 2 focus groups (in total N=10 participants) were conducted with gynaecologists. The transcripts of the discussions were analysed using Mayring's approach of qualitative text analysis. Results: Avoidance of addressing substance abuse directly, the social and educational background of patients influencing the communication in this matter and the physicians' ambivalence about their limits of responsibility were barriers often mentioned by the participants. Conclusion: In view of the several structural and individual barriers among gynaecologists identified in this study, gynaecologists obviously cannot be the only health professionals taking responsibility for coping with substance abuse among pregnant women. Strategies should be designed, e. g., to standardise the identification, counselling and referral process. Physicians should receive more support in improving their competences, and effective low-threshold treatment programmes for the women affected are required.
28008075	Non-verbal communication plays a major role in social interaction understanding. Using functional magnetic resonance imaging, we explored the development of the neural networks involved in social interaction recognition based on human motion in children (8-11), adolescents (13-17), and adults (20-41). Participants watched point-light videos depicting two actors interacting or moving independently and were asked whether these agents were interacting or not. All groups successfully performed the discrimination task, but children had a lower performance and longer response times than the older groups. In all three groups, the posterior parts of the superior temporal sulci and middle temporal gyri, the inferior frontal gyri and the anterior temporal lobes showed greater activation when observing social interactions. In addition, adolescents and adults recruited the caudate nucleus and some frontal regions that are part of the mirror system. Adults showed greater activations in parietal and frontal regions (part of them belonging to the social brain) than adolescents.An increased number of regions that are part of the mirror system network or the social brain, as well as the caudate nucleus, were recruited with age. In conclusion, a shared set of brain regions enabling the discrimination of social interactions from neutral movements through human motion is already present in 8-year-old children. Developmental processes such as refinements in the social brain and mirror system would help grasping subtle cues in non-verbal aspects of social interactions.
28007689	When parents of young children with special health care needs (CSHCN) receive their child's diagnosis, they encounter information they may not understand, emotions they may not know how to cope with, and questions about their child's immediate and long-term future that frequently lack answers. The challenge of health care providers is how to prepare parents for caring for their CSHCN, for coping with any resulting challenges, and for accessing the systems and services that can assist them.The purpose of this work was to review evidence of the information and support needs of parents of young CSHCN and to determine whether online social support can serve as an avenue for learning and empowerment for these parents.	A scoping review identified the challenges, coping mechanisms, and support needs among parents of CSHCN, and the reach and effectiveness of digital technologies with these families and health care providers. We also conducted interviews with professionals serving parents of CSHCN.	The literature review and interviews suggested that parents best learn the information they need, and cope with the emotional challenges of raising a CSHCN, with support from other parents of CSHCN, and that young parents in recent years have most often been finding this parent-to-parent support through digital media, particularly social media, consistent with the theory of online social support. Evidence also shows that social media, particularly Facebook, is used by nearly all women aged 18-29 years across racial and socioeconomic lines in the United States.	Parents of young CSHCN experience significant stress but gain understanding, receive support, and develop the ability to care for and be advocates for their child through parent-to-parent emotional and informational social support. Online social support is most effective with young adults of childbearing age, with social media and apps being the most useful within the theoretical framework of social support. This opens new opportunities to effectively educate and support parents of young CSHCN. Providers seeking to inform, educate, and support families of CSHCN should develop strategies to help parents find and use social support through digital resources to facilitate their emotional adjustment and practical abilities to care for and access services for their child.	
28007470	Autism spectrum disorder is a neurodevelopmental disorder characterized by impaired social interaction, poor communication skills, and repetitive/restrictive behaviors. Elevated blood levels of pro-inflammatory cytokines have been reported in subjects with autism spectrum disorder. On the other hand, early childhood adverse experience also increases blood levels of these cytokines. Since social experience of children with autism spectrum disorder is generally unlike to typically developing children, we hypothesized that social interaction during childhood contribute to pro-inflammatory cytokine expression in subjects with autism spectrum disorder. We compared revised Autism Diagnostic Interview scores and expression levels of pro-inflammatory cytokines in peripheral blood mononuclear cells of subjects with autism spectrum disorder (n = 30). The score of domain A on the revised Autism Diagnostic Interview, indicating social interaction impairment in early childhood, was negatively correlated with tumor necrosis factor-α mRNA expression level in peripheral blood mononuclear cells but not interleukin-1β or -6. Consistently, tumor necrosis factor-α mRNA expression was markedly low in subjects with autism spectrum disorder compared to typically developing children who presumably experienced the regular levels of social interaction. These findings suggest that the low blood levels of tumor necrosis factor-α mRNA in subjects with autism spectrum disorder might be due to impaired social interaction in early childhood.
28007040	The purpose of the study reported in this Research Communication was to evaluate alterations in concentration of total antioxidant capacity (TAC) of plasma, plasma total thiols as markers of oxidative protein damage and malondialdehyde (as a final product of lipid peroxidation) in samples obtained at different stages of the lactation cycle and dry period of dairy cows. We found that TAC was significantly lower in the primiparous cows compared to multiparous cows. This study clearly demonstrates a need for monitoring primiparous cows during the production cycle, especially when they are faced with severe metabolic conditions. Furthermore, TAC may be a sensitive, reliable and useful indicator for measurement of cumulative effects of antioxidants as an addition to metabolic profile tests, which are currently used to analyse dairy cattle health.
28007023	Diet is a major risk factor for non-communicable diseases (NCDs) and is also strongly patterned by socioeconomic factors. Whether interventions promoting healthy eating reduce social inequalities in diet in low- and middle-income countries (LMICs) remains uncertain. This paper aims to summarize current evidence on interventions promoting healthy eating in LMICs, and to establish whether they reduce social inequalities in diet.Systematic review of cross-sectional or quasi-experimental studies (pre- and post-assessment of interventions) in Pubmed, Scielo and Google Scholar databases, including adults in LMICs, assessing at least one outcome of healthy eating and showing results stratified by socioeconomic status.	Seven intervention studies including healthy eating promotion, conducted in seven LMICs (Brazil, Chile, Colombia, Iran, Panama, Trinidad and Tobago, and Tunisia), met our inclusion criteria. To promote healthy eating, all interventions used nutrition education and three of them combined nutrition education with improved acces to foods or social support. Interventions targeted mostly women and varied widely regarding communication tools and duration of the nutrition education sessions. Most interventions used printed material, media use or face-to-face training and lasted from 6 weeks to 5 years. Four interventions targeted disadvantaged populations, and three targeted the entire population. In three out of four interventions targeting disadvantaged populations, healthy eating outcomes were improved suggesting they were likely to reduce social inequalities in diet. All interventions directed to the entire population showed improved healthy eating outcomes in all social strata, and were considered as having no impact on social inequalities in diet.	In LMICs, agentic interventions promoting healthy eating reduced social inequalities in diet when specifically targeting disadvantaged populations. Further research should assess the impact on social inequalities in diet of a combination of agentic and structural approaches in interventions promoting healthy eating.	
28007008	Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This longitudinal study examines psychosocial and biopsy- and spirituality-related factors associated with mood in patients day of CNB and one week after receiving results. Ninety women undergoing CNB completed questionnaires on psychosocial factors (chronic stress, social support), biopsy experiences (pain, radiologist communication), and spirituality (peace, meaning, faith) day of CNB. Measures of positive and negative mood were completed day of CNB and one week after receiving results (benign n = 50; abnormal n = 25). Multiple linear regression analyses were conducted. Greater positive mood correlated with greater peace (β = .25, p = .02) day of CNB. Lower negative mood correlated with greater peace (β = -.29, p = .004) and there was a trend for a relationship with less pain during CNB (β = .19, p = .07). For patients with benign results, day of CNB positive mood predicted positive mood post-results (β = .31, p = .03) and only chronic stress predicted negative mood (β = .33, p = .03). For women with abnormal results, greater meaning day of CNB predicted lower negative mood post-results (β = -.45, p = .03). Meaning and peace may be important for women undergoing CNB and receiving abnormal results.
28006961	Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children.This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation.	Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants.	Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition.	Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.	
28005763	The objective of this study was to assess the competency of surgery residents from the patient perspective in the current healthcare environment in China. The authors performed an assessment of 508 surgery residents in Liaoning province. Seven patients were as a group to complete the self-administered questionnaires on the survey for each individual corresponding resident. A 5-point rating scale with an unable-to-evaluate category was used to assess surgery resident competency by patients. Reliability and validity were assessed by Cronbach alpha (α) and exploratory factor analysis, respectively. Statistical analysis was performed using SPSS 13.0. The surveys on 421 residents were valid, and the valid response rate was 82.8%. A total of 2947 questionnaires from patients were analyzed in this study. The Cronbach α coefficient was 0.92. The 4 factors emerging in the exploratory factor analysis reached a cumulative contribution rate of 66.98%. The items of "promotes health maintenance (talks about preventive care)" (206/7.0%), "tells me about any side effects of the medicine" (177/6.0%), "spends enough time with me" (189/6.4%), and "answers my questions thoroughly" (168/5.7%) were scored <4 by higher percentage of patients. The instrument provided an acceptable means for patients to evaluate the competency of Chinese surgery residents. Surgery residents should improve their competencies on preventive care, patient safety, and communication skills.
28005444	Along with the digital revolution, information and communication technology applications are currently transforming the delivery of health and social care services. This paper investigates prevailing opinions toward future technology-based healthcare solutions among Austrian healthcare professionals. During a biphasic online Delphi survey, panelists rated expected outcomes of two future scenarios describing pervasive health monitoring applications. Experts perceived that the scenarios were highly innovative, but only moderately desirable, and that their implementation could especially improve patients' knowledge, quality of healthcare, and living standard. Contrarily, monetary aspects, technical prerequisites, and data security were identified as key obstacles. We further compared the impact of professional affiliation. Clearly, opinions toward pervasive healthcare differed between the interest groups, medical professionals, patient advocates, and administrative personnel. These data suggest closer collaborations between stakeholder groups to harmonize differences in expectations regarding pervasive health monitoring.
28005173	To determine the contributing factors in the successful diabetes education of patients and their entourage.Prospective observational study conducted in a pre-hospital setting by 17 emergency services across France (September 2009-January 2011) included all insulin-treated patients (≥18 years) provided that at least one family member was present on scene. Data were collected from patients and their entourage: (1) personal details including language proficiency and educational attainment, (2) treatments, (3) diabetes-related data (log sheets, glucose meter, glucagon, glycated hemoglobin, prior hypoglycemic episodes); (4) care by diabetologist, general practitioner and/or visiting nurse. The main end points were ability to measure capillary blood sugar (patient) and awareness of hypoglycemia symptoms and ability to administer glucagon (entourage).	Overall, 561 patients and 736 family members were included; 343 patients (61%) were experiencing a hypoglycemic episode (<2.5 mmol/L). A total of 141 (75%) patients and 343 (50%) family members could measure capillary blood sugar. They could name a median of 2 [0-3‰] hypoglycemia symptoms although 217 (39%) patients and 262 (39%) family members could name no symptom. Few patients (33%) had glucagon available. In multivariate analyses, the main factor associated with better patient education was care by a diabetologist. Lack of an educational qualification and visits by a nurse were associated with poor patient education, and French mother tongue and care by a diabetologist with better education of the entourage.	In France, diabetic patients and their entourage are inadequately educated. Their education benefits most from care by a diabetologist.	
28004412	To gain a better understanding of how children aged 6-18 years who use wheelchairs and their families conceptualized physical exercise and keeping fit.Disabled children with reduced mobility are commonly overweight and unfit. Nurse-led health screening programmes in schools commonly exclude disabled children if they cannot use standard weighing scales or stand against height measuring sticks.	Qualitative interview study at two time points over 6 months with children who use wheelchairs and their families.	Framework analysis using the theory of planned behaviour.	Mainly physically active participants were recruited (24 children and 23 parents) 2013-2014. Despite engaging in high levels of physical exercise, children were assessed as fit but had elevated body fat and did not realize how fit they were or that they were slightly overweight and nor did their parents. Children enjoyed the social benefits of exercise. Unlike their parents, children confused the purpose and outcomes of physical exercise with therapy (e.g. physiotherapy) and incorrectly understood the effects of physical exercise on body function and strength, preventing stiffness, increasing stamina and reducing fatigue. A new model was developed to show children's misconceptions.	Proactive parents can overcome barriers to enable their children to benefit from physical exercise. Professionals need to increase communication clarity to improve children's understanding of therapy compared with physical exercise outcomes. Inclusion of children who use wheelchairs in health education policy; routine health screening; physical education classes and teacher training requires improvement. Body composition measurement is recommended, for which nurses will need training.	
28004222	Research on children with autism spectrum disorders suggests differences from neurotypical children in the preference for 'social' versus 'nonsocial' sounds. Conclusions have been based largely on the use of head-turn methodology which has various limitations as a means of establishing auditory preference. In the present study, preference was assessed by measuring the frequency with which children pressed a button to hear different sounds using an interactive toy. Contrary to prior results, both groups displayed a strong preference for the highly social sounds. These findings have implications for approaches to language intervention and for theoretical debates regarding social motivation.
28003957	While music-making interventions are increasingly recognised as enhancing mental health, little is known of why music may engender such benefit. The objective of this article is to elucidate the features of a programme of group drumming known to enable mental health recovery.Qualitative research was conducted with 39 mental health patients and carers who had demonstrated recovery following engagement with a programme of group djembe drumming in the UK. Data were collected through semi-structured individual interviews and focus group interviews designed to understand the connection between drumming and recovery and analysed using Interpretative Phenomenological Analysis (IPA).	Results revealed three overarching features of the drumming intervention: (1) the specific features of drumming, including drumming as a form of non-verbal communication, as a connection with life through rhythm, and as a grounding experience that both generates and liberates energy; (2) the specific features of the group, including the group as a space of connection in and through the rhythmic features of the drumming, as well as facilitating feelings of belonging, acceptance, safety and care, and new social interactions; (3) the specific features of the learning, including learning as an inclusive activity in which the concept of mistakes is dissolved and in which there is musical freedom, supported by an embodied learning process expedited by the musical facilitator.	The findings provide support for the conceptual notion of 'creative practice as mutual recovery', demonstrating that group drumming provides a creative and mutual learning space in which mental health recovery can take place.	
28003386	The increasing number of criminal defendants who are choosing to self-represent poses special challenges for legal systems with regard to the types of limits that should be placed on a defendant's basic human right to defend himself without the assistance of counsel. While courts strive to respect the dignity and autonomy of the defendant that are encompassed in this right, they also want to ensure that justice is delivered and the dignity of the courtroom is maintained. The Supreme Court of the United States, in its opinion in Indiana v. Edwards (2008), held that while the right to self-represent recognized in Faretta v. California (1975) remains, states and trial judges can place limits on a defendant's right to self-representation when a defendant lacks the mental capacities needed to prepare and conduct an adequate defense. Following the court's lead, we first examine the types and range of tasks that a defendant who chooses to self-represent must perform. Based on this analysis, we propose a five-part model that forensic practitioners can use as a conceptual framework for assessing whether a defendant has deficits that would affect his competence to perform critical self-representation tasks. The five areas that the model recommends practitioners assess are whether a defendant can engage in goal-directed behaviors, has sufficient communication skills, can engage in constructive social intercourse, can control his emotions in an adversarial arena, and has the cognitive abilities needed to argue his case adequately. It is recommended that practitioners use the model in their testimony to provide the trier of fact with a comprehensive report of the areas in which a defendant has deficits that will prevent him from protecting his interests in receiving a fair and equitable trial.
28003369	Sharing daily activities on social media has become a part of our lifestyle, but little is known about sharing sensitive health information in the Arab world.The objective of this study is to explore how social media users in the Arab world share sensitive health information through Facebook.	A retrospective qualitative analysis was used in the study.	A total of 110 Facebook groups, related to HIV, sickle cell and depression were screened between 5 June and 1 December 2014.	Forty four Facebook groups met the inclusion criteria. 28 471 posts were extracted, of which 649 met inclusion criteria. Forty two percent of health information exchanged were related to HIV, 34% to depression and 24% to sickle cell diseases. The majority of postings were from Egypt 21.1%, Saudi Arabia 20%, Algeria 10% and Libya 9.2%. Male posts were 54.2% while 45.8% were posted by females. Individuals utilized Facebook groups to share personal experiences of their disease 31%, in addition to being used for seeking queries 13.6%, offering explicit advice 8.3%, reporting signs and symptoms of the disease 7.3% and posting their communication with the health-care provider 6.6%.	Users in the Arab world use social media to exchange sensitive health information, which could have serious implications regarding the privacy of the information shared with other members of the group. On the other hand, sharing health information could have positive effects for patients, such as sharing disease experiences and peer support. However, more work is needed to ensure that Facebook users in the Arab world are aware of the potential consequences of sharing sensitive health information through social media.	
28002686	The article presents a narrative review of scholarship on social support through social networking sites (SNSs) published from 2004 to 2015. By searching keywords related to social support and SNSs in major databases for social sciences, we identified and content analyzed directly relevant articles (N = 88). The article summarizes the prevalence of theory usage; the function of theory usage (e.g., testing a theory, developing a theory); major theories referenced; and methodologies, including research designs, measurement, and the roles of social support and SNS examined in this literature. It also reports four themes identified across the studies, indicating the trends in the current research. Based on the review, the article presents a discussion about study sites, conceptualization of social support, theoretical coherence, the role of social networks, and the dynamic relationships between SNS use and social support, which points out potential avenues for shaping a future research agenda.
28002509	Non-melanoma skin cancers (NMSCs) are the most frequent types of cancer in white skin populations, all over the world. In the last 40 years, there was observed a rapid increase of their incidence, because of the UV radiations exposure and weather changes. Although its morbidity is a relatively modest one, the direct social costs of NMSCs are quite substantial due to a high incidence. Due to these reasons, numerous studies try to clarify the etiopathogenic mechanisms of NMSCs, to elaborate treatment and prevention measures. In the last years, a special attention was given to the relation between inflammation and skin cancer. In our study, we performed a histological and immunohistological evaluation of the inflammatory reaction on a number of 73 surgical exeresis pieces coming from the patients diagnosed with NMSCs. Of these, 21 were squamous cell carcinomas (SCCs) and 52 basal cell carcinomas (BCCs). The peritumoral inflammatory reaction in NMSCs was an extremely variable one in intensity and distribution, from one case to another and even from one area to another within the same tumor, thus proving the complexity of the relations between tumor cells and the cells of the immune system. By comparing the intensity of the inflammatory reaction between the two main types of NMSCs, there was observed that in SCCs the inflammatory reaction was more intense in comparison to BCCs. Also, in SCC there was highlighted a more abundant inflammatory infiltrate in poorly differentiated carcinomas, in comparison to the well-differentiated ones. The presence of the immune system cells (T-lymphocytes, macrophages, mast cells) among the tumoral cells, in a direct contact with these, makes us believe that between the two categories of cells there may appear mechanisms of intercellular communication, distinct from the mechanisms of paracrine signaling.
28001321	To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department.Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication.	A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview.	Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis.	Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a consultation.	The findings reveal that the quality of communication in this Hong Kong emergency department is compromised by specific factors inherent in the linguistic complexity of Hong Kong emergency departments. These factors include the constant translation of medical information, inadequate documentation of medical information and significant professional and cultural pressures. Each of these issues increases the likelihood that healthcare communication will be difficult, incomplete or incorrect. This research provides empirical evidence for, and justifies the development of, an effective framework to enable clinicians to overcome communication challenges.	The findings of this study may shed light on the unique conditions faced by clinicians, particularly in relation to communication, in the complex trilingual healthcare context of an emergency department similar to those in Hong Kong, and provide potential policy solutions for barriers to improve communication in such settings.	
28000541	Social-rank cues communicate social status or social power within and between groups. Information about social-rank is fluently processed in both visual and auditory modalities. So far, the investigation on the processing of social-rank cues has been limited to studies in which information from a single modality was assessed or manipulated. Yet, in everyday communication, multiple information channels are used to express and understand social-rank. We sought to examine the (in)voluntary nature of processing of facial and vocal signals of social-rank using a cross-modal Stroop task. In two experiments, participants were presented with face-voice pairs that were either congruent or incongruent in social-rank (i.e. social dominance). Participants' task was to label face social dominance while ignoring the voice, or label voice social dominance while ignoring the face. In both experiments, we found that face-voice incongruent stimuli were processed more slowly and less accurately than were the congruent stimuli in the face-attend and the voice-attend tasks, exhibiting classical Stroop-like effects. These findings are consistent with the functioning of a social-rank bio-behavioural system which consistently and automatically monitors one's social standing in relation to others and uses that information to guide behaviour.
28000212	Lipid-lowering drugs are widely underused, despite strong evidence indicating they improve cardiovascular end points. Poor patient adherence to a medication regimen can affect the success of lipid-lowering treatment.To assess the effects of interventions aimed at improving adherence to lipid-lowering drugs, focusing on measures of adherence and clinical outcomes.	We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO and CINAHL up to 3 February 2016, and clinical trials registers (ANZCTR and ClinicalTrials.gov) up to 27 July 2016. We applied no language restrictions.	We evaluated randomised controlled trials of adherence-enhancing interventions for lipid-lowering medication in adults in an ambulatory setting with a variety of measurable outcomes, such as adherence to treatment and changes to serum lipid levels. Two teams of review authors independently selected the studies.	Three review authors extracted and assessed data, following criteria outlined by the Cochrane Handbook for Systematic Reviews of Interventions. We assessed the quality of the evidence using GRADEPro.	For this updated review, we added 24 new studies meeting the eligibility criteria to the 11 studies from prior updates. We have therefore included 35 studies, randomising 925,171 participants. Seven studies including 11,204 individuals compared adherence rates of those in an intensification of a patient care intervention (e.g. electronic reminders, pharmacist-led interventions, healthcare professional education of patients) versus usual care over the short term (six months or less), and were pooled in a meta-analysis. Participants in the intervention group had better adherence than those receiving usual care (odds ratio (OR) 1.93, 95% confidence interval (CI) 1.29 to 2.88; 7 studies; 11,204 participants; moderate-quality evidence). A separate analysis also showed improvements in long-term adherence rates (more than six months) using intensification of care (OR 2.87, 95% CI 1.91 to 4.29; 3 studies; 663 participants; high-quality evidence). Analyses of the effect on total cholesterol and LDL-cholesterol levels also showed a positive effect of intensified interventions over both short- and long-term follow-up. Over the short term, total cholesterol decreased by a mean of 17.15 mg/dL (95% CI 1.17 to 33.14; 4 studies; 430 participants; low-quality evidence) and LDL-cholesterol decreased by a mean of 19.51 mg/dL (95% CI 8.51 to 30.51; 3 studies; 333 participants; moderate-quality evidence). Over the long term (more than six months) total cholesterol decreased by a mean of 17.57 mg/dL (95% CI 14.95 to 20.19; 2 studies; 127 participants; high-quality evidence). Included studies did not report usable data for health outcome indications, adverse effects or costs/resource use, so we could not pool these outcomes. We assessed each included study for bias using methods described in the Cochrane Handbook for Systematic Reviews of Interventions. In general, the risk of bias assessment revealed a low risk of selection bias, attrition bias, and reporting bias. There was unclear risk of bias relating to blinding for most studies.	The evidence in our review demonstrates that intensification of patient care interventions improves short- and long-term medication adherence, as well as total cholesterol and LDL-cholesterol levels. Healthcare systems which can implement team-based intensification of patient care interventions may be successful in improving patient adherence rates to lipid-lowering medicines.	
27999683	Music therapy is gaining popularity as an intervention strategy for children with developmental disabilities, including autism spectrum disorder (ASD). This study was a pilot investigation of a classroom-based music-based intervention, Voices Together®, for improving communication skills in children with ASD and children with intellectual disabilities. Four local public elementary school special education classrooms, serving 5 children with a classification of autistic disorder and 32 children with intellectual disability without autism, were randomly selected to receive one of two levels of exposure to Voices Together music therapy: "long-term" (15 weeks beginning in January 2015 (Time 1), n = 14) or "short-term" (7 weeks beginning 7 weeks later in February (Time 2), n = 17). Using observational ratings, investigators reliably scored participants live in terms of their level of verbal responsiveness to prompts during three songs featured each week of the program. Both groups demonstrated increases in verbal responses over time; however, only the long-term group demonstrated significant within-group increases. Preliminary findings suggest that music therapy delivered in a classroom in 45-minute weekly sessions for 15 weeks can promote improvements in verbal responsiveness among individuals with autism and other developmental disabilities. Findings warrant further investigation into the efficacy of classroom-based music therapy programs.
27999222	Cross-disciplinary approaches to Global Environmental Health are essential to address environmental health threats within and beyond national boundaries, taking into account the links among health, environment and socio-economic development. The aim of this study is to present a cross-disciplinary approach where knowledge and findings from environmental epidemiology and social research are integrated in studying environmental health issues, focusing on environmental health inequities, public and environmental health literacy, and international scientific cooperation. In the case of contaminated sites, environmental epidemiology can contribute investigating the multidimensionality of equity for sustainable development practices. These practices entail a better understanding of environmental contamination, health effects pathways and improved capacities of different stakeholders to identify policy options for environmental risk prevention, remediation and management that will foster informed participation in decisions influencing communities. International scientific cooperation frameworks adopting equity principles shared by scientific community, populations and decision-makers may be of valuable support to this task.
27999058	Excessive use of antibiotics accelerates the acquisition/spread of antimicrobial resistance. A systematic review was conducted to identify the components of successful communication interventions targeted at the general public to improve antibiotic use.The databases MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library were searched. Search terms were related to the population (public, community), intervention (campaign, mass media) and outcomes (antibiotic, antimicrobial resistance). References were screened for inclusion by one author with a random subset of 10% screened by a second author. No date restrictions were applied and only articles in the English language were considered. Studies had to have a control group or be an interrupted time-series. Outcomes had to measure change in antibiotic-related prescribing/consumption and/or the public's knowledge, attitudes or behaviour. Two reviewers assessed the quality of studies. Narrative synthesis was performed.	Fourteen studies were included with an estimated 74-75 million participants. Most studies were conducted in the United States or Europe and targeted both the general public and clinicians. Twelve of the studies measured changes in antibiotic prescribing. There was quite strong ( P  < 0·05 to ≥ 0·01) to very strong ( P  < 0·001) evidence that interventions that targeted prescribing for RTIs were associated with decreases in antibiotic prescribing; the majority of these studies reported reductions of greater than -14% with the largest effect size reaching -30%.	Multi-faceted communication interventions that target both the general public and clinicians can reduce antibiotic prescribing in high-income countries but the sustainability of reductions in antibiotic prescribing is unclear.	
27998830	This paper provides reflection on the journey of completing a PhD by using emergent themes that occurred in supervision sessions as recorded in a reflective journal. The paper highlights the need to reflect and accept decisions that can be challenging. The paper also indicates examples where past understandings are questioned and newer insights have to be explored. A conclusion related to accepting responsibility for what happens as a consequence of supervision sessions is debated. Finally a new insight into identity is arrived at.
27998331	In the wake of the Second World War there was a movement to counterbalance the apparently increasingly technical nature of medical education. These reforms sought a more holistic model of care and to put people - rather than diseases - back at the centre of medical practice and medical education. This article shows that students often drove the early stages of education reform. Their innovations focused on relationships between doctors and their communities, and often took the form of informal discussions about medical ethics and the social dimensions of primary care. Medical schools began to pursue 'humanistic' education more formally from the 1980s onwards, particularly within the context of general practice curricula and with a focus on individual doctor-patient relationships. Overall from the 1950s to the 1990s there was a broad shift in discussions of the human aspects of medical education: from interest in patient communities to individuals; from social concerns to personal characteristics; and from the relatively abstract to the measurable and instrumental. There was no clear shift from 'less' to 'more' humanistic education, but rather a shift in the perceived goals of integrating human aspects of medical education. The human aspects of medicine show the importance of student activism in driving forward community and ethical medicine, and provide an important backdrop to the rise of competencies within general undergraduate education.
27998262	Autism Spectrum Disorder (ASD) is characterised by poor social competence; and since Theory of Mind (ToM) is a building block for social-communicative skills and successful social integration, these skills are important to assess when preparing and monitoring educational and therapeutic plans. ToM is a complex skill requiring the ability to form mental concepts, to represent complex constructs verbally, to inhibit some mental states in favour of others, and to consider and compare multiple perspectives. It is critical to consider cognitive influences on the ability to develop and convey ToM skills to ensure that deficits in other cognitive domains do not falsely present as ToM deficits. This consideration is particularly vital in ASD populations with known difficulties not only in ToM, but also in intellectual functioning, language, and executive functioning. This article reviews the influence of intellectual ability, language, working memory, and inhibition skills on the presentation of ToM; with particular focus on ToM in ASD. We discuss practical suggestions based on clinical experience in neuropsychological practice and research in South Africa for the successful assessment of ToM ability.
27998043	To understand the perspectives of patients with rheumatoid arthritis (RA) about the risk of their relatives developing RA in the future, and about communicating with their relatives about risk and its modulation.Twenty-one RA patients took part in semi-structured interviews.	Participants reported willingness to communicate with relatives about their risk of developing RA, but described choosing which relatives to communicate with, on the basis of their perceived receptivity to such risk information. Participants described the potential for risk information to cause negative emotions. Some participants did not consider RA to be hereditable, and few reported smoking as a risk factor. Patients described a lack of public awareness about the causes of RA and the negative impact that RA has on quality of life. Awareness of this negative impact was identified as an important driver for predictive and preventive strategies. Participants held positive perceptions of predictive testing for RA, though the results of predictive tests were conceptualised as having a high degree of accuracy. Negative views of predictive testing were associated with an appreciation of the probabilistic nature of risk information. Participants felt that their relatives would prefer lifestyle modification over medication as a risk reduction strategy.	Information about risk factors for RA, and the potential impact of RA on quality of life, is needed to support family communication about RA risk. Management of expectations is needed in relation to the probabilistic nature of risk information, and appropriate support should be provided for negative psychological outcomes. This article is protected by copyright. All rights reserved.	
27997938	Falls and fall-related injury are emerging issues for older Aboriginal people. Despite this, it is unknown whether older Aboriginal people access available fall prevention programs, or whether these programs are effective or acceptable to this population.To investigate the use of available fall prevention services by older Aboriginal people and identify features that are likely to contribute to program acceptability for Aboriginal communities in New South Wales (NSW), Australia.	A questionnaire was distributed to Aboriginal and mainstream health and community services across NSW to identify the fall prevention and healthy ageing programs currently used by older Aboriginal people. Services with experience in providing fall prevention interventions for Aboriginal communities, and key Aboriginal health services that delivered programs specifically for older Aboriginal people, were followed up and staff members were nominated from within each service to be interviewed. Service providers offered their suggestions as to how a fall prevention program could be designed and delivered to meet the health and social needs of their older Aboriginal clients.	Of the 131 services that completed the questionnaire, four services (3%) had past experience in providing a mainstream fall prevention program to Aboriginal people; however, there were no programs being offered at the time of data collection. From these four services, and from a further five key Aboriginal health services, 10 staff members experienced in working with older Aboriginal people were interviewed. Barriers preventing services from offering appropriate fall prevention programs to their older Aboriginal clients were identified, including limited funding, a lack of available Aboriginal staff, and communication difficulties between health services and sectors. According to the service providers, an effective and acceptable fall prevention intervention would be evidence based, flexible, community-oriented and social, held in a familiar and culturally safe location and delivered free of cost.	This study identified a gap in the availability of acceptable fall prevention programs designed for, and delivered to, older Aboriginal people in NSW. Further consultation with older Aboriginal people is necessary to determine how an appropriate and effective program can be designed and delivered. Terminology: The authors recognise the two distinctive Indigenous populations of Australia: Aboriginal and Torres Strait Islander people. Because the vast majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (95.4%)1, this population will be referred to as 'Aboriginal' in this manuscript.	
27997937	To explore understanding, perceptions and feelings about meningococcal disease in members of higher risk groups. To explore what people say are the most important health messages and communication preferences about invasive meningococcal disease (IMD).Three focus groups and two semistructured interviews were conducted with people at higher risk of IMD in Hunter New England Local Health District in New South Wales.	Participants generally had a low understanding of IMD, but described intense feelings about the disease and empathy for those who had experienced the disease. Fear of stigma and the impact of stigma were identified. Participants identified reasons for delaying presentation for care as perceptions of invincibility (particularly among young people), the cost of care (for all groups), and racism (particularly for Aboriginal people). These issues were both potential and experienced barriers for participants accessing help when acutely unwell. Factors for effective communication to improve understanding of IMD included the communication being acceptable, accessible and appropriate.	IMD is a serious but uncommon disease that has a range of impacts on people, families and communities. Higher risk groups may benefit from receiving more appropriate and accessible information about early signs and symptoms of IMD. Communication and understanding about the disease could be improved by working with new technologies and partnering with key people in high-risk groups. Use of text messages and social networking for urgent communication could be considered and trialled in public health practice. It is also important to recognise the potential direct or indirect experience of racism and stigma for patients with IMD and their families. Management of IMD could be strengthened by connecting people and families with support groups or services to reduce the impact of the disease.	
27997482	To evaluate the effectiveness of a quality improvement intervention to increase delivery of 2 evidence-based health promotion workshops, Stepping On and Chronic Disease Self-Management Program (CDSMP), in rural communities.A cluster-randomized wait-list control group design.	Rural Wisconsin counties with trained workshop leaders but no workshops in the prior year were eligible to participate.	Sixteen counties were randomized to receive the NIATx intervention or wait-list control. The 1-year intervention consisted of training and coaching county aging unit staff to apply NIATx methods to increase and sustain the number of Stepping On or CDSMP workshops in their community.	Mann-Whitney tests examined effect on workshops held, participants, and workshop completers. The paired Wilcoxon signed rank test explored change in participants' health behaviors and health care utilization.	Counties receiving the NIATx intervention significantly increased the number of workshops per county per year as compared with baseline (1.5 vs 0.19, P < .001) and sustained improvements during the year following the intervention. Stepping On participants, during the 6 months postintervention, had reduced falls risk behaviors (P < .001), 0.43 fewer falls (P < .01), and 0.028 fewer medical record-verified emergency department visits for falls-related injuries (P < .05) compared with the 6 months before the intervention. CDSMP participants had reduced social isolation (P = .018) and improved physician communication skills (P = .005).	Our study demonstrates that coaching rural service organizations in use of the quality improvement process, NIATx, may increase implementation reach of evidence-based health promotion/disease prevention programs. Initiative findings indicate that this approach may be a new and potentially important strategy to increase reach of health promotion programs for older adults in community settings.	A quality improvement approach effectively increases and sustains delivery of evidence-based health promotion/workshops for older adults in rural communities. Counties or states struggling to engage older adults in evidence-based health promotion workshops could integrate quality improvement into policies and practices to increase workshop availability. Once engaged, older adults experience improved health behaviors from both programs and reduced falls and emergency department utilization from Stepping On.	
27997477	To assess the self-selected asynchronous leadership module-based learning choices of public health professionals participating in the Maternal and Child Health Public Health Leadership Institute (MCH PHLI).Online module completion and evaluation data were used to determine the topics most utilized by the Fellows; whether the topics and mode of training were acceptable, relevant, and practical; and whether participant characteristics explained any usage patterns.	A total of 109 enrolled Fellows in the MCH PHLI program.	Module frequency of selection by Fellows; Fellows' rating scores in regard to relevance, practicality, and acceptability of module topics.	All program titles were highly rated. The 5 most frequently selected module topics were employee engagement (87.2%), talent acquisition strategies (84.4%), employee motivation (79.8%), emotional intelligence (78.9%), and workforce development strategies (68.8%). The least accessed topics focused on cultural competence (15.6%), social marketing (25.7%), effective communication and advocacy (25.7%), family partnerships (25.9%), and creating learning organizations (31.2%). All module topics provided were rated as relevant, practical, and acceptable to these public health leaders.	Self-directed computer-based learning was rated strongly by the MCH public health leaders in this study. Such an approach can be used to customize training to individual needs and interests. These findings suggest that inclusion of skills that enable public health leaders to effectively work with and through others was of core interest in the MCH PHLI. The finding of higher usage of topics related to workforce management can provide guidance for those developing leadership development programs for maternal and child health professionals. In addition, leadership needs and interests should be assessed regularly to ensure that competency-based leadership development guidelines are adapting to the evolving and complex challenges faced by leaders. While these results were tested in MCH professionals, they may be generalizable to other disciplines within the field of public health.	
27997308	To examine the short-term impact of the WIXX multimedia communication campaign on children's physical activity (PA) beliefs and behaviors, 3 repeated cross-sectional telephone surveys were conducted before, 9 months after, and 21 months after the launch of the campaign. A random-digit dialing procedure was used to recruit children ages 9 to 13 years. Children's PA beliefs, behaviors, and recall of the WIXX ads were self-reported. Logistic regression models showed that girls exposed to the WIXX ads were more likely to believe that PA would help to make new friends (odds ratio [OR] = 1.4, 95% confidence interval [CI] [1.0, 1.9]) and that they can be active even if too busy (OR = 1.4, 95% CI [1.0, 1.8]) compared to girls not exposed. Boys exposed were more likely to believe that PA would help to spend time with friends (OR = 1.4, 95% CI [1.1, 1.9]). Boys (OR = 1.5, 95% CI [1.1, 2.0.]) and girls (OR = 1.4, 95% CI [1.1, 1.8]) exposed were more likely to report having tried new PAs. No significant impact of the campaign was observed on overall PA after we controlled for confounders. Recall of the WIXX ads was associated with a significant, albeit modest, impact on some PA beliefs and intermediate PA behaviors.
27997285	Current warning labels on cigarette packages are generally focused on long-term losses that can be incurred if one continues smoking. This study compares the effects of these labels against warning labels that stress short-term losses of smoking as well as labels that stress short- and long-term benefits that can be obtained when one quits smoking. A 2 (message frame: gain vs. loss) × 2 (temporal context: short vs. long term) between-subjects experiment was conducted among 132 smokers, with attitude toward quitting smoking and intention to quit smoking, as well as information-seeking behavior and message recall, as the dependent variables. Findings were in line with theory regarding message framing and temporal discounting, showing enhanced effects of gain over loss frames and short-term over long-term consequences on warning labels for attitudes and intentions. In addition, an interaction between message frame and temporal context was found. Especially, gain-framed messages showed stronger effects on intentions to quit smoking than loss-framed messages when warning labels concerned short-term outcomes. Findings suggest that current warning labels, with an emphasis on long-term negative health outcomes, should be reconsidered.
27997233	To test the hypothesis that violence among US adolescents spreads like a contagious disease through social networks.Participants were a nationally representative sample of 90 118 US students aged 12 to 18 years who were involved in the National Longitudinal Study of Adolescent Health. Violence was assessed by having participants report the number of times in the preceding 12 months they had been involved in a serious physical fight, had hurt someone badly, and had pulled a weapon on someone.	Participants were 48% more likely to have been involved in a serious fight, 183% more likely to have hurt someone badly, and 140% more likely to have pulled a weapon on someone if a friend had engaged in the same behavior. The influence spread up to 4 degrees of separation (i.e., friend of friend of friend of friend) for serious fights, 2 degrees for hurting someone badly, and 3 degrees for pulling a weapon on someone.	Adolescents were more likely to engage in violent behavior if their friends did the same, and contagion of violence extended beyond immediate friends to friends of friends.	
27996354	The purpose of interprofessional collaboration is to bring better services for sexual assault victims. In order to avoid secondary victimisation and improve the quality of forensic examination and prosecution rate, a one-stop service has been developed recently in Taiwan. However, whether the collaboration is successful may depend on participants' professional backgrounds and personal experiences and can be influenced by a number of factors. This study used the Index of Interdisciplinary Collaboration to examine the different perceptions of collaboration in team members and the related influences on collaboration. Surveys were conducted in 140 team members including social workers, doctors, nurses, and police officers. The result indicated that collaboration was perceived differently in different professionals and significantly lower by social workers in the domain of interdependence and reflection on process. Factors such as professional roles, structural characteristics, personal characteristics, and history of collaboration were positively associated with the overall perception of collaboration. Only structural and personal characteristics predicted the type of profession. This study highlights the importance to acknowledge different experiences. Additional efforts and investments for improving mutual help and trust by the organisations are recommended.
27996329	To further examine the proposed relationship between executive impairments in inhibitory control and social communication difficulties reflecting poor inhibition following TBI.Inhibitory control was assessed in 14 adults with TBI on the Hayling Sentence Completion Test (HSCT). Errors on Part B (failed inhibition) and Part B-Part A response latencies (delayed inhibition) were examined. A relative, friend or frequent communication partner of each participant with TBI completed the La Trobe Communication Questionnaire (LCQ) on the communication difficulties of the person with TBI. The Inhibitory Control Factor (ICF) score of the LCQ based on seven items relating to poor inhibition was specifically analysed against performance on the HSCT.	Multiple regression analysis indicated that 58% (51% adjusted) of the variance in LCQ ICF scores was accounted for by measures on the HSCT. Only B-A response latencies on the HSCT explained a significant proportion of the variability in LCQ ICF scores.	Reduced inhibition speed may more strongly contribute to disinhibited communication behaviours than failures in inhibition. These findings contribute to understanding of the cognitive processes underlying social communication and have the potential to support and inform the use and development of management practices for individuals following TBI.	
27996094	The purpose of this study was to examine the relationship between typically difficult living conditions and psychological distress in Latino migrant day laborers (LMDLs), with attention to the potentially protective roles of contact with family in country of origin (i.e., communication, sending money, etc.), availability of local culture (i.e., food, music, people from one's country of origin), and utilization of community resources perceived to be culturally competent (i.e., services that are respectful, able to serve Latinos, able to solve problems, in Spanish, etc.). Participants were 344 LMDLs surveyed in the San Francisco Bay Area. As hypothesized: (a) difficult living conditions were related to depression, anxiety, and desesperación [desperation], the latter a popular Latino idiom of psychological distress recently validated on LMDLs; (b) contact with family moderated the relation between difficult living conditions and depression and desesperación but not anxiety and (c) access to local culture, and utilization of community resources, mediated the relation between difficult living conditions and depression and desesperación but not anxiety. Implications for intervening at local and larger levels in order to provide some protection against distress built into the LMDL experience in the United States are discussed.
27995958	In humans, facial expressions are rich sources of social information and have an important role in regulating social interactions. However, the extent to which this is true in non-human animals, and particularly in non-primates, remains largely unknown. Therefore we tested whether domestic horses (Equus caballus) could discriminate between facial expressions of their conspecifics captured in different contexts, and whether viewing these expressions elicited functionally relevant reactions. Horses were more likely to approach photographic stimuli displaying facial expressions associated with positive attention and relaxation, and to avoid stimuli displaying an expression associated with aggression. Moreover, differing patterns of heart rate changes were observed in response to viewing the positive anticipation and agonistic facial expressions. These results indicate that horses spontaneously discriminate between photographs of unknown conspecifics portraying different facial expressions, showing appropriate behavioural and physiological responses. Thus horses, an animal far-removed from the primate lineage, also have the ability to use facial expressions as a means of gaining social information and potentially regulating social interactions.
27995697	Evidence-based practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered 'under-served' or 'hard-to-reach' by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served are complex.To describe beliefs and reported practices, in relation to speech and language development, delay and intervention, of parents and carers from a small number of groups in England who were perceived to be under-served in relation to SLT services.	As part of a wider National Institute for Health Research (NIHR)-funded study (Child Talk), seven focus groups (with a total of 52 participants) were held with parents from three communities in England. Topics addressed included beliefs about language development, language delay and parents' reported responses to language delay. Data were transcribed and analysed using adapted framework analysis, which also drew on directed content analysis.	Four themes resulted that broadly matched the topics addressed in the focus groups: language development and the environment; causes and signs of speech and language delay; responses to concerns about speech, language and communication; and improving SLT. These produced some previously unreported ideas, e.g., about how language develops and the causes of delay.	The findings are discussed in relation to previous literature and the Developmental Niche Framework. Clinical implications include ideas about issues for SLTs to discuss with families and the need to recognize that parents may see themselves as competent facilitators of language. Suggestions are made for future research, including: expanded investigation of a wider range of under-served groups, an exploration of who parents consult when concerned about their child's language, and how key community figures advise parents in relation to language delay.	
27995427	Primary care providers (PCPs) can play a critical role in helping patients receive the preventive health benefits of cancer genetic risk information. Thus, the objective of this systematic review was to identify studies of US PCPs' knowledge, attitudes, and communication-related behaviors regarding genetic tests that could inform risk-stratification approaches for breast, colorectal, and prostate cancer screening in order to describe current findings and research gaps.We conducted a systematic search of six electronic databases to identify peer-reviewed empirical articles relating to US PCPs and genetic testing for breast, colorectal, or prostate cancer published in English from 2008 to 2016. We reviewed these data and used narrative synthesis methods to integrate findings into a descriptive summary and identify research needs.	We identified 27 relevant articles. Most focused on genetic testing for breast cancer (23/27) and colorectal cancer risk (12/27); only one study examined testing for prostate cancer risk. Most articles addressed descriptive research questions (24/27). Many studies (24/27) documented PCPs' knowledge, often concluding that providers' knowledge was incomplete. Studies commonly (11/27) examined PCPs' attitudes. Across studies, PCPs expressed some concerns about ethical, legal, and social implications of testing. Attitudes about the utility of clinical genetic testing, including for targeted cancer screening, were generally favorable; PCPs were more skeptical of direct-to-consumer testing. Relatively fewer studies (9/27) examined PCPs' communication practices regarding cancer genetic testing.	This review indicates a need for investigators to move beyond descriptive research questions related to PCPs' knowledge and attitudes about cancer genetic testing. Research is needed to address important gaps regarding the development, testing, and implementation of innovative interventions and educational programs that can improve PCPs' genetic testing knowledge, assuage concerns about the appropriateness of cancer genetic testing, and promote open and effective patient-provider communication about genetic risk and genetic testing.	

27994284	إجراء عدد من التقييمات للوقوف على مدى التأهب لمواجهة مرض فيروس الإيبولا في البلدان الواقعة ضمن منطقة جنوب شرق آسيا ضمن اختصاص منظمة الصحة العالمية.وافقت 11 بلدًا من البلدان الواقعة في المنطقة على الخضوع للتقييم. وقام فريق مشترك من منظمة الصحة العالمية ووزارات الصحة في كل بلد بالذهاب في مهمات تستغرق من 4 إلى 5 أيام إلى كل من بنغلاديش وبوتان وإندونيسيا وملديف وميانمار ونيبال وسري لانكا وتايلند وتيمور- لشتي، وذلك في الفترة من شهر شباط/فبراير وحتى شهر تشرين الثاني/نوفمبر من عام 2015. قمنا بجمع معلومات من خلال المناقشات التوجيهية مع بعضٍ من كبار المسؤولين المتخصصين ومن خلال الزيارات إلى المستشفيات والمختبرات والمطارات. قمنا بتقييم مدى التأهب لمواجهة مرض فيروس الإيبولا الذي تبديه كل بلد بإجراء 41 مهمة تتضمن تسعة عناصر أساسية معتمدة من قائمة الفحص الخاصة بمنظمة الصحة العالمية لقياس مدى التأهب لمواجهة الإيبولا في شهر كانون الثاني/يناير من عام 2015.	كان الالتزام بزيادة حالة التأهب لمواجهة الإيبولا مرتفعًا لدى الجهات السياسية في جميع البلدان. وكان التخطيط متقدمًا للغاية بالنسبة للعناصر التالية التي تم تخطيطها أو اختبارها مسبقًا لمواجهة وباء الإنفلونزا: التنسيق متعدد المستويات ومتعدد القطاعات؛ وفرق الاستجابة السريعة متعددة التخصصات؛ والاتصالات العامة والتعبئة الاجتماعية؛ وإجراء التدريبات في المطارات الدولية؛ والتدريب على استخدام معدات الوقاية الشخصية. تضمنت نقاط الضعف الرئيسية عدم كفاية أعداد تقييم المخاطر والإبلاغ عن المخاطر؛ ووجود فجوات في مجال إدارة البيانات وتحليلها لمراقبة الحدث؛ وتوفير تقنيات التشخيص الجزيئي بسعة محدودة. وقامت العديد من البلدان بعمليات تخطيط محدودة لمجموعة من الحالات المصابة بالإيبولا. وشملت المهام الأخرى التي تحتاج إلى التحسين ما يلي: تقديم النصيحة للمسافرين القادمين؛ وتوفير عدد كافٍ من غرف العزل؛ وإجراء الممارسات المناسبة لمكافحة العدوى؛ ووضع أنظمة فرز المصابين في المستشفيات؛ وزيادة السعة التشخيصية في المختبرات؛ وتتبع حالات الاختلاط؛ ومنح الموظفين بدل الخطر لضمان استمرارية أعمال الرعاية.	إن التقييم وإبداء الملاحظات المشترك حول مدى فاعلية أنظمة التأهب لمواجهة فيروس الإيبولا يساعد البلدان في تعزيز قدراتها الأساسية على الالتزام باللوائح التنظيمية الصحية الدولية.	旨在评估东南亚地区世界卫生组织 (WHO) 成员国的埃博拉病毒病预防情况。.	该地区 11 个国家中 9 个国家同意接受评估。2015 年 2 月至 11 月期间，WHO 及各国卫生部门组成了一个联合团队，在不丹、东帝汶、印度尼西亚、马尔代夫、孟加拉国、缅甸、尼泊尔、斯里兰卡、泰国开展了一项为期 4 到 5 天的任务。我们通过与高级技术领导人讨论、走访医院、实验室和机场收集信息，并针对 41 项任务对每个国家的埃博拉病毒预防情况进行了评估，其中 9 个关键组成部分来自于 WHO 2015 年 1 月的埃博拉预防清单。.	所有国家政府都高度承诺对埃博拉进行预防。对于之前针对大流行性流感进行过计划或测试的组成部分实施最高级的计划：多层次和多部分协调；多学科快速反应小组；大众传播和社会动员；国际机场演习以及有关个人防护装备的培训。主要的不足包括风险评估和风险交流不足；针对事件监控的数据管理和分析不一致；以及分子诊断技术能力有限。许多国家应对埃博拉病例剧增的计划不足。需要提升的其他任务包括：向入境旅客提供建议；充足的隔离房间；恰当的感染控制措施；医院分诊系统；实验室诊断能力；接触者追踪；以及给予员工危险工作补贴以确保护理的连续性。.	对埃博拉病毒预防体系的功能性进行联合评估和反馈，这有助于各国增强其符合国际卫生条例的核心能力。.	Réaliser des évaluations de la préparation au virus Ebola dans des pays de la région Asie du Sud-Est de l'Organisation mondiale de la Santé (OMS).	Sur les 11 pays de la région, neuf ont accepté d'être évalués. De février à novembre 2015, une équipe composée de membres de l'OMS et des ministères de la Santé ont effectué des missions de 4 à 5 jours au Bangladesh, au Bhoutan, en Indonésie, aux Maldives, au Myanmar, au Népal, au Sri Lanka, en Thaïlande et au Timor-Leste. Nous avons recueilli des informations lors de discussions guidées avec des directeurs techniques et lors de visites dans des hôpitaux, des laboratoires et des aéroports. Nous avons évalué la préparation de chaque pays au virus Ebola d'après 41 tâches relevant de neuf composantes clés, inspirées de la liste de contrôle de l'OMS pour faire face au virus Ebola de janvier 2015.	L'engagement politique en matière de préparation au virus Ebola était élevé dans tous les pays. La planification était plus avancée vis-à-vis des composantes qui avaient déjà été planifiées ou testées pour les pandémies de grippe: coordination multisectorielle et multi-niveaux, équipes d'intervention rapide multidisciplinaires, communication publique et mobilisation sociale, exercices dans les aéroports internationaux et formation au port d'équipements de protection individuelle. Les principales vulnérabilités étaient une mauvaise évaluation et communication des risques, des failles dans la gestion et l'analyse des données en vue de la surveillance, et des capacités limitées au niveau des techniques de diagnostic moléculaire. Dans de nombreux pays, la planification était limitée en cas de flambée du virus Ebola. D'autres tâches nécessitaient des améliorations, par exemple: les conseils aux voyageurs entrant dans le pays, la mise à disposition de chambres d'isolement adéquates, l'adoption de pratiques correctes de lutte contre la maladie, des systèmes de triage dans les hôpitaux, des capacités de diagnostic dans les laboratoires, la recherche des contacts et le paiement d'une prime de risque au personnel afin d'assurer la continuité des soins.	L'évaluation conjointe et la communication au sujet de la fonctionnalité des systèmes de préparation au virus Ebola permettent aux pays de renforcer leurs capacités afin de respecter le Règlement sanitaire international.	Провести оценку готовности к борьбе с вирусной лихорадкой Эбола в странах-участницах Всемирной организации здравоохранения (ВОЗ), расположенных в Юго-Восточной Азии.	Согласие на проведение оценки выразили девять из 11 стран региона. С февраля по ноябрь 2015 года объединенная группа специалистов ВОЗ и представителей министерств здравоохранения осуществляла 4–5-дневные поездки в Бангладеш, Бутан, Индонезию, на Мальдивские острова, в Мьянму, Непал, Таиланд, Тимор-Лешти и Шри-Ланку. Информация была нами получена в ходе управляемых дискуссий с представителями высшего технического руководства этих стран и при посещении лабораторий, аэропортов и больниц. Готовность каждой из стран к борьбе с вирусной лихорадкой Эбола оценивалась исходя из 41 задачи в рамках 9 основных компонентов, которые были получены из списка контрольных вопросов по готовности к лихорадке Эбола, разработанных ВОЗ в январе 2015 года.	Идеологическая установка и подготовка к борьбе с лихорадкой Эбола оказалась высокой во всех странах. Что касается планирования, оно было наиболее развито в тех направлениях, которые уже ранее были спланированы или испытаны для случаев эпидемии гриппа: координация различных секторов и уровней, группы быстрого реагирования, имеющие многоплановый характер, связь с общественностью и социальная мобилизация, учения в международных аэропортах и обучение использованию средств индивидуальной защиты. Наиболее уязвимыми моментами оказались недостаточная оценка риска и недостаточная информированность о риске, были также выявлены недостатки в управлении данными и анализе при осуществлении контроля над событием, а также было выявлено, что применение молекулярных технологий диагностики недостаточно развито. Во многих странах планирование действий в случае вспышки лихорадки Эбола было ограниченным. К числу других задач, требующих улучшения, относятся следующие: рекомендации для лиц, перемещающихся внутри страны, достаточно оснащенные изоляторы, соответствующие практики ограничения распространения инфекции, системы сортировки пациентов в больницах, наращивание возможностей лабораторной диагностики, отслеживание контактов и дополнительная оплата работникам за риск для обеспечения непрерывного ухода за больными.	Совместная оценка и отзывы относительно функционирования систем готовности к вирусной лихорадке Эбола помогают странам укрепить ключевые возможности, необходимые для соблюдения международных медико-санитарных правил.	Llevar a cabo evaluaciones de la preparación ante el virus del Ébola en países de la región del sudeste asiático de la Organización Mundial de la Salud (OMS).	Nueve de once países de la región aceptaron ser evaluados. De febrero a noviembre de 2015, un equipo conjunto de la OMS y los ministerios de sanidad llevaron a cabo misiones de entre 4 y 5 días en Bangladesh, Bután, Indonesia, Maldivas, Myanmar, Nepal, Sri Lanka, Tailandia y Timor-Leste. Se recopiló información a través de conversaciones dirigidas con jefes técnicos y visitas a hospitales, laboratorios y aeropuertos. Se evaluó la preparación ante el virus del Ébola de cada país en 41 tareas con 9 componentes clave adaptados de la lista de preparación ante el ébola de la OMS de enero de 2015.	El compromiso político para la preparación ante el ébola era elevado en todos los países. La planificación era más avanzada para los componentes que habían sido previamente planificados o probados para pandemias de gripe: coordinación de varios niveles y sectores, equipos de respuesta rápida multidisciplinares, comunicación pública y movilización social, simulacros en aeropuertos internacionales y formación sobre equipos de protección individual. Entre las principales vulnerabilidades se encontraba una evaluación de riesgos y comunicación de riesgos poco adecuadas, lagunas en la gestión y el análisis de datos para el control de acontecimientos y una capacidad limitada en técnicas de diagnóstico molecular. Muchos países tenían una planificación limitada en caso de que resurgieran casos de ébola. Entre otras tareas que necesitaban mejorar se encontraban: asesoría a viajeros entrantes, salas de aislamiento adecuadas, prácticas de control de infecciones adecuadas, sistemas de clasificación en hospitales, capacidad de diagnóstico en laboratorios, localización de contactos y prima de peligrosidad para el personal para garantizar la continuidad de la atención.	La evaluación conjunta y los comentarios sobre la funcionalidad de los sistemas de preparación ante el virus del Ébola ayudan a los países a fortalecer sus capacidades principales para cumplir el Reglamento Sanitario Internacional.	To conduct assessments of Ebola virus disease preparedness in countries of the World Health Organization (WHO) South-East Asia Region.	Nine of 11 countries in the region agreed to be assessed. During February to November 2015 a joint team from WHO and ministries of health conducted 4-5 day missions to Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste. We collected information through guided discussions with senior technical leaders and visits to hospitals, laboratories and airports. We assessed each country's Ebola virus disease preparedness on 41 tasks under nine key components adapted from the WHO Ebola preparedness checklist of January 2015.	Political commitment to Ebola preparedness was high in all countries. Planning was most advanced for components that had been previously planned or tested for influenza pandemics: multilevel and multisectoral coordination; multidisciplinary rapid response teams; public communication and social mobilization; drills in international airports; and training on personal protective equipment. Major vulnerabilities included inadequate risk assessment and risk communication; gaps in data management and analysis for event surveillance; and limited capacity in molecular diagnostic techniques. Many countries had limited planning for a surge of Ebola cases. Other tasks needing improvement included: advice to inbound travellers; adequate isolation rooms; appropriate infection control practices; triage systems in hospitals; laboratory diagnostic capacity; contact tracing; and danger pay to staff to ensure continuity of care.	Joint assessment and feedback about the functionality of Ebola virus preparedness systems help countries strengthen their core capacities to meet the International Health Regulations.	

27993497	We used an integrative review to synthesize existing literature on the factors associated with HIV testing by youth ages 13 to 24 years in the United States. PubMed, CINAHL, PsycINFO, and Google Scholar were systematically searched and 44 original research studies met our criteria. A directed qualitative content analysis was conducted to integrate findings according to the personal, relationship, community, and society levels of the social-ecological model. Female gender, African American race, age, and physical illness were some of the factors more consistently associated with HIV testing. Modifiable factors such as fear, drug use, poor condom use, partner communication, and multiple sexual partners were also noted as influencing HIV testing in youth. Our integrative review revealed gaps in the literature that need further exploration, particularly in the area of community and society influences on HIV testing for youth. Implications for research, practice, and policy are discussed.
27993402	This short communication summarizes the strengths and weaknesses of current organisational structures in government veterinary services, as well as future technical, financial and societal challenges and related necessary competencies for government veterinary services of the future as discussed by an expert panel at ISVEE2015. First, participating representatives of veterinary services of diverse geographical backgrounds and statements from the audience confirmed that non-technical skills such as ability to work in teams, adaptability to new environments and situations, social and communication skills are increasingly seen as important. The second challenge faced by veterinary services is related to capacity issues, i.e. to have enough manpower to plan and deliver according to legislation in a period of shrinking budgets. New and emerging diseases can result in sudden, massive increases in the workload of veterinary services. Technical complexity has also increased for some hazards. Staff skills in veterinary services therefore need to be continuously updated, and it is essential to establish cross technical collaboration with other sectors including food safety, public health and environment. ISVEE conferences were seen as an opportunity to provide a global platform to develop skills needed by veterinary services, now and in the future.
27992729	The use of social network theory and analysis methods as applied to public health has expanded greatly in the past decade, yielding a significant academic literature that spans almost every conceivable health issue. This review identifies several important theoretical challenges that confront the field but also provides opportunities for new research. These challenges include (a) measuring network influences, (b) identifying appropriate influence mechanisms, (c) the impact of social media and computerized communications, (d) the role of networks in evaluating public health interventions, and (e) ethics. Next steps for the field are outlined and the need for funding is emphasized. Recently developed network analysis techniques, technological innovations in communication, and changes in theoretical perspectives to include a focus on social and environmental behavioral influences have created opportunities for new theory and ever broader application of social networks to public health topics.
27992491	Despite the Institute of Medicine's (IOM) 2005 recommendation, few care organizations have instituted standard survivorship care plans (SCPs). Low health literacy and low English proficiency are important factors to consider in SCP development. Our study aimed to identify information needs and survivorship care plan preferences of low literacy, multi-lingual patients to support the transition from oncology to primary care and ongoing learning in survivorship.We conducted focus groups in five languages with African American, Latina, Russian, Filipina, White, and Chinese medically underserved breast cancer patients. Topics explored included the transition to primary care, access to information, knowledge of treatment history, and perspectives on SCPs.	Analysis of focus group data identified three themes: 1) the need for information and education on the transition between "active treatment" and "survivorship"; 2) information needed (and often not obtained) from providers; and 3) perspectives on SCP content and delivery.	Our data point to the need to develop a process as well as written information for medically underserved breast cancer patients. An SCP document will not replace direct communication with providers about treatment, symptom management and transition, a communication that is missing in participating safety-net patients' experiences of cancer care. Women turned to peer support and community-based organizations in the absence of information from providers.	"Clear and effective" communication of survivorship care for safety-net patients requires dedicated staff trained to address wide-ranging information needs and uncertainties.	
27990746	Early intervention for autism spectrum disorder (ASD) tends to focus on enhancing social communication skills. We report data collected via focus group discussions as part of a feasibility and acceptability pilot randomized controlled trial (RCT) about a new parent group intervention to manage restricted and repetitive behaviours (RRB) in young children with ASD.The focus groups were led by two independent facilitators and followed a semi-structured topic guide with the aim of considering three key topics: experiences of participating in a RCT, opinions about the intervention and the impact of the intervention on the participants, their children and the family.	Fourteen participants attended the focus groups. Most participants reported that they had little knowledge of RRB before attending the intervention and that it had had a positive impact on them, their children and their family.	The findings support the view that there is an unmet need for a parent-mediated intervention focusing on RRB.	
27990716	Angelman syndrome is a rare disorder in which most individuals do not develop speech. Testing of communication ability using traditional neuropsychological measures reveals a performance level at or near the floor of the instrument resulting in an inability to detect change when experimental therapeutics are applied.Nine individuals, with molecularly confirmed AS, ranging in age from 34 to 126 months, and a single healthy control child (age 16 months) were audio and video-recorded while interacting with a licensed speech-language pathologist in an attempt to elicit vocalization and non-verbal communication. Thirty-minute audio recordings were transcribed and categorized per the Stark Assessment of Early Vocal Development-Revised and a phonetic inventory was created. Using video recordings, gestures were classified by function, either behavioral regulation or social interaction and further categorized as deictic or representational (i.e., behavioral regulation) and joint attention or shared engagement (i.e., social interaction).	The range of vocalizations produced by the children with AS was characteristic of children between 0-6 months and none of the children with AS used advanced forms of vocalizations. The mean frequency of reflexive vocalizations, control of phonation and expansion far exceeded the number of uses of canonical syllables, consistant with the characteristics of children around 12 months of age. Most vocalizations were either laughter or isolated vowels, only three children with AS produced consonant-vowel combinations. Children with AS tended to use central and low vowels with few producing high vowels, suggesting the presence of childhood apraxia of speech.	Our results show the utilization of video-recorded behavioral observations provides a feasible and reliable alternative for quantification of communication ability in this patient population and may be employed during future clinical studies of potential therapeutics.	
27990571	This study aimed at conducting a strategic analysis of Tuberculosis prevention and control actions in Brazil and Ethiopia, looking at the potential of directly observed treatment short-course strategy (DOTS) and community DOTS in both countries.Literature review was conducted using PubMed, Medline-Ovid, EMBASE, and SCIELO databases. The reviewed terms were Tuberculosis, prevention and control and Brazil (or Brasil) or Ethiopia (or Etiopia). Study's eligibility included article's title or abstract in English or Portuguese and comprised the following Tuberculosis policy components: management; care; communication, and social mobilization; training and professional development; epidemiological surveillance, and monitoring and evaluation. The study identified, compared, and analyzed the challenges and recommendations reported in the literature.	Although DOTS was not able to address all the difficulties regarding Tuberculosis control and prevention, it contributes to overcome challenges identified in the literature review. Decentralizing DOTS in Ethiopia and implementing DOTS in Brazil were key recommendations to overcome problems of access and treatment default.	DOTS and Community DOTS cannot solve every identified Tuberculosis challenge, but together they complement each other. Both strategies need to be tailored to site's challenges.	
27990102	Although observational data suggest that men's attempts and behavior at quitting smoking are often stimulated during their spouses' pregnancy, few studies have systematically examined this phenomenon.This was a cross-sectional study which examined Chinese men's smoking behaviors during and after their wives' pregnancy. Women who visited community health centers for routine immunization of their children were approached. Information was mainly collected on men's tobacco use before, during and after pregnancy in July to August 2011. Individual and socio-environmental factors were examined by non-conditional logistical regression analysis to find potential reasons behind men's quitting during pregnancy and maintained this change till the post-partum period.	Totally 765 of 811 eligible women (94.3%) completed the interview. Prior to pregnancy, 42.9% of husbands smoked; this decreased to 36.34% during pregnancy, a reduction of 6.53%. Although the rate increased to a higher level (43.79%) after delivery, positive changes in men's smoking behavior were detected. One-third (29.88%) reduced the daily number of cigarettes smoked, and nearly half (45.12%) relocated themselves to smoke when their pregnant wives were nearby. Noticeably, those who quit were most likely occasional smokers (Odds Ratio(OR) = 4.83, 95%CI [2.22, 10.48]), smoking less than ten years (OR = 2.80, 95%CI [1.19, 6.58]), not smoking at home (OR = 4.48, 95%CI [1.94, 10.39]), not smoking for social use (OR = 4.05, 95%CI [1.74, 9.41]), under lower financial pressure after the birth of child (OR = 5.28, 95%CI [2.14, 13.02]) and influenced by family members (OR = 2.82, 95%CI [1.25, 6.38]). However, only 22% of spontaneous cessation was maintained postpartum. Most relapses occurred within 6 months after delivery.	Pregnancy offers an opportunity to decrease smoking amongst Chinese males. Intervention programs involving expectant fathers may be effective to further reduce prevalence of smoking among men in China.	
27989493	There is general consensus that explicit expression of empathy in patient-GP communication is highly valued. Yet, little is known so far about patients' personal experiences with and expectations of empathy. Insight into these experiences and expectations can help to achieve more person-centeredness in GP practice care.Participants were recruited by a press report in local newspapers.	adults, a visit to the GP in the previous year. Exclusion criterion: a formal complaint procedure. Five focus groups were conducted. The discussions were analyzed using constant comparative analysis.	In total 28 participants took part in the focus group interviews. Three themes were identified: (1) Personalized care and enablement when empathy is present; (2) Frustrations when empathy is absent; (3) Potential pitfalls of empathy. Participants indicated that empathy helps build a more personal relationship and makes them feel welcome and at ease. Furthermore, empathy makes them feel supported and enabled. A lack of empathy can result in avoiding a visit to the GP.	Empathy is perceived as an important attribute of patient-GP communication. Its presence results in feelings of satisfaction, relief and trust. Furthermore, it supports patients, resulting in new coping strategies. A lack of empathy causes feelings of frustration and disappointment and can lead to patients avoiding visiting their GP.	More explicit attention should be given to empathy during medical education in general and during vocational GP-training.	
27987519	DiGeorge syndrome is the most common chromosome microdeletion disease. The classical complications include congenital heart disease, hypothyroidism, immunodeficiency, facial abnormalities, and hypocalcemia. According to whether there is an absence or hypoplasia of the thymus, DiGeorge syndrome can be divided into two types, complete DiGeorge syndrome and partial DiGeorge syndrome. The patient was a female born with congenital heart disease, facial abnormalities and cleft palate. When the patient went to school, she had learning difficulty and had problems in communication and personal social behavior. Breath-holding occurred when she was 6 years old. She got infections about 2-3 times a year, which was easy to be cured each time. Chromosome microdeletion test of peripheral blood showed the classical 22q11.2 microdeletion, and no evidence showed that she has thymus absence, thus her disease was diagnosed as partial DiGeorge syndrome. When the patient was 6 years old, the blood routine test showed slight thrombocytopenia, and reexaminations after that indicated the similar result. When 9 years old, she was found with anemia and severe thrombocytopenia. At the age of 10, the patient was admitted to our hospital, complaining of petechia in the body and mucous of mouth. According to the various examinations results, doctors eventually considered the situation as an autoimmune disorder phenomenon. After being treated by pulse-dose methylprednisolone for three days, the bleeding ceased. Then the patient orally took prednisone acetate and pulse-dose cyclophosphamide, however the thrombocyte and hemoglobin levels had not been back to a normal range. But when the dose of prednisone acetate was reduced, the blood platelet count declined again while the hemoglobin kept normal. The long-term follow-up of this case lasted for more than 20 years. Until now, the patient is taking orally prednisone acetate as a maintainance treatment, and the anemia has been improved since, but thrombocytopenia still exists. The mechanism of DiGeorge syndrome in combination with immunodeficiency is still unclear. The most likely reason is that this phenomenon has some relationship with the dysfunction of the thymus and finally had an effect on the function of T cells. The clinical manifestation is always stubborn and need treatment and follow-up visit for a long time.
27987087	Sexualizing media content is prevalent in various media types. Sexualizing media messages and portrayals emphasize unattainable body and appearance ideals as the primary components of sexual desirability. The internalization of these ideals is positively related to self-objectification and sexual body consciousness. In turn, self-objectification and sexual body consciousness affect adolescents' sexual behavior, albeit in opposing directions. While objectifying self-perceptions are linked to higher levels of sexual behavior, body consciousness during physical intimacy is linked to lower levels of sexual behavior. Based on this knowledge, the present three-wave panel study of 824 Belgian, predominant heterosexual adolescents (M age = 15.33; SD = 1.45) proposes a dual-pathway model that investigates two different pathways through which the internalization of media ideals may impact adolescents' sexual behavior. An inhibitory pathway links media internalization to lower levels of sexual behavior through sexual body consciousness, and a supportive pathway links media internalization to higher levels of sexual behavior through self-objectification. Structural equation analyses supported the proposed dual-pathway, showing that the impact of media internalization on adolescents' sexual behavior proceeds through an inhibitory pathway and a supportive pathway. Regarding the supportive pathway, media internalization (W1) positively predicted sexual behavior (W3), through valuing appearance over competence (W2). Regarding the inhibitory pathway, media internalization (W1) positively predicted body surveillance, which, in turn, positively predicted sexual body consciousness (all W2). Sexual body consciousness (W2) is negatively related to sexual behavior (W3). From a sexual developmental perspective, these findings emphasize the importance of guiding adolescents in interpreting and processing sexualizing media messages.
27987063	Children with autism have atypical gaze behavior but it is unknown whether gaze differs during distinct types of reciprocal interactions. Typically developing children (N = 20) and children with autism (N = 20) (4-13 years) made similar amounts of eye contact with an examiner during a conversation. Surprisingly, there was minimal eye contact during interactive play in both groups. Gaze behavior was stable across 8 weeks in children with autism (N = 15). Lastly, gaze behavior during conversation but not play was associated with autism social affect severity scores (ADOS CSS SA) and the Social Responsiveness Scale (SRS-2). Together findings suggests that eye contact in typical and atypical development is influenced by subtle changes in context, which has implications for optimizing assessments of social communication skills.
27987062	This study tested whether including objects perceived as highly interesting by children with autism during a gaze following task would result in increased first fixation durations on the target objects. It has previously been found that autistic children differentiate less between an object another person attends to and unattended objects in terms of this measure. Less differentiation between attended and unattended objects in ASD as compared to control children was found in a baseline condition, but not in the high interest condition. However, typically developing children differentiated less between attended and unattended objects in the high interest condition than in the baseline condition, possibly reflecting reduced influence of gaze cues on object processing when objects themselves are highly interesting.
27986392	Emergent responses of the immune system result from the integration of molecular and cellular networks over time and across multiple organs. High-content and high-throughput analysis technologies, concomitantly with data-driven and mechanistic modeling, hold promise for the systematic interrogation of these complex pathways. However, connecting genetic variation and molecular mechanisms to individual phenotypes and health outcomes has proven elusive. Gaps remain in data, and disagreements persist about the value of mechanistic modeling for immunology. Here, we present the perspectives that emerged from the National Institute of Allergy and Infectious Disease (NIAID) workshop 'Complex Systems Science, Modeling and Immunity' and subsequent discussions regarding the potential synergy of high-throughput data acquisition, data-driven modeling, and mechanistic modeling to define new mechanisms of immunological disease and to accelerate the translation of these insights into therapies.
27986354	to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity.a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes.	one NHS Trust maternity and dietetic services, North East England, UK.	fifteen pregnant women with a booking body mass index ≥30kg/m2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m2.	four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring.	women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.	it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy.	
27984183	Autism spectrum disorder (ASD) is a developmental brain disorder characterized by restricted and repetitive patterns of behavior, social and communication defects, and is commonly associated with difficulties with motor coordination. The etiology of ASD, while mostly idiopathic, has been linked to hereditary factors and teratogens, such as valproic acid (VPA). VPA is used clinically to treat epilepsy, mood disorders, and in the prevention of migraines. The use of VPA during pregnancy significantly increases the risk of ASD in the offspring. Neuropathological studies show decreased cerebellar function in patients with ASD, resulting in gait, balance and coordination impairments. Herein, we have exposed pregnant rats to a repeated oral dose of VPA on embryonic days 10 and 12 and performed a detailed investigation of the structure and function of the cerebellar vermis. We found that throughout all ten lobules of the cerebellar vermis, Purkinje cells were significantly smaller and expression of the calcium binding protein calbindin (CB) was significantly reduced. We also found that dendritic arbors of Purkinje cells were shorter and less complex. Additionally, animals exposed to a repeated dose of VPA performed significantly worse in a number of motor tasks, including beam walking and the rotarod. These results suggest that repeated embryonic exposure to VPA induces significant cerebellar dysfunction and is an effective animal model to study the cerebellar alterations in ASD.
27982701	The Internet offers adolescents unique opportunities to actively shape their own sexual media environment. The aim of this study was to gain in-depth insight into Dutch adolescents' motives, perceptions, and reflections toward Internet use for (a) finding information or advice related to romance and sexuality; (b) searching for and viewing pornographic or erotic material; and (c) romantic and sexual communication (i.e., cybersex/sexting). Data were collected through 12 Web-based focus groups (36 adolescents aged 16 to 19 years, 72.2% girls) and analyzed through three stages of open, axial, and selective coding. The themes that emerged from the focus-group discussions suggest that sex-related Internet use is a complex and ambivalent experience for adolescents. Sex-related Internet use seems an increasingly normalized and common phenomenon. Participants perceived the Internet as a useful source of sexual information, stimulation, inspiration, and communication. Yet they discussed a range of negative consequences and risks related to sex-related online behaviors, particularly concerning pornography's potential to create unrealistic expectations about sex and sexual attractiveness. Participants generally believed they had the necessary skills to navigate through the online sexual landscape in a responsible way, although they believed other young people could be influenced inadvertently and adversely by sex-related online content.
27982699	Cancer survivors narrate their experiences in unique ways, articulating different aspects of the cancer journey. The purpose of this study was to analyze the content of cancer narratives that melanoma survivors share online in order to present the ways that survivors narrate their cancer experience, to identify survivors' motivations for sharing, and to better understand the ways in which survivors are impacted by and cope with the diagnosis and treatment of cancer. The sample consisted of 95 unique melanoma survivor narratives, accessed from the Melanoma Research Foundation in November 2015, that were inductively and deductively coded for key themes and subthemes. Emergent themes described different aspects of the melanoma experience during prediagnosis (identification of self-phenotype, searching for causes, suspicious findings, delay in diagnosis), diagnosis (communication of diagnosis, emotional responses), transition from diagnosis to beginning treatment (second opinion), treatment (positive reframing of attitude, proactive cancer management, side effects), and posttreatment phases (social support, vigilance behaviors posttreatment). Two themes that cut across all phases of the cancer journey included recognizing and dealing with uncertainty and survivors' motive for sharing narrative. These findings have implications for understanding how melanoma survivors may benefit personally from sharing their cancer experience online and for the potential for survivor narratives to motivate behavior change and facilitate coping among readers.
27982508	Although federal mandate prohibits the allocation of solid organs for transplantation based on "accidents of geography," geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from nine partnering organ procurement organizations and interview data from 1339 family decision makers (FDMs) were compared across eight geographically distinct US donor service areas (DSAs). Authorization for organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process, discussion of the least donation-related topics, the highest levels of pressure to donate, and the least comfort with the donation decision. Organ procurement organization region predicted authorization (odds ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters' communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation.
27982460	Vulnerability assessments are a cornerstone of contemporary disaster research. This paper shows how research procedures and the presentation of results of vulnerability assessments are politically filtered. Using data from a study of tsunami risk assessment in Portugal, the paper demonstrates that approaches, measurement instruments, and research procedures for evaluating vulnerability are influenced by institutional preferences, lines of communication, or lack thereof, between stakeholder groups, and available technical expertise. The institutional setting and the pattern of stakeholder interactions form a filter, resulting in a particular conceptualisation of vulnerability, affecting its operationalisation via existing methods and technologies and its institutional embedding. The Portuguese case reveals a conceptualisation that is aligned with perceptions prevalent in national government bureaucracies and the exclusion of local stakeholders owing to selected methodologies and assessment procedures. The decisions taken by actors involved in these areas affect how vulnerability is assessed, and ultimately which vulnerability reduction policies will be recommended in the appraisal.
27982292	Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research .
27982278	This paper explores the role of film and medical-health practices and discourses in the building and legitimating strategies of Franco's fascist regime in Spain. The analysis of five medical-colonial documentary films produced during the 1940s explores the relationship between mass media communication practices and techno-scientific knowledge production, circulation and management processes. These films portray a non-problematic colonial space where social order is articulated through scientific-medical practices and discourses that match the regime's need to consolidate and legitimize itself while asserting the inclusion-exclusion dynamics involved in the definition of social prototypes through processes of medicalization.
27981655	The study of discourses (i.e. verbal interactions or written accounts) is increasingly used in social sciences to gain insight into issues connected to discourse, such as meanings, behaviours and actions. This paper situates discourse analysis in medical education, based on a framework developed in organisational discourse analysis and widely deployed in other social science disciplines.This paper aims to examine the constructs of 'discourse' and 'discourse analysis', and how various understandings of discourse and discourse analysis may play out in empirical and analytical settings, with a particular focus on the field of medical education.	The study is based on a literature analysis of discourse analysis approaches published in Medical Education.	Findings suggest that empirical studies through discourse analysis can be heuristically understood in terms of the links between text, practices and meaning.	Discourse analysis provides a more strongly supported argument when it is possible to defend claims on three levels: practice, using observational data; meaning, using ethnographic data, and text, using conversational and textual data.	
27981150	This article reflects on the development and implementation of a consumer engagement in teaching initiative by the authors. The authors highlight the challenges of engaging undergraduate nursing students on the psychosocial aspects of living with cancer and other chronic illnesses when students have very limited personal and professional experiences to draw on. The authors discuss how they have responded to these challenges by integrating the voices of consumers into their classrooms. Speakers from consumer advocacy organization, Cancer Voices SA, participated in a series of tutorials in a 1st year topic in the Undergraduate Nursing Program at the School of Nursing and Midwifery, Flinders University. Student feedback from the implementation of the initiative indicated that students found consumers' stories and experiences of living with cancer, "moving and powerful" and that they encouraged students to question their assumptions about the psychosocial impacts of cancer on individuals and families. The importance of good communication in reducing patient distress was identified by students as an important element of consumers' experiences of the health care system as was the need for transparency and information sharing between health care providers across the health care system. For many students, consumers' stories and experiences had reinforced students' commitment to studying nursing and pursuing a career in nursing. The article concludes that involving consumers in the education of health care professionals encourages a much deeper understanding of and empathy for how patients experience disease, which is integral to the provision of patient-centered and holistic care.
27977650	The aim of the Te Mata Ira project was to explore Māori views on biobanking and genomic research, and to identify ways to address Māori concerns over the collection and use of human tissue. Key informant interviews and workshops were conducted with Māori to identify Māori views in relation to biobanking and genomic research; and, informed by these views, interviews and workshops were conducted with Māori and non-Māori key informants (Indigenous Advisory Panel (IAP) members and science communities) to explore key issues in relation to Māori participation in biobanking and genomic research. Māori key informants identified the following as key deliberations: (1) the tension for Māori between previous well-publicised negative experiences with genomic research and the potential value for whānau and communities as technologies develop, (2) protection of Māori rights and interest, (3) focus on Māori health priorities, (4) control of samples and data, (5) expectations of consultation and consent and (6) a desire for greater feedback and communication. Māori and non-Māori key informants highlighted the need to enhance levels of Māori participation in the governance of genomic research and biobanking initiatives, and acknowledged that only by increasing the level of transparency and accountability in relation to these activities will Māori communities feel that their whakapapa, rights and interests are being appropriately protected.
27977346	To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people.Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers.	Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole.	To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.	
27977231	The primary objectives of the present study were: (a) to develop the African American Dementia Caregiver Problem Inventory (DCPI-A) that assesses the types and frequency of problems reported by African American dementia caregivers seeking cognitive-behavioral intervention, (b) to evaluate the intercoder reliability of the DCPI-A, and (c) to measure the perceived severity of common problems reported by this caregiver population.The development of the DCPI-A was divided into 3 major steps: (a) creating an initial sample pool of caregiver problems derived from 2 parent randomized clinical trials, (b) formulating a preliminary version of the DCPI-A, and (c) finalizing the development of the DCPI-A that includes 20 problem categories with explicit coding rules, definitions, and illustrative examples.	The most commonly reported caregiver problems fell into 5 major categories: (a) communication problems with care recipients, family members, and/or significant others, (b) problems with socialization, recreation, and personal enhancement time; (c) problems with physical health and health maintenance, (d) problems in managing care recipients' activities of daily living; and (e) problems with care recipients' difficult behaviors. Intercoder reliability was moderately high for both percent agreement and Cronbach's kappa. A similar positive pattern of results was obtained for the analysis of coder drift.	The descriptive analysis of the types and frequency of problems of African American dementia caregivers coupled with the outcomes of the psychometric evaluation bode well for the adoption of the DCPI-A in clinical settings. (PsycINFO Database Record	
27977228	One major source of mental health problems in health professionals are personally demanding encounters at work. Thus, a crucial prevention focus is the development of emotional and social skills necessary to effectively manage interactions with clients, colleagues, and supervisors. The aim of our pre-post intervention field study was to evaluate an employee training in nonviolent communication (NVC) within a public health organization. A training group participated in a 3-day NVC training and completed questionnaires before and 3 months after training. Changes in NVC skills, empathic distress, empathy, and social stressors at work were compared with data from a control group without training. Additionally, we observed NVC-trained participants' communication behavior immediately before and after the intervention. We found a promotion of communication skills in training participants as evidenced by increased emotion verbalization behavior and enhanced use of NVC at work. Empathic distress declined, and an increase of social stressors at work was prevented by enhanced emotion verbalization. The findings demonstrate that NVC training can be an effective means to foster emotional and interpersonal skills and to prevent empathic distress and social stressors at work in individuals working in socioemotionally challenging settings. Possible causal mechanisms explaining the training effects are discussed. (PsycINFO Database Record
27976953	Exergaming is one way to foster social interaction among older adults and to improve their psychosocial well-being, which is a crucial component of healthy aging. This study examined how exergaming affects older adults' social anxiousness, sociability, and loneliness, and it further analyzed differences in the exergaming effects across different types of game play and between different aging cohorts.A 2 (pre-test vs. post-test) × 2 (young-old vs. old-old) × 3 (play alone vs. play with elderly vs. play with youths) mixed quasi-experiment (N = 89) was conducted in Singapore, and three-way MANOVAs were executed.	Results showed a significant three-way interaction effect among exergaming, play type, and age group on older adults' psychosocial well-being. There was a significant decline in social anxiousness and an increase in sociability for young-old participants playing with youths. The sociability improved significantly for old-old participants playing with their peers. There was also a significant decrease in loneliness after exergaming, but little differences were found across different play types or age groups.	The findings made contributions to aging research and shed light on our understanding about how to foster social interaction among older adults and, thus, promote healthy and active aging.	
27976925	Individuals with a genetic predisposition to develop hereditary breast and ovarian cancer (HBOC), but who have not been diagnosed with cancer, are referred to as previvors. Although genetic testing may reduce previvors' worries about whether or not they have a high genetic cancer risk, testing positive produces negative emotions and long-term uncertainty-thus requiring the management of uncertainty. Existing research indicates family, friends, and social support networks are limited in their assistance for previvors' uncertainty management. Therefore, this study examined how health care providers may assist previvors in uncertainty management by asking: What strategies do BRCA-positive previvors enact with their health care providers to help manage their uncertainty about HBOC? Purposive sampling was employed to recruit participants via online social media. The final sample consisted of 34 BRCA-positive women. Interviews revealed four uncertainty management strategies-seeking health care providers as informational sources, seeking health care providers as partners for decision making, seeking health care providers for supportive communication, and seeking referrals from health care providers for social support networks. Findings indicate that health care providers who are knowledgeable about BRCA, provide information, answer questions, check understanding, and provide additional resources assist previvors in managing their uncertainties by distinguishing options and fostering meaning.
27976535	During the clinical encounter, rheumatoid arthritis (RA) patient goals for care often go unexplored. The aim of the present systematic review was to identify needs, goals and expectations of RA patients in order better to guide systematic elicitation of patient goals in clinical encounters.An academic librarian searched MEDLINE, PsychINFO and the Cochrane Library using a specialized algorithm developed to identify articles about patient goals for RA care. Investigators screened search results according to prespecified inclusion criteria and then reviewed included articles and synthesized the evidence qualitatively, utilizing an inductive approach.	A total of 909 titles were retrieved in the literature search, of which 871 were excluded after a title/abstract screen. Of the remaining 38, 22 papers were included in the final review. Investigators identified four major themes in the literature: (a) the bodily experience of RA; (b) achieving normalcy and maintaining wellness; (c) social connectedness and support; and (d) interpersonal and healthcare system interactions.	Patients' goals when receiving care for RA are multidimensional and span several facets of everyday life. Goals for RA care should be collaboratively developed between patients and providers, with particular attention to the patient's life context and priorities.	
27976522	The objective of this study was to investigate the experience of waiting for publicly funded bariatric surgery in an Australian tertiary healthcare setting. Focus groups and individual interviews involving people waiting for or who had undergone publicly funded bariatric surgery were audio-recorded, transcribed and analysed thematically. A total of 11 women and 6 men engaged in one of six focus groups in 2014, and an additional 10 women and 9 men were interviewed in 2015. Mean age was 53 years (range 23-66); mean waiting time was 6 years (range 0-12), and mean time since surgery was 4 years (range 0-11). Waiting was commonly reported as emotionally challenging (e.g. frustrating, depressing, stressful) and often associated with weight gain (despite weight-loss attempts) and deteriorating physical health (e.g. development of new or worsening obesity-related comorbidity or decline in mobility) or psychological health (e.g. development of or worsening depression). Peer support, health and mental health counselling, integrated care and better communication about waitlist position and management (e.g. patient prioritization) were identified support needs. Even if wait times cannot be reduced, better peer and health professional supports, together with better communication from health departments, may improve the experience or outcomes of waiting and confer quality-of-life gains irrespective of weight loss.
27975044	British Columbia falls short in uptake of recommended clinical prevention services, with even lower rates among immigrant populations. This study explored facilitators of and barriers to uptake of clinical prevention services among people from South Asia, who represent 31% of the population in Surrey, British Columbia.We used a qualitative descriptive approach and employed vignettes in a focus group setting to elicit perspectives of South Asian people on accessing clinical prevention services. Participants aged 40 years or more were recruited between October 2014 and February 2015 from health care and community settings such as older-adult housing, day programs and health education events. Letters of introduction to the study were provided in English or Punjabi or both to all potential participants. We conducted qualitative content analysis of the results.	Sixty-two South Asian adults (36 women and 26 men) aged 40-87 years participated in 1 of 8 focus groups in health care or community settings. Facilitators of and barriers to accessing clinical prevention services were noted at the patient, primary care provider and health care system levels. Facilitators at the patient level included taking ownership over one's health, health literacy and respecting the provider's advice; barriers included fear of the diagnosis, death and/or procedures, perceived low risk of disease or utility of the intervention, and side effects of procedures. Provider factors centred on a trust-based patient-provider relationship, strong communication and adequate time during visits. Health care system factors included such facilitators as processes to routinely offer prevention services as part of other health care or social services, systems that encourage prevention-oriented family practice and services at low or no cost to the patient.	Our findings validate previously identified facilitators of and barriers to accessing preventive care for immigrant populations. However, the results suggest that system-level factors influencing the duration of primary care visits may have a more salient impact on uptake of clinical prevention services in this population.	
27975042	Einleitung: Die Durchführung operativer Eingriffe bedarf der rechtsgültigen Aufklärung. Diese hat insbesondere bei geplanten elektiven Eingriffen umfassend und verständlich zu erfolgen. Darüber hinaus hat sich die ärztliche Aufklärung hinsichtlich der Einwilligungserklärung an der juristisch definierten Volljährigkeit zu orientieren. Infolge der großen transnationalen Migrationen gibt es einen Anteil an Patienten, deren Lebensalter unbekannt ist und deren ärztliche Alterseinschätzung das Erreichen des 18. Lebensjahres ausschließlich anhand des äußeren Erscheinungsbildes nur unsicher vermuten lässt. In dieser Situation kann die aus der forensischen Odontostomatologie bekannte Altersschätzung nach den radiologisch bestimmten Entwicklungsphasen der Weisheitszahnentwicklung die juristisch relevante Entscheidung unterstützen, ob die ärztliche Aufklärung einem Heranwachsenden oder Erwachsenen gilt. Da die Beurteilung der Zahnwurzelentwicklungsstadien der Weisheitszähne lediglich einen Zeitkorridor des wahrscheinlichen Lebensalters vorgibt, war es das Anliegen dieser Untersuchung, mit zusätzlichen Parametern der Radiomorphologie des unteren Weisheitszahns die Altersschätzung für das Erreichen des 18. Lebensjahres zu präzisieren.Material und Methoden: Es wurden 1.900 Orthopantomogramme der Kiefer von Patienten mit bekanntem Geburtsdatum untersucht, 5 Orthopantomogramme entsprachen nicht den Einschlusskriterien. Das Lebensalter lag zwischen 15 und 24 Jahren. Es wurde eine Gleichverteilung der Untersuchungsgruppe nach Alter (je Lebensjahr) und Geschlecht bei der Auswahl der Röntgenbilder angestrebt und hinreichend eingehalten. Die Röntgenaufnahmen wurden in den Jahren 2000 bis 2013 in der Abteilung Zahnärztliche Radiologie des Universitätsklinikums Hamburg-Eppendorf oder in einer mund-kiefer-gesichtschirurgischen Praxis in Rostock angefertigt. Eine mehrfache Untersuchung von Patienten (n=1.804, mit 1.895 auswertbaren Orthopantomogrammen) war nicht ausgeschlossen und wurde ggf. bei den Analysen berücksichtigt. An den unteren Weisheitszähnen wurden vier Parameter bestimmt: Nachweis und Ausdehnung des Parodontalspaltes bzw. der periradikulären Sklerose, vertikaler Knochenverlust des Alveolarfortsatzes im Bereich des Zahnes, Durchbruchsstadium des Zahnes in die Mundhöhle und das Wurzelentwicklungsstadium (nach Demirjian). Nach einer Überprüfung, ob bereits die Erhebung eines Parameters ausreicht und hinreichend gute Erkenntnisse über die Volljährigkeit des Untersuchten liefert, wurden die erhobenen Parameter in drei Ansätzen kombiniert; hier wurde das Augenmerk auf unterschiedliche Aspekte, Anwendungen und Aussagen gerichtet. Die erste Analyse betrachtet die Entwicklung der vier Parameter im jeweiligen Patienten über die Zeit. Der zweite Ansatz untersucht die Vorhersage des Lebensalters basierend auf allen vier erhobenen Parametern unter Berücksichtigung der Messwiederholungen mittels eines gemischten linearen Modells, und schließlich wurden ein Gesamtmodell und geschlechtsspezifische Entscheidungsbäume erstellt, mit deren Hilfe bei Vorliegen der vier erhobenen Parameter eine Abschätzung der Wahrscheinlichkeit für das Erreichen bzw. Nicht-Erreichen der Volljährigkeit abgeleitet werden kann.Ergebnisse: Es ließen sich keine signifikanten Unterschiede hinsichtlich der Lokalisation der Weisheitszähne (rechts/links) nachweisen. In den univariaten ROC-AUC-Analysen zeigten die Parameter Zahndurchbruchsstadium, Parodontalspalt und der Knochenschwund des den Weisheitszahn umgebenden Alveolarfortsatzes einen klaren signifikanten prognostischen Wert hinsichtlich der Volljährigkeit in der Untersuchungsgruppe. Das Mineralisationsstadium zeigte sich nicht als geeigneter Parameter zur direkten Bestimmung der Volljährigkeit. Für die Prognose scheinen drei der vier Parameter somit geeignet. Betrachtet man die Entwicklung der Zähne in Individuen anhand der vier Parameter mit wachsendem Lebensalter, konnte eine Veränderung der vier Zahnparameter nachgewiesen werden. Eine Umkehr der Kausalität und die Vorhersage des Lebensalters durch die vier Zahnparameter erscheint jedoch problematisch. Eine erhebliche individuelle Komponente ist bei den untersuchten Personen zu beobachten. Dies liegt u.a. daran, dass eine Entwicklung der Weisheitszähne durchaus vor und nach dem Erreichen des 18. Lebensjahres stattfinden kann. In multivariaten Analysen konnte gezeigt werden, dass durch die Kombination der Parameter mit wesentlich größerer Wahrscheinlichkeit ein Lebensalter von 18 Jahren und höher korrekt vorausgesagt werden kann und somit eine Formel die Kalkulation des Alters ermöglicht. Eine Trennung zwischen Heranwachsenden und Volljährigen ist mit einer Formel jedoch bei weitem nicht so perfekt, wie man es sich eigentlich wünschen würde. Ein Entscheidungsbaum, der nach geeigneten, aufeinander abgestimmten Cut-off-Werten sucht, verspricht eine leicht handhabbare Lösung zu liefern. Der Gesamtentscheidungsbaum hatte eine Fläche unter der Kurve (AUC) von 78%. Die Wahl der Entscheidungsregel setzt jedoch eine Abwägung der Priorisierung von Sensitivität oder Spezifität voraus. Ausgehend von der Annahme, dass beide Kriterien gleichwertig sind, lässt sich eine angestrebte Maximierung der Summe der beiden Maßzahlen anstreben. Die Ableitung eines Entscheidungsbaumes führte bei geeigneter Wahl der Knoten zu einer Sensitivität von 74% und einer Spezifität von 73% (hieraus folgt ein Youden-Index von 47%). Eine vollständig sichere Unterscheidung forensisch relevanter Lebensalter ist mit den vorgestellten Methoden somit nicht zu treffen.Diskussion: In der ärztlichen Aufklärung ist besondere Sorgfalt auf die alters- und entwicklungsangepasste Kommunikation mit dem Patienten zu achten. Ein wesentlicher Pfeiler der juristischen Personeneinschätzung ist das Erreichen der Volljährigkeit, die in Deutschland im Grundsatz mit dem 18. Lebensjahr erreicht ist. Für Personen mit unbekanntem Geburtsdatum können gelegentlich Schwierigkeiten entstehen, auf welcher Grundlage die ärztliche Aufklärung zu erfolgen hat, wenn es sich dem Anschein nach um eine Person im fortgeschrittenen Heranwachsenden-Alter handelt. Unter der Voraussetzung, dass die ärztliche Einschätzung für einen geplanten Eingriff von einem einverständnisfähigen Patienten ausgeht, kann die hier vorgestellte Methode die Bestimmung des 18. Lebensjahres anhand einer radiologischen Standarduntersuchung der Kiefer mit Wahrscheinlichkeit leisten. Die biologische Breite der Weisheitszahnentwicklung liegt jedoch beidseits des 18ten Lebensjahres. Die Fehlerbreite nimmt mit zunehmendem Alter ab, insbesondere bei der Abschätzung der Volljährigkeit von tatsächlich bereits 21-Jährigen, erreicht aber auch hier keine vollständige Sicherheit der Abschätzung der Volljährigkeit. Die vorgelegten Untersuchungsergebnisse sind geeignet, die forensische Altersschätzung in mehreren Bereichen ärztlicher Tätigkeit fundiert zu unterstützen. Die Untersuchungsmethoden sind für den Behandler jedoch ungeeignet, anhand dieser Berechnungen sich der genauen Kenntnis der individuellen Lebensumstände des jeweiligen Patienten zu entziehen. Insbesondere die sorgfältig erhobene Lebensgeschichte und körperliche Untersuchung bleiben vorrangig zu bestimmende Werte der Personeneinschätzung. Die Erweiterung des Berechnungsansatzes durch Anwendung in anderen Populationen ist anzustreben.Introduction: Surgical procedures require informed patient consent, which is mandatory prior to any procedure. These requirements apply in particular to elective surgical procedures. The communication with the patient about the procedure has to be comprehensive and based on mutual understanding. Furthermore, the informed consent has to take into account whether a patient is of legal age. As a result of large-scale migration, there are eventually patients planned for medical procedures, whose chronological age can't be assessed reliably by physical inspection alone. Age determination based on assessing wisdom tooth development stages can be used to help determining whether individuals involved in medical procedures are of legal age, i.e., responsible and accountable. At present, the assessment of wisdom tooth developmental stages barely allows a crude estimate of an individual's age. This study explores possibilities for more precise predictions of the age of individuals with emphasis on the legal age threshold of 18 years. Material and Methods: 1,900 dental orthopantomograms (female 938, male 962, age: 15-24 years), taken between the years 2000 and 2013 for diagnosis and treatment of diseases of the jaws, were evaluated. 1,895 orthopantomograms (female 935, male 960) of 1,804 patients (female 872, male 932) met the inclusion criteria. The archives of the Department of Diagnostic Radiology in Dentistry, University Medical Center Hamburg-Eppendorf, and of an oral and maxillofacial office in Rostock, Germany, were used to collect a sufficient number of radiographs. An effort was made to achieve almost equal distribution of age categories in this study group; 'age' was given on a particular day. The radiological criteria of lower third molar investigation were: presence and extension of periodontal space, alveolar bone loss, emergence of tooth, and stage of tooth mineralization (according to Demirjian). Univariate and multivariate general linear models were calculated. Using hierarchical multivariate analyses a formula was derived quantifying the development of the four parameters of wisdom tooth over time. This model took repeated measurements of the same persons into account and is only applicable when a person is assessed a second time. The second approach investigates a linear regression model in order to predict the age. In a third approach, a classification and regression tree (CART) was developed to derive cut-off values for the four parameters, resulting in a classification with estimates for sensitivity and specificity. Results: No statistically significant differences were found between parameters related to wisdom tooth localization (right or left side). In univariate analyses being of legal age was associated with consecutive stages of wisdom tooth development, the obliteration of the periodontal space, and tooth emergence, as well with alveolar bone loss; no association was found with tooth mineralization. Multivariate models without repeated measurements revealed imprecise estimates because of the unknown individual-related variability. The precision of these models is thus not very good, although it improves with advancing age. When calculating a CART-analysis and a receiver operating characteristics - area under the curve of 78% was achieved; when maximizing both specificity and sensitivity, a Youden's index of 47% was achieved (with 73% specificity and 74% sensitivity). Discussion: This study provides a basis to help determine whether a person is 18 years or older in individuals who are assumed to be between 15 and 24 years old. From repeated measurements, we found a linear effect of age on the four parameters in the individuals. However, this information can't be used for prognosis, because of the large intra-individual variability. Thus, although the development of the four parameters can be estimated over time, a direct conclusion with regard to age can't be drawn from the parameters without previous biographic information about a person. While a single parameter is of limited value for calculating the target age of 18 years, combining several findings, that can be determined on a standard radiography, may potentially be a more reliable diagnostic tool for estimating the target age in both sexes. However, a high degree of precision can't be achieved. The reason for persistent uncertainty lies in the wide chronological range of wisdom tooth development, which stretches from well below to above the 18th life year. The regression approach thus seems not optimal. Although sensitivity and specificity of the CART-model are moderately high, this model is still not reliable as a diagnostic tool. Our findings could have impact, e.g. on elective surgeries for young individuals with unknown biography. However, these results cannot replace social engagement, in particular thorough physical examination of patients and careful registration of their histories. Further studies on the use of this calculation method in different ethnic groups would be desirable.	
27974861	Both human and nonhuman primates use imperative pointing to request a desired object from another individual. Gaze alternation often accompanies such pointing gestures, and in species that have no hands this can in itself function as imperative pointing. Dogs have exceptional skills in communicating with humans. The early development of these skills is suggested to have been facilitated by domestication. Adult wolves socialized with humans can use human-provided information to find food in various situations, but it is unclear whether they would use gaze alternation to show their human partner a target location they cannot reach on their own. In our experiment, we tested wolves and dogs in a task where they could indicate an out-of-reach food location to one of two human partners. One partner reacted in a cooperative way and gave the food hidden in the indicated location to the subject whereas the other responded in a competitive way and ate the food herself. Our results suggest that wolves, as well as dogs, use 'showing' behaviours to indicate a food location to a human partner, and that both can adjust their communication to the cooperativeness of their human partners, showing more indicating signals in the presence of the cooperative partner than in the presence of the competitive one. We conclude that wolves and dogs, both kept in packs under the same conditions, can use humans as cooperative partners, and point imperatively in order to receive a desired out-of-reach object. It seems that intensive socialization with humans enables both wolves and dogs to communicate cooperatively about a food location with humans, most probably relying on skills that evolved to promote social coordination within their packs.
27974571	The uneven distribution of wealth and individual economic capacities are among the main forces, which shape modern societies and arguably bias the emerging social structures. However, the study of correlations between the social network and economic status of individuals is difficult due to the lack of large-scale multimodal data disclosing both the social ties and economic indicators of the same population. Here, we close this gap through the analysis of coupled datasets recording the mobile phone communications and bank transaction history of one million anonymized individuals living in a Latin American country. We show that wealth and debt are unevenly distributed among people in agreement with the Pareto principle; the observed social structure is strongly stratified, with people being better connected to others of their own socioeconomic class rather than to others of different classes; the social network appears to have assortative socioeconomic correlations and tightly connected 'rich clubs'; and that individuals from the same class live closer to each other but commute further if they are wealthier. These results are based on a representative, society-large population, and empirically demonstrate some long-lasting hypotheses on socioeconomic correlations, which potentially lay behind social segregation, and induce differences in human mobility.
27974283	Autism Spectrum Disorders (ASD) are characterized by: social and communication impairments, and by restricted repetitive behaviors. The aim of the present paper is to review abnormalities of oxytocin (OXT) and related congenital malformations in ASD. A literature search was conducted in the PubMed database up to 2016 for articles related to the pathomechanism of ASD, abnormalities of OXT and the OXT polymorphism in ASD. The pathomechanism of ASD has yet to be. The development of ASD is suggested to be related to abnormalities of the oxytocin-arginin-vasopressin system. Previous results suggest that OXT and arginine vasopressin (AVP) may play a role in the etiopathogenesis of ASD.
27974140	Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual needs for connectedness to the land and water, reinforce cultural ties, are economically important and promote overall good health for many. The risk and benefit balance associated with the consumption of traditional Arctic foods is complicated to communicate and has been referred to as the "Arctic Dilemma". This article gives an update on health risk communication in the Arctic region. It briefly summarizes some research on risk communication methodologies as well as approaches to an evaluation of the outcomes of risk communication initiatives. It provides information on specific initiatives in several Arctic countries, and particularly those that were directed at Indigenous populations. This article also summarizes some international versus local risk communication activities and the complexity of developing and delivering messages designed for different audiences. Finally, the potential application of social media for risk communication and a summary of "best practices" based on published literature and a survey of Inuit in a few Arctic countries are described.Several of the risk communication initiatives portrayed in this article indicate that there is only limited awareness of the outcome of risk communication messages. In some cases, risk communication efforts appear to have been successful, at least when effectiveness is measured in an indirect way, for example, by lower contaminant levels. However, due to missing effectiveness evaluation studies, uncertainty remains as to whether a specific risk communication method was successful and could be clearly linked to behavioural changes that resulted in decreased contaminant exposure.	
27969081	The success of the current model of psychiatric care depends on de-stigmatization of mental illnesses, highlighting the need for research on perception of mental illnesses. This study compared the knowledge, attitude and social distancing practices of the young undergraduate sub-population towards mental illness. A cross-sectional survey was done using a pretested questionnaire, which in addition to demographic details assessed exposure, knowledge, attitude and social distancing practices for mental illnesses. The study included (N=289; 55% Females; Average age 20.5 years) responses from nearly equal number of students from medical, psychology and other courses. Medical students chiefly attributed mental illness to biological factors while students from other courses perceived mental illness as God's punishment. More medical students believed that mental illnesses can be successfully treated and appeared to have less social distancing from the mentally ill. Males mostly reported stress and brain damage as the causative factors while females attributed mental illnesses to other biological factors. Males were found to be less afraid of a communication with mentally ill and more open to the possibility of marriage with someone suffering from a mental illness. Exposure to information about mental illness led to no significant variation in the studied variables. Thus, demographic variables and the academic course contribute to variations in knowledge and attitude of young adults. Education received by medical students has a positive impact on their attitudes, highlighting the need of introduction of informative awareness measures among other courses as well.
27969073	Social media activities have gained popularity amongst children and adolescents as a means of communication; giving them the opportunity for independence and social development as well as rendering them vulnerable to negative influences. In traditionally collectivistic societies like India, moving rapidly towards modernisation, not only is there a divide between parents and adolescents over the endorsement of these sites, but also regarding value systems related to autonomy and dating that are facilitated by such activities. We present cases of two adolescent girls to highlight adolescent parent conflict that arises in the age of social media in a cultural context. Further, the cases underscore that value systems and culture play an important role in resolution of such conflict.
27969032	The thought of producing offspring has rooted in Chinese culture after thousands of years of feudal society. Infertility in men would bear significant psychological distress in this social environment.In this study, we explored the association between the outcomes of IVF treatment and anxiety, depression, marital satisfaction, communication, sexual relationship and social support.	A cross-sectional study was conducted. A total of 202 Chinese men who received IVF treatment for the first time were investigated using socio-demographic questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, ENRICH Marital Inventory and Social Support Rating Scale on the first day of IVF treatment.	The overall prevalence of depression and anxiety was 49.1% and 27.2%, respectively. Subjects with IVF failure had higher levels of depression and anxiety, lower levels of "Marital satisfaction", "communication" and "Sexual relationship" and social support. Logistic regression analysis indicated that depression, anxiety, marital satisfaction and sexual relationship were independent predictors of IVF failure.	The prevalence of depression and anxiety in Chinese men undergoing IVF was higher than that in other countries. These findings suggest that anxiety, depression, marital satisfaction, and sexual relationship are important factors leading to IVF failure. Therefore, it is important to provide psychological aid to male patients undergoing IVF treatment.	

27967040	Big Data has become the primary source of understanding the structure and dynamics of the society at large scale. The network of social interactions can be considered as a multiplex, where each layer corresponds to one communication channel and the aggregate of all of them constitutes the entire social network. However, usually one has information only about one of the channels or even a part of it, which should be considered as a subset or sample of the whole. Here we introduce a model based on a natural bilateral communication channel selection mechanism, which for one channel leads to consistent changes in the network properties. For example, while it is expected that the degree distribution of the whole social network has a maximum at a value larger than one, we get a monotonically decreasing distribution as observed in empirical studies of single-channel data. We also find that assortativity may occur or get strengthened due to the sampling method. We analyze the far-reaching consequences of our findings.
27966675	Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels.A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n = 4; control n = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer-supporters. Approximately 15 % of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer-supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer-supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully-powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be largely descriptive and focus on recruitment, attendance and data provision rates. The findings will inform the sample size required for a definitive trial. A detailed process evaluation using qualitative and quantitative methods will be conducted with a variety of stakeholders (i.e. pupils, parents, teachers and peer-supporter trainers) to identify areas of success and necessary improvements prior to proceeding to a definitive trial.	This paper describes the protocol for the PLAN-A feasibility cluster randomised controlled trial which will provide the information necessary to design a fully-powered trial should PLAN-A demonstrate evidence of promise.	ISRCTN12543546.	
27966659	By two-three months, infants show active social expressions during face-to-face interactions. These interactions are important, as they provide the foundation for later emotional regulation and cognition, but little is known about how infant social expressiveness develops. We considered two different accounts. One emphasizes the contingency of parental responsiveness, regardless of its form; the other, the functional architecture account, emphasizes the preparedness of both infants and parents to respond in specific ways to particular forms of behaviour in their partner. We videotaped mother-infant interactions from one to nine weeks, and analysed them with a micro-analytic coding scheme. Infant social expressiveness increased through the nine-week period, particularly after 3 weeks. This development was unrelated to the extent of maternal contingent responsiveness, even to infant social expressions. By contrast, specific forms of response that mothers used preferentially for infant social expressions-mirroring, marking with a smile- predicted the increase in these infant behaviours over time. These results support a functional architecture account of the perceptual and behavioural predispositions of infants and parents that allow young infants to capitalize on relatively limited exposure to specific parental behaviours, in order to develop important social capacities.
27966240	The information needs of patients and carers from culturally and linguistically diverse backgrounds, including from the Chinese community, are not well understood, and there has been no previous synthesis of the literature. We conducted a systematic review of the information needs of the Chinese community affected by cancer.Database, reference list, and author searches were conducted to identify studies reporting information needs of the Chinese community affected by cancer. Data synthesis was undertaken to define categories of information needs.	Initial searches yielded 2558 articles. Out of the 40 full-text articles reviewed, 26 met all the eligibility criteria. Cancer-specific, treatment, and prognosis information were the most frequently reported information needs across the cancer care continuum. Similarly, this information was the most commonly reported information needs across different health systems, migration statuses, and Chinese cultural values. Though less frequent, information needs related to interpersonal/social, financial/legal, and body image/sexuality were also raised. Thirteen studies quantified the prevalence of unmet needs, and the most frequently reported unmet needs were related to health system and information, followed by psychological, patient care and support, physical daily living, and sexuality needs. Language and cultural factors were identified in all studies involving Chinese migrants living in English-speaking countries.	Failing to meet the information needs of the Chinese community members affected by cancer increases the risk for poor cancer outcomes. Potential interventions such as translated resources, bilingual advocates, an online information portal, and communication aids can be helpful in addressing the unmet needs for this community.	
27965883	Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence, and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels. In addition, this paper describes an update that has been made to the protocol for the PLAN-A feasibility cluster randomised controlled trial.A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n = 4; control n = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer supporters. Approximately 15% of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be largely descriptive and focus on recruitment, attendance and data provision rates. The findings will inform the sample size required for a definitive trial. A detailed process evaluation using qualitative and quantitative methods will be conducted with a variety of stakeholders (i.e. pupils, parents, teachers and peer-supporter trainers) to identify areas of success and necessary improvements prior to proceeding to a definitive trial.	The study will provide the information necessary to design a fully powered trial should PLAN-A demonstrate evidence of promise. This paper describes an update to the protocol for the PLAN-A feasibility cluster randomised controlled trial related to the data-linkage component.	ISRCTN12543546.	
27965768	Globally, an estimated 300 million people have asthma, presenting a considerable and increasing burden of disease for healthcare systems, families, and patients themselves. Despite two decades of guidelines, asthma seems to remain not optimally controlled in a substantial proportion of people. The achievement of asthma control is the result of the interaction among different variables concerning the disease pattern and patients' and physicians' knowledge and behavior. It is well known that adherence to treatment increases in parallel to patient education. There is now a growing interest in the use of digital information technologies to promote asthma control and improve outcomes. Mobile health, or mHealth, refers to mobile devices, medical sensors, and communication technologies that can enhance chronic disease care and monitoring. Aim of this review was to evaluate the web resources nowadays available and to analyze the published studies about the web-based instruments used to improve asthma knowledge, control asthma outcomes. In general, studies revealed that the technology is well accepted. Interactive asthma technology may be, in addition, of help in reaching populations difficult to reach, such as inner city populations. The number of tools and apps available continues to increase, and agencies such as the FDA, become involved in their regulation, thus the mHealth landscape will continue to evolve. Although asthma tools and apps have great potential to improve care for asthma, the proof of data reproducibility, the demonstration of effectiveness, and the privacy issues still represent the major technical problems.
27965602	Social networks are often inferred from spatial associations, but other parameters like acoustic communication are likely to play a central role in within group interactions. However, it is currently difficult to determine which individual initiates vocalizations, or who responds to whom. To this aim, we designed a method that allows analyzing group vocal network while controlling for spatial networks, by positioning each group member in equidistant individual cages and analyzing continuous vocal interactions semi-automatically. We applied this method to two types of zebra finch groups, composed of either two adult females and two juveniles, or four young adults (juveniles from the first groups). Young often co-occur in the same social group as adults but are likely to have a different social role, which may be reflected in their vocal interactions. Therefore, we tested the hypothesis that the social structure of the group influences the parameters of the group vocal network. We found that groups including juveniles presented periods with higher level of activity than groups composed of young adults. Using two types of analyses (Markov analysis and cross-correlation), we showed that juveniles as well as adults were more likely to respond to individuals of their own age-class (i.e. to call one after another, in terms of turn-taking, and within a short time-window, in terms of time delay). When juveniles turned into adulthood, they showed adult characteristics of vocal patterns. Together our results suggest that vocal behavior changes during ontogeny, and individuals are more strongly connected with individuals of the same age-class within acoustic networks.
27965533	Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, modulates neuronal excitability by the application of a small electrical current. The low cost and ease of the technique has driven interest in potential clinical applications. However, outcomes are highly sensitive to stimulation parameters, leading to difficulty maximizing the technique's effectiveness. Although reversing the polarity of stimulation often causes opposite effects, this is not always the case. Effective clinical application will require an understanding of how tDCS works; how it modulates a neuron; how it affects the local network; and how it alters inter-network signaling. We have summarized what is known regarding the mechanisms of tDCS from sub-cellular processing to circuit level communication with a particular focus on what can be learned from the polarity specificity of the effects.
27965029	Communication is commonly understood by health professional researchers to consist of relatively isolated exchanges of information. The social and organizational context is given limited credit. This article examines the significance of the environmental complexity of the emergency department (ED) in influencing communication strategies and makes the case for adopting a richer understanding of organizational communication.This study draws on approximately 12 months (1,600 hours) of ethnographic observations, yielding approximately 4,500 interactions across 260 clinicians and staff in the EDs of 2 metropolitan public teaching hospitals in Sydney, Australia.	The study identifies 5 communication competencies of increasing complexity that emergency clinicians need to accomplish. Furthermore, it identifies several factors-hierarchy, formally imposed organizational boundaries and roles, power, and education-that contribute to the collective function of ensuring smooth patient transfer through and out of the ED. These factors are expressed by and shape external communication with clinicians from other hospital departments.	This study shows that handoff of patients from the ED to other hospital departments is a complex communication process that involves more than a series of "checklistable" information exchanges. Clinicians must learn to use both negotiation and persuasion to achieve objectives.	
27960229	Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention.To assess the effects of ATCS for preventing disease and managing long-term conditions on behavioural change, clinical, process, cognitive, patient-centred and adverse outcomes.	We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled-trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015.	Randomised, cluster- and quasi-randomised trials, interrupted time series and controlled before-and-after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible.	We used standard Cochrane methods to select and extract data and to appraise eligible studies.	We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty-one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long-term conditions, and seven studies for appointment reminders. We downgraded our certainty in the evidence primarily because of the risk of bias for many outcomes. We judged the risk of bias arising from allocation processes to be low for just over half the studies and unclear for the remainder. We considered most studies to be at unclear risk of performance or detection bias due to blinding, while only 16% of studies were at low risk. We generally judged the risk of bias due to missing data and selective outcome reporting to be unclear.For preventive healthcare, ATCS (ATCS Plus, IVR, unidirectional) probably increase immunisation uptake in children (risk ratio (RR) 1.25, 95% confidence interval (CI) 1.18 to 1.32; 5 studies, N = 10,454; moderate certainty) and to a lesser extent in adolescents (RR 1.06, 95% CI 1.02 to 1.11; 2 studies, N = 5725; moderate certainty). The effects of ATCS in adults are unclear (RR 2.18, 95% CI 0.53 to 9.02; 2 studies, N = 1743; very low certainty).For screening, multimodal ATCS increase uptake of screening for breast cancer (RR 2.17, 95% CI 1.55 to 3.04; 2 studies, N = 462; high certainty) and colorectal cancer (CRC) (RR 2.19, 95% CI 1.88 to 2.55; 3 studies, N = 1013; high certainty) versus usual care. It may also increase osteoporosis screening. ATCS Plus interventions probably slightly increase cervical cancer screening (moderate certainty), but effects on osteoporosis screening are uncertain. IVR systems probably increase CRC screening at 6 months (RR 1.36, 95% CI 1.25 to 1.48; 2 studies, N = 16,915; moderate certainty) but not at 9 to 12 months, with probably little or no effect of IVR (RR 1.05, 95% CI 0.99, 1.11; 2 studies, 2599 participants; moderate certainty) or unidirectional ATCS on breast cancer screening.Appointment reminders delivered through IVR or unidirectional ATCS may improve attendance rates compared with no calls (low certainty). For long-term management, medication or laboratory test adherence provided the most general evidence across conditions (25 studies, data not combined). Multimodal ATCS versus usual care showed conflicting effects (positive and uncertain) on medication adherence. ATCS Plus probably slightly (versus control; moderate certainty) or probably (versus usual care; moderate certainty) improves medication adherence but may have little effect on adherence to tests (versus control). IVR probably slightly improves medication adherence versus control (moderate certainty). Compared with usual care, IVR probably improves test adherence and slightly increases medication adherence up to six months but has little or no effect at longer time points (moderate certainty). Unidirectional ATCS, compared with control, may have little effect or slightly improve medication adherence (low certainty). The evidence suggested little or no consistent effect of any ATCS type on clinical outcomes (blood pressure control, blood lipids, asthma control, therapeutic coverage) related to adherence, but only a small number of studies contributed clinical outcome data.The above results focus on areas with the most general findings across conditions. In condition-specific areas, the effects of ATCS varied, including by the type of ATCS intervention in use.Multimodal ATCS probably decrease both cancer pain and chronic pain as well as depression (moderate certainty), but other ATCS types were less effective. Depending on the type of intervention, ATCS may have small effects on outcomes for physical activity, weight management, alcohol consumption, and diabetes mellitus. ATCS have little or no effect on outcomes related to heart failure, hypertension, mental health or smoking cessation, and there is insufficient evidence to determine their effects for preventing alcohol/substance misuse or managing illicit drug addiction, asthma, chronic obstructive pulmonary disease, HIV/AIDS, hypercholesterolaemia, obstructive sleep apnoea, spinal cord dysfunction or psychological stress in carers.Only four trials (3%) reported adverse events, and it was unclear whether these were related to the interventions.	ATCS interventions can change patients' health behaviours, improve clinical outcomes and increase healthcare uptake with positive effects in several important areas including immunisation, screening, appointment attendance, and adherence to medications or tests. The decision to integrate ATCS interventions in routine healthcare delivery should reflect variations in the certainty of the evidence available and the size of effects across different conditions, together with the varied nature of ATCS interventions assessed. Future research should investigate both the content of ATCS interventions and the mode of delivery; users' experiences, particularly with regard to acceptability; and clarify which ATCS types are most effective and cost-effective.	
27960129	As the number of personal exposure studies expands and trends favor greater openness and transparency in the health sciences, ethical issues arise around reporting back individual results for contaminants without clear health guidelines. Past research demonstrates that research participants want their results even when the health implications are not known. The experiences of researchers and institutional review boards (IRBs) in studies that have reported personal chemical exposures can provide insights about ethical and practical approaches while also revealing areas of continued uncertainty. We conducted semi-structured interviews with 17 researchers and nine IRB members from seven personal exposure studies across the United States to investigate their experiences and attitudes about the report-back process. Researchers reported multiple benefits of report-back, including increasing retention and recruitment, advancing environmental health literacy, empowering study participants to take actions to reduce exposures, encouraging shifts in government and industry practices, and helping researchers discover sources of exposure through participant consultation. Researchers also reported challenges, including maintaining ongoing contact with participants, adopting protocols for notification of high exposures to chemicals without health guidelines, developing meaningful report-back materials, and resource limitations. IRB members reported concern for potential harm to participants, such as anxiety about personal results and counterproductive behavior changes. In contrast, researchers who have conducted personal report-back in their studies said that participants did not appear overly alarmed and noted that worry can be a positive outcome to motivate action to reduce harmful exposures. While key concerns raised during the early days of report-back have been substantially resolved for scientists with report-back experience, areas of uncertainty remain. These include ethical tensions surrounding the responsibility of researchers to leverage study results and resources to assist participants in policy or community-level actions to reduce chemical exposures, and how to navigate report-back to vulnerable populations.
27960121	Weight-related stereotypes may have a detrimental impact on interactions between midwives and pregnant women with a body mass index (BMI) outside the recommended range of 18-30kg/m2. This paper explores the reciprocal construal of midwives and pregnant women with a raised BMI and considers the clinical implications of these constructs.Ten pregnant women with a BMI≥30kg/m2 and 11 midwives and from an inner city maternity service were recruited.	Participants provided information that allowed for the creation of a repertory grid; generating psychological constructs (perceptions or attitudes) identifying similarities and differences between pregnant women and midwives across a BMI range.	Midwives were extremely conscious of being perceived as judgemental. They construed all pregnant women as anxious and vulnerable, but attributed characteristics such as "less health-conscious" and "complacent" to those with a raised BMI. The ideal pregnant woman and ideal midwife were typically construed as more likely to have a BMI of 18-30kg/m2. Pregnant women with a BMI≤18kg/m2 were construed as lacking warmth. While midwives differentiated between the elements based on role, the pregnant women construed the elements according to their BMI. Similarly, they construed those with a BMI≤18kg/m2 as having an undesirable personality, and acknowledged weight-related stereotypes for those with a raised BMI.	It is possible these constructs impact on the way midwives care for and interact with women. Midwives may be supported through reflective clinical supervision and communication skills training to reduce the perceptions of stigma experienced by women with a raised BMI. It may be beneficial to involve pregnant women with a raised BMI in service development to ensure services meet their needs.	
27959973	The purpose of this study was to explore relationships among adoption, individual, and family variables on false belief performance of children adopted internationally (CAI).Using a quasiexperimental design, thirty-five 4-year-old children adopted from Asian and Eastern European countries before age 2 years were compared with a U.S. group of 33 nonadopted 4-year-old children on a standardized English-language measure, 3 false belief tasks, and a go/no-go inhibition measure.	The adopted group differed significantly from the U.S. nonadopted group in expressive language and false belief performance. For the adopted group, inhibition measures were significantly correlated with core language scores. Core language scores and number of older siblings predicted false belief performance.	Similar to children who are not adopted, language competence and living with older siblings positively influenced social understanding in CAI. Because CAI experience interrupted language acquisition and live with fewer older siblings, they are at risk of having weaker language competence and social understanding in their adopted language. When working with CAI, practitioners should assess social communication, language competence, and inhibition skills. They should assist adoptive families in providing socially mentored opportunities for their children to observe and interact with older children.	
27956757	Building on the influence of presumed influence (IPI) model, this study examines how smoking- related messages on social media influence college students' smoking. We surveyed 366 college students from three U.S. Midwestern universities in 2012 and examined the effects of expression and reception of smoking-related messages on smoking using path analysis. We found that the expression and reception of prosmoking messages not only directly affected smoking but also had indirect effects on smoking through (1) perceived peer expression of prosmoking messages and (2) perceived peer smoking norms. For antismoking messages, only reception had a significant indirect influence on smoking through (1) perceived peer reception of antismoking messages and (2) perceived peer smoking norms. In conclusion, social media function as an effective communication channel for generating, sharing, receiving, and commenting on smoking-related content and are thus influential on college students' smoking.
27956632	Autism spectrum disorder (ASD) is a heterogeneous, highly heritable neurodevelopmental syndrome characterized by impaired social interaction, communication, and repetitive behavior. It is estimated that hundreds of genes contribute to ASD. We asked if genes with a strong effect on survival and fitness contribute to ASD risk. Human orthologs of genes with an essential role in pre- and postnatal development in the mouse [essential genes (EGs)] are enriched for disease genes and under strong purifying selection relative to human orthologs of mouse genes with a known nonlethal phenotype [nonessential genes (NEGs)]. This intolerance to deleterious mutations, commonly observed haploinsufficiency, and the importance of EGs in development suggest a possible cumulative effect of deleterious variants in EGs on complex neurodevelopmental disorders. With a comprehensive catalog of 3,915 mammalian EGs, we provide compelling evidence for a stronger contribution of EGs to ASD risk compared with NEGs. By examining the exonic de novo and inherited variants from 1,781 ASD quartet families, we show a significantly higher burden of damaging mutations in EGs in ASD probands compared with their non-ASD siblings. The analysis of EGs in the developing brain identified clusters of coexpressed EGs implicated in ASD. Finally, we suggest a high-priority list of 29 EGs with potential ASD risk as targets for future functional and behavioral studies. Overall, we show that large-scale studies of gene function in model organisms provide a powerful approach for prioritization of genes and pathogenic variants identified by sequencing studies of human disease.
27956376	As the use of electronic cigarettes (e-cigarettes) rises, social media likely influences public awareness and perception of this emerging tobacco product.This study examined the public conversation on Twitter to determine overarching themes and insights for trending topics from commercial and consumer users.	Text mining uncovered key patterns and important topics for e-cigarettes on Twitter. SAS Text Miner 12.1 software (SAS Institute Inc) was used for descriptive text mining to reveal the primary topics from tweets collected from March 24, 2015, to July 3, 2015, using a Python script in conjunction with Twitter's streaming application programming interface. A total of 18 keywords related to e-cigarettes were used and resulted in a total of 872,544 tweets that were sorted into overarching themes through a text topic node for tweets (126,127) and retweets (114,451) that represented more than 1% of the conversation.	While some of the final themes were marketing-focused, many topics represented diverse proponent and user conversations that included discussion of policies, personal experiences, and the differentiation of e-cigarettes from traditional tobacco, often by pointing to the lack of evidence for the harm or risks of e-cigarettes or taking the position that e-cigarettes should be promoted as smoking cessation devices.	These findings reveal that unique, large-scale public conversations are occurring on Twitter alongside e-cigarette advertising and promotion. Proponents and users are turning to social media to share knowledge, experience, and questions about e-cigarette use. Future research should focus on these unique conversations to understand how they influence attitudes towards and use of e-cigarettes.	
27955953	We present the results of our eighth annual horizon scan of emerging issues likely to affect global biological diversity, the environment, and conservation efforts in the future. The potential effects of these novel issues might not yet be fully recognized or understood by the global conservation community, and the issues can be regarded as both opportunities and risks. A diverse international team with collective expertise in horizon scanning, science communication, and conservation research, practice, and policy reviewed 100 potential issues and identified 15 that qualified as emerging, with potential substantial global effects. These issues include new developments in energy storage and fuel production, sand extraction, potential solutions to combat coral bleaching and invasive marine species, and blockchain technology.
27955934	Facial port-wine stains (PWS) are considered by some an aesthetic skin problem, yet impact on quality of life (QoL) has not been objectively documented.We sought to (1) characterize the effect of PWS on QoL in adults, (2) to identify the clinical and demographic factors that affect QoL, and (3) to compare our results with QoL studies in other skin conditions.	In total, 244 adults with facial PWS completed an online QoL survey, which included the Skindex-29 instrument.	QoL in adults with facial PWS was diminished, especially from an emotional perspective. Variables associated with reduced QoL in all Skindex-29 subdomains included comorbid depression, limited facial mobility, and presence of other skin conditions. Persons with hypertrophy had more emotional and symptomatic impairment. The composite dermatologic-specific QoL scores were similar to those of cutaneous T-cell lymphoma, rosacea, alopecia, and vitiligo.	Selection bias was a potential limitation, as participants were primarily recruited from patient support groups.	Our analysis demonstrates that the presence of a facial PWS has a significant negative impact on QoL. Dermatologists caring for patients with PWS should inquire about QoL, provide appropriate support and resources, and consider QoL when discussing treatment options and obtaining authorization for these procedures.	
27955653	Medical training can be a challenging and emotionally intense period for medical students. However the emotions experienced by medical students in the face of challenging situations and the emotion regulation strategies they use remains relatively unexplored. The aim of the present study was to explore the emotions elicited by memorable incidents reported by medical students and the associated emotion regulation strategies.Peer interviewing was used to collect medical students' memorable incidents. Medical students at both preclinical and clinical stage of medical school were eligible to participate. In total 104 medical students provided memorable incidents. Only 54 narratives included references to emotions and emotion regulation and thus were further analyzed.	The narratives of 47 clinical and 7 preclinical students were further analyzed for their references to emotions and emotion regulation strategies. Forty seven out of 54 incidents described a negative incident associated with negative emotions. The most frequently mentioned emotion was shock and surprise followed by feelings of embarrassment, sadness, anger and tension or anxiety. The most frequent reaction was inaction often associated with emotion regulation strategies such as distraction, focusing on a task, suppression of emotions and reappraisal. When students witnessed mistreatment or disrespect exhibited towards patients, the regulation strategy used involved focusing and comforting the patient.	The present study sheds light on the strategies medical students use to deal with intense negative emotions. The vast majority reported inaction in the face of a challenging situation and the use of more subtle strategies to deal with the emotional impact of the incident.	
27951605	A brain-injured patient's system of relationships is severely disbalanced, and seeks a new equilibrium very much like a kinetic mobile sculpture responding to an impulse. Thus, it is not only the deficits in the patients and their environment and resources that define the success of participation in the process of rehabilitation. Fundamentally, it relies on stable and adjustable relationships as well as trustful communication in the patients' social systems. Negotiating participation is a concerted, interactive adjustment process for everyone involved in dealing with a disruptive life event. Dysfunction in relationships and communication, which frequently is a direct or indirect consequence of brain injuries, puts at risk the sustainability of progress reached during rehabilitation. In this system of relationships often heavily burdened, neuropsychological rehabilitation counseling is needed to secure the long-term success of rehabilitation.

27943551	Despite the adverse effects that treatment for colorectal cancer can have on patients' quality of life and, in particular, their intimate relationships, very little research has been conducted on the psychosocial adjustment for both patients and their partners/spouses.The aim of this systematic review was to examine dyadic studies of adjustment in couples in which one partner has been diagnosed with colorectal cancer.	Pub Med, PsychINFO, MEDLINE, Social Sciences Abstracts (EBSCO), and the Cochrane Library were systematically searched for studies reporting quality of life outcomes for colorectal cancer patients and their partners/spouses. Only studies that included dyads in the sample were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was used to evaluate each study.	A total of 277 studies were identified, of which 9 studies met the inclusion criteria (N = 388 couples). The methodological quality of the studies was high in that they used standardized instruments validated with their samples, conducted dyadic data analyses (when appropriate), and used longitudinal designs. A synthesis of the studies revealed that (1) relationship factors (eg, support, communication, dyadic coping, and relationship satisfaction) affect adjustment to cancer; (2) cancer-related distress impacts each partner's adjustment or the relationship; and (3) gender, role (patient/caregiver), and clinical characteristics (treatment, mental health) can mediate adjustment to cancer.	The quality of the relationship can influence patients' and their partners' adjustment to colorectal cancer. Psychosocial interventions that address relationship issues may be beneficial to couples facing the challenges of colorectal cancer.	
27943007	Doctor-patient communication is the primary way for women diagnosed with breast cancer to learn about their risk of distant recurrence. Yet little is known about how doctors approach these discussions.A weighted random sample of newly diagnosed early-stage breast cancer patients identified through SEER registries of Los Angeles and Georgia (2013-2015) was sent surveys about ~2 months after surgery (Phase 2, N = 3930, RR 68%). We assessed patient perceptions of doctor communication of risk of recurrence (i.e., amount, approach, inquiry about worry). Clinically determined 10-year risk of distant recurrence was established for low and intermediate invasive cancer patients. Women's perceived risk of distant recurrence (0-100%) was categorized into subgroups: overestimation, reasonably accurate, and zero risk. Understanding of risk and patient factors (e.g. health literacy, numeracy, and anxiety/worry) on physician communication outcomes was evaluated in multivariable regression models (analytic sample for substudy = 1295).	About 33% of women reported that doctors discussed risk of recurrence as "quite a bit" or "a lot," while 14% said "not at all." Over half of women reported that doctors used words and numbers to describe risk, while 24% used only words. Overestimators (OR .50, CI 0.31-0.81) or those who perceived zero risk (OR .46, CI 0.29-0.72) more often said that their doctor did not discuss risk. Patients with low numeracy reported less discussion. Over 60% reported that their doctor almost never inquired about worry.	Effective doctor-patient communication is critical to patient understanding of risk of recurrence. Efforts to enhance physicians' ability to engage in individualized communication around risk are needed.	
27942534	Evidence suggests that Internet, mobile, or social media based-interventions may promote obesity-lowering behavior change, which has implications for cancer prevention and control interventions. However, the uptake of communication technologies among low socioeconomic status individuals, who need obesity management strategies most, is unclear.Using the baseline data from a cluster-randomized behavioral intervention trial, we examined the cross-sectional associations of frequency of information and communication technologies (ICT) use among female public housing residents, as well as the variation of ICT use across demographic and health-related variables.	ICT use was common among female public housing residents, with mobile use for calls and texts most prevalent (97% and 84%, respectively). Internet, social media, and health information users tended to be younger compared to non-users. Email, Internet, multimodal, and health information users were more likely to be born in the U.S. and be more highly educated than non-users. Social media and health information users were more likely to be Spanish speakers and people of Hispanic ethnicity compared to non-users, although this was not statistically significant. There were few differences according to obesity or physical activity level.	Our findings of differential socio-demographics between users vs. non-users suggests that future cancer prevention and control interventions among public housing residents should consider selecting ICT that are aligned with the usage patterns of different groups making up the intended audience.	
27941813	Major histocompatibility complex (MHC) genes play a pivotal role in vertebrate self/nonself recognition, parasite resistance and life history decisions. In evolutionary terms, the MHC's exceptional diversity is likely maintained by sexual and pathogen-driven selection. Even though MHC-dependent mating preferences have been confirmed for many species, the sensory and genetic mechanisms underlying mate recognition remain cryptic. Since olfaction is crucial for social communication in vertebrates, variation in chemosensory receptor genes could explain MHC-dependent mating patterns. Here, we investigated whether female mate choice is based on MHC alleles and linked to variation in chemosensory trace amine-associated receptors (TAARs) in the greater sac-winged bat (Saccopteryx bilineata). We sequenced several MHC and TAAR genes and related their variation to mating and paternity data. We found strong evidence for MHC class I-dependent female choice for genetically diverse and dissimilar males. We also detected a significant interaction between mate choice and the female TAAR3 genotype, with TAAR3-heterozygous females being more likely to choose MHC-diverse males. These results suggest that TAARs and olfactory cues may be key mediators in mammalian MHC-dependent mate choice. Our study may help identify the ligands involved in the chemical communication between potential mates.
27940872	Juvenile songbirds learn vocal communication from adult tutors of the same species but not from adults of other species. How species-specific learning emerges from the basic features of song prosody remains unknown. In the zebra finch auditory cortex, we discovered a class of neurons that register the silent temporal gaps between song syllables and are distinct from neurons encoding syllable morphology. Behavioral learning and neuronal coding of temporal gap structure resisted song tutoring from other species: Zebra finches fostered by Bengalese finch parents learned Bengalese finch song morphology transposed onto zebra finch temporal gaps. During the vocal learning period, temporal gap neurons fired selectively to zebra finch song. The innate temporal coding of intersyllable silent gaps suggests a neuronal barcode for conspecific vocal learning and social communication in acoustically diverse environments.
27940795	Today's children and adolescents are immersed in both traditional and new forms of digital media. Research on traditional media, such as television, has identified health concerns and negative outcomes that correlate with the duration and content of viewing. Over the past decade, the use of digital media, including interactive and social media, has grown, and research evidence suggests that these newer media offer both benefits and risks to the health of children and teenagers. Evidence-based benefits identified from the use of digital and social media include early learning, exposure to new ideas and knowledge, increased opportunities for social contact and support, and new opportunities to access health promotion messages and information. Risks of such media include negative health effects on sleep, attention, and learning; a higher incidence of obesity and depression; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confidentiality. This technical report reviews the literature regarding these opportunities and risks, framed around clinical questions, for children from birth to adulthood. To promote health and wellness in children and adolescents, it is important to maintain adequate physical activity, healthy nutrition, good sleep hygiene, and a nurturing social environment. A healthy Family Media Use Plan (www.healthychildren.org/MediaUsePlan) that is individualized for a specific child, teenager, or family can identify an appropriate balance between screen time/online time and other activities, set boundaries for accessing content, guide displays of personal information, encourage age-appropriate critical thinking and digital literacy, and support open family communication and implementation of consistent rules about media use.
27940794	This policy statement focuses on children and adolescents 5 through 18 years of age. Research suggests both benefits and risks of media use for the health of children and teenagers. Benefits include exposure to new ideas and knowledge acquisition, increased opportunities for social contact and support, and new opportunities to access health-promotion messages and information. Risks include negative health effects on weight and sleep; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confidentiality. Parents face challenges in monitoring their children's and their own media use and in serving as positive role models. In this new era, evidence regarding healthy media use does not support a one-size-fits-all approach. Parents and pediatricians can work together to develop a Family Media Use Plan (www.healthychildren.org/MediaUsePlan) that considers their children's developmental stages to individualize an appropriate balance for media time and consistent rules about media use, to mentor their children, to set boundaries for accessing content and displaying personal information, and to implement open family communication about media.
27940704	To investigate the association of gestational age and mode of birth with early child development.Population-based record linkage cohort study was conducted among 153 730 live-born infants of ≥32 weeks' gestation with developmental assessments at school age, in New South Wales, Australia, 2002 to 2007. Children were assessed in 5 domains: physical health and well-being, language and cognition, social competence, emotional maturity, and general knowledge and communication. Children scoring in the bottom 10% of national domains were considered developmentally vulnerable, and children developmentally vulnerable for ≥2 domains were classified as developmentally high risk (DHR), the primary outcome. Robust multivariable Poisson models were used to obtain individual and combined adjusted relative risks (aRRs) of gestational age and mode of birth for DHR children.	Overall, 9.6% of children were DHR. The aRR (95% confidence interval) of being DHR increased with decreasing gestational age (referent: 40 weeks); 32 to 33 weeks 1.25 (1.08-1.44), 34 to 36 weeks 1.26 (1.18-1.34), 37 weeks 1.17 (1.10-1.25), 38 weeks 1.06 (1.01-1.10), 39 weeks 0.98 (0.94-1.02), ≥41 weeks 0.99 (0.94-1.03), and for labor induction or prelabor cesarean delivery (planned birth; referent: vaginal birth after spontaneous labor), 1.07 (1.04-1.11). The combined aRR for planned birth was 1.26 (1.18-1.34) at 37 weeks and 1.13 (1.08-1.19) at 38 weeks.	Early (at <39 weeks) planned birth is associated with an elevated risk of poor child development at school age. The timing of planned birth is modifiable, and strategies to inform more judicious decision-making are needed to ensure optimal child health and development.	

27940151	Previous investigations of vocal expressions of emotion have identified acoustic and perceptual distinctions between expressions of different emotion categories, and between spontaneous and volitional (or acted) variants of a given category. Recent work on laughter has identified relationships between acoustic properties of laughs and their perceived affective properties (arousal and valence) that are similar across spontaneous and volitional types (Bryant & Aktipis, 2014; Lavan et al., 2016). In the current study, we explored the neural correlates of such relationships by measuring modulations of the BOLD response in the presence of itemwise variability in the subjective affective properties of spontaneous and volitional laughter. Across all laughs, and within spontaneous and volitional sets, we consistently observed linear increases in the response of bilateral auditory cortices (including Heschl's gyrus and superior temporal gyrus [STG]) associated with higher ratings of perceived arousal, valence and authenticity. Areas in the anterior medial prefrontal cortex (amPFC) showed negative linear correlations with valence and authenticity ratings across the full set of spontaneous and volitional laughs; in line with previous research (McGettigan et al., 2015; Szameitat et al., 2010), we suggest that this reflects increased engagement of these regions in response to laughter of greater social ambiguity. Strikingly, an investigation of higher-order relationships between the entire laughter set and the neural response revealed a positive quadratic profile of the BOLD response in right-dominant STG (extending onto the dorsal bank of the STS), where this region responded most strongly to laughs rated at the extremes of the authenticity scale. While previous studies claimed a role for right STG in bipolar representation of emotional valence, we instead argue that this may in fact exhibit a relatively categorical response to emotional signals, whether positive or negative.
27938866	To explore health care providers' experiences of providing care to immigrant women seeking abortion care.A qualitative study including interviews with ten midwives and three medical doctors at four abortion clinics in the Stockholm area. Interviews were analysed using thematic analysis.	Initially, health care providers were reluctant to make statements concerning the specific needs among immigrant women. Yet, the health care providers sometimes found it challenging to deal with the specific needs among immigrant, mostly non-European, women. Three themes were identified: (1) Reluctance to acknowledge specific needs among immigrant women; (2) Striving to provide contraceptive counselling to immigrant women; (3) Organizational barriers hindering patient-centred abortion care to immigrant women CONCLUSIONS: Health care providers' experiences of the specific needs among non-European, immigrant women are not openly discussed, although they are acknowledged. To achieve equitable access to sexual and reproductive health (SRH), health care providers need to be better equipped when encountering immigrant women in abortion care, especially regarding contraceptive counselling. The potential impact of patients' knowledge, norms and values is not adequately dealt with in the clinical encounter. Moreover, to provide patient-centred care, it is crucial to understand how to develop and implement SRH care that ensures equal access to high-quality care.	

27938305	The goal of this study is to explore motivating factors for recovering from methamphetamine abuse. The source of data was 202 anonymous letters and stories submitted to an online support platform for methamphetamine users. Qualitative data were analyzed in Dedoose software using grounded theory methodology. Ten primary motivating factors for recovering from methamphetamine abuse were identified and mapped onto four constructs from the Health Belief Model: (1) perceived susceptibility (learning from others and learning from self); (2) perceived severity (fear of death and declining health); (3) perceived benefits (reconnecting with family, reconnecting with society, and recovering self-esteem); and (4) cues to action (hitting rock bottom, finding God, and becoming pregnant). By using data from an online support group and categorizing emerging themes within a theoretical framework, findings from this study provide a comprehensive understanding of factors involved in recovery from methamphetamine abuse and offer further insights in developing theoretically informed interventions for methamphetamine users. This study suggests the utility of online platforms for obtaining anonymous but unique experiences about drug abuse and recovery. Findings may benefit healthcare professionals, counselors, and researchers by helping to develop theoretically informed interventions for methamphetamine abuse.
27937437	The diagnosis and treatment of cancer is a life-altering experience that signals profound changes in a person's life. However, most people do not experience cancer in isolation or cope alone. Despite the fact that partners (i.e. spouses, significant others) provide emotional support and play a critical role in caregiving, cancer exacts a heavy toll on them and challenges their relationship with the patient by altering established communication patterns and roles. In recognition of this, a burgeoning literature involving couple-based interventions to improve patient and partner quality of life and adaptation has emerged. However, questions remain regarding how we can improve these interventions to exact greater impact on patient and partner outcomes.A narrative review of the literature on couples' communication processes in cancer was conducted in order to describe knowledge gaps and directions for future research.	Most couple-based interventions have included a communication skills training component because communication is an important process through which couples make sense of cancer, engage in social support, negotiate role changes and coordinate coping responses. However, scholars still know very little about what they should instruct couples to talk about, how often they should talk and when talking (or not talking) is beneficial (and for whom - the patient, partner, or both).	In order push this field forward, we need to develop a more nuanced view of couples' communication that acknowledges that there are multiple ways to talk, different aspects of the cancer experience to talk about, and preexisting communication patterns and preferences for different couples that may influence the utility of talk. Interventions that replace the unilateral and generic prescription to talk openly about cancer with targeted questions that prompt reflection on couples' unique strengths, preexisting communication patterns and support resources may thus help bolster the impact of couple-based interventions on patient and partner quality of life.	
27936954	The addition of social (pragmatic) communication disorder [S(P)CD] to the DSM-5 taxonomy has left clinicians and researchers searching for appropriate diagnostic measures. Factor analysis procedures examined the extent to which S(P)CD symptoms presented within the Children's Communication Checklist-Second Edition (CCC-2) represented a unique construct and whether these factors were influenced by children's sex. Parents of 208 children (males = 125 and females = 83) from a community-based sample completed the CCC-2. Two pragmatic scores from the CCC-2 were analysed as follows: the social interaction difference index (SIDI) and a pragmatic composite from the original CCC (PC-5). Factor analysis failed to find a unique factor structure for either pragmatic composite. Analyses uncovered different factor structures for the CCC-2 SIDI and PC-5 composites and for boys and girls. S(P)CD represents a complex combination of symptoms that are poorly differentiated from other language and socioemotional behavioural difficulties.
27936876	Information and communication technologies (ICT) developers, together with dementia experts have created several technological solutions to improve and facilitate social health and social participation and quality of life of older adults living with dementia. However, there is a need to carry out a systematic literature review that focuses on the validity and efficacy of these new technologies assessing their utility to promote 'social health' and 'active ageing' in people with dementia.Searches in electronic databases identified 3824 articles of which 6 met the inclusion criteria and were coded according to their methodological approach, sample sizes, type of outcomes and results.	Six papers were identified reporting the use of 10 different interventions with people with dementia. Qualitative studies (four) showed a benefit of the use of technologies to foster social participation in people with dementia. At the same time, barriers to a widespread use of these technologies in this population were identified. A quantitative study and a mixed-method study with quantitative outcomes showed that ICT-based interventions promote more social behaviours than non-technology-based interventions.	In the last years, several technological devices for living independently and fostering social health and social participation in people with dementia have been developed. However, specific outcome measures to assess social health and social participation are needed. Even though the analysed studies provided some evidence-base for the use of technology in this field, there is an urge to develop high quality studies and specific outcome measures.	
27936372	The current study is one of the first to examine how self-reported alcohol consumption, friends' perceived alcohol consumption, and the perceived number of friends sharing alcohol references on social networking sites (SNS) is associated with adolescents' sharing of alcohol references on SNS.A cross-sectional paper-and-pencil survey was administered among 3,172 adolescents (n = 3,133 used for analyses, mean age = 17.16 years, SD = 0.93; 50.7% male). Structural equation modeling was used to test the hypotheses.	First, the results indicated that both self-reported drinking behavior and the perceived number of friends sharing alcohol references were related to sharing alcohol references on SNS, but the perceived number of friends sharing alcohol references was a stronger predictor than self-reported drinking behavior. Friends' perceived drinking behavior was not a significant predictor. In the second place, self-reported drinking behavior was a stronger predictor for girls than for boys, whereas the perceived number of friends sharing alcohol references was a stronger predictor for boys than for girls.	Adolescents' alcohol-related self-representation is in line with their alcohol consumption and is also strongly related to what their friends are sharing. Thus, adolescents appear to communicate authentically about their drinking experiences, but the decision to do so is heavily influenced by the prevailing social norm regarding alcohol-related communication.	
27936255	Introduction Nurses' notes are used primarily as a communication tool between nurses, doctors and member of the professional team to ensure continuity of patient care. They contain life-history of individuals with mental health disorders. This nurses' communication tool describes the patient care during hospitalization in acute psychiatric ward. In fact, these observations contained in the progress notes represent more than a simple picture of mental illness. They always tell a story constructed by socio-cultural norms.Objectives The purpose of this article is to demonstrate the value of these narratives data as a comprehensive source of information to understand the experience of mental health following the deinstitutionalization project.Results The use of nursing progress notes of the Psychiatric Department allows, among other things, a better understanding of the life course of some hospitalized patients. The narrative data in those documents enhance the intersection between personal experiences and social, institutional and professional structures. These primary sources offer a multitude of possibilities in mental health research and can be examined from different angles of analysis. They deserve to be exploited in future research project to increase our understanding of mental illness.
27935147	First Nations people with cancer in Canada confront several critical inequities in physical and psychosocial domains. First Nations women are at a particular disadvantage as they are disproportionately affected by social determinants of health, but how they navigate these challenges within their communities is poorly understood.Our study explores survivorship experiences of First Nations women with cancer and their caregivers. Drawing from a larger data set on survivorship, we identify several major barriers to cancer communication and support in First Nations communities.	Our team conducted a participatory, arts-based study using several data collection methods (interviews, sharing sessions, photovoice, and other creative activities) with 43 participants (24 cancer survivors and 19 caregivers) from four First Nations communities in Canada.	Two major themes have emerged out of our data analyses: (1) suffering without support leads to cycles of silence and (2) community-based supports can disrupt these cycles. We identified several social, historical, and institutional barriers to speaking about cancer and finding/providing support; however, communities met the challenge of silence through voluntary and unsolicited provision of support.	Widespread silence around cancer reflects both the limited access First Nations people have to formal, supportive programs and services, as well as the creative ways they provide emotional, social, and financial support within their informal networks. Beyond the support of their communities, they also required institutional provision of care that is culturally safe, addressing the colonial impacts on cancer communication and the disproportionate burdens of disease in First Nations communities.	
27933005	A key driver of brain evolution in primates and humans is the cognitive demands arising from managing social relationships. In primates, grooming plays a key role in maintaining these relationships, but the time that can be devoted to grooming is inherently limited. Communication may act as an additional, more time-efficient bonding mechanism to grooming, but how patterns of communication are related to patterns of sociality is still poorly understood. We used social network analysis to examine the associations between close proximity (duration of time spent within 10 m per hour spent in the same party), grooming, vocal communication, and gestural communication (duration of time and frequency of behavior per hour spent within 10 m) in wild chimpanzees. This study examined hypotheses formulated a priori and the results were not corrected for multiple testing. Chimpanzees had differentiated social relationships, with focal chimpanzees maintaining some level of proximity to almost all group members, but directing gestures at and grooming with a smaller number of preferred social partners. Pairs of chimpanzees that had high levels of close proximity had higher rates of grooming. Importantly, higher rates of gestural communication were also positively associated with levels of proximity, and specifically gestures associated with affiliation (greeting, gesture to mutually groom) were related to proximity. Synchronized low-intensity pant-hoots were also positively related to proximity in pairs of chimpanzees. Further, there were differences in the size of individual chimpanzees' proximity networks-the number of social relationships they maintained with others. Focal chimpanzees with larger proximity networks had a higher rate of both synchronized low- intensity pant-hoots and synchronized high-intensity pant-hoots. These results suggest that in addition to grooming, both gestures and synchronized vocalizations may play key roles in allowing chimpanzees to manage a large and differentiated set of social relationships. Gestures may be important in reducing the aggression arising from being in close proximity to others, allowing for proximity to be maintained for longer and facilitating grooming. Vocalizations may allow chimpanzees to communicate with a larger number of recipients than gestures and the synchronized nature of the pant-hoot calls may facilitate social bonding of more numerous social relationships. As group sizes increased through human evolution, both gestures and synchronized vocalizations may have played important roles in bonding social relationships in a more time-efficient manner than grooming.
27932316	There is increasing interest in Pinterest as a method of disseminating health information. However, it is unclear whether the health information promoted on Pinterest is evidence-based or incorporates behavior change theory.The objective of the study was to determine the presence of health behavior theory (HBT) constructs in pins found on Pinterest and assess the relationship between various pin characteristics and the likelihood of inclusion of HBT.	A content analysis was conducted on pins collected from Pinterest identified with the search terms "nutrition infographic" and "healthy eating infographic." The coding rubric included HBT constructs, pin characteristics, and visual communication tools. Each HBT construct was coded as present or not present (yes=1, no=0). A total theory score was calculated by summing the values for each of the 9 constructs (range 0-9). Adjusted regression analysis was used to identify factors associated with the inclusion of health behavior change theory in pins (P<.05).	The mean total theory score was 2.03 (SD 1.2). Perceived benefits were present most often (170/236, 72%), followed by behavioral capability (123/238, 51.7%) and perceived severity (79/236, 33.5%). The construct that appeared the least was self-regulation/self-control (2/237, 0.8%). Pin characteristics associated with the inclusion of HBT included a large amount of text (P=.01), photographs of real people (P=.001), cartoon pictures of food (P=.01), and the presence of references (P=.001). The number of repins (P=.04), likes (P=.01), and comments (P=.01) were positively associated with the inclusion of HBT.	These findings suggest that current Pinterest infographics targeting healthy eating contain few HBT elements. Health professionals and organizations should create and disseminate infographics that contain more elements of HBT to better influence healthy eating behavior. This may be accomplished by creating pins that use both text and images of people and food in order to portray elements of HBT and convey nutritional information.	
27932233	Schizophrenia typically onsets after puberty but is often preceded by observable childhood neurodevelopmental impairments. Whether these childhood antecedents index genetic liability is unknown. We used polygenic risk scores derived from a patient discovery sample as indicators of the genetic liability of schizophrenia. Our aim was to identify the early childhood manifestations of this liability in a UK population-based cohort.The study sample was the Avon Longitudinal Study of Parents and Children, a prospective population-based cohort study of 14701 children. Data were primarily analysed with regression-based analyses. Polygenic risk score were generated from a published Psychiatric Genomics Consortium genome-wide association study. Outcomes were childhood (age 4-9 years) dimensional measures in four developmental domains with 12 indicators: cognition and learning, social and communication, emotion and mood regulation, and behaviour (n=5100-6952).	At age 7-9 years, schizophrenia polygenic risk scores showed associations with lower performance intelligence quotient (β -0·056, OR 1·13 [95% CI 1·04-1·23]), poorer social understanding (β -0·032, OR 1·08 [1·00-1·17]), worse language intelligibility and fluency (β -0·032, OR 1·10 [1·02-1·20]), more irritability (β 0·032, OR 1·07 [1·01-1·14]), and more headstrong behaviour (β 0·031, OR 1·08 [1·02-1·15]). The schizophrenia polygenic risk scores also predicted social and behavioural impairments as early as age 4 years.	Childhood cognitive, social, behavioural, and emotional impairments, implicated as antecedents to schizophrenia in high-risk, developmental studies, might represent early manifestations of genetic liability.	Medical Research Council.	
27931254	Regular physical activity has important health benefits for children with type 1 diabetes mellitus (T1DM), yet children and their parents face barriers to participation such as lack of self-efficacy or concerns around hypoglycaemia. Multimedia interventions are useful for educating children about their health and demonstrate potential to improve children's health-related self-efficacy, but few paediatric clinics offer web-based resources as part of routine care. The Steps to Active Kids with Diabetes (STAK-D) programme is an online intervention grounded in psychological theory (social cognitive theory) and informed by extensive preliminary research. The aim of the programme is to encourage and support safe engagement with physical activity for children with T1DM. The aim of this research is to explore the feasibility of delivering the STAK-D programme to children aged 9-12 years with T1DM, and to assess the feasibility of further research to demonstrate its clinical and cost-effectiveness.Up to 50 children aged 9-12 years with T1DM and their parents will be recruited from two paediatric diabetes clinics in the UK. Child-parent dyads randomised to the intervention group will have access to the intervention website (STAK-D) and a wrist-worn activity monitor for 6 months. The feasibility of intervention and further research will be assessed by rate of recruitment, adherence, retention, data completion and adverse events. Qualitative interviews will be undertaken with a subsample of children and parents (up to 25 dyads) and health care professionals (up to 10). Health outcomes and the feasibility of outcome measurement tools will be assessed. These include self-efficacy (CSAPPA), objective physical activity, self-reported physical activity (PAQ), fear of hypoglycaemia (CHFS; PHFS), glycaemic control (HbA1c), insulin dose, Body Mass Index (BMI), health-related quality of life (CHU9D; CHQ-PF28), health service use and patient-clinician communication. Assessments will be taken at baseline (T0), 8 weeks (T1) and at 6-month follow-up (T2).	The goal of this feasibility trial is to assess the delivery of STAK-D to promote physical activity among children with T1DM, and to assess the potential for further, definitive research to demonstrate its effectiveness. Results will provide the information necessary to design a larger randomised controlled trial and maximise the recruitment rate, intervention delivery and trial retention.	ISRCTN, ISRCTN48994721 . Registered on 28 October 2016.	
27931252	Patient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate this clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants.This is a cluster trial, embedded within a host trial ('EQUIP') recruiting service users diagnosed with severe mental illness. The intervention was informed by a systematic review, a qualitative study, social comparison theory and a stakeholder workshop including service users and carers. Adopting Participatory Design approaches, we co-designed the recruitment intervention with PPIR partners using a leaflet to advertise the PPIR in EQUIP and sent potential participants invitations with the leaflet (intervention group) or not (control group). Primary outcome was the proportion of patients enrolled in EQUIP. Secondary outcomes included the proportions of patients who positively responded to the trial invitation.	Thirty-four community mental health teams were randomised and 8182 service users invited. For the primary outcome, 4% of patients in the PPIR group were enrolled versus 5.3% of the control group. The intervention was not effective for improving recruitment rates (adjusted OR = 0.75, 95% CI = 0.53 to 1.07, p = 0.113). For the secondary outcome of positive response, the intervention was not effective, with 7.3% of potential participants in the intervention group responding positively versus 7.9% of the control group (adjusted OR = 0.74, 95% CI = 0.53 to 1.04, p = 0.082). We did not find a positive impact of directly advertising PPIR on any other outcomes.	To our knowledge, this is the largest ever embedded trial to evaluate a recruitment or PPIR intervention. Advertising PPIR did not improve enrolment rates or any other outcome. It is possible that rather than advertising PPIR being the means to improve recruitment, PPIR may have an alternative impact on trials by making them more attractive, acceptable and patient-centred. We discuss potential reasons for our findings and implications for recruitment practice and research.	ISRCTN, ISRCTN16488358 . Registered on 14 May 2014. Study Within A Trial, SWAT-26 . Registered on 21 January 2016.	
27931210	Despite evidence that connecting people to relevant wellbeing-related resources brings therapeutic benefit, there is limited understanding, in the context of mental health recovery, of the potential value and contribution of pet ownership to personal support networks for self-management. This study aimed to explore the role of pets in the support and management activities in the personal networks of people with long-term mental health problems.Semi-structured interviews centred on 'ego' network mapping were conducted in two locations (in the North West and in the South of England) with 54 participants with a diagnosis of a long-term mental health problem. Interviews explored the day-to-day experience of living with a mental illness, informed by the notion of illness work undertaken by social network members within personal networks. Narratives were elicited that explored the relationship, value, utility and meaning of pets in the context of the provision of social support and management provided by other network members. Interviews were recorded, then transcribed verbatim before being analysed using a framework analysis.	The majority of pets were placed in the central, most valued circle of support within the network diagrams. Pets were implicated in relational work through the provision of secure and intimate relationships not available elsewhere. Pets constituted a valuable source of illness work in managing feelings through distraction from symptoms and upsetting experiences, and provided a form of encouragement for activity. Pets were of enhanced salience where relationships with other network members were limited or difficult. Despite these benefits, pets were unanimously neither considered nor incorporated into individual mental health care plans.	Drawing on a conceptual framework built on Corbin and Strauss's notion of illness 'work' and notions of a personal workforce of support undertaken within whole networks of individuals, this study contributes to our understanding of the role of pets in the daily management of long-term mental health problems. Pets should be considered a main rather than a marginal source of support in the management of long-term mental health problems, and this has implications for the planning and delivery of mental health services.	
27931048	Introduction Quantify quality of life (QoL) outcomes in gastroschisis children is little assessed. The primary objective was to describe the long-term outcome of newborns with gastroschisis treated in three tertiary care hospitals of France in terms of neurodevelopment and QoL. Materials and Methods The study reported was a cross-sectional, descriptive multicentric retrospective study assessing the outcome of newborns with gastroschisis, born between January 1, 2009, and December 31, 2014, treated at two large and French level III neonatal intensive care units. Long-term outcome data were assessed by questionnaires sent to the infants' parents. Questionnaires explored global health, neurological development, and quality of life (overall assessment including socio-economic and medical), Age & Stages Questionnaire, infants' quality of life (KIDSCREEN), and quality of parents' life (General Questionnaire Short Form-36). Results In this study, 50% of the survivor's families answered the assessment form (n = 33). The average follow-up age was 40 months, ranging from 8 months to 6 years. Cases of simple gastroschisis more often had a normal score for "communication" (p = 0.033), while patients who received morphine for a longer duration had significantly lower scores for the items "communication" and "problem resolving" (p = 0.024 and p = 0.011, respectively). Children's QoL was significantly lower for patients with gestational age younger than 36 weeks (p = 0.023) and for patients born following "fetal cause delivery" (p = 0.022). Parents had a significantly higher physical composite score if their child underwent primary closure (p = 0.012). Conclusion Our analyses confirm the idea that cases of complex gastroschisis and preterm delivery may lead to poorer outcome. Such hindsight (40 months in mean) allowed for an interesting assessment of development long after the patient's initial hospitalization and to confirm these results, a standardized neuropsychological evaluation of patients should be done when at least 6 years old. An accurate assessment of the social environment and its impact on the development and QoL of children will be fundamental to avoid selection bias.
27930606	As test and treat rolls out, effective interventions are needed to address the determinants of outcomes across the HIV treatment continuum and ensure that people infected with HIV are promptly tested, initiate treatment early, adhere to treatment, and are virally suppressed. Communication approaches offer viable options for promoting relevant behaviors across the continuum.This article introduces a conceptual framework, which can guide the development of effective health communication interventions and activities that aim to impact behaviors across the HIV treatment continuum in low- and medium-income countries. The framework includes HIV testing and counseling, linkage to care, retention in pre-antiretroviral therapy and antiretroviral therapy initiation in one single-stage linkage to care and treatment, and adherence for viral suppression. The determinants of behaviors vary across the continuum and include both facilitators and barriers with communication interventions designed to focus on specific determinants presented in the model. At each stage, relevant determinants occur at the various levels of the social-ecological model: intrapersonal, interpersonal, health services, community, and policy. Effective health communication interventions have mainly relied on mHealth, interpersonal communication through service providers and peers, community support groups, and treatment supporters.	The conceptual framework and evidence presented highlight areas across the continuum where health communication can significantly impact treatment outcomes to reach the 90-90-90 goals by strategically addressing key behavioral determinants. As test and treat rolls out, multifaceted health communication approaches will be critical.	
27929601	Undifferentiated pleomorphic sarcoma, previously called malignant fibrous histiocytoma, usually arises in the extremities and retroperitoneum. Primary laryngeal undifferentiated pleomorphic sarcoma is very rare, with only 63 cases having been reported in the literature as of 2015. The disease has a poor prognosis because of problems with local recurrence and metastasis. Wide resection has been recommended as a treatment modality in previous reports. We report a case of undifferentiated pleomorphic sarcoma of the vocal fold in a 64-year-old man presenting with rapid growth. The lesion was treated with type III microlaryngeal surgery followed by radiation therapy. The patient's voice was good enough for social communication, and there was no evidence of recurrence on regular examination.
27929455	Honey bees demonstrate astonishing learning abilities and advanced social behavior and communication. In addition, their brain is small, easy to visualize and to study. Therefore, bees have long been a favored model amongst neurobiologists and neuroethologists for studying the neural basis of social and natural behavior. It is important, however, that the experimental techniques used to study bees do not interfere with the behaviors being studied. Because of this, it has been necessary to develop a range of techniques for pharmacological manipulation of honey bees. In this paper we demonstrate methods for treating restrained or free-flying honey bees with a wide range of pharmacological agents. These include both noninvasive methods such as oral and topical treatments, as well as more invasive methods that allow for precise drug delivery in either systemic or localized fashion. Finally, we discuss the advantages and disadvantages of each method and describe common hurdles and how to best overcome them. We conclude with a discussion on the importance of adapting the experimental method to the biological questions rather than the other way around.
27929321	In analyzing data from the National Database for Autism Research, we utilized Mokken scaling techniques as a means of creating a more effective and efficient screening procedure for autism spectrum disorder (ASD) via the Social Communication Questionnaire (SCQ). With a sample of 1,040, approximately 80% (n = 827) of the sample were males while approximately 20% (n = 213) were females. In regard to ethnicity, approximately 68% of the sample were White/Caucasian, while 7% were African American, 16% were Hispanic, 4% were Asian, and 1% were Native American or American Indian. As the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) states that, "individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder," (American Psychiatric Association, 2013, p. 51), the primary labeling difference between the DSM-IV and the DSM-5 would appear to be in identifying social communication disorder as a newly introduced disorder in the DSM-5, which we discuss. Though school psychologists are not dependent on the DSM to the same extent as clinical psychologists to provide services, school psychology is invested in the effective and efficient assessment of ASD. The current study demonstrates how Mokken scaling procedures may be utilized with respect to ASD identification via the SCQ as well as providing information regarding the prevalence of potential social communication disorder as a new disorder and its discrimination with ASD. (PsycINFO Database Record
27929316	Over the past 3 decades, there has been an unprecedented increase in students identified as eligible for special education as a result of students meeting criteria for autism spectrum disorder (ASD). The increasing number of students with ASD in the schools presents significant challenges to teachers, school psychologists, and other school professionals working with this population. Although there is considerable research addressing assessment, identification, and support services for children with ASD, there is a need for further research focused on these topics within the school context. Employing a diverse array of methodologies, the articles in this special topic section address several gaps in the literature, including (a) the application of evidence-based programs within the school context, (b) the social validity of well-established evidence-based practices with both parents and educators, (c) the assessment of social communication, (d) intervention and assessment of spatial and body awareness for children with ASD, (e) the use of peer-mediated discreet trial training, and (f) discrepancies across informants for both externalizing and internalizing symptoms associated with ASD. The results of these studies provide school psychologists and other education professionals with specific directions for advocacy and service delivery that aim to enhance school outcomes for students with ASD. (PsycINFO Database Record
27929100	The neuropeptide oxytocin has been shown to affect social interaction. Meanwhile, the underlying mechanism remains highly debated. Using an interpersonal finger-tapping paradigm, we investigated whether oxytocin affects the ability to synchronise with and adapt to the behaviour of others. Dyads received either oxytocin or a non-active placebo, intranasally. We show that in conditions where one dyad-member was tapping to another unresponsive dyad-member - i.e. one was following another who was leading/self-pacing - dyads given oxytocin were more synchronised than dyads given placebo. However, there was no effect when following a regular metronome or when both tappers were mutually adapting to each other. Furthermore, relative to their self-paced tapping partners, oxytocin followers were less variable than placebo followers. Our data suggests that oxytocin improves synchronisation to an unresponsive partner's behaviour through a reduction in tapping-variability. Hence, oxytocin may facilitate social interaction by enhancing sensorimotor predictions supporting interpersonal synchronisation. The study thus provides novel perspectives on how neurobiological processes relate to socio-psychological behaviour and contributes to the growing evidence that synchronisation and prediction are central to social cognition.
27928529	Public Service Advertising (PSA) is a public interest message disseminated in the form of an advertisement communication and its main purpose is to promote public behavioral changes regarding a social issue. Korea Centers for Disease Control and Prevention (KCDC) has been delivering PSA by various media. However, the effect of PSAs has never been evaluated. The purpose of this study was to estimate the effects of broadcasted PSA produced by KCDC on cardiovascular disease (CVD).One thousand adult participants throughout 15 provinces in Korea were chosen through the quota sampling method in 2012. A face-to-face research survey with 13 questions was conducted using a Computer Assisted Personal Interview (CAPI) system. Previous exposure to the PSA message, understanding, and behavioral intention to change was assessed.	After watching the PSA, about 75% of participants answered that they could understand the contents well and 70% had willingness to change their behaviors associated with CVD. However, only 24% of participants answered they watched the PSA during the past year.	The PSA had positive effects on increasing the level of understanding and intention to change behaviors regarding CVD. However, the level of exposure was low. KCDC should make an effort to increase the public exposure level, which could be an important success factor regarding the PSA. In addition, KCDC should consider customized PSA for vulnerable people such as multi-cultural families, the disabled, and the elderly.	
27928515	Autism spectrum disorders (ASD) are classified as neurodevelopmental disorders characterised by diminished social communication and interaction. Recently, evidence has accrued that a significant proportion of individuals with autism have concomitant diseases such as mitochondrial disease and abnormalities of energy generation. This has therefore led to the hypothesis that autism may be linked to mitochondrial dysfunction. We review such studies reporting decreased activity of mitochondrial electron transport chain (ETC) complexes and reduced gene expression of mitochondrial genes, in particular genes of respiratory chain complexes, in individuals with autism. Overall, the findings support the hypothesis that there is an association of ASD with impaired mitochondrial function; however, many of the studies have small sample sizes and there is variability in the techniques utilised. There is therefore a vital need to utilise novel imaging techniques, such as near-infrared spectroscopy, that will allow non-invasive measurement of metabolic markers for neuronal activity such as cytochrome c oxidase, in order to better establish the link between autism and mitochondrial dysfunction.
27928136	Objective The purpose of this study was to evaluate the comprehensive health program "Sumida TAKE10!", which aims to improve dietary habits and promote physical activity among community-dwelling older adults including the pre-frail elderly. This study has been ongoing since 2005 in Sumida Ward, Tokyo with the ultimate aim of preventing or delaying the need for long-term nursing care. We used the term "pre-frail elderly" for older adults who are at risk of requiring long-term care.Methods "Sumida TAKE10!" consists of a general lecture in a public hall followed by 5 educational sessions biweekly at 4-6 community centers. From 2008 to 2013, 402 participants aged ≥65 years were enrolled and included as subjects of the study. The main outcome measures were changes in 10 food intake frequencies, food frequency score (FFS), dietary variety score (DVS), frequency of exercise (obtained via questionnaire) and physical fitness (5-meter maximal walking time, 5-meter walking time, handgrip strength, one-leg standing time with eyes opened (time to upright posture for standing on one leg with eyes open), and the timed up & go test). The secondary outcome measures were changes in the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence score, appetite, frequency of walking and sports, self-rated health, frequency of leaving the house, communication with neighbors, engagement in hobbies, participation in group activities and participation in volunteer activities (obtained via questionnaire).Results Compared to baseline, all outcomes showed significant improvement. "Sumida TAKE10!" can improve dietary habits and increase the physical activity of participants. Positive secondary effects were seen for life function, self-rated health, and social activities. Almost identical positive results were obtained from the pre-frail elderly group, while improvement was also seen in the dietary habits of the subjects who do not cook.Conclusion These results suggest that this program may be useful for population-based approach programs. In addition, comprehensive programs like TAKE10! may increase the health consciousness of community-dwelling older adults.
27927031	Individuals with High Functioning Autism (HFA) experience high levels of underemployment and unemployment, resulting in negative economic, social, and health outcomes. Given what is known about labor market participation difficulties experienced by women generally, and the paucity of research concerning women with HFA, this systematic review synthesized what is known about the labor market experiences of women with HFA.A systematic review of the literature concerning adult females with HFA in relation to the workplace yielded 1947 results; 11 met inclusion criteria being based on original data, but not necessarily focusing solely on women.	The total number participants with HFA across all studies was 731 (M = 66.45, SD = 95.44, Mdn = 18.00) aged between 18 and 70 years (M = 34.38, SD = 7.71); females represented 38% (n = 279) of those sampled. The principal challenges reported for individuals with HFA at work were communication, social interaction, and stress, together with negative mental and physical health.	These results should be interpreted with caution. Of the studies found, 73% were qualitative and based on small samples. Only one paper differentiated female data in analyses. These factors combined suggest large-scale mixed method research focused on females with HFA is required to gain an accurate insight into the challenges faced in the workplace, to in turn inform intervention and support. However, implications for rehabilitation based on what is known are discussed. Implication for Rehabilitation Unemployment and underemployment of persons with High Functioning Autism (HFA) poses social, health and economic issues for both individuals and the wider community. Those with HFA have the intellectual capacity to make a substantial contribution to the workplace. Based on what is known, some of the challenges for females with HFA might be similar to those experienced by men with HFA, however it is possible that there are gender-based differences (in both type and severity of challenges) that require attention.	
27926450	In the past, medicine was dominated by acute diseases. Since treatments were unknown to patients they followed their medical doctors´ directives-at least for the duration of the disease. Behavior was thus largely motivated by avoiding expected costs associated with alternative behaviors (I-must). The health challenges prevailing today are chronic conditions resulting from the way we chose to live. Traditional directive communication has not been successful in eliciting and maintaining appropriate lifestyle changes. An approach successful in other fields is to motivate behavior by increasing expected rewards (I-want). Drawing on neuroeconomic and marketing research, we outline strategies including simplification, repeated exposure, default framing, social comparisons, and consumer friendliness to foster sustained changes in preference. We further show how these measures could be integrated into the health care system.
27925798	Social networking sites (SNS) are a popular form of communication among undergraduate students. Body image concerns and disordered eating behaviors are also quite prevalent among this population. Maladaptive use of SNS has been associated with disordered eating behaviors; however, the mechanisms remain unclear. The present study examined if body image concerns (e.g., appearance and weight esteem) mediate the relationship between excessive time spent on SNS and disordered eating behaviors (restrained and emotional eating). The sample included 383 (70.2 percent female) undergraduate students (mean age = 23.08 years, standard deviation = 3.09) who completed self-report questionnaires related to SNS engagement, body image, disordered eating behaviors, and demographics. Parallel multiple mediation and moderated mediation analyses revealed that lower weight and appearance esteem mediated the relationship between excessive time on SNS and restrained eating for males and females, whereas appearance esteem mediated the relationship between excessive time on SNS and emotional eating for females only. The study adds to the literature by highlighting mediational pathways and gender differences. Intervention research is needed to determine if teaching undergraduate students more adaptive ways of using SNS or reducing exposure to SNS reduces body dissatisfaction and disordered eating in this high-risk population.
27925489	With the rapid proliferation and adoption of social media among healthcare professionals and organizations, social media-based HIV/AIDS intervention programs have become increasingly popular. However, the question of the effectiveness of the HIV/AIDS messages disseminated on social media has received scant attention in the literature. The current study applies content analysis to examine the relationship between Facebook messaging strategies employed by 110 HIV/AIDS nonprofit organizations and audience reactions in the form of liking, commenting, and sharing behavior. The results reveal that HIV/AIDS nonprofit organizations often use informational messages as one-way communication with their audience instead of dialogic interactions. Some specific types of messages, such as medication-focused messages, engender better audience engagement; in contrast, event-related messages and call-to-action messages appear to translate into lower corresponding audience reactions. The findings provide guidance to HIV/AIDS organizations in developing effective social media communication strategies.
27925414	This study aimed to explore healthcare providers' perceptions of the issues and problems as well as suggestions regarding the development of cancer survivorship care models in South Korea. An exploratory, descriptive, qualitative study was conducted with eight Korean healthcare providers using individual interviews. Purposive sampling was performed in a university hospital in Gyeonggi-do, Korea. Three concepts of the Chronic Care Model (CCM) were employed to identify the issues and problems with developing a survivorship care model for Korean cancer survivors. Based on these concepts, seven themes were identified: (1) absence of a multidisciplinary care system; (2) fragmented care services; (3) lack of emotional support; (4) absence of a shared care system for long-term survivorship care; (5) lack of communication between physicians and cancer survivors; (6) limited resources in the communities; and (7) poorly tailored long-term survivorship cancer care. In terms of suggestions, four themes were identified: (1) healthcare organisation; (2) clinical information systems; (3) community resources; and (4) follow-up care. The current study identified the applicability of key concepts from the CCM to formulate a Korean cancer survivorship model. Findings suggest that cancer survivors should be managed as persons with chronic diseases based on long-term survivorship care.
27925217	People are beginning to develop symbiotic relationships with social networking sites (SNSs), which provide users with abundant opportunities for social interaction. We contend that if people perceive SNSs as sources of social connection, the idea of SNSs may reduce the desire to pursue offline social activities and offline pleasures. Experiment 1 demonstrated that priming with SNSs was associated with a weakened desirability of offline social activities and an increased inclination to work alone. Felt relatedness mediated the link between SNS primes and reduced desire to engage in offline social activities. Experiment 2 showed that exposure to SNS primes reduced the desirability of offline socializing and lowered the desire for offline pleasurable experiences as well. Moreover, heavy users were more susceptible to this detrimental effect. We provide the first experimental evidence that the idea of online social networking may modulate users' engagement in offline social activities and offline pleasures. Hence, online social networking may satisfy the need for relatedness but undercut the likelihood of reaping enjoyment from offline social life.
27925142	Information and communication technologies (ICT) are promising for the long-term care of older and frequently frail people. These innovations can improve health outcomes, quality of life and efficiency of care processes, while supporting independent living. However, they may be disruptive innovations. As all European member states are facing an increasing complexity of health and social care, good practices in ICT should be identified and evaluated. Three projects funded by DG CNECT are related to Active and Healthy Ageing (AHA) and frailty: (i) BeyondSilos, dealing with independent living and integrated services, (ii) CareWell, providing integrated care coordination, patient empowerment and home support and (iii) SmartCare, proposing a common set of standard functional specifications for an ICT platform enabling the delivery of integrated care to older patients. The three projects described in this paper provide a unique pan-European research field to further study implementation efforts and outcomes of new technologies. Below, based on a description of the projects, the authors display four domains that are in their views fundamental for in-depth exploration of heterogeneity in the European context: 1. Definition of easily transferable, high level pathways with solid evidence-base; 2. Change management in implementing ICT enabled integrated care; 3. Evaluation and data collection methodologies based on existing experience with MAST and MEDAL methodologies; and 4. Construction of new models for delivery of health and social care. Understanding complementarity, synergies and differences between the three unique projects can help to identify a more effective roll out of best practices within a varying European context.
27924967	ResearchGate has been regarded as one of the most attractive academic social networking site for scientific community. It has been trying to improve user-centered interfaces to gain more attractiveness to scientists around the world. Display of journal related scietometric measures (such as impact factor, 5-year impact, cited half-life, eigenfactor) is an important feature in ResearchGate. Open access publishing has added more to increased visibility of research work and easy access to information related to research. Moreover, scientific community has been much interested in promoting their work and exhibiting its impact to others through reliable scientometric measures. However, with the growing market of publications and improvements in the field of research, this community has been victimized by the cybercrime in the form of ghost journals, fake publishers and magical impact measures. Particularly, ResearchGate more recently, has been lenient in its policies against this dark side of academic writing. Therefore, this communication aims to discuss concerns associated with leniency in ResearchGate policies and its impact of scientific community.
27923919	Quorum sensing (QS) is a microbial cell-cell communication system that regulates gene expression in response to population density to coordinate collective behaviors. Yet, the role of QS in resolving the stresses caused by the accumulation of toxic metabolic by-products at high cell density is not well defined. In response to cell density, QS could be involved in reprogramming of the metabolic network to maintain population stability. Using unbiased metabolomics, we discovered that Vibrio cholerae mutants genetically locked in a low cell density (LCD) QS state are unable to alter the pyruvate flux to convert fermentable carbon sources into neutral acetoin and 2,3-butanediol molecules to offset organic acid production. As a consequence, LCD-locked QS mutants rapidly lose viability when grown with fermentable carbon sources. This key metabolic switch relies on the QS-regulated small RNAs Qrr1-4 but is independent of known QS regulators AphA and HapR. Qrr1-4 dictate pyruvate flux by translational repression of the enzyme AlsS, which carries out the first step in acetoin and 2,3-butanediol biosynthesis. Consistent with the idea that QS facilitates the expression of a common trait in the population, AlsS needs to be expressed cooperatively in a group of cells. Heterogeneous populations with high percentages of cells not expressing AlsS are unstable. All of the cells, regardless of their respective QS states, succumb to stresses caused by toxic by-product accumulation. Our results indicate that the ability of the bacteria to cooperatively control metabolic flux through QS is critical in maintaining a sustainable environment and overall population stability.Our work reveals a novel role for Vibrio cholerae quorum sensing (QS) in relieving the stresses caused by toxic metabolite accumulation when the population becomes crowded through metabolic reprogramming. QS enables V. cholerae switching from a low cell density energy-generating metabolism that is beneficial to individuals at the expense of the environment to a high cell density mode that preserves environmental habitability by sacrificing individual fitness. This cooperative switch provides a stable environment as the common good in maintaining the stability of the community. However, the common good can be exploited by uncooperative mutants that pollute the environment, causing population collapse. Our findings provide insights into the metabolic stress response of a major human pathogen, with implications for our understanding of microbial social biology and cooperation from an ecological and evolutionary perspective.	
27923863	Smoke-free laws, which ban smoking in public venues, can be effective in protecting public health, but it has been difficult to achieve compliance with these laws in low- and middle-income countries. This study was conducted to understand the social norms around public smoking and learn how to improve compliance in Bogor, the first Indonesian city to pass a comprehensive smoke-free law. Eleven stratified focus groups were conducted (n = 89). Data were analyzed using the theory of normative social behavior, which posits that the influence of descriptive norms (perceptions about what other people do) on behavior is moderated by injunctive norms (perceptions about what one is expected to do), outcome expectations and group identity. The findings showed that participants perceived smoking in public to be common for men (descriptive norm). Public smoking is acceptable except in places with air conditioning and around children or pregnant women (injunctive norms). Men smoke without penalty of social or legal sanctions (outcome expectations) and may feel affiliation with other smokers (group identity). Together, these factors support public smoking and inhibit compliance with the smoke-free law. Theory-based communication and policy remedies are suggested that may bolster compliance with Bogor's smoke-free law given the current pro-smoking norms.
27923777	Most youth asthma apps are not designed with parent and clinician use in mind, and rarely is the app development process informed by parent or clinician input.This study was conducted to generate formative data on the use, attitudes, and preferences for asthma mHealth app features among parents and clinicians, the important stakeholders who support adolescents with asthma and promote adolescent self-management skills.	We conducted a mixed-methods study from 2013 to 2014 employing a user-centered design philosophy to acquire feedback from a convenience sample of 20 parents and 6 clinicians. Participants were given an iPod Touch and asked to evaluate 10 features on 2 existing asthma apps. Participant experiences using the apps were collected from questionnaires and a thematic analysis of audio-recorded and transcribed (verbatim) interviews using MAXQDA. Descriptive statistics were calculated to characterize the study sample and app feature feedback. Independent samples t tests were performed to compare parent and clinician ratings of app feature usefulness (ratings: 1=not at all useful to 5=very useful).	All parents were female (n=20), 45% were black, 20% had an income ≥US $50,000, and 45% had a bachelor's degree or higher education. The clinician sample included 2 nurses and 4 physicians with a mean practice time of 13 years. Three main themes provided an understanding of how participants perceived their roles and use of asthma app features to support adolescent asthma self-management: monitoring and supervision, education, and communication/information sharing. Parents rated the doctor report feature highest, and clinicians rated the doctor appointment reminder highest of all evaluated app features on usefulness. The peak flow monitoring feature was the lowest ranked feature by both parents and clinicians. Parents reported higher usefulness for the doctor report (t(10)=2.7, P<.02), diary (t(10)=2.7, P<.03), and self-check quiz (t(14)=2.5, P<.02) features than clinicians. Specific participant suggestions for app enhancements (eg, a tutorial showing correct inhaler use, refill reminders, pop-up messages tied to a medication log, evidence-based management steps) were also provided.	Parent and clinician evaluations and recommendations can play an important role in the development of an asthma app designed to help support youth asthma management. Two-way asthma care communication between families and clinicians and components involving families and clinicians that support adolescent self-management should be incorporated into adolescent asthma apps.	
27923673	To analyse stress in parents whose infants with very low birth weight have just concluded high-level care in a Neonatal Intensive Care Unit (NICU). More specifically, we aimed 1) to identify groups of parents in the NICU who are particularly at risk of experiencing stress, and 2) to explore the effects of clinical staffś communication on parental stress.Our multi-center-study evaluated views from 1277 parents about care for 923 infants in 66 German NICUs. Answers were linked with separately evaluated medical outcomes of the infants. Separate generalised mixed models estimated the influence of personal, medical and communication-related characteristics on specific parental stress.	Parents of a younger age and those of infants with severe prognoses were more likely to experience stress. While empathetic communication as one aspect of staffś communication was shown as appropriate in reducing parental stress, an initial introduction and the quantity of information were only slightly associated with lower levels of stress.	Results provide evidence for the need to involve parents empathetically from the beginning of their child's stay in the NICU.	Staff in the NICU should communicate empathetically and help to reduce stress in parents particularly at risk.	

27922780	Working with patients in their own homes gives community matrons an advantage of seeing patients in the context of their everyday lives. This allows comprehensive assessment of need with an aim of promoting health or promoting stability for people living with chronic disease. Complex issues are resolved through problem-solving and this can result in patients being maintained in their own homes and thus in reduced unplanned hospitalisation. Data were collected from participants using semi-structured interviews and audio diaries. The sample comprised professionals: CMs (n=21), managers (n=4), former commissioners (n=2) and GPs (n=3); and patients (n=10) and their family carers (n=5). In this article, data from community matrons is discussed. Community matrons often drew on the social determinants model of health to problem solve and to create meaningful strategies that work for patients in their care. Raising awareness of the high-level skills of community matrons and promoting appreciation of the importance of a social determinants model of health is important in explaining why nurses are such a crucial element of the primary health care workforce.
27922657	With the uprise of the Internet of Things, wearables and smartphones are moving to the foreground. Ambient Assisted Living solutions are, for example, created to facilitate ageing in place. One example of such systems are fall detection systems. Currently, there exists a wide variety of fall detection systems using different methodologies and technologies. However, these systems often do not take into account the fall handling process, which starts after a fall is identified or this process only consists of sending a notification. The FallRisk system delivers an accurate analysis of incidents occurring in the home of the older adults using several sensors and smart devices. Moreover, the input from these devices can be used to create a social-aware event handling process, which leads to assisting the older adult as soon as possible and in the best possible way.The FallRisk system consists of several components, located in different places. When an incident is identified by the FallRisk system, the event handling process will be followed to assess the fall incident and select the most appropriate caregiver, based on the input of the smartphones of the caregivers. In this process, availability and location are automatically taken into account.	The event handling process was evaluated during a decision tree workshop to verify if the current day practices reflect the requirements of all the stakeholders. Other knowledge, which is uncovered during this workshop can be taken into account to further improve the process.	The FallRisk offers a way to detect fall incidents in an accurate way and uses context information to assign the incident to the most appropriate caregiver. This way, the consequences of the fall are minimized and help is at location as fast as possible. It could be concluded that the current guidelines on fall handling reflect the needs of the stakeholders. However, current technology evolutions, such as the uptake of wearables and smartphones, enables the improvement of these guidelines, such as the automatic ordering of the caregivers based on their location and availability.	
27922220	We describe teacher fidelity (adherence to the components of the treatment as specified by the research team) based on a series of studies of a multicomponent intervention, Promoting Acceleration of Comprehension and Content Through Text (PACT), with middle and high school social studies teachers and their students. Findings reveal that even with highly specified materials and implementing practices that are aligned with effective reading comprehension and content instruction, teachers' fidelity was consistently low for some components and high for others. Teachers demonstrated consistently high implementation fidelity and quality for the instructional components of building background knowledge (comprehension canopy) and teaching key content vocabulary (essential words), whereas we recorded consistently lower fidelity and quality of implementation for the instructional components of critical reading and knowledge application.
27921273	The following commentary critically reflects on the pragmatic and semiotic approach to language and identity articulated by Tapia, Rojas, and Picado (Culture & Psychology, Tapia et al. 2017). The following questions are central: 1) What theoretical position is (tacitly) being articulated regarding the nature of language and discourse? Although the authors admit that an explicit theorization of language and discourse is not their focus, the absence of a clear theoretical position is conspicuously problematic. And 2) is there an unintended cognitivism present in the way the authors formulate the relationship between language/discourse and identity? After discussing these questions, select parts of a radical interactional approach, grounded in discursive positioning, will be presented as an amendment to the present work, insofar as it attempts to both articulate a progressive theorization of language and discourse and avoid an unintended slide into cognitivism.
27921174	Although recent studies have investigated the effect of extreme heat on emergency transport, few have investigated the spatiotemporal variations of extreme low temperature for emergency transport on a national scale. Data pertaining to emergency ambulance transport and weather variation in the 47 prefectures of Japan between 2007 and 2010 were obtained. Nonlinear and delayed relationships between temperature and morbidity were assessed using a two-stage analysis. First, a Poisson regression analysis allowing for overdispersion in a distributed lag nonlinear model was used to estimate the prefecture-specific effects of temperature on morbidity. Second, a multivariate meta-analysis was applied to pool estimates on a national level. Of 15,868,086 emergency transports over the study period, 5,375,621 emergency transports were reported during the winter months (November through February). The overall cumulative relative risk (RR) at the first percentile vs. the minimum morbidity percentile was 1.24 (95 % CI = 1.15-1.34) for all causes, 1.50 (95 % CI = 1.30-1.74) for cardiovascular diseases, and 1.59 (95 % CI = 1.33-1.89) for respiratory diseases. There were differences in the temporal variations between extreme low temperature and respiratory disease morbidity. Spatial variation between prefectures was observed for all causes (Cochran Q test, p < 0.001; I 2 = 34.0 %) and respiratory diseases (Cochran Q test, p = 0.026; I 2 = 18.2 %); however, there was no significant spatial heterogeneity for cardiovascular diseases (Cochran Q test, p = 0.413; I 2 = 2.0 %). Our findings indicated that there were differences in the spatiotemporal variations of extreme low temperatures for emergency transport during winter in Japan. Our findings highlight the importance of further investigating to identify social and environmental factors, which can be responsible for spatial heterogeneity between prefectures.
27920340	Many individuals, including dementia caregivers, use blogs to share their experiences. These blogs contain rich narratives representing an untapped resource for understanding the psychosocial impact of caring for a person with dementia at the family level. The present study used blogs written by caregivers of persons with dementia to explore how these individuals leveraged this medium as part of the caregiving experience. Blogs written by self-identified informal caregivers of persons with dementia were identified using a systematic search method, and data were analyzed using a qualitative thematic analysis. Four themes emerged from the narratives: social support through communication and engagement, information gathering and seeking, reminiscing and legacy building, and altruism. By understanding the ways in which individuals providing care for persons with dementia use social media as part of the caregiving experience, family nurses can develop interventions and services aimed at improving caregiver burden and quality of life.
27919863	Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. There are several vaccines that protect against strains of HPV most associated with cervical and other cancers. Thus, HPV vaccination has become an important component of adolescent preventive health care. As media evolves, more information about HPV vaccination is shifting to social media platforms such as Twitter. Health information consumed on social media may be especially influential for segments of society such as younger populations, as well as ethnic and racial minorities.The objectives of our study were to quantify HPV vaccine communication on Twitter, and to develop a novel methodology to improve the collection and analysis of Twitter data.	We collected Twitter data using 10 keywords related to HPV vaccination from August 1, 2014 to July 31, 2015. Prospective data collection used the Twitter Search API and retrospective data collection used Twitter Firehose. Using a codebook to characterize tweet sentiment and content, we coded a subsample of tweets by hand to develop classification models to code the entire sample using machine learning procedures. We also documented the words in the 140-character tweet text most associated with each keyword. We used chi-square tests, analysis of variance, and nonparametric equality of medians to test for significant differences in tweet characteristic by sentiment.	A total of 193,379 English-language tweets were collected, classified, and analyzed. Associated words varied with each keyword, with more positive and preventive words associated with "HPV vaccine" and more negative words associated with name-brand vaccines. Positive sentiment was the largest type of sentiment in the sample, with 75,393 positive tweets (38.99% of the sample), followed by negative sentiment with 48,940 tweets (25.31% of the sample). Positive and neutral tweets constituted the largest percentage of tweets mentioning prevention or protection (20,425/75,393, 27.09% and 6477/25,110, 25.79%, respectively), compared with only 11.5% of negative tweets (5647/48,940; P<.001). Nearly one-half (22,726/48,940, 46.44%) of negative tweets mentioned side effects, compared with only 17.14% (12,921/75,393) of positive tweets and 15.08% of neutral tweets (3787/25,110; P<.001).	Examining social media to detect health trends, as well as to communicate important health information, is a growing area of research in public health. Understanding the content and implications of conversations that form around HPV vaccination on social media can aid health organizations and health-focused Twitter users in creating a meaningful exchange of ideas and in having a significant impact on vaccine uptake. This area of research is inherently interdisciplinary, and this study supports this movement by applying public health, health communication, and data science approaches to extend methodologies across fields.	
27919714	Pain is common in trauma patients who may be older and also may have cognitive impairment leading to reduced communication about their pain. A number of observational pain assessment tools are available and have been found to have limited clinical usefulness. The Bolton Pain Assessment Tool (BPAT) was developed following a trial of three established tools and includes a section to involve family and/or close carers in the pain assessment process. The aim of this paper is to present the findings of initial testing of BPAT. BPAT was used and evaluated by clinical staff in four trauma units in the UK. Forty-six staff evaluations were completed and 98% indicated it was easy to use; it took between one and two minutes to complete by 69.5% and led to pain management interventions by 93.5% of the respondents. It was rated highly by the clinical staff, but the involvement of families and close carers in the assessment process was different at each unit, with one unit not involving the family/close carer. There remains the need for a simple and practical way of assessing pain. This initial testing of the clinical feasibility of BPAT suggests that it is easy to use and helps to identify pain, but further testing of its reliability and validity is required.
27919521	We aimed to identify topics of research that have been neglected, undervalued, or overseen in the past 2 decades of placebo/nocebo research.A highly specialized literature database containing >3200 articles on the placebo or nocebo effects or response was screened for articles covering placebo effects in nutrition, sports medicine, physical therapy, and psychotherapy; for article covering gender, age, and culture as influencing factors; for articles dealing with long-term outcome, multimodality; and for articles related to technical (eHealth, mHealth) aspects of placebo effects.	Although placebo research has gained substantial progress over the past 2 decades, it has not resolved all its puzzles, it has ignored some obvious and some less obvious facets of the placebo topic, and it has overlooked that during these years, medicine has further developed and progressed, as has the doctor-patient relationship and the social environment in which this communication happens.	The biggest threat for placebo research is that it may outdate itself by declaring all and everything as a placebo effect even if there may be better terms and concepts (eg, patient expectations, doctor-patient communication, empathy), and by ignoring that medicine continuously changes its face, for patients as well as for clinical researchers. Its biggest opportunity is the fact that it, as no other topic in medicine, requires both medical and psychological experts for its exploration and to stay updated.	
27919505	It seems that gene-environment interaction play most important role in Multiple Sclerosis development. Increasing the incidence and prevalence of MS during the recent decades in the low prevalence area such as Iran is explained better by environment factors. Environmental Risk Factors in Multiple Sclerosis (the 'EnvIMS-Q') is a 6-page self-administered questionnaire for case control studies.the objectives of study are validation and adaptation of the EnvIMS-Q' then development of a Persian version for case control studies in Persian population.	This questionnaire translated literally and in culturally relevant form, then content validation process was done by three groups' experts. According to giving rating to each item, each section and the whole instrument, we calculated their content validation indexes and also added some new questions and a new section to EnvIMS-Q. Finally, we analyzed repeatability of the answers within a 4 weeks interval.	Relevancy and clarity indexes of all items were more than 80%. Scale relevancy index equaled 99% and scale clarity index equaled 97%. Repeatability of most items was acceptable.	the use of standardized validated questionnaires will assist the researchers to perform local studies on the role of environmental factors on the basis of reliable data.	
27919479	Increasingly, Government and Charity funders require public engagement in research. Invariably these research outputs describe the condition of someone with the disease of interest. We therefore sought to identify the preferred descriptor of someone with a disease, such as multiple sclerosis (MS) and to determine what descriptors are currently used by academics.Several surveys were undertaken: one from the Research Network of the MS Society (MSSRN), a major MS Charity within the United Kingdom, who are involved in reviewing grant applications, priority setting and research governance (n=146), and surveys from both the United Kingdom MS register (MSR; n=1713) and the North American Research Committee on Multiple Sclerosis (NARCOMS) registry (n=518). People were asked to rate descriptors of someone affected with MS. These were compared to that used by academic experimenters in basic science and clinical science research papers.	Although the frequency of responses varied between surveys the overall findings showed many consistencies. This included use of person/people with MS (pwMS) as the preferred descriptor for someone with MS for social media and scientific publications. This was the preferred choice in about 55-60% people from the MRS and in over 70% in the NARCOMS and the MSSRN, respectively. Although MSer was the second preferred-choice for use in social media, there was as a large range of preferences from the 'most-preferred' to the 'most-disliked.' This reflected an earlier survey by UK-based research blogs using the term MSer (n=173). In contrast, pwMS had few 'dislikes' and results were skewed towards the 'liked' and 'most-preferred' choices. Client and sufferer were generally disliked terms, although there was some regional variation in levels of choice. Patient was generally seen as a neutral term that was neither strongly liked nor disliked. However, patient gained more public support for use within scientific publications (~20-25%) compared to social media (~10-15%). This descriptor was however most commonly used (98-99%) within both pre-clinical (searched in 6-month output of preclinical autoimmune MS models; n=161) and in clinical publications (specialist MS journals; n=220), whereas pwMS was not reported in over 75% of papers published in some specialised MS journals, and did not appear in the pre-clinical animal studies examined.	There is a clear disconnection between preferences by individuals living with MS and current academic practise. As pwMS are increasingly reading primary research publications and are involved in patient and public involvement in research and grant review activities, the sensitivities of lay readers should be considered when writing research outputs. This issue may affect other diseases and a change in writing style could be adopted to show that we respect the wishes of the people that we study and wish to help.	
27919369	Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team.To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program.	Two methods were used. First was a structured literature review: electronic databases were searched up to 2015 with combinations of MeSH terms and text-words such as chronic pain, self-management, self-efficacy, technology, Internet-based, patient portal, and e-health. A narrative synthesis of the characteristics and content of Internet-based pain management programs emerging from the literature review and how they relate to gaps in chronic pain management were completed. Second, four audiotaped focus group sessions were conducted with individuals with chronic pain and caregivers (n=9) and health professionals (n=7) recruited from three multidisciplinary tertiary and rehabilitation centres. A thematic analysis of the focus group transcripts was conducted.	Thirty-nine primary articles related to 20 patient-oriented Internet-based programs were selected. Gaps in CP management included lack of knowledge, limited access to health care, suboptimal care, and lack of self-management support. Overall, 14 themes related to information needs and gaps in care were identified by both health professionals and patients, three were exclusive to patients and five to health professionals. Common themes from the focus groups included patient education on chronic pain care, attitude-belief-culture, financial and legal issues, end-of-program crash, and motivational content.	Internet-based programs contain automated, communication and decision support features that can address information and care gaps reported by patients and clinicians. However, focus groups identified functionalities not reported in the literature, non-medical and condition- and context-specific information, integration of personal health records, and the role of the different health professionals in chronic pain management were not identified. These gaps need to be considered in the future development of Internet-based programs. While the association between the mechanisms of Internet-based programs' features and outcomes is not clearly established, the results of this study indicate that interactivity, personalization and tailored messages, combined with therapist contact will maximize the effectiveness of an Internet-based chronic pain program in enhancing self-management.	
27919206	The Intentional Relationship Model (IRM) is a new model of the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or 'mode' use, but to date no group comparisons have been reported.To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use.	The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n = 109) and of second-year occupational therapy students (n = 96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analysed with independent t-tests.	The occupational therapists responded more within the collaborative and empathizing modes than the students did. The students responded more within the advocating and instructing modes than the occupational therapists did.	There may be systematic differences between occupational therapists and students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.	
27918841	This community effectiveness randomized clinical trial examined the feasibility and effectiveness of a comprehensive psychosocial treatment, summerMAX, when implemented by a community agency. Fifty-seven high-functioning children (48 male, 9 female), ages 7-12 years with autism spectrum disorder participated in this study. The 5-week summerMAX treatment included instruction and therapeutic activities targeting social/social-communication skills, interpretation of nonliteral language skills, face-emotion recognition skills, and interest expansion. A behavioral program was also used to increase skills acquisition and decrease autism spectrum disorder symptoms and problem behaviors. Feasibility was supported via high levels of fidelity and parent, child, and staff clinician satisfaction. Significant treatment effects favoring the treatment group over waitlist controls were found on all 5 of the primary outcome measures (i.e., child test of nonliteral language skills and parent ratings of the children's autism spectrum disorder symptoms, targeted social/social-communication skills, broader social performance, and withdrawal). Staff clinician ratings substantiated the improvements reported by parents. Results of this randomized clinical trial are consistent with those of prior studies of summerMAX and suggest that the program was feasible and effective when implemented by a community agency under real-world conditions.
27918179	This article aims to introduce the reader to essential tools that can be used to obtain insights and build predictive models using large data sets. Recent user proliferation in the digital environment has led to the emergence of large samples containing a wealth of traces of human behaviors, communication, and social interactions. Such samples offer the opportunity to greatly improve our understanding of individuals, groups, and societies, but their analysis presents unique methodological challenges. In this tutorial, we discuss potential sources of such data and explain how to efficiently store them. Then, we introduce two methods that are often employed to extract patterns and reduce the dimensionality of large data sets: singular value decomposition and latent Dirichlet allocation. Finally, we demonstrate how to use dimensions or clusters extracted from data to build predictive models in a cross-validated way. The text is accompanied by examples of R code and a sample data set, allowing the reader to practice the methods discussed here. A companion website (http://dataminingtutorial.com) provides additional learning resources. (PsycINFO Database Record
27917964	La communication est vitale pour le développement socio-économique et culturel des pasteurs. Utilisée de manière constructive, la communication peut contribuer à créer un environnement propice au changement et à la modernisation. Les auteurs s’efforcent de déceler les tendances de la communication en tant que soutien du développement pastoral, en soulignant les méthodes de communication tant traditionnelles que modernes et leurs principales contraintes. Cette étude révèle que l’échec fréquent des interventions du passé visant à développer le pastoralisme s’explique par le fait qu’elles adoptaient des méthodes de nature centralisée, « du haut vers le bas », et qu’elles dépendaient de stratégies et de canaux extérieurs qui négligeaient les savoirs autochtones ainsi que les systèmes de communication des pasteurs. Les pasteurs utilisent leurs propres systèmes de communication bien établis pour partager les informations sur les conditions climatiques et écologiques ainsi que sur des questions économiques, sociales et politiques. Ils recourent de plus en plus aux technologies modernes de communication, en particulier la radio et la téléphonie mobile pour accéder aux informations et actualités régionales. Néanmoins, le développement pastoral dans le secteur des communications se heurte actuellement à l’incapacité de diverses agences de développement et parties prenantes à recourir à des méthodes participatives, ainsi qu’à une pénurie d’infrastructures et de capacités. Les auteurs préconisent de privilégier les méthodes de communication participatives et intégrées, d’améliorer les infrastructures et de renforcer les capacités.La comunicación es vital para el desarrollo socioeconómico y cultural de las sociedades pastorales. Utilizada constructivamente, puede ayudar a crear condiciones propicias para el cambio y la modernización. Los autores tratan de desvelar una serie de tendencias en materia de comunicación como parte del desarrollo pastoral, haciendo hincapié en los métodos de comunicación tanto indígenas como modernos y en los factores que actualmente constriñen su buen funcionamiento. El estudio aquí descrito demuestra que en el pasado las intervenciones de desarrollo pastoral han sido a menudo poco fructuosas porque respondían a planteamientos centralizados y «descendentes» y reposaban en estrategias y canales externos que hacían caso omiso del conocimiento indígena y de los arraigados sistemas de comunicación propios de las sociedades pastorales que sirven para compartir información sobre condiciones climáticas y ecológicas u otras cuestiones de índole económica, social y política. Los pastores utilizan cada vez más las modernas tecnologías de comunicación, en especial la radio y el teléfono móvil, para mantenerse al corriente de la actualidad regional. No obstante, por lo que respecta a las comunicaciones, el desarrollo pastoral se ve lastrado actualmente por el hecho de que diversos interlocutores y organismos de desarrollo no apliquen métodos participativos, a lo que se añaden las deficiencias en materia de infraestructura y capacidades. Los autores propugnan por lo tanto la aplicación de planteamientos más participativos e integrados para abordar las cuestiones de comunicación, junto con la expansión de las infraestructuras y el fomento de las capacidades.	Communication is vital for the socio-economic and cultural development of pastoralists. If used constructively, communication can help to create a favourable environment for change and modernisation. This paper tries to uncover trends in communication as part of pastoral development, emphasising both indigenous and current methods of communication and prevailing constraints. This study reveals that pastoral development interventions in the past have often failed to achieve their goals, due to the centralised, 'top-down' approaches adopted and to reliance on external strategies and channels which ignored the indigenous knowledge and communications systems of pastoralists. Pastoralists have their own well-established communications systems for sharing information on climatic conditions and ecology, as well as economic, social and political issues. Modern communication technologies, especially radio and mobile telephones, are increasingly being used by pastoralists to access current regional information. However, pastoral development in the communications area is currently constrained by the failure of various development agencies and stakeholders to use participatory approaches, and by poor infrastructure and weak capacity. The authors therefore call for the adoption of more participatory and integrated approaches towards communication, the expansion of infrastructure and building of capacity.	
27917963	Au Sahel et en Afrique centrale et de l’Ouest, les moyens de subsistance des pasteurs nomades peuls se définissent par la mobilité (liée aux besoins de leurs troupeaux), par des réseaux sociaux extensifs et par l’importance des liens sociaux en tant que base du prestige et de l’influence des individus (le « patrimoine relationnel » fondé sur les liens personnels). Le Sahel où vivent nombre de nomades peuls se trouve actuellement entraîné dans le djihadisme, les conflits et la violence ; en même temps, cette région offre désormais bien plus de possibilités de se connecter grâce à la technologie de la communication mobile non filaire. Les auteurs analysent les interactions entre la mobilité, la communication et l’insécurité afin de mieux comprendre la situation actuelle des pasteurs peuls nomades et semi-nomades ainsi que leur dynamique identitaire. Les Peuls se retrouvent au coeur de conflits qui mettent fin à leur mobilité et entraînent souvent la destruction de leurs troupeaux. Pourront-ils garder leur mode de vie et leur identité nomade ? L’analyse présentée dans cet article repose sur des études de cas qualitatives et des récits de vie recueillis auprès de pasteurs nomades et semi-nomades qui ont été confrontés à des conflits et à la violence, au Cameroun, au Tchad et au Mali. Il ressort de ces études que si le pastoralisme nomade devient plus difficile en raison des conflits et des pertes de bétail, l’identité « mobile » (ou nomade) reste très présente et se voit renforcée par la téléphonie mobile qui permet notamment de pérenniser les liens à la base du patrimoine relationnel ainsi que les réseaux sociaux.Los medios de sustento de los pastores nómadas Fulani (o peul, o fulbe) del Sahel, África Central y África Occidental se caracterizan por la movilidad (ligada a las necesidades de sus animales), por extensas redes de sociabilidad y por el lugar central que ocupan los vínculos sociales como fundamento del rango y la influencia de la persona («grado de riqueza en gente»). El medio saheliano en el que viven muchos nómadas fulani se ha convertido hoy en un avispero de jihadismo, conflictos y violencia. Al mismo tiempo, la región conoce ahora un auge de las posibilidades de conexión gracias a los sistemas móviles de comunicación inalámbrica. Los autores analizan el triángulo formado por la movilidad, la comunicación y la inseguridad con el fin de aprehender la situación actual de los pastores fulani nómadas y seminómadas y su dinámica identitaria. El hecho de que los fulani se vean atrapados en esos conflictos coarta su movilidad y acarrea a menudo la pérdida de sus rebaños. ¿Serán capaces de mantener su modo de vida y su identidad, enraizados en el nomadismo? Los autores se basan aquí en estudios monográficos cualitativos y en historias biográficas recogidas entre y con pastores nómadas y seminómadas del Camerún, el Chad y Malí que han tenido que convivir con conflictos y violencia. Estos estudios monográficos evidencian que, si bien el pastoreo móvil resulta hoy una actividad difícil debido a los conflictos y a la pérdida de ganado, la identidad ‘móvil’ sigue estando muy presente y cobrando vigor gracias a la telefonía móvil, que permite especialmente mantener la ‘riqueza’ en gente y redes de sociabilidad.	The livelihoods of the Fulani mobile pastoralists in the Sahel, West and Central Africa are characterised by mobility (related to the needs of their animals), extensive social networks, and a focus on social ties as the basis of status and influence ('wealth in people'). The Sahel environment in which many Fulani nomads live has become embroiled in jihadism, conflict, and violence; at the same time, this region has experienced an increase in opportunities to connect through the wireless mobile communication system. This paper analyses the triangle of mobility, communication, and insecurity in order to understand the present-day situation of the nomadic and semi-nomadic Fulani pastoralists and their identity dynamics. The Fulani find themselves caught in between these conflicts, which end their mobility and often lead to the loss of their herds. Will they be able to keep their mobile lifestyle and identity? This article is based on qualitative case studies and the biographical narratives of nomadic and semi-nomadic pastoralists who have lived through conflict and violence in Cameroon, Chad and Mali. These case studies show that, despite the fact that mobile pastoralism has become difficult as a consequence of the conflicts and loss of cattle, the 'mobile' identity is very present and reinforced with the help of mobile telephony, through which social networks and 'wealth in people' are sustained.	
27917754	Heart failure (HF) affects up to 20 per cent of residents in long-term care (LTC) and is associated with substantial morbidity, mortality, and health service utilization. Our study objective was to formulate recommendations on implementing HF care processes in LTC. A three-phase and iterative stakeholder consultation process, guided by expert panel input, was employed to develop recommendations on implementing care processes for HF in LTC. This article presents the results of the third phase, which consisted of a series of interdisciplinary workshops. We developed 17 recommendations. Key elements of these recommendations focus on improving interprofessional communication and improving HF-related knowledge among all LTC stakeholders. Engaging frontline staff, including personal support workers, was stated as an essential component of all recommendations. System-level recommendations include improving communication between LTC homes and acute care and other external health service providers, and developing facility-wide interventions to reduce dietary sodium intake and increase physical activity.
27917486	The values, perspectives, and behavior patterns that begin in adolescence can continue throughout one's life. Because of these lifetime effects, much research has focused on adolescent risk and prevention, but a new body of knowledge investigates protective factors and strengths. Positive youth development (PYD) increases internal and external assets during adolescence and is often based within communities. This review, however, focuses on school-based PYD interventions because these institutions are the largest youth-serving institutions in the country.This review considered 711 PYD school-based programs found using 4 databases. We included articles published after 2000, and did not review those reporting on regular school curriculum or activities.	The 24 remaining articles describe PYD programs that fall under 3 general categories: curriculum-based, leadership development, and student-based mentorship programs.	Evaluations indicate that programs increase intrapsychic measures of well-being in youth as well as social confidence and healthy behaviors. However, it is important to not only include "at-risk" persons in programming, because a mixed group of young people encourages a more positive peer-to-peer climate. In addition, peer mentorship activities should be actively facilitated by an adult supervisor to ensure positive communication and trust between the mentor and mentee.	
27917126	The Internet has become a common and global medium. It contains vast information resources and a wide range of communication instruments. One of the communication channels are social media, which increasingly are also used in the business field. Social media combined with mobile technology introduced new challenges to marketing activity. This trend is also observed on specific and highly regulated drug market. The aim of this article is to describe the perspectives for the use of social media in e-pharmamarketing. We find that this require personalized communication, the use of online promotion tools, in order to perform advertising in contact with a demanding client. Currently pharmaceutical companies use social media to communicate basic information on their life, but they still do not appreciate it sufficiently as a tool to build the image of company or products. It is therefore considered that these companies should attach greater importance to the presence in this type of media, especially in the light of dynamic changes in the way people communicate.
27917002	Condom distribution programmes are an important means of preventing sexually transmitted infections (STIs); yet little research has examined their perceived and actual impact on college campuses.Quantitative, cross-sectional study.	Large public university in the Southeastern USA.	Approximately 2 months after a campus-wide condom distribution programme began, we utilised intercept surveys with 355 students (68% women; 43% racial/ethnic minorities) to examine their perceptions of the availability, accessibility and acceptability of condoms, and their perceptions and use of the newly installed condom dispensers.	Students perceived condoms to be available and accessible on campus after implementation of the condom dispensers. Students had heard about the dispensers from other people (36%), through social media (18%) and the campus newspaper (15%). Most students (71%) had seen the dispensers. Almost one in four students (23%) had taken a condom from the dispensers; among those who were sexually active during the 2months that the dispensers were available, 33% had used them. More than one-third of students (37%) - and 53% of sexually active students - indicated intentions to use the dispensers in the next 6months. Multiple regression analysis controlling for age, gender and race revealed that prior condom use, attitudes about the dispensers and comfort with the dispensers were significant predictors of sexually active students' intentions to use the dispensers (p<.001).	Overall, results indicate that over a short time period, this condom distribution programme was successful in reaching students and providing free condoms. Implications for implementing condom distribution programmes on college campuses as well as future directions for research are discussed.	
27916111	An international expert consultation was convened by the World Health Organization (WHO). The purpose of the meeting was to review the use of CT in examining asymptomatic people. This is often referred to as individual health assessment (IHA). IHA was identified as a global phenomenon unenthusiastically tolerated, and not actively promoted, structured, or regulated in most countries. This paper identifies the state of the art for IHA and some considerations in relation to its justification, in different regions of the world. The outcomes reached include the following: questions around terminology and culture of IHA practice; review of IHA in some countries, regions, and international bodies; dilemmas for participants in IHA; risk communication, education, and training for professions and public; the desirability of guidelines and clinical audit; social, ethical, public health, and resource considerations; and a framework for IHA and regulatory considerations. Three subcategories of examination for asymptomatic individuals were identified: formal screening programs; examinations for which the evidence base or risk profile is incomplete; and opportunistic examinations with little or no evidence or risk profile to suggest they have any merit. The latter challenges the justification principle of radiation protection. In addition, the issue of the costs, direct and indirect, associated with false positives and/or equivocal/incidental findings were highlighted. These and other considerations make it difficult to view some IHA as a bona fide medical activity. To allow it to be viewed as such requires that it be conducted within a robust clinical governance framework that includes regulatory dimensions.
27915463	Predicting neurological outcomes of neonates with acute brain injury is an essential component of shared decision-making, in order to guide the development of treatment goals and appropriate care plans. It can aid parents in imagining the child's future, and guide timely and ongoing treatment decisions, including shifting treatment goals and focusing on comfort care. However, numerous challenges have been reported with respect to evidence-based practices for prognostication such as biases about prognosis among clinicians. Additionally, the evaluation or appreciation of living with disability can differ, including the well-known disability paradox where patients self-report a good quality of life in spite of severe disability. Herein, we put forward a set of five practice principles captured in the "ouR-HOPE" approach (Reflection, Humility, Open-mindedness, Partnership, and Engagement) and related questions to encourage clinicians to self-assess their practice and engage with others in responding to these challenges. We hope that this proposal paves the way to greater discussion and attention to ethical aspects of communicating prognosis in the context of neonatal brain injury.
27914633	The pharmacovigilance of drugs for orphan diseases presents problems related to the small patient population. Obtaining high-quality information on individual reports of suspected adverse reactions is of particular importance for the pharmacovigilance of orphan drugs. The possibility of mining "big data" to detect suspected adverse reactions is being explored in pharmacovigilance generally but may have limited application to orphan drugs. Sources of big data such as social media may be infrequently used as communication channels by patients with rare disease or their caregivers or by health care providers; any adverse reactions identified are likely to reflect what is already known about the safety of the drug from the network of support that grows up around these patients. Opportunities related to potential future big data sources are discussed.
27914356	Improving assessment guidance and feedback for students has become an international priority within higher education. Podcasts have been proposed as a tool for enhancing teaching, learning and assessment. However, a stronger theory-based rationale for using podcasts, particularly as a means of facilitating assessment guidance and feedback, is required.To explore students' experiences of using podcasts for assessment guidance and feedback. To consider how these podcasts shaped beliefs about their ability to successfully engage with, and act on, assessment guidance and feedback Design Exploratory qualitative study. Setting Higher education institution in North-East Scotland. Participants Eighteen third year undergraduate nursing students who had utilised podcasts for assessment guidance and feedback within their current programme of study.	Participants took part in one of four focus groups, conducted between July and September 2013. Purposive sampling was utilised to recruit participants of different ages, gender, levels of self-assessed information technology skills and levels of academic achievement. Data analysis was guided by the framework approach.	Thematic analysis highlighted similarities and differences in terms of students' experiences of using podcasts for assessment guidance and feedback. Further analysis revealed that Self-Efficacy Theory provided deeper theoretical insights into how the content, structure and delivery of podcasts can be shaped to promote more successful engagement with assessment guidance and feedback from students. The structured, logical approach of assessment guidance podcasts appeared to strengthen self-efficacy by providing readily accessible support and by helping students convert intentions into action. Students with high self-efficacy in relation to tasks associated with assessment were more likely to engage with feedback, whereas those with low self-efficacy tended to overlook opportunities to access feedback due to feelings of helplessness and futility.	Adopting well-structured podcasts as an educational tool, based around the four major sources of information (performance accomplishments, vicarious experience, social persuasion, and physiological and emotional states), has potential to promote self efficacy for individuals, as well as groups of students, in terms of assessment guidance and feedback.	
27914304	Evidence suggests that parents of children with disabilities feel that not all their information needs are being met, but it remains unclear how parents try to fill these information gaps.The aim of this study is to describe how parents of children with physical disabilities search for and evaluate information.	Qualitative semi-structured interviews were conducted with 15 parents of children with a disability, aged 1.5-21 years. Data were analysed using thematic analysis.	There was much variation in information needs between parents. Parents used different sources, depending on the type of information needed, the most important being healthcare professionals, peers, and websites. Peers played an important role in information provision and were the preferred source of experience-based knowledge and support. The Internet is a widely used medium to search for information and to access various sources. There was a general preference for closed Internet communities for peer contact. Information was commonly evaluated by comparing sources.	Parents use different sources for different information needs, and evaluate information by comparing them. Healthcare professionals and parents can support each other in locating and evaluating information including experience-based knowledge. Healthcare professionals should guide parents in their search for information and experience-based knowledge from peers.	
27914194	Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and "freedom" in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.
27913084	Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals.To evaluate ComMed quality variations by hospital characteristics.	In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys).	After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=<0.0001), hospitals with HIT infrastructure (OR = 1.29, 95% CI: 1.05-1.59, p = 0.02) were more likely while Northeast vs. Western region hospitals (OR = 0.67, 95% CI: 0.50-0.89, p=<0.0001) and hospitals in metropolitan areas with 1 million or more population vs. Nonmetro area with less than 2500 population were less likely (OR = 0.68, 95% CI: 0.48-0.95, p=<0.0001), to be associated with high ComMed quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality.	One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care.	
27913082	Traditionally assessment in medical training programs has been through subjective faculty evaluations or multiple choice questions. Conventional examinations provide assessment of the global performance rather than individual competencies thus making the final feedback less meaningful. The objective structured clinical examination (OSCE) is a relatively new multidimensional tool for evaluating training. This study was carried out to determine the efficacy and feasibility of OSCE as a tool for the internal assessment of surgery residents.This study was carried out on the marks obtained by surgery residents at different levels of training in a single tertiary center in India over the 4 OSCEs conducted in the years 2015 and 2016. The marks of the OSCE were collected from the departmental records and analyzed. Reliability was calculated using internal consistency using Cronbach's α. Validity was calculated by item total correlation. Content validation was done by obtaining expert reviews from 5 experts using a proforma, to assess the content and checklist of each station of the OSCE.	A total of 49 surgery residents were assessed in small batches during the above mentioned period. Of the 4 OSCEs conducted by us, 3 had a high value of Cronbach's α of greater than 0.9, as opposed to the set standard of 0.7. Out of 23 stations used in the 4 examinations separately, only 3 stations were found to have a low correlation coefficient (item total correlation), and hence, a low validity. The remaining 20 stations were found to have a high validity. Expert review showed unanimous validation of the content of 17 out of the 23 stations, with few suggestions for change in the remaining 6 stations. The material and manpower used was minimal and easy to obtain, thus making the OSCE feasible to conduct.	OSCE is a reliable, valid. and feasible method for evaluating surgery residents at various levels of training.	
27912963	Complementary/integrative medicine (CIM) services are increasingly being integrated into conventional supportive cancer care, presenting a number of challenges to communication between healthcare professionals (HCPs). The purpose of the present study was to explore the impact of the communication between integrative physicians (IPs) trained in CIM and social workers (SWs) working as psycho-oncologists in the same oncology setting. We examine whether IP-SW communication correlates with the number of patient-SW sessions, as provided within the oncology department.SW-IP communication, defined as a summary of the IP consultation sent to the patient's SW, was compared to SW-patient communication, defined as the number of psycho-oncology treatment sessions.	Of 344 patients referred by their oncology HCP for IP consultation, 91 were referred by an SW and 253 by an oncologist or nurse. IP-to-SW summaries were provided for 150 patients referred by a non-SW HCP (43.6%), and for 91 of SW-referred patients (26.5%). In all, 32 patients referred to the IP had no psycho-oncology interaction with an SW; 58 only one meeting; and 254 with ≥2 interactions, with 119 having >6 sessions. SW-patient interactions were greater with higher rates of IP-SW communication, for both patients referred by an SW (79.1%) and those referred by a non-SW HCP (77.3%) when compared to patients for whom no summary was provided (64.1%; p= 0.02).	A greater level of IP-SW communication, measured by the provision of an IP summary to the patient's SW, was found to correlate with a higher rate of SW-patient interactions. The use of a structured two-way referral-summary between IPs and SWs has the potential to advance the SW-patient psycho-oncology interaction, within an integrative supportive cancer care setting.	
27912935	To preliminarily assess the effects of Bushen Huoxue Granule (BHG) on Parkinson's Patients with Parkinson's Disease Questionnaire-39 (PDQ-39)and to provide data for further research.A randomized, double-blinded, placebo controlled study with a 3-month intervention period and a 6-month follow-up.	Participants were patients with Parkinson's Disease (PD) of age ranging from 50 to 80 years and Hoehn and Yahr (H-Y) stage I-IV of the disease.120 participants were allocated to BHG group or placebo group at a 1:1 ratio. The BHG group received BHG twice a day for 3 months, and was followed-up for 6 months after treatment; the placebo group did not receive any Chinese Herb treatment for 9 months. All the patients were given the conventional therapy of levodopa (Madopar).	Primary outcome measure was PDQ-39 comprises 39 questions with five different options of answer related to the frequency of the disease manifestation.	Significant statistical difference appeared in the following PDQ-39 dimensions: mobility; emotional well-being; stigma; cognition (P<0.01) and bodily discomfort (P<0.05).There was no statistical difference in the dimensions of social support, ADL and communication between the data of these two group patients (P≥0.05). We found that the sum index of PDQ-39 was significantly different between two groups.	The results of this study show that BHG treatment makes significant effects in most domains of PD patients life quality,especially in mobility, emotional well-being, stigma and cognition. The affected factors should be confirmed in larger studies.	
27912860	In the collection of essays On Late Style, Edward Said reflects on the new idiom achieved by great artists in their work near the end of their lives as "late style." Drawing on Adorno's essay on Beethoven's late style, Said also focuses on the aesthetic aspects of lateness. Defining the late works of artists as "a form of exile," however, Said moves beyond Adorno's aesthetic conception of late style. Highlighting the artist's abandonment of communication with the established social order, who achieves a contradictory, alienated relationship with it instead, Said compares artistic lateness with the experience of the subject in exile. Drawing on the analogy provided by Said, this article argues that the relationship between "self" and "other" in the different theoretical contexts of Postcolonial Studies and Age Studies can be usefully combined in the composite concept of "late style as exile." In order to explore how the concept of lateness correlates with that of exile, this contribution turns to theoretical and autobiographical texts by Edward Said.
27912853	Negotiations about problem definitions are a crucial part of psychotherapeutic and counselling work. In a conversation with a psychotherapist or a counsellor, the client's initial description of his or her trouble is transformed into an expert-informed problem formulation. This study aims to explicate how reasoning about troubles and life difficulties in a dialogue with a psychotherapist may be grounded in cultural knowledge about ageing.We draw upon ethnomethodology, and particularly on conversation analysis and membership categorisation analysis, to describe how age identities can be invoked in reasoning about explanations and solutions of psychological problems. The data consist of telephone conversations between a psychotherapist and people seeking help for their life difficulties on a Swedish radio programme.	Our analysis shows how references to callers' age were used to position the callers as members of stage-of-life categories, in order to invoke expectations tied to the categories. The callers' positions in the life course served as an interpretative resource for negotiating understanding of the callers' troubles, and suggesting a normative description of their life situations.	This study explicates in interactional detail the interpretative use of cultural common-sense knowledge about the life course in the context of the specific institutional tasks of radio counselling.	
27912847	While previous research has explored the meaning of positive aging discourses from the perspective of older adults, the perspective of older adults aging with a disability has not been studied. In fact the intersection of aging and disability has been largely underexplored in both social gerontology and disability studies.This critical ethnography engaged ten older adults aging with vision loss in narrative interviews, participant observation sessions, and semi-structured in-depth interviews. The overarching objective was to understand those attributes that older adults with age-related vision loss perceive as being the markers of a 'good old age.' The authors critically examined how these markers, and their disabling effects, are situated in ageist and disablist social assumptions regarding what it means to 'age well'.	The participants' descriptions of the markers of a 'good old age' were organized into five main themes: 1) maintaining independence while negotiating help; 2) responding positively to vision loss; 3) remaining active while managing risk; 4) managing expectations to be compliant, complicit, and cooperative and; 5) striving to maintain efficiency.	The study findings have provided helpful insights into how the ideas and assumptions that operate in relation to disability and impairment in late life are re-produced among older adults with age-related vision loss and how older adults take on an identity that is consistent with socially embedded norms regarding what it means to 'age well'.	
27911792	A major aim of sociogenomic research is to uncover common principles in the molecular evolution of sociality. This endeavor has been hampered by the small number of specific genes currently known to function in social behavior. Here we provide several lines of evidence suggesting that ants have evolved a large and novel clade of odorant receptor (OR) genes to perceive hydrocarbon-based pheromones, arguably the most important signals in ant communication. This genomic expansion is also mirrored in the ant brain via a corresponding expansion of a specific cluster of glomeruli in the antennal lobe. We show that in the clonal raider ant, hydrocarbon-sensitive basiconic sensilla are found only on the ventral surface of the female antennal club. Correspondingly, nearly all genes in a clade of 180 ORs within the 9-exon subfamily of ORs are expressed exclusively in females and are highly enriched in expression in the ventral half of the antennal club. Furthermore, we found that across species and sexes, the number of 9-exon ORs expressed in antennae is tightly correlated with the number of glomeruli in the antennal lobe region innervated by odorant receptor neurons from basiconic sensilla. Evolutionary analyses show that this clade underwent a striking gene expansion in the ancestors of all ants and slower but continued expansion in extant ant lineages. This evidence suggests that ants have evolved a large clade of genes to support pheromone perception and that gene duplications have played an important role in the molecular evolution of ant communication.
27911478	Bottlenose dolphins are highly social cetaceans with an extensive sound production including clicks, burst-pulsed sounds, and whistles. Some whistles, known as signature whistles, are individually specific. These acoustic signatures are commonly described as being emitted in contexts of stress during forced isolation and as group cohesion calls. Interactions between humans and captive dolphins is largely based on positive reinforcement conditioning within several training/feeding sessions per day. Vocal behavior of dolphins during these interactions might vary. To investigate this, we recorded 10 bottlenose dolphins of Parc Asterix dolphinarium (France) before, during and after 10 training sessions for a total duration of 7 hr and 32 min. We detected 3,272 whistles with 2,884 presenting a quality good enough to be categorized. We created a catalog of whistle types by visual categorization verified by five naive judges (Fleiss' Kappa Test). We then applied the SIGID method to identify the signatures whistles present in our recordings. We found 279 whistles belonging to one of the four identified signature whistle types. The remaining 2,605 were classified as non-signature whistles. The non-signature whistles emission rate was higher during and after the training sessions than before. Emission rate of three signature whistles types significantly increased afterwards as compared to before the training sessions. We suggest that dolphins use their signature whistles when they return to their intraspecific social interactions succeeding scheduled and human-organized training sessions. More observations are needed to make conclusions about the function of signature whistles in relation to training sessions. Zoo Biol. 35:495-504, 2016. © 2016 Wiley Periodicals, Inc.
27911168	People with traumatic brain injury (TBI) describe everyday interactions as a long-term challenge frequently associated with ongoing stress. Communication-specific Coping Intervention (CommCope-I) is a new treatment developed to target coping in the context of communication breakdown. The intervention incorporates principles of cognitive behavioural therapy, self-coaching and context-sensitive social communication therapy. The purpose of this study was to examine the effectiveness of CommCope-I in a group of adults with severe TBI and ongoing functional communication difficulties. Participants were 13 adults with severe TBI (GCS = 3-8; mean age = 35.2 years; mean time post-injury = 7.6 years). The project involved three phases: (1) Control/pre-intervention wait phase (multiple assessments), (2) Treatment (6 weeks), and (3) Follow-up (12 weeks). Repeated measures ANOVA with planned pairwise comparisons were used to test the significance of change. Intervention elicited statistically significant improvements in communication-specific coping, functional communication and stress that were maintained for three months. Improved use of communication-specific coping strategies was evident in clinician blind ratings. Clients reported significant reduction in stress at the end of treatment and one and three months later. This intervention provides a promising means of improving communication-specific coping and reducing communication dysfunction and its negative consequences for people with TBI.
27911096	Unlike traditional media, social media systems often present information of different types from different kinds of contributors within a single message pane, a juxtaposition of potential influences that challenges traditional health communication processing. One type of social media system, question-and-answer advice systems, provides peers' answers to health-related questions, which yet other peers read and rate. Responses may appear good or bad, responders may claim expertise, and others' aggregated evaluations of an answer's usefulness may affect readers' judgments. An experiment explored how answer feasibility, expertise claims, and user-generated ratings affected readers' assessments of advice about anonymous HIV testing. Results extend the heuristic-systematic model of persuasion (Chaiken, 1980) and warranting theory (Walther & Parks, 2002). Information that is generally associated with both systematic and heuristic processes influenced readers' evaluations. Moreover, content-level cues affected judgments about message sources unexpectedly. When conflicting cues were present, cues with greater warranting value (consensus user-generated ratings) had greater influence on outcomes than less warranted cues (self-promoted expertise). Findings present a challenge to health professionals' concerns about the reliability of online health information systems.
27911072	Massachusetts faces an opioid and substance abuse crisis at the same time the U.S. and Massachusetts have some of highest rates of incarceration in the world. This issue brief examines the problem and economic costs and consequences of untreated substance abuse. It examines the benefits of expanding access to treatment in the community, at arrest and initial detention, within the courts, within jails and prisons, at re‐entry and under community supervision, with the intent to reduce substance abuse, incarceration and recidivism and thereby improve health and public safety. The report recommends (1) implementing a pre‐arrest program to divert low‐level drug offenders to treatment, (2) enhancing and expanding specialty courts throughout the state, (3) increasing access to medication‐assisted treatment (MAT), and (4) expanding a Medicaid enrollment program in DOC and HOC facilities to improve access to healthcare services immediately upon release. To facilitate change and judicious invest of resources, it also recommends instating governance structures to coordinate efforts between health and criminal justice organizations within the Executive, Legislative and Judiciary branches of government.
27911014	Outdoor adventure programmes aim to improve interpersonal relationships using adventurous activities. The current study examined the effectiveness of an outdoor adventure programme in children with autism spectrum disorders (ASD).The study included 51 participants (40 males, 11 females; age 3y 4mo-7y 4mo) enrolled in ASD special education kindergartens. Only the intervention group (n=30) participated in the outdoor adventure programme for 13 weeks, completing challenging physical activities that required cooperation and communication with peers and instructors. The control group (n=21) was not significantly different from the research group in age, sex, cognitive, and adaptive behaviour measures.	Outcomes after the intervention revealed significant improvement in social-communication and different directions in the two groups in the social cognition, social motivation, and autistic mannerisms subdomains of the Social Responsiveness Scale. While the group that received an outdoor adventure programme showed a tendency toward a reduction in severity, the control group showed the opposite (p<0.010).	The outdoor adventure programme required problem-solving skills and forced the child to communicate in exciting situations. This study suggests that an outdoor adventure programme may be an effective intervention in addition to traditional treatments in young children with ASD. Future studies should examine the outcome of outdoor adventure programmes delivered for longer periods of time and maintenance of the achievements over time.	
27910886	Birdsong is a prime example of acoustically sophisticated vocal behaviour, but its complexity has evolved mainly through sexual selection to attract mates and repel sexual rivals. In contrast, non-human primate calls often mediate complex social interactions, but are generally regarded as acoustically simple. Here, we examine arguably the most complex call in great ape vocal communication, the chimpanzee (Pan troglodytes schweinfurthii) 'pant hoot'. This signal consists of four acoustically distinct phases: introduction, build-up, climax and let-down. We applied state-of-the-art Support Vector Machines (SVM) methodology to pant hoots produced by wild male chimpanzees of Budongo Forest, Uganda. We found that caller identity was apparent in all four phases, but most strongly in the low-amplitude introduction and high-amplitude climax phases. Age was mainly correlated with the low-amplitude introduction and build-up phases, dominance rank (i.e. social status) with the high-amplitude climax phase, and context (reflecting activity of the caller) with the low-amplitude let-down phase. We conclude that the complex acoustic structure of chimpanzee pant hoots is linked to a range of socially relevant information in the different phases of the call, reflecting the complex nature of chimpanzee social lives.
27910235	Restricted and repetitive behaviors (RRBs) are a core feature of autism spectrum disorder (ASD). Compared to the social-communication impairments, we know considerably less about why children engage in RRBs and if and how to intervene with these behaviors. As a result, early intervention has typically focused on social-communication. In this study, we were interested in understanding how child RRBs changed following an intervention targeting social-communication behaviors and if caregiver training changed how they responded to their child's RRBs. Eighty-six toddlers with ASD and their caregivers received one of two interventions: caregivers were either actively coached while playing with their child (JASPER) or attended information sessions about ASD. On three different occasions (when they entered the study, following 10 weeks of intervention and 6-months after) caregivers were filmed playing with their child. From these recordings, we coded child RRBs and caregiver responses to these behaviors. Child RRBs remained relatively stable following intervention in both groups, but increased when the children returned at 6-months. Caregivers who received one-on-one coaching (JASPER) responded to a greater number of their child's RRBs and their responses were rated as more successful. Our study showed that a short-term social-communication intervention delivered through caregivers had "spillover effects" on how they also responded to their child's RRBs. Interventions targeting social-communication behaviors should also examine how these treatments affect child RRBs and how caregiver responses to these behaviors may change following training. Autism Res 2017, 10: 983-992. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
27909415	Climate change and other long-term environmental issues are often perceived as abstract and difficult to imagine. The images a person associates with environmental change, i.e., a person's environmental mental images, can be influenced by the visual information they come across in the public domain. This paper reviews the literature on this topic across social, environmental, and cognitive psychology, and the wider social sciences; thereby responding to a call for more critical investigations into people's responses to visual information. By integrating the literature we come to a better understanding of the lack in vivid and concrete environmental mental imagery reported by the public, the link between environmental mental images and goals, and how affectively charged external images could help in making mental imagery less abstract. Preliminary research reports on the development of a new measure of environmental mental imagery and three tests of the relationship between environmental mental imagery, pro-environmental goals and behavior. Furthermore, the paper provides a program of research, drawing upon approaches from different disciplines, to set out the next steps needed to examine how and why we should encourage the public to imagine environmental change.
27909399	Autism spectrum disorder (ASD) comprises a range of neurological conditions that affect individuals' ability to communicate and interact with others. People with ASD often exhibit marked qualitative difficulties in social interaction, communication, and behavior. Alterations in neurite arborization and dendritic spine morphology, including size, shape, and number, are hallmarks of almost all neurological conditions, including ASD. As experimental evidence emerges in recent years, it becomes clear that although there is broad heterogeneity of identified autism risk genes, many of them converge into similar cellular pathways, including those regulating neurite outgrowth, synapse formation and spine stability, and synaptic plasticity. These mechanisms together regulate the structural stability of neurons and are vulnerable targets in ASD. In this review, we discuss the current understanding of those autism risk genes that affect the structural connectivity of neurons. We sub-categorize them into (1) cytoskeletal regulators, e.g., motors and small RhoGTPase regulators; (2) adhesion molecules, e.g., cadherins, NCAM, and neurexin superfamily; (3) cell surface receptors, e.g., glutamatergic receptors and receptor tyrosine kinases; (4) signaling molecules, e.g., protein kinases and phosphatases; and (5) synaptic proteins, e.g., vesicle and scaffolding proteins. Although the roles of some of these genes in maintaining neuronal structural stability are well studied, how mutations contribute to the autism phenotype is still largely unknown. Investigating whether and how the neuronal structure and function are affected when these genes are mutated will provide insights toward developing effective interventions aimed at improving the lives of people with autism and their families.
27909393	We describe a large-scale simulation of the aftermath of a hypothetical 10kT improvised nuclear detonation at ground level, near the White House in Washington DC. We take a synthetic information approach, where multiple data sets are combined to construct a synthesized representation of the population of the region with accurate demographics, as well as four infrastructures: transportation, healthcare, communication, and power. In this article, we focus on the model of agents and their behavior, which is represented using the options framework. Six different behavioral options are modeled: household reconstitution, evacuation, healthcare-seeking, worry, shelter-seeking, and aiding & assisting others. Agent decision-making takes into account their health status, information about family members, information about the event, and their local environment. We combine these behavioral options into five different behavior models of increasing complexity and do a number of simulations to compare the models.

27907981	Social media (SM), a virtual place where people can share, exchange, and communicate their ideas and knowledge, has become the new trend in communication and learning. This study aims to explore Saudi Arabian medical students' usage of SM and to discover the most common resources used in medical education. Furthermore, it aims to illustrate students' belief about the influence of SM on their learning.This cross-sectional study administered validated questionnaires to medical students from different universities in Saudi Arabia, via emails, Twitter, Facebook, and short message service. A non-probability sampling technique was utilized and a sample size of 381 students was arrived at, using 95% confidence interval and 5% margin of error, since the total number of medical students in Saudi Arabia is approximately 36,000. The total respondents were 657 students from 23 different Saudi Arabian medical schools (females: 60.5%, n=397; males: 39.5%, n=260).	The questionnaires of 21% of the students (n=139) were excluded from the analysis since they were incomplete. The most common website used by both genders was YouTube (42.3%, n=185); however, males preferred using Twitter and Wikis (p=0.001). With regard to utilizing SM for learning, 95.8% (n=419) of the students believed that it is beneficial. Females stated that SM helps them link basic and clinical science (p=0.003).	Medical schools need to improve the utilization of SM by their faculty and students by developing activities and encouraging the usage of SM in education.	
27907072	Medications are mostly taken in patients' own homes, increasingly administered by carers, yet studies of medication safety have been largely conducted in the hospital setting. We aimed to review studies of how carers cause and/or prevent medication administration errors (MAEs) within the patient's home; to identify types, prevalence and causes of these MAEs and any interventions to prevent them.A narrative systematic review of literature published between 1 Jan 1946 and 23 Sep 2013 was carried out across the databases EMBASE, MEDLINE, PSYCHINFO, COCHRANE and CINAHL. Empirical studies were included where carers were responsible for preventing/causing MAEs in the home and standardised tools used for data extraction and quality assessment.	Thirty-six papers met the criteria for narrative review, 33 of which included parents caring for children, two predominantly comprised adult children and spouses caring for older parents/partners, and one focused on paid carers mostly looking after older adults. The carer administration error rate ranged from 1.9 to 33% of medications administered and from 12 to 92.7% of carers administering medication. These included dosage errors, omitted administration, wrong medication and wrong time or route of administration. Contributory factors included individual carer factors (e.g. carer age), environmental factors (e.g. storage), medication factors (e.g. number of medicines), prescription communication factors (e.g. comprehensibility of instructions), psychosocial factors (e.g. carer-to-carer communication), and care-recipient factors (e.g. recipient age). The few interventions effective in preventing MAEs involved carer training and tailored equipment.	This review shows that home medication administration errors made by carers are a potentially serious patient safety issue. Carers made similar errors to those made by professionals in other contexts and a wide variety of contributory factors were identified. The home care setting should be a priority for the development of patient safety interventions.	
27906996	Dementia is a disease characterized by cognitive impairment and physical decline that worsens over time. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia, maximizing function and independence. The purpose of this study was to explore physical therapists' (PTs) experiences and reflections on facilitating high-intensity functional exercise with older people living with dementia, in residential care home settings. The study used a qualitative design based on interviews, individually or in small groups, with seven PTs engaged as leaders in the training of older people with dementia. The interviews were analyzed with a modified Grounded Theory method with focus on constant comparisons. To increase trustworthiness the study used triangulation within investigators and member checking. The core category "Discover and act in the moment-learn over time" reflects how the PTs continuously developed their own learning in an iterative process. They built on previous knowledge to communicate with residents and staff and to tailor the high intensity training in relation to each individual at that time point. The category "Be on your toes" highlights how the PTs searched for sufficient information about each individual, before and during training, by eliciting the person's current status from staff and by interpreting the person's body language. The category "Build a bond with a palette of strategies" describes the importance of confirmation to build up trust and the use of group members and the room to create an interplay between exercise and social interaction. These findings highlight the continuous iterative process of building on existing knowledge, sharing and reflecting, being alert to any alterations needed for individuals that day, communication skills (both with residents and staff) and building a relationship and trust with residents in the effective delivery of high intensity functional exercise to older people living with dementia in care settings.
27906923	In the context of possible regulation, to quantify and describe: (1) indoor tanning businesses in New Zealand; (2) sunbeds available for sale on Trade Me©.In January 2016, we conducted a national audit of businesses potentially providing sunbed services (solariums, beauty-salons, hairdressers, gyms and fitness centres) to assess the availability and cost of indoor tanning services (sunbeds and spray tanning). In addition, Trade Me©, New Zealand's largest auction site for second-hand goods, was monitored for one year to determine whether ex-commercial sunbeds were being sold in the domestic market.	Overall, 176 businesses were currently providing sunbeds, which for most (92.4%), were supplementary to other 'non-tanning' services. Of 168 sunbeds for sale on TradeMe©, 42 were ex-commercial.	Given scientific evidence that there is no safe level of sunbed use for individuals of any age, a ban on commercial sunbed services would have a significant positive impact on skin cancer incidence. Since few New Zealand businesses depend on providing sunbed services, a ban would have minimal negative economic impact, affecting only a small number of businesses. There should be a total ban on the importation, manufacture, sale and rental of sunbeds for commercial or private use in New Zealand.	
27906552	Few data are available describing the involvement and activities of social workers in advance care planning (ACP).We sought to provide data about (1) social worker involvement and leadership in ACP conversations with patients and families; and (2) the extent of functions and activities when these discussions occur.	We conducted a large web-based survey of social workers employed in hospice, palliative care, and related settings to explore their role, participation, and self-rated competency in facilitating ACP discussions. Respondents were recruited through the Social Work Hospice and Palliative Care Network and the National Hospice and Palliative Care Organization. Descriptive analyses were conducted on the full sample of respondents (N = 641) and a subsample of clinical social workers (N = 456). Responses were analyzed to explore differences in ACP involvement by practice setting.	Most clinical social workers (96%) reported that social workers in their department are conducting ACP discussions with patients/families. Majorities also participate in, and lead, ACP discussions (69% and 60%, respectively). Most respondents report that social workers are responsible for educating patients/families about ACP options (80%) and are the team members responsible for documenting ACP (68%). Compared with other settings, oncology and inpatient palliative care social workers were less likely to be responsible for ensuring that patients/families are informed of ACP options and documenting ACP preferences.	Social workers are prominently involved in facilitating, leading, and documenting ACP discussions. Policy-makers, administrators, and providers should incorporate the vital contributions of social work professionals in policies and programs supporting ACP.	
27906518	In the first 20 years of life, the human brain undergoes tremendous growth in size, weight, and synaptic connectedness. Over the same time period, a person achieves remarkable transformations in perception, thought, and behavior. One important area of development is face processing ability, or the ability to quickly and accurately extract extensive information about a person's identity, emotional state, attractiveness, intention, and numerous other types of information that are crucial to everyday social interaction and communication. Associating particular brain changes with specific behavioral and intellectual developments has historically been a serious challenge for researchers. Fortunately, modern neuroimaging is dramatically advancing our ability to make associations between morphological and behavioral developments. In this article, we demonstrate how neuroimaging has revolutionized our understanding of the development of face processing ability to show that this essential perceptual and cognitive skill matures consistently yet slowly over the first two decades of life. In this manner, face processing is a model system of many areas of complex cognitive development. WIREs Cogn Sci 2017, 8:e1423. doi: 10.1002/wcs.1423 For further resources related to this article, please visit the WIREs website.


27905229	Social media is everywhere: it accompanies us on our daily commute to work, helps us keep in touch with friends and family in far-flung places, enables us to make professional connections we wouldn't usually have access to, and even helps to win political elections.
27904573	Emotional intelligence (EI) helps humans to perceive their own and others' emotions. It helps to make better interpersonal communication that consequently leads to an increase in everyday performance and professional career. Teaching, particularly teaching in the clinical environment, is among the professions that need a high level of EI due to its relevance to human interactions.We adopted EI competencies with characteristics of a good clinical teacher. As a result, we extracted 12 strategies and then reviewed the literatures relevant to these strategies.	In the present article, 12 strategies that a clinical teacher should follow to use EI in her/his teaching were described.	To apply EI in clinical settings, a teacher should consider all the factors that can bring about a more positive emotional environment and social interactions. These factors will increase students' learning, improve patients' care, and maintain her/his well-being. In addition, he/she will be able to evaluate her/his teaching to improve its effectiveness.	
27903795	The aim of this study was to explore informal adult support experienced by children with parental alcohol problems to understand how professionals can show recognition in a similar way.We conducted a qualitative interview study with retrospective accounts from nine adults growing up with problem-drinking parents. Data were analysed with systematic text condensation. Goffman's concept "frame" offered a lens to study how supportive situations were defined and to understand opportunities and limitations for translation of recognition acts and attitudes to professional contexts.	Analysis demonstrated frames of commonplace interaction where children experienced that adults recognised and responded to their needs. However, the silent support from an adult who recognised the problems without responding was an ambiguous frame. The child sometimes felt betrayed. Concentrating on frames of recognition which could be passed over to professional interactions, we noticed that participants called for a safe harbour, providing a sense of normality. Being with friends and their families, escaping difficulties at home without having to tell, was emphasised as important. Recognition was experienced when an adult with respect and dignity offered an open opportunity to address the problems, without pushing towards further communication.	Our study indicates some specific lessons to be learnt about recognition for professional service providers from everyday situations. Frames of recognition, communicating availability and normality, and also unconditional confidentiality and safety when sharing problems may also be offered by professionals in public healthcare within their current frames of competency and time.	
27903776	Strong social bonds form between individuals in many group-living species, and these relationships can have important fitness benefits. When responding to vocalizations produced by groupmates, receivers are expected to adjust their behaviour depending on the nature of the bond they share with the signaller. Here we investigate whether the strength of the signaller-receiver social bond affects response to calls that attract others to help mob a predator. Using field-based playback experiments on a habituated population of wild dwarf mongooses (Helogale parvula), we first demonstrate that a particular vocalization given on detecting predatory snakes does act as a recruitment call; receivers were more likely to look, approach and engage in mobbing behaviour than in response to control close calls. We then show that individuals respond more strongly to these recruitment calls if they are from groupmates with whom they are more strongly bonded (those with whom they preferentially groom and forage). Our study, therefore, provides novel evidence about the anti-predator benefits of close bonds within social groups.
27903310	Health nudge interventions to steer people into healthier lifestyles are increasingly applied by governments worldwide, and it is natural to look to such approaches to improve health by altering what people choose to eat. However, to produce policy recommendations that are likely to be effective, we need to be able to make valid predictions about the consequences of proposed interventions, and for this, we need a better understanding of the determinants of food choice. These determinants include dietary components (e.g. highly palatable foods and alcohol), but also diverse cultural and social pressures, cognitive-affective factors (perceived stress, health attitude, anxiety and depression), and familial, genetic and epigenetic influences on personality characteristics. In addition, our choices are influenced by an array of physiological mechanisms, including signals to the brain from the gastrointestinal tract and adipose tissue, which affect not only our hunger and satiety but also our motivation to eat particular nutrients, and the reward we experience from eating. Thus, to develop the evidence base necessary for effective policies, we need to build bridges across different levels of knowledge and understanding. This requires experimental models that can fill in the gaps in our understanding that are needed to inform policy, translational models that connect mechanistic understanding from laboratory studies to the real life human condition, and formal models that encapsulate scientific knowledge from diverse disciplines, and which embed understanding in a way that enables policy-relevant predictions to be made. Here we review recent developments in these areas.
27902889	This article reports on a pilot study that examined the complexities of doctor-patient-family communication in an oncology setting in Singapore. Twenty consultation visits were audio-recorded and a postconsultation questionnaire was administered to patients and their accompanying person (AP) to examine their communication preferences. Patients and APs rated physician expertise and message content as highly important; supportive elements of the communication were rated as less important. Patients preferred information concerning their condition, while APs preferred information regarding treatment options. There was discordance between what was perceived by the patient/AP and actual delivery, and within patient-AP dyads. Our findings elucidate some of the complexities in communication preferences in an Asian oncology context that can inform clinical practice.
27901627	Disparities by race and socioeconomic status persist in pediatric asthma morbidity, mortality, and treatment. Improving parent/provider communication and parents' asthma-management confidence may result in better asthma control in vulnerable populations. The Merck Childhood Asthma Network, Inc. funded an initiative to implement medical-social care coordination to improve asthma outcomes at sites in four low-income, urban communities (Los Angeles, CA; Philadelphia, PA; Chicago, IL; and San Juan, PR.) As part of a cross-site evaluation of this effort, pre- post-program changes in parents' reports of asthma care and management were assessed.Across sites, 805 parents or other caregivers responded to a baseline survey that was repeated one year later following their child's participation in care coordination. Parents' asthma-management confidence, as well as their perceptions of provider access, trust, and communication, were measured with Likert scales. Linear mixed models were used to assess improvement in these variables, across and within sites, adjusting for sociodemographics.	Pooled across sites, the adjusted mean estimate for all outcomes showed a significant improvement (p <.05) from baseline to follow-up. Knowledge and Between-Provider Communication improved significantly (p <.05) within all four sites; Access improved significantly in Chicago, Philadelphia, and Puerto Rico; Trust improved significantly in Chicago, Los Angeles, and Philadelphia; and Patient-Provider Communication improved significantly in Philadelphia only.	Pediatric asthma care coordination, as implemented variously in diverse settings, was associated with improvement in parents' perceptions of asthma care and self-reported asthma-management knowledge and confidence. This positive impact on parents may help sustain care coordination's impact on children.	
27901600	Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.
27901352	This study explores the implications of the digital network society for public health communication and management through an empirical study on communication related to the transboundary haze crisis in Singapore. Using the Social Amplification of Risk Framework (SARF), the authors applied sentiment and thematic analysis on haze-related posts on an online discussion forum (HardwareZone) and a social networking site (Facebook), and to haze-related articles in The Straits Times (a newspaper). The study shows that the medium matters in social amplification of risk: Facebook had an effect on the amplification of emotions, while HardwareZone and The Straits Times did not. In addition, the results show that spikes in online risk amplification were strongly influenced by unprecedented events. They also suggest that anger expressed online may be linked to a sense of futility. Implications for practice and recommendations for future research are provided in the conclusion.
27900995	Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up.A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method.	Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [CI]: 0.176-2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057-0.067; P = 0.034).	The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.	Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.	
27900934	In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births.A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender.	Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health.	Inequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities.	
27900669	Disruptive behaviour, which we define as behaviour that does not show others an adequate level of respect and causes victims or witnesses to feel threatened, is a concern in the operating room. This review summarizes the current literature on disruptive behaviour as it applies to the perioperative domain.Searches of MEDLINE®, Scopus™, and Google books identified articles and monographs of interest, with backreferencing used as a supplemental strategy.	Much of the data comes from studies outside the operating room and has significant methodological limitations. Disruptive behaviour has intrapersonal, interpersonal, and organizational causes. While fewer than 10% of clinicians display disruptive behaviour, up to 98% of clinicians report witnessing disruptive behaviour in the last year, 70% report being treated with incivility, and 36% report being bullied. This type of conduct can have many negative ramifications for clinicians, students, and institutions. Although the evidence regarding patient outcomes is primarily based on clinician perceptions, anecdotes, and expert opinion, this evidence supports the contention of an increase in morbidity and mortality. The plausible mechanism for this increase is social undermining of teamwork, communication, clinical decision-making, and technical performance. The behavioural responses of those who are exposed to such conduct can positively or adversely moderate the consequences of disruptive behaviour. All operating room professions are involved, with the rank order (from high to low) being surgeons, nurses, anesthesiologists, and "others". The optimal approaches to the prevention and management of disruptive behaviour are uncertain, but they include preventative and professional development courses, training in soft skills and teamwork, institutional efforts to optimize the workplace, clinician contracts outlining the clinician's (and institution's) responsibilities, institutional policies that are monitored and enforced, regular performance feedback, and clinician coaching/remediation as required.	Disruptive behaviour remains a part of operating room culture, with many associated deleterious effects. There is a widely accepted view that disruptive behaviour can lead to increased patient morbidity and mortality. This is mechanistically plausible, but more rigorous studies are required to confirm the effects and estimate their magnitude. An important measure that individual clinicians can take is to monitor and control their own behaviour, including their responses to disruptive behaviour.	

27899901	Exposure to environmental chemicals, such as dioxin, is known to have adverse effects on the homeostasis of gonadal steroids, thereby potentially altering the sexual differentiation of the brain to express autistic traits. Dioxin-like chemicals act on the aryl hydrocarbon receptor (AhR), polymorphisms, and mutations of AhR-related gene may exert pathological influences on sexual differentiation of the brain, causing autistic traits. To ascertain the relationship between AhR-related gene polymorphisms and autism susceptibility, we identified genotypes of them in patients and controls and determined whether there are different gene and genotype distributions between both groups. In addition, to clarify the relationships between the polymorphisms and the severity of autism, we compared the two genotypes of AhR-related genes (rs2066853, rs2228099) with the severity of autistic symptoms. Although no statistically significant difference was found between autism spectrum disorder (ASD) patients and control individuals for the genotypic distribution of any of the polymorphisms studied herein, a significant difference in the total score of severity was observed in rs2228099 polymorphism, suggesting that the polymorphism modifies the severity of ASD symptoms but not ASD susceptibility. Moreover, we found that a significant difference in the social communication score of severity was observed. These results suggest that the rs2228099 polymorphism is possibly associated with the severity of social communication impairment among the diverse ASD symptoms.
27899810	This study aims to evaluate a potential selection effect caused by exclusion of children with non-identifiable infancy peak (IP) and adiposity rebound (AR) when estimating associations between age and body mass index (BMI) at IP and AR and later weight status.In 4744 children with at least 4 repeated measurements of height and weight in the age interval from 0 to 8 years (37 998 measurements) participating in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants)/I.Family cohort study, fractional polynomial multilevel models were used to derive individual BMI trajectories. Based on these trajectories, age and BMI at IP and AR, BMI values and growth velocities at selected ages as well as the area under the BMI curve were estimated. The BMI growth measures were standardized and related to later BMI z-scores (mean age at outcome assessment: 9.2 years).	Age and BMI at IP and AR were not identifiable in 5.4% and 7.8% of the children, respectively. These groups of children showed a significantly higher BMI growth during infancy and childhood. In the remaining sample, BMI at IP correlated almost perfectly (r⩾0.99) with BMI at ages 0.5, 1 and 1.5 years, whereas BMI at AR correlated perfectly with BMI at ages 4-6 years (r⩾0.98). In the total study group, BMI values in infancy and childhood were positively associated with later BMI z-scores where associations increased with age. Associations between BMI velocities and later BMI z-scores were largest at ages 5 and 6 years. Results differed for children with non-identifiable IP and AR, demonstrating a selection effect.	IP and AR may not be estimable in children with higher-than-average BMI growth. Excluding these children from analyses may result in a selection bias that distorts effect estimates. BMI values at ages 1 and 5 years might be more appropriate to use as predictors for later weight status instead.	
27899797	The growth of social media presents opportunities for public health to increase its influence and impact on the social determinants of health and health equity. The National Collaborating Centre for Determinants of Health at St. Francis Xavier University conducted a survey during the first half of 2016 to assess how public health used social media for knowledge translation, relationship building, and specific public health roles to advance health equity. Respondents reported that social media had an important role in public health. Uptake of social media, while relatively high for personal use, was less present in professional settings and varied for different platforms. Over 20 per cent of those surveyed used Twitter or Facebook at least weekly for knowledge exchange. A lesser number used social media for specific health equity action. Opportunities to enhance the use of social media in public health persist. Capacity building and organizational policies that support social media use may help achieve this.
27899794	Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports, we identified 50 digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian cycle that they were used in, and the health outcomes or determinants of health they affected. Digital technologies were found to facilitate communication, coordination, and collection and analysis of data, enabling timely responses in humanitarian contexts. A lack of evaluation of these technologies, a paternalistic approach to their development, and issues of privacy and equity constituted major challenges. We highlight the need to create a space for dialogue between technology designers and populations affected by humanitarian crises.
27899712	The Social Communication Questionnaire is one of the most commonly used screening tools for autism spectrum disorder. The Social Communication Questionnaire is a caregiver-reported questionnaire with 40 items based on questions from the Autism Diagnostic Interview-Revised. This study collected Social Communication Questionnaire data from a community-based, multi-stage case identification design epidemiologic study in one socioeconomically disadvantaged county in Taiwan. The Social Communication Questionnaire was distributed to 3034 school children, aged 6-8 years. Item prevalence results indicate males were reported to have more autism-related behaviors than females (higher prevalence on most items), in the whole study sample as well as in children meeting Social Communication Questionnaire clinical cut-offs (⩾15). Children whose biological fathers completed the Social Communication Questionnaire were reported to have more behavioral issues than children whose biological mothers were the respondent. Lower respondent education levels were associated with reports of clinically concerning autism-related behaviors. However, males were not at higher risk of meeting Social Communication Questionnaire clinical cut-offs than females in this study population. Findings from this study help to better understand reporting patterns on children's autism-related behaviors potentially due to social demographic characteristics and child sex, which may lead to improved identification of these behaviors.
27899711	We present a meta-analysis of studies that compare figurative language comprehension in individuals with autism spectrum disorder and in typically developing controls who were matched based on chronological age or/and language ability. A total of 41 studies and 45 independent effect sizes were included based on predetermined inclusion criteria. Group matching strategy, age, types of figurative language, and cross-linguistic differences were examined as predictors that might explain heterogeneity in effect sizes. Overall, individuals with autism spectrum disorder showed poorer comprehension of figurative language than their typically developing peers (Hedges' g = -0.57). A meta-regression analysis showed that group matching strategy and types of figurative language were significantly related to differences in effect sizes, whereas chronological age and cross-linguistic differences were not. Differences between the autism spectrum disorder and typically developing groups were small and nonsignificant when the groups were matched based on the language ability. Metaphors were more difficult to comprehend for individuals with autism spectrum disorder compared with typically developing controls than were irony and sarcasm. Our findings highlight the critical role of core language skills in figurative language comprehension. Interventions and educational programmes designed to improve social communication skills in individuals with autism spectrum disorder may beneficially target core language skills in addition to social skills.
27899710	Autobiographical descriptions and clinician observations suggest that some individuals with autism, particularly females, 'camouflage' their social communication difficulties, which may require considerable cognitive effort and lead to increased stress, anxiety and depression. Using data from 60 age- and IQ-matched men and women with autism (without intellectual disability), we operationalized camouflaging in adults with autism for the first time as the quantitative discrepancy between the person's 'external' behavioural presentation in social-interpersonal contexts (measured by the Autism Diagnostic Observation Schedule) and the person's 'internal' status (dispositional traits measured by the Autism Spectrum Quotient and social cognitive capability measured by the 'Reading the Mind in the Eyes' Test). We found that the operationalized camouflaging measure was not significantly correlated with age or IQ. On average, women with autism had higher camouflaging scores than men with autism (Cohen's d = 0.98), with substantial variability in both groups. Greater camouflaging was associated with more depressive symptoms in men and better signal-detection sensitivity in women with autism. The neuroanatomical association with camouflaging score was largely sex/gender-dependent and significant only in women: from reverse inference, the most correlated cognitive terms were about emotion and memory. The underlying constructs, measurement, mechanisms, consequences and heterogeneity of camouflaging in autism warrant further investigation.
27899479	Physical activity (PA) levels are lower among some UK Black and minority ethnic (BME) groups than the majority White British population and a variety of tailored interventions have emerged. This study documents the characteristics and logic of local adaptations, a vital first step in evaluating such innovations.An English PA data set was examined to identify and characterize PA programmes focussed on BME populations. Three case studies were conducted, employing documentary analysis and qualitative interviews. Netto et al.'s principles of adapting health promotion interventions for BME populations guided the analysis.	Out of 861 PA interventions, 57 focussed on BME populations. These were typically aimed to engage the most inactive groups, improve both health and social outcomes and were largely publically/charitably funded. Tailored approaches matched Netto et al.'s five principles: using community resources for publicity, identifying and addressing barriers, developing sensitive communication strategies, working with values and accommodating cultural identification. Another common principle was identified: building community capacity for sustainability.	PA interventions tailored to the needs of BME groups reflect their largely disadvantaged position in society and focus on inactivity. The six principles could be used as a framework for developing, designing and evaluating tailored interventions for BME populations.	
27899339	Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children.This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers' permissiveness regarding their teenage daughters' use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers.	The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers' permissiveness regarding their teenage daughters' use of indoor tanning, teenage daughters' perception of their mothers' permissiveness, and indoor tanning by both mothers and daughters.	The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019.	This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations.	
27899268	Information and Communication Technology (ICT) is connected with every aspect of social, cultural, economic, educational, and commercial activity. Smart devices in particular have changed society and are necessary goods for modern people. Smart device usage is rapidly growing in everyday life, so the ability to use a smart device is increasingly important, yet there is little data supporting increased digital inclusion of people with disabilities in mobile device use.This study investigates the effects of the smart environment on the information divide experienced by people with disabilities.	Data from the 2013 Information Divide Index Data of the National Information Society Agency was analyzed regarding three aspects: access, skill, and competence. The accessibility difference was investigated by comparing access to a PC or smart device in two groups. The effects of a smart environment on the information divide were analyzed using General Linear Modeling (GLM).	The access rate was higher for the general group than for that of those with disabilities, and this difference appeared to be greater in the smart environment. The results of the GLM showed that disability and device access had statistically significant effects on skill and all aspects of competence.	These results provide evidence that the smart environment further creates the information divide for people with disabilities. Strategies should be formed to reduce this divide, particularly within smart environments.	
27899138	Converging evidence demonstrates the important role of the neuropeptide hormone oxytocin (OT) in human behaviour and cognition. Intranasal OT administration has been shown to improve several aspects of social communication, such as the theory of mind performance and gaze to the eye region, and reduce anxiety and related negative cognitive appraisals. While this early research has demonstrated the potential for intranasal OT to treat psychiatric illnesses characterized by social impairments, the neurobiological mechanisms are not well known. Researchers have used functional magnetic resonance imaging (fMRI) to examine the neural correlates of OT response; however, results have been variable and moderating factors are poorly understood. The aim of this meta-analysis is to synthesize data examining the impact of intranasal OT administration on neural activity.Studies that report fMRI data after intranasal OT administration will be identified. PubMed, Embase, PsycINFO, and Google Scholar databases will be searched as well as the citation lists of retrieved articles. Eligible articles written in English from 2005 onwards will be included in the meta-analysis, and corresponding authors of these papers will be invited to contribute t-maps. Data will be collected from eligible studies for synthesis using Seed-based d Mapping (SDM) or Multi-Level Kernel Density Analysis (MKDA), depending on the number of usable t-maps received. Additionally, publication bias and risk of bias will be assessed.	This systematic review and meta-analysis will be the first pre-registered synthesis of data to identify the neural correlates of OT nasal spray response. The identification of brain regions underlying OT's observed effects will help guide future research and better identify treatment targets.	PROSPERO CRD42016038781.	
27898573	To address low human papillomavirus (HPV) vaccination coverage, the American Academy of Family Physicians (AAFP) and the American Academy of Pediatrics (AAP) have launched national campaigns encouraging physicians to deliver strong HPV vaccine recommendations. We surveyed family physicians and pediatricians to examine the impact of these efforts on physicians' recommendation practices.A national sample of family physicians and pediatricians (n = 776) completed our online survey in 2014. The survey assessed reach, content, and influence of AAFP and AAP communications about HPV vaccination. The survey also assessed quality of physicians' communication practices for recommending HPV vaccination.	Forty-seven percent of family physicians reported receiving information on HPV vaccination from AAFP, whereas 62% of pediatricians reported receiving information from AAP. Among physicians reached by AAFP or AAP, most reported receiving the message to give strong recommendations to adolescent boys (71%) and girls (78%). Although receiving information was not associated with HPV vaccine recommendation quality, receiving the message to give strong recommendations correlated with delivering higher-quality recommendations for boys (odds ratio, 4.19, 95% confidence interval, 2.64-6.64) and girls (odds ratio, 3.15, 95% confidence interval, 1.91-5.18). Over half of physicians reported improving their HPV vaccine communication after receiving information from AAFP (69%) or AAP (53%).	Our findings suggest that it is important for AAFP and AAP to communicate the need for strong HPV vaccine recommendations. Given that many physicians reported improving their recommendation practices, professional organizations stand to contribute to increasing HPV vaccination coverage, but they will likely need to increase the intensity of quality improvement efforts to do so.	
27898281	Dementia affects more than 5 million Americans, and is a leading cause of death. Family members of nursing home (NH) residents with advanced dementia report difficulty making decisions about care toward the end of life. As part of a randomized trial testing an intervention to improve decision making, this qualitative study aimed to understand how family decision makers experienced goal-based decision making in advance of the death of their relative.This qualitative study was conducted as part of the goals of care clinical trial. Study participants (n = 16) were family decision makers in North Carolina whose relative with advanced dementia died after participating in the goals of care intervention. Semi-structured interviews were analyzed using a qualitative description approach.	Family members' experience of decision making and death differed based on the presence or absence of trusting relationships with NH staff. Family members who reported trust described a positive end-of-life experience and less need for prescribed goals of care discussions. In the absence of trust, family members reported that goals of care discussions were ignored by staff or created confusion.	Among family members of persons who recently died from dementia in NHs, expressions of trust in staff were strongly related to perceptions of decision making about goals of care. Although goals of care discussions may potentially promote communication to earn trust, the presence of pre-existing trust ultimately influenced the decision making and end-of-life experiences of residents and families.	
27897609	The researchers conducted a communication training intervention for certified nursing assistants (CNAs). The intervention aimed at improving CNAs' therapeutic techniques for relating to agitated residents during care. This study focused on an in-depth evaluation of mealtime interactions using videos. Sixteen CNAs and 16 residents living with dementia from one long-term care facility were videotaped during mealtime interactions before and after a therapeutic communication training program. Mixed-effect Poisson regression revealed no effect of the intervention as a whole on residents' refusals, but the intervention did improve CNAs' communication. Additional analyses using specific CNAs' therapeutic communication behaviors indicated a significant negative association with refusals at post-test but not pretest. The findings suggest some communication mechanisms for how the intervention positively influenced residents' refusals.
27897466	Telemedicine holds promise in bridging the gap between homebound patients and high quality health care, but uptake of such technology remains limited. Qualitative interviews conducted with 17 homebound patients found two major barriers to telemedicine. First, participants who lack familiarity with technology are hesitant about telemedicine, as baseline use of technology in the home is limited, participants did not feel capable of learning, and the advantages of telemedicine were unclear. Second, homebound patients place a high value on in-office visits due to therapeutic benefit, face-to-face communication, and the social aspect of medical appointments.
27897451	Although death has been frequently discussed in health communication, there has been a lack of research on coping with loss. Nevertheless, there are many websites and social network sites that offer suggestions to people as to how to cope with loss, including sites for support, sharing of experiences, and expressing grief. This article provides a theoretical understanding of grief by considering it as an emotional experience in terms of how it is expressed, its consequences, and the confrontation between the offline and online grief experience.

27896539	There are various reasons why efforts to promote "support for self-management" have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When (the promotion of) support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling 'partnership working'; run the risk of undermining patients' self-evaluative attitudes (and then of failing to notice that as harmful); limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live (and die) well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people (both generally and more specifically) for living well, help keep the importance of disease control in perspective, recognize social influences on people's values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice.
27895966	In order to adopt and activate telemedicine it is necessary to survey how medical staff, who are providers of medical service, and consumers, who are the service targets, perceive information and communication technology (ICT)-based healthcare service.This study surveyed the awareness and acceptability of ICT-based healthcare by involving service targets, specifically workers and students living in the Seoul and Gyeonggi regions who are consumers of healthcare service. To determine the correlation among awareness of ICT-based healthcare, the need for self-management, and acceptability, this study conducted a correlation analysis and a simple regression analysis.	According to the responses to the questions on the need for ICT-based healthcare service by item, blood pressure (n = 279, 94.3%) and glucose (n = 277, 93.6%) were revealed to be the physiological signal monitoring area. Among the six measurement factors affecting ICT-based healthcare service acceptability, age, health concerns, and effect expectation had the most significant effects. As effect expectation increased, acceptability became 4.38 times higher (p < 0.05).	This study identified a positive awareness of service targets on ICT-based healthcare service. The fact that acceptability is higher among people who have family disease history or greater health concerns may lead to service targets' more active participation. This study also confirmed that a policy to motivate active participation of those in their 40s (who had high prevalence rates) was needed.	
27895894	Social media has become a major platform for debates on science and health. This commentary argues that while social media can present challenges to communicating important health matters, it can also provide health experts a unique opportunity to engage with and build trust among members of the public.
27895699	This study aimed to identify the resilience and burnout status of nurses working in the field of oncology.This descriptive study was conducted with 140 oncology nurses. The data were collected using a socio-demographic attributes form, Resilience Scale for Adults, and the Maslach's Burnout Inventory. Percentage ratios, mean and median values, Kruskal-Wallis test, Mann-Whitney U test, correlation analysis, and multiple stepwise linear regression analysis were used to evaluate the data.	The Maslach's Burnout Inventory total median score was 49.00. The emotional exhaustion median score was 24.00, the depersonalization median score was 9.00, and the personal accomplishment median score was 16.00. The Resilience Scale for Adults total median score was 134.00. The median resilience subscale scores, such as structural style, perception of future, family cohesion, self-perception, social competence, and social resources, were 16.00, 16.00, 24.00, 25, 23, and 31, respectively. A relationship existed between emotional exhaustion and perception of future; depersonalization and structured style and self-perception; and personal accomplishment and structured style, perception of future, and self-perception. Multiple stepwise linear regression analysis revealed a significant relationship between the number of years in the field and emotional exhaustion and depersonalization scores. Moreover, a significant relationship between structured style variables and personal accomplishment scores was observed.	This study demonstrated the relationship between burnout and resilience situations among the oncology nurses. The results can be used to plan individual and organizational interventions to increase resilience and reduce the experience of burnout by developing measures such as improving communication skills, providing education on stress management and coping strategies, using social resources, and organizing programs that provide psychological support.	
27895559	Vision is a very important sensory modality in humans. Visual disorders are numerous and arising from diverse and complex causes. Deficits in visual function are highly disabling from a social point of view and in addition cause a considerable economic burden. For all these reasons there is an intense effort by the scientific community to gather knowledge on visual deficit mechanisms and to find possible new strategies for recovery and treatment. In this review, we focus on an important and sometimes neglected player of the visual function, the corpus callosum (CC). The CC is the major white matter structure in the brain and is involved in information processing between the two hemispheres. In particular, visual callosal connections interconnect homologous areas of visual cortices, binding together the two halves of the visual field. This interhemispheric communication plays a significant role in visual cortical output. Here, we will first review the essential literature on the physiology of the callosal connections in normal vision. The available data support the view that the callosum contributes to both excitation and inhibition to the target hemisphere, with a dynamic adaptation to the strength of the incoming visual input. Next, we will focus on data showing how callosal connections may sense visual alterations and respond to the classical paradigm for the study of visual plasticity, i.e., monocular deprivation (MD). This is a prototypical example of a model for the study of callosal plasticity in pathological conditions (e.g., strabismus and amblyopia) characterized by unbalanced input from the two eyes. We will also discuss the findings of callosal alterations in blind subjects. Noteworthy, we will discuss data showing that inter-hemispheric transfer mediates recovery of visual responsiveness following cortical damage. Finally, we will provide an overview of how callosal projections dysfunction could contribute to pathologies such as neglect and occipital epilepsy. A particular focus will be on reviewing noninvasive brain stimulation techniques and optogenetic approaches that allow to selectively manipulate callosal function and to probe its involvement in cortical processing and plasticity. Overall, the data indicate that experience can potently impact on transcallosal connectivity, and that the callosum itself is crucial for plasticity and recovery in various disorders of the visual pathway.
27895097	This paper presents the results of a large study of 1340 articles published by two major newspapers in six European countries (Belgium, Italy, Norway, Slovenia, Spain and Russia) in the first 2 months after the Fukushima Daiichi nuclear disaster. The focus of the analysis is on the application and overall impact of protective actions, both during the emergency phase and later, how the newspapers describe those actions, which differences were apparent between countries and what recommendations can be extracted in order to improve general communication about these issues. A clear lesson is that, even under uncertainty and recognising limitations, responsible authorities need to provide transparent, clear and understandable information to the public and the mass media right from the beginning of the early phase of any nuclear emergency. Clear, concise messages should be given. Mass media could play a key role in reassuring the public if the countermeasures are clearly explained.
27895050	The dissemination of information is a basic element of group cohesion. In honey bees (Apis mellifera Linnaeus 1758), like in other social insects, the principal method for colony-wide information exchange is communication via pheromones. This medium of communication allows multiple individuals to conduct tasks critical to colony survival. Social signaling also establishes conflict at the level of the individual who must trade-off between attending to the immediate environment or the social demand. In this study we examined this conflict by challenging highly social worker honey bees, and less social male drone honey bees undergoing aversive training by presenting them with a social stress signal (isopentyl acetate, IPA). We utilized IPA exposure methods that caused lower learning performance in appetitive learning in workers. Exposure to isopentyl acetate (IPA) did not affect performance of drones and had a dose-specific effect on worker response, with positive effects diminishing at higher IPA doses. The IPA effects are specific because non-social cues, such as the odor cineole, improve learning performance in drones, and social homing signals (geraniol) did not have a discernible effect on drone or worker performance. We conclude that social signals do generate conflict and that response to them is dependent on signal relevance to the individual as well as the context. We discuss the effect of social signal on learning both related to its social role and potential evolutionary history.
27894440	Most neurodevelopmental disorders are defined by their clinical symptoms and many disorders share common features. Recently there has been an increase in the number of children diagnosed with autism spectrum disorder, although concerns have been raised about the accuracy of the reported prevalence rates. This article reviews the essential features of autism spectrum disorder and describes other conditions that may include similar symptoms that may be misdiagnosed as autism spectrum disorder (primary communication disorders, anxiety disorders, attachment disorders, intellectual disability, vision and hearing impairment, and normal variations). An approach to differential diagnosis is discussed with particular attention to evaluation of young children.
27894417	Social insects frequently engage in oral fluid exchange - trophallaxis - between adults, and between adults and larvae. Although trophallaxis is widely considered a food-sharing mechanism, we hypothesized that endogenous components of this fluid might underlie a novel means of chemical communication between colony members. Through protein and small-molecule mass spectrometry and RNA sequencing, we found that trophallactic fluid in the ant Camponotus floridanus contains a set of specific digestion- and non-digestion related proteins, as well as hydrocarbons, microRNAs, and a key developmental regulator, juvenile hormone. When C. floridanus workers' food was supplemented with this hormone, the larvae they reared via trophallaxis were twice as likely to complete metamorphosis and became larger workers. Comparison of trophallactic fluid proteins across social insect species revealed that many are regulators of growth, development and behavioral maturation. These results suggest that trophallaxis plays previously unsuspected roles in communication and enables communal control of colony phenotypes.
27894371	Parental criminal offending is an established risk factor for offending among offspring, but little evidence is available indicating the impact of offending on early childhood functioning. We used data from a large Australian population cohort to determine associations between exposure to parental offending and a range of developmental outcomes at age 5 years.Multi-generation data in 66 477 children and their parents from the New South Wales Child Development Study were combined using data linkage. Logistic and multinomial regressions tested associations between any and violent offending histories of parents (fathers, mothers, or both parents) obtained from official records, and multiple measures of early childhood developmental functioning (social, emotional-behavioural, cognitive, communication and physical domains) obtained from the teacher-reported 2009 Australian Early Development Census.	Parental offending conferred significantly increased risk of vulnerability on all domains, particularly the cognitive domain. Greater risk magnitudes were observed for offending by both parents and by mothers than by fathers, and for violent than for any offending. For all parental offending exposures, vulnerability on multiple domains (where medium to large effects were observed) was more likely than on a single domain (small to medium effects). Relationships remained significant and of comparable magnitude following adjustment for sociodemographic covariates.	The effect of parental offending on early childhood developmental outcomes is pervasive, with the strongest effects on functioning apparent when both parents engage in violent offending. Supporting affected families in early childhood might mitigate both early developmental vulnerability and the propensity for later delinquency among these offspring.	
27894273	Autism spectrum disorder (ASD) is a heterogeneous disorder characterized not only by deficits in communication and social interactions but also a high rate of co-occurring disorders, including metabolic abnormalities, gastrointestinal and sleep disorders, and seizures. Seizures, when present, interfere with cognitive development and are associated with a higher mortality rate in the ASD population.To determine the relative prevalence of non-febrile seizures in children with idiopathic ASD from multiplex and simplex families compared with the unaffected siblings in a cohort of 610 children with idiopathic ASD and their 160 unaffected siblings, participating in the Autism Genetic Resource Exchange project, the secondary analysis was performed comparing the life-time prevalence of non-febrile seizures. Statistical models to account for non-independence of observations, inherent with the data from multiplex families, were used in assessing potential confounding effects of age, gender, and history of febrile seizures on odds of having non-febrile seizures.	The life-time prevalence of non-febrile seizures was 8.2% among children with ASD and 2.5% among their unaffected siblings. In a logistic regression analysis that adjusted for familial clustering, children with ASD had 5.27 (95%CI: 1.51-18.35) times higher odds of having non-febrile seizures compared to their unaffected siblings. In this comparison, age, presence of gastrointestinal dysfunction, and history of febrile seizures were significantly associated with the prevalence of non-febrile seizures.	Children with idiopathic ASD are significantly more likely to have non-febrile seizures than their unaffected siblings, suggesting that non-febrile seizures may be ASD-specific. Further studies are needed to determine modifiable risk factors for non-febrile seizures in ASD.	
27893907	Studies of graduate online education indicate a need for increased interaction among students and faculty. However, it can be challenging to foster a high level of scholarly interaction and engagement in fully online courses. The objective of this study was to evaluate student perceptions and participation patterns related to online, asynchronous video discussion in a graduate health sciences course.An asynchronous video discussion was piloted in a 2014 interprofessional informatics course and students were subsequently surveyed to determine their perceptions of this approach. Participation patterns were analyzed using descriptive statistics and social network analysis.	The results indicate broad and inclusive interaction among students and faculty, with discussion characteristics perceived as equivalent to, or better than, traditional classroom discussion. The quality of student participation was high, and students spent additional time researching and preparing their contributions.	This format for a seminar-style discussion holds good potential for effective teaching and learning in online graduate-level health courses and supports the development of students' critical thinking and scholarly communication skills. [J Nurs Educ. 2016;55(12):706-710.].	
27893884	In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired.To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia.	A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes.	A GOC video decision aid plus a structured discussion with nursing home health care providers; attention control with an informational video and usual care planning.	Primary outcomes at 3 months were quality of communication (QOC, questionnaire scored 0-10 with higher ratings indicating better quality), family report of concordance with clinicians on the primary goal of care (endorsing same goal as the "best goal to guide care and medical treatment," and clinicians' "top priority for care and medical treatment"), and treatment consistent with preferences (Advance Care Planning Problem score). Secondary outcomes at 9 months were family ratings of symptom management and care, palliative care domains in care plans, Medical Orders for Scope of Treatment (MOST) completion, and hospital transfers. Resident-family dyads were the primary unit of analysis, and all analyses used intention-to-treat assignment.	Residents' mean age was 86.5 years, 39 (12.9%) were African American, and 246 (81.5%) were women. With the GOC intervention, family decision makers reported better quality of communication (QOC, 6.0 vs 5.6; P = .05) and better end-of-life communication (QOC end-of-life subscale, 3.7 vs 3.0; P = .02). Goal concordance did not differ at 3 months, but family decision makers with the intervention reported greater concordance by 9 months or death (133 [88.4%] vs 108 [71.2%], P = .001). Family ratings of treatment consistent with preferences, symptom management, and quality of care did not differ. Residents in the intervention group had more palliative care content in treatment plans (5.6 vs 4.7, P = .02), MOST order sets (35% vs 16%, P = .05), and half as many hospital transfers (0.078 vs 0.163 per 90 person-days; RR, 0.47; 95% CI, 0.26-0.88). Survival at 9 months was unaffected (adjusted hazard ratio [aHR], 0.76; 95% CI, 0.54-1.08; P = .13).	The GOC decision aid intervention is effective to improve end-of-life communication for nursing home residents with advanced dementia and enhance palliative care plans while reducing hospital transfers.	
27893748	Each stage of the human life course is characterised by a distinctive pattern of social relations. We study how the intensity and importance of the closest social contacts vary across the life course, using a large database of mobile communication from a European country. We first determine the most likely social relationship type from these mobile phone records by relating the age and gender of the caller and recipient to the frequency, length, and direction of calls. We then show how communication patterns between parents and children, romantic partner, and friends vary across the six main stages of the adult family life course. Young adulthood is dominated by a gradual shift of call activity from parents to close friends, and then to a romantic partner, culminating in the period of early family formation during which the focus is on the romantic partner. During middle adulthood call patterns suggest a high dependence on the parents of the ego, who, presumably often provide alloparental care, while at this stage female same-gender friendship also peaks. During post-reproductive adulthood, individuals and especially women balance close social contacts among three generations. The age of grandparenthood brings the children entering adulthood and family formation into the focus, and is associated with a realignment of close social contacts especially among women, while the old age is dominated by dependence on their children.
27893318	The present study explored the prevalence of the r-word in schools and students' bystander behavior in response to hearing the word. In total, 2,297 students from 12 high schools across the country participated in this study. Results revealed the r-word was used frequently among high school students, most often toward individuals without intellectual disability (ID). Students were more likely to take an active bystander role when hearing the r-word used toward students with ID than when hearing it used toward students without ID. Students' gender and prosocialness also played a role in determining their bystander behavior in response to the r-word. This study has implications for reducing the use of the r-word and the stigma associated with ID.
27891726	There has been increasing interest in dementia care in recent years, including how practitioners, service providers and society in general can help individuals to live well with the condition. An important aspect to this is provision of advice to ensure conversation partners effectively support the person with dementia in conversation.To provide a descriptive review of the literature examining everyday conversation in dementia in order to inform practice and research.	This review used a method specifically developed for reviewing conversation analytic and related literature. A range of databases were searched using key words and explicitly described inclusion criteria leading to a final corpus of 50 titles. Using this qualitative methodology, each paper was examined and data extracted. The contribution of each of these is described and the implications for practice and research are outlined.	This review examined studies into conversation in Alzheimer's disease, vascular dementia and Lewy body dementia, grouping these into: early influential studies; work drawing on positioning theory; studies using social and linguistic approaches; collaborative storytelling; formulaic language; studies specifically using conversation analysis; and conversation as a target for individualized therapy. In addition, more recent work examining primary progressive aphasia and behavioural variant frontotemporal dementia was explored. Overall, this review indicates that research examining conversation in natural settings provides a rich source of data to explore not just the challenges within conversation for those taking part, but also the skills retained by the person with dementia. An important aspect of this understanding is the notion that these skills relate not only to information exchange but also aspects of social interaction. The role of others in scaffolding the conversation abilities of the person with dementia and the potential of this for developing interventions are discussed.	The review indicates that interventions targeting conversation in dementia are often advocated in the literature but currently such approaches remain to be systematically evaluated. In addition, many of the important insights arising from these studies have yet to inform multidisciplinary dementia care practice.	
27891725	Social communication problems are common in adults with traumatic brain injury (TBI), particularly problems in spoken discourse. Social communication problems are thought to reflect underlying cognitive impairments.To measure the contribution of two cognitive processes, executive functioning (EF) and theory of mind (ToM), to the communication of adults with TBI, and to investigate the relationships between discourse performance and potential communication partners' perceptions.	Twenty-one adults with moderate-to-severe TBI and 23 uninjured adults completed a discourse task in which EF and ToM demands were manipulated across three conditions: baseline, high-EF and high-ToM. Dependent variables were fluency (for EFs), number of mental state terms (MSTs; for ToM) and speech rate. Discourse from high-EF/ToM conditions was judged by naïve raters for social acceptability.	The TBI group produced significantly fewer MSTs than the comparison group across conditions and also spoke at a slower rate, and there were significant effects of condition on both measures (MST: high-EF < baseline = high-ToM; speech rate: high-EF < high-ToM < baseline). There were no significant between-groups differences in fluency or interaction of fluency with condition. MST use and fluency were associated with social acceptability ratings.	Results added further evidence of social communication problems in adults with TBI and demonstrated that discourse behaviours may negatively affect how a speaker is perceived. Results also indicated that task manipulations can affect discourse performance, suggesting that general cognitive demands may influence social communication after TBI.	
27891524	Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.
27891471	Autism is a neuro-developmental disorder which is manifested as impairment of social interaction, communication and a repetitive behaviour. Autism can obscure dental treatment for the affected patients; furthermore, children with autism commonly have destructive oral habits.The aims of this study were to evaluate the Modified Gingival Index (MGI), Plaque Index (PI), salivary pH and buffering capacity of the saliva among autistic children compared to normal children in Riyadh City that may provide baseline data to enable comparison and future planning of dental services for autistic children.	A total of 50 children diagnosed with autism (mean age 8.5 years) were selected from Azzam Autism School, Riyadh City. The control group consisted of 50 non-autistic school children (mean age 8.7 years), gender matched, selected from Outpatient Clinic, Riyadh Colleges of Dentistry and Pharmacy. MGI, PI, salivary pH and salivary buffer capacity tests were done for all participants. The buffering capacity of the stimulated saliva was grouped under 'very low', 'low' and 'normal'. Pearson's Chi square and one way ANOVA were used to find statistical significance if any among the autistic and the normal control group.	The results of the study showed that the mean ± standard deviation of MGI, PI and pH of unstimulated resting saliva for autistic group were 1.82 ± 0.65, 1.92 ± 0.35 and 6.8 ± 0.5 respectively. Normal control group had values 1.35 ± 0.85, 1.44 ± 0.43 and 7 ± 0.4 respectively. A statistically significant difference between both groups for all parameters was found. Salivary buffering capacity was found to be normal for the majority among both groups. However, 60% children among the autistic group presented with normal buffering capacity of the stimulated saliva as compared to 70% among the normal control group. However, this difference was not statistically significant (p = 0.544).	Children with autism appear to have higher gingival inflammation, poor oral hygiene and a slightly lower salivary pH as compared to healthy control group. Special oral health programmes regarding treatment and maintenance of good oral health should be taken in consideration for autistic children.	
27891433	There are estimated 400,000 wandering mentally ill persons in India, found in poor physical state wandering on streets and railway stations; mainly treated either by government run Hospitals for Mental Health (HMH) or Psychiatry units of a Government Medical College (GMC). They require psychosocial rehabilitation along with treatment.To study the presentation, clinical profile and rehabilitative outcome of wandering mentally ill admitted in government psychiatric care facilities. The objective was to establish them as a distinct psychiatric inpatient population requiring special attention.	The study was a chart review of all wandering mentally ill patients institutionalized during a period of two years in two distinct government facilities. Additionally, clinical staff was interviewed for cross checking the data and for eliciting problems faced in management. The discharged patients were contacted to assess the present status.	Forty seven patients in HMH and 35 patients in GMC were studied. Wandering mentally ill patients were brought to mental health facility by helping person (30) and police (23). Majority of them (61) were picked up from streets and railway station. Most of them (56) belonged to <40 years age group and communication with them was difficult due to language barrier in 51. Diagnosed as Psychosis NOS (45) initially, they presented with poor physical condition, with positive viral markers (25) and pregnancy in females (4). Most common final diagnosis was schizophrenia (45) along with prominent negative symptoms and poor cognitive abilities. Forty three of them showed good improvement on treatment. Forty five gave their address; Relatives were found in 39 through police, post cards and social workers and were rehabilitated back to family.	Wandering mentally ill constitutes a unique patient population with specific challenges different from other inpatients in management and rehabilitation. Provisions to take care of this most vulnerable group of the society and mechanisms to watch for their continuous implementation are required.	
27891209	To test the feasibility, usability, and proximal outcomes of Connecting, an adaptation of a low-cost, self-directed, family-based substance use prevention program, Staying Connected with Your Teen, with foster families in a randomized, waitlist control pilot study.Families (n = 60) fostering teens between 11 and 15 years of age were recruited into the study and randomly assigned into the self-administered program with telephone support from a family consultant (n = 32) or a waitlist control condition (n = 28).	Overall satisfaction with the program was high, with 100% of parents reporting they would recommend the program to other caregivers and reporting being "very satisfied" or "satisfied with the program. Program completion was good, with 62% of families completing all 91 specified tasks. Analyses of proximal outcomes revealed increased communication about sex and substance use (posttest1 OR = 1.97, and 2.03, respectively). Teens in the intervention vs. the waitlist condition reported lower family conflict (OR=.48), and more family rules related to monitoring (OR = 4.02) and media use (OR = 3.24). Caregivers in the waitlist group reported significant increases in the teen's positive involvements (partial eta sq = 17% increase) after receiving the intervention.	Overall, program participation appeared to lead to stronger family management, better communication between teens and caregivers around monitoring and media use, teen participation in setting family rules, and decreased teen attitudes favorable to antisocial behavior. This small pilot study shows promising results for this adapted program.	
27891107	Online communication applications such as Facebook, WhatsApp, and Twitter are some of the most frequently used Internet applications. There is a growing amount of individuals suffering diminished control over their use of online communication applications which leads to diverse negative consequences in offline life. This could be referred to as Internet-communication disorder (ICD). The current study investigates the role of individual characteristics (e.g., psychopathological symptoms, feelings of loneliness) and specific cognitions. In a sample of 485 participants a structural equation model was tested to investigate predictors and mediators which may predict an excessive use. The results emphasize that a higher level of social loneliness and less perceived social support enhance the risk of a pathological use. The effects of psychopathological symptoms (depression and social anxiety) as well as individual characteristics (self-esteem, self-efficacy, and stress vulnerability) on ICD symptoms are mediated by Internet-use expectancies and dysfunctional coping mechanisms. The results illustrate mediation effects which are in line with the theoretical model by Brand et al. (2016). As suggested in the model social aspects seem to be key predictors of ICD symptoms. Further research should investigate convergent and divergent factors of other types of specific Internet-use disorders.
27890155	Humans encounter crowd situations on a daily basis, resulting in both negative and positive experiences. Understanding how to optimise the participant experience of crowds is important. In the study presented in this paper, 5 focus groups were conducted (35 participants, age range: 21-71 years) and 55 crowd situations observed (e.g. transport hubs, sport events, retail situations). Influences on participant experience in crowds identified by the focus groups and observations included: physical design of crowd space and facilities (layout, queuing strategies), crowd movement (monitoring capacity, pedestrian flow), communication and information (signage, wayfinding), comfort and welfare (provision of facilities, environmental comfort), and public order. It was found that important aspects affecting participant experience are often not considered systematically in the planning of events or crowd situations. The findings point to human factors aspects of crowds being overlooked, with the experiences of participants often poor.
27890048	We live in an age when education is being internationalized. This can confront students with 'cultural hegemony' that can result from the unequal distribution of power and privilege in global society. The name that is given to awareness of social inequality is 'critical consciousness'. Cross-cultural dialogue provides an opportunity for learners to develop critical consciousness to counter cultural hegemony. The purpose of this research was to understand how learners engage with cross-cultural dialogue, so we can help them do so more effectively in the future.The setting for this research was an online discussion in an international health professions educator fellowship program. We introduced scenarios with cultural references to study the reaction of participants to cultural conversation cues. We used an inductive thematic analysis to explore power and hegemony issues.	Participants reflected that personally they were more likely to take part in cross-cultural discussions if they recognized the context discussed or had prior exposure to educational settings with cultural diversity. They identified barriers as lack of skills in facilitating cross-cultural discussions and fear of offending others. They suggested deliberately introducing cultural issues throughout the curriculum.	Our results indicate that developing critical consciousness and cross-cultural competency will require instructional design to identify longitudinal opportunities to bring up cross-cultural issues, and training facilitators to foster cross-cultural discussions by asking clarifying questions and navigating crucial/sensitive conversations.	
27889945	The engagement of social media in healthcare continues to expand. For members of the colorectal community, social media has already made a significant impact on practice, education and patient care. The applications are unique such that they provide a platform for instant communication and information sharing with other users worldwide. The purpose of this article is to provide an overview of how social media has the potential to change clinical practice, training, research and patient care in colorectal surgery.
27889825	A critical review of complementary and alternative medicine (CAM) use among people with arthritis was conducted focusing upon prevalence and profile of CAM users as well as their motivation, decision-making, perceived benefits and communication with healthcare providers. A comprehensive search of peer-reviewed literature published from 2008 to 2015 was undertaken via CINAHL, Medline and AMED databases. The initial search identified 4331 articles, of which 49 articles met selection criteria. The review shows a high prevalence of CAM use (often multiple types and concurrent to conventional medical care) among those with arthritis which is not restricted to any particular geographic or social-economic status. A large proportion of arthritis sufferers using CAM consider these medicines to be somewhat or very effective but almost half do not inform their healthcare provider about their CAM use. It is suggested that rheumatologists and others providing health care for patients with arthritis should be cognizant of the high prevalence of CAM use and the challenges associated with possible concurrent use of CAM and conventional medicine among their patients.
27888950	As patients continue to turn to online resources for health care information to guide their care decisions, it is becoming increasingly important for radiologists to engage with patients online via social media platforms. There are many ways physicians can use social media to provide patients with valuable information and improve the overall patient experience. By optimizing online discoverability, curating radiology content, engaging with patient communities, and producing mineable social media content, radiologists can emerge as thought leaders in this new form of patient-centered communication and information exchange.
27888276	Previous research highlights the difficulties patients with end-stage renal disease awaiting kidney transplant experience while attempting to manage both the logistical and the content-related aspects of discussions about transplantation. This article presents pilot results of the behavioral communication intervention program, Communicating about Choices in Transplantation (COACH), designed to improve transplant candidates' communication about transplantation.As compared to matched controls, increases in knowledge of deceased and living donor transplantation, communication self-efficacy, intentions to hold conversations about transplantation, and self-reported discussion were expected for pilot participants from pre- and postassessment; decreases in conversational difficulties were also posited.	Using a nonrandomized quasi-experimental design, we compared transplant knowledge and communication between patients completing a 2-hour COACH session (pilot sample) to a sample of matched controls (n = 10). Data were collected via semi-structured telephone interviews upon enrollment and 1 month after enrollment or attendance at a COACH program session.	The results revealed significant differences in knowledge from pre- to postassessment between the pilot and control samples ( P = .02). Although no other statistically significant between-group differences were found, paired-sample t tests revealed significant pre-post increases in transplant knowledge (7.6 [standard deviation, SD = 2.0] to 9.5 [SD =1.8]; P = .05) and communication self-efficacy (1255.8 [SD = 239.7] to 1513.8 [SD = 114.3]; P = .009) for pilot participants. Decreases in perceived conversational difficulties were also observed ( P = .53).	Results provide preliminary support for the program's impact. Moreover, participant evaluations of the COACH were overwhelmingly positive. A more definitive program evaluation with a larger, more diverse sample is currently underway.	
27888168	After the Fukushima Dai-ichi Nuclear Power Station accident in Japan on March 11, 2011, a large number of comments, both positive and negative, were posted on social media.The objective of this study was to clarify the characteristics of the trend in the number of tweets posted on Twitter, and to estimate how long public concern regarding the accident continued. We surveyed the attenuation period of the first term occurrence related to radiation exposure as a surrogate endpoint for the duration of concern.	We retrieved 18,891,284 tweets from Twitter data between March 11, 2011 and March 10, 2012, containing 143 variables in Japanese. We selected radiation, radioactive, Sievert (Sv), Becquerel (Bq), and gray (Gy) as keywords to estimate the attenuation period of public concern regarding radiation exposure. These data, formatted as comma-separated values, were transferred into a Statistical Analysis System (SAS) dataset for analysis, and survival analysis methodology was followed using the SAS LIFETEST procedure. This study was approved by the institutional review board of Hokkaido University and informed consent was waived.	A Kaplan-Meier curve was used to show the rate of Twitter users posting a message after the accident that included one or more of the keywords. The term Sv occurred in tweets up to one year after the first tweet. Among the Twitter users studied, 75.32% (880,108/1,168,542) tweeted the word radioactive and 9.20% (107,522/1,168,542) tweeted the term Sv. The first reduction was observed within the first 7 days after March 11, 2011. The means and standard errors (SEs) of the duration from the first tweet on March 11, 2011 were 31.9 days (SE 0.096) for radioactive and 300.6 days (SE 0.181) for Sv. These keywords were still being used at the end of the study period. The mean attenuation period for radioactive was one month, and approximately one year for radiation and radiation units. The difference in mean duration between the keywords was attributed to the effect of mass media. Regularly posted messages, such as daily radiation dose reports, were relatively easy to detect from their time and formatted contents. The survival estimation indicated that public concern about the nuclear power plant accident remained after one year.	Although the simple plot of the number of tweets did not show clear results, we estimated the mean attenuation period as approximately one month for the keyword radioactive, and found that the keywords were still being used in posts at the end of the study period. Further research is required to quantify the effect of other phrases in social media data. The results of this exploratory study should advance progress in influencing and quantifying the communication of risk.	
27887665	A plethora of new development goals and funding institutions have greatly increased the demand for internationally comparable health estimates in recent years and have brought important new players into the field of health estimate production. These changes have rekindled debates about the validity and legitimacy of global health estimates. This paper draws on country case studies and personal experience to support our opinion that the production and use of estimates are deeply embedded in specific social, economic, political, and ideational contexts, which vary at different levels of the global health architecture. Broadly, most global health estimates tend to be made far from the localities where the data upon which they are based are collected and where the results of estimation processes must ultimately be used if they are to make a difference to the health of individuals. Internationally standardised indicators are necessary, but they are no substitute for data that meet local needs and that fit with local ideas of what is credible and useful - in other words, data that are both technically and socially robust for those who make key decisions about health. We suggest that greater engagement of local actors (and local data) in the formulation, communication, and interpretation of health estimates would increase the likelihood that these data will be used by those most able to translate them into health gains for the longer term. Besides strengthening national information systems, this requires ongoing interaction, building trust, and establishing a communicative infrastructure. Local capacities to use knowledge to improve health must be supported.
27887029	We investigated whether exposure to same humorous antitobacco videos via different types of social media platforms and contexts (health vs. humor) influences individual's health risk perceptions, attitudes, and behavioral intents. An experiment with a 2 (social media types: YouTube and Facebook) × 2 (message contexts: health-focused and humor-focused contexts) factorial design was conducted. It was found that those who watched the humorous antitobacco videos on Facebook in the health-context exhibited a higher level of risk perception of smoking, less positive attitude toward smokers, and a higher level of intention to avoid smoking in the future than the participants who viewed the same videos on YouTube in the health-context or on Facebook in the humor-context. These findings provide useful practical guidelines in using social media for health communication/promotion. Humorous health promotion messages are best circulated on social networking sites such as Facebook accompanied by others' support for the given health topic (i.e., in health-contexts). Practical/theoretical implications and limitations of the study were further discussed in this article.
27886390	Adolescents have the highest risk for food allergy-related fatalities. Our main aim was to investigate the level of risk in everyday social situations as perceived by adolescents/young adults with peanut allergy, their families, and their friends.The web-based 'Colours Of Risks' (COR) questionnaire was completed by 70 patients (aged 12-23 years), 103 mothers and fathers, 31 siblings (aged 12-26 years), and 42 friends (aged 12-24 years). COR deals with six main contexts (home, school/university, work, visiting/social activities, special occasions/parties, and vacations), each with 1-12 items. Response categories are green (I feel safe), yellow (I feel uncertain), or red (I feel everything is risky).	There was a high level of agreement between participants in defining situations as safe, uncertain, or risky, but female patients and mothers rated fewer situations as safe compared to male patients and fathers. Being with close friends and family, and attending planned parties without alcohol were perceived as situations of low risk. While 94% of patients took an epinephrine auto-injector (EAI) into risky situations, only 65% took it into safe situations. In contrast to the close family, 31% of the friends did not know the patient had an EAI, and fewer knew how to administer the EAI.	Young adults with peanut allergy face challenges when moving from the safe home with ready assistance if needed, to independence with unpredictable surroundings and less certain help. Perceived 'safe' situations may in fact be the riskiest, as patients often do not take the EAI with them.	
27886096	In the last few years, the service demand for wireless data over mobile networks has continually been soaring at a rapid pace. Thereinto, in Mobile Social Networks (MSNs), users can discover adjacent users for establishing temporary local connection and thus sharing already downloaded contents with each other to offload the service demand. Due to the partitioned topology, intermittent connection and social feature in such a network, the service demand discovery is challenging. In particular, the service demand discovery is exploited to identify the best relay user through the service registration, service selection and service activation. In order to maximize the utilization of limited network resources, a hybrid service demand discovery architecture, such as a Virtual Dictionary User (VDU) is proposed in this paper. Based on the historical data of movement, users can discover their relationships with others. Subsequently, according to the users activity, VDU is selected to facilitate the service registration procedure. Further, the service information outside of a home community can be obtained through the Global Active User (GAU) to support the service selection. To provide the Quality of Service (QoS), the Service Providing User (SPU) is chosen among multiple candidates. Numerical results show that, when compared with other classical service algorithms, the proposed scheme can improve the successful service demand discovery ratio by 25% under reduced overheads.
27886087	The current social impact of new technologies has produced major changes in all areas of society, creating the concept of a smart city supported by an electronic infrastructure, telecommunications and information technology. This paper presents a review of Bluetooth Low Energy (BLE), Near Field Communication (NFC) and Visible Light Communication (VLC) and their use and influence within different areas of the development of the smart city. The document also presents a review of Big Data Solutions for the management of information and the extraction of knowledge in an environment where things are connected by an "Internet of Things" (IoT) network. Lastly, we present how these technologies can be combined together to benefit the development of the smart city.
27886069	In recent years, the evolution of urban environments, jointly with the progress of the Information and Communication sector, have enabled the rapid adoption of new solutions that contribute to the growth in popularity of Smart Cities. Currently, the majority of the world population lives in cities encouraging different stakeholders within these innovative ecosystems to seek new solutions guaranteeing the sustainability and efficiency of such complex environments. In this work, it is discussed how the experimentation with IoT technologies and other data sources form the cities can be utilized to co-create in the OrganiCity project, where key actors like citizens, researchers and other stakeholders shape smart city services and applications in a collaborative fashion. Furthermore, a novel architecture is proposed that enables this organic growth of the future cities, facilitating the experimentation that tailors the adoption of new technologies and services for a better quality of life, as well as agile and dynamic mechanisms for managing cities. In this work, the different components and enablers of the OrganiCity platform are presented and discussed in detail and include, among others, a portal to manage the experiment life cycle, an Urban Data Observatory to explore data assets, and an annotations component to indicate quality of data, with a particular focus on the city-scale opportunistic data collection service operating as an alternative to traditional communications.
27885971	Perceptions of menstruation by media discourses portray this bodily function to be messy, inconvenient, and as an unnecessary phenomenon to be controlled or possibly eliminated. Commercials shown on YouTube targeted toward young women suggest that having a monthly period is not healthy and a lifestyle that is menses free is both pharmacologically available and recommended in order to live a fuller life. We explored the meanings attached to online menstrual suppression commercials with 10 women aged between 18 and 25. In-depth open-ended interviews were conducted over a 10-month period in 2014 after each participant viewed three menstrual suppression online advertisements. Feminist critical discourse was used for analysis with both authors coding for inter-rater reliability recognizing how our age difference and relationship as mother and daughter informed our interpretation. An overarching theme of tension emerged from the interviews with participants feeling detached due to the gendered stereotypes the commercials used to frame menstruation as compared to their own lived experience. Meanings associated with the menstrual suppression commercials were contrary to the participants' lived experience of menstruation as a healthy process not a detrimental one to their well-being as suggested by the commercials. Subliminal messages within the advertisements were identified as reinforcing gender bias and prejudices, including those associated with femininity. Despite attempting to emulate popular culture, the menstrual suppression advertisements were largely dismissed by this group of participants as undermining their intelligence and of intentionally creating divisive binaries between groups of women. This study suggests that historical bias and stereotypical prejudices were identified by this group of young women within the marketing of menstrual suppression products and, as such, were dismissed as inauthentic to the menstruation experience reflecting a form of menstrual activism.
27885909	Synopses of a selection of recently published research articles of relevance to palliative care.
27885738	This study explored underlying reasons for the expression of dissatisfaction with services among Bangladeshi and Pakistani social care users in England and investigated, using a collaborative approach, how these could be addressed. In-depth interviews were conducted in Birmingham, Leeds and London during 2012-2013 with 63 Bangladeshi, Pakistani and white British service users and 24 social care managers, social workers and care workers. A further 34 cognitive interviews were conducted within the same study. Following data analysis, three collaborative workshops involving service users and providers were held to validate the findings and to draw out policy and practice recommendations. Analysis of the cognitive interviews showed that higher dissatisfaction among Bangladeshi and Pakistani service users reported in social care surveys was not due to questionnaire design. Instead in-depth interviews showed that dissatisfaction across all three groups was expressed along the social care journey, including accessing care, communication with social workers and the nature of care received. While many issues were common to all three groups, cultural differences also emerged as affecting experiences of social care. These included misunderstandings about family roles in care; gender issues, especially relating to women; language and communication barriers, alongside the need for a more nuanced approach to ethnic 'matching'; and continuing limited cultural understanding among care workers. The collaborative workshops identified practical actions that could address some of the issues identified. These covered raising awareness of services within communities; improving support for informal carers; service user input to assessments; consistent and ongoing sharing of information; improving access; and more efforts to diversify and appropriately train the social care workforce. In conclusion, the paper presents the reality of dissatisfaction among these groups and argues for more action involving communities and service providers to address these persistent issues collaboratively.
27885651	Contrasting the classical explanation of military group cohesion as sustained by interpersonal bonds, recent scholars have highlighted the importance of ritualized communication, training and drills in explaining effective military performance in professional armies. While this has offered a welcome addition to the cohesion literature and a novel micro-sociological method of examining cohesion, its primary evidential base has been combat groups. Indeed, despite their prominent role in directing operations over the past decade, the British Army's officer corps has received relatively little attention from sociologists during this period. No attempt has been made to explain cohesion in the officer corps. Using a similar method to recent cohesion scholars, this paper seeks to address this imbalance by undertaking a micro-sociology of one ritual in particular: 'Barossa Night' in the Royal Irish Regiment. Firstly, it draws on the work of Durkheim to examine how cohesion amongst the officer corps is created and sustained through a dense array of practises during formal social rituals. It provides evidence that the use of rituals highlights that social solidarity is central to understanding officer cohesion. Secondly, following Hockey's work on how private soldiers negotiate order, the paper shows how this solidarity in the officer corps is based on a degree of negotiated order and the need to release organizational tensions inherent in a strictly hierarchical rank structure. It highlights how the awarding of gallantry medals can threaten this negotiated order and fuel deviancy. In examining this behaviour, the paper shows that even amongst an officer class traditionally viewed as the elite upholders of organizational discipline, the negotiation of rank and hierarchy can be fluid. How deviant behaviour is later accepted and normalized by senior officers indicates that negotiated order is as important to understanding cohesion in the British Army's officer corps as it is amongst private soldiers.
27885551	Most studies of condomless sex among homeless youth have focused on peer norms, while excluding other potentially pertinent influences. This study explored how different types of relationships contributed to norms about condomless sex and whether such norms were associated with engagement in condomless sex among homeless youth. Additionally, because recent work has noted gender differences in social networks of male and female homeless youth, gender differences in social network norms of condomless sex were also assessed. Egocentric network data were collected from homeless youth accessing services at two drop-in centers in Los Angeles, CA (N = 976). Multivariate analyses (non-stratified and stratified by gender) assessed associations between descriptive, injunctive, and communicative norms and participants' engagement in condomless sex. Multivariate analyses indicated that perception of peer condom use and communication with sexual partners were significantly associated with not engaging in condomless sex. These relationships, however, varied by gender. Implications for interventions are discussed.
27885547	This study was a replication of Mazefsky et al.'s (Journal of Autism and Developmental Disabilities 43:1236-1242, 2013) investigation among a sample of 45 high ability children and adolescents diagnosed with ASD under DSM-IV-TR. Items from the ADOS and ADI-R were mapped onto DSM-5 diagnostic criteria for ASD and SCD to determine whether participants would meet either diagnosis under DSM-5. If the ADOS were administered alone, 62% of individuals diagnosed with ASD would no longer meet criteria under DSM-5; however, when the ADI-R and ADOS scores were combined, 100% of individuals would continue to meet ASD diagnosis. The ADOS was determined to be an insufficient measure for SCD due to the small number of algorithm items measuring SCD diagnostic criteria, suggesting the development of SCD measures is required.
27885519	Some domestic animals are thought to be skilled at social communication with humans due to the process of domestication. Horses, being in close relationship with humans, similar to dogs, might be skilled at communication with humans. Previous studies have indicated that they are sensitive to bodily signals and the attentional state of humans; however, there are few studies that investigate communication with humans and responses to the knowledge state of humans. Our first question was whether and how horses send signals to their potentially helpful but ignorant caretakers in a problem-solving situation where a food item was hidden in a bucket that was accessible only to the caretakers. We then examined whether horses alter their behaviours on the basis of the caretakers' knowledge of where the food was hidden. We found that horses communicated to their caretakers using visual and tactile signals. The signalling behaviour of the horses significantly increased in conditions where the caretakers had not seen the hiding of the food. These results suggest that horses alter their communicative behaviour towards humans in accordance with humans' knowledge state.
27884917	Current daily general practice has become increasingly technical and somatically oriented (where attention to patients' feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP-patient communication have shifted from a focus on listening and empathy to task-oriented communication.To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed.	Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed.	The consolidated criteria for reporting qualitative research (COREQ) were applied. The verbatim transcripts were then analysed.	According to participating GPs, the current emphasis on protocol-driven care can be a significant barrier to genuineness in communication. Other potential barriers mentioned were time pressures and constraints, and dealing with patients displaying 'unruly behaviour' or those with personality disorders. GPs indicated that it can be difficult to balance emotional involvement and professional distance. Longer consulting times, smaller practice populations, and efficient practice organisation were described as practical solutions. In order to focus on a patient-as-person approach, GPs strongly suggested that deviating from guidelines should be possible when necessary as an element of good-quality care. Joining intercollegiate counselling groups was also discussed.	In addition to practical solutions for barriers to behaving empathically, GPs indicated that they needed more freedom to balance working with protocols and guidelines, as well as a patient-as-person and patient-as-partner approach. This balance is necessary to remain connected with patients and to deliver care that is truly personal.	
27884509	This study adopted a social-ecological perspective to exploring perpetration of serious physical violence against others among Arab-Palestinian adolescents. A total of 3178 adolescents (aged 13-18) completed anonymous, structured, self-report questionnaire, which included selected items from several instruments that measured variables relating to the constructs examined in the study. We explored the association of individual characteristics (age, gender, normative beliefs about violence, and perceived ethnic discrimination), familial characteristics (parent-adolescent communication and socioeconomic status), and contextual characteristics (exposure to community violence in the neighborhood) with perpetration of serious physical violence against others. A moderation-mediation model was tested, and 28.4% of the adolescents reported that they had perpetrated serious physical violence against others at least once during the month preceding the study. The findings also show that exposure of youth to violence in their neighborhood correlated significantly and positively with their perpetration of serious physical violence against others. A similar trend was revealed with respect to personal perceptions of ethnic discrimination. These correlations were mediated by the adolescents' normative beliefs about violence. Furthermore, the correlation of direct exposure to violence in the neighborhood and normative beliefs about violence with perpetration of serious physical violence against others was stronger among adolescents who have poor communication with their parents than among those who have strong parental communication.
27884232	Adherence to antihypertensive medication remains a key modifiable factor in the management of hypertension. The multidimensional nature of adherence and blood pressure (BP) control call for multicomponent, patient-centered interventions to improve adherence. Promising strategies to improve antihypertensive medication adherence and BP control include regimen simplification, reduction of out-of-pocket costs, use of allied health professionals for intervention delivery, and self-monitoring of BP. Research to understand the effects of technology-mediated interventions, mechanisms underlying adherence behavior, and sex-race differences in determinants of low adherence and intervention effectiveness may enhance patient-specific approaches to improve adherence and disease control.
27884133	Social capital is often believed to be one of the key prerequisites for successful implementation of community-based health programs. In less-developed countries, local leaders are positioned as major players in broad community health strategies and interventions, and their capacities and roles are expected to increase in prominence in future community-health-care promotions. In this study, we examined how local leaders' capacities could be related to social capital in rural villages in Lao PDR, and thus to villagers' willingness to participate in community-based health efforts.We adopted a qualitative approach, conducting semi-structured interviews for both individuals and focus groups. In 2012, 103 people from six villages in the Khoun and Phoukoud districts participated in the interviews. For the individual interviews, we interviewed 22 mothers who had given birth in the past 5 years. For the focus groups, we interviewed 30 women (six groups), 30 men (six groups), and 21 senior villagers (five groups).	First, we noted large variations in the levels of community social capital across villages: four out of six study villages showed a high level of social capital, while two villages suffered greatly from a low level of social capital. In search of the reasons for the disrupted social capital in the latter two villages, interviews revealed that failed leadership, especially in regard to local resource allocations-lack of transparency and corrupt practices-were commonly cited reasons for disrupted social capital. The data also showed that the villagers' mistrust of these failed local leaders critically reduced their willingness to participate in community-based health efforts, and especially in those that involved resource mobilization and risk-sharing for healthcare. Finally, we found that good communication skills and participatory decision-making styles were attributes that rural villagers in Lao PDR expected of their local leaders.	This study suggests that failed local leadership is detrimental to community participation, resource mobilization, and building communities' social capital. To achieve intended health care goals through community-based interventions, there is a need to first support local leadership at all levels through capacity-building and improved communication within communities.	
27884056	Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention.The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region.	The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools.	Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement.	

27882864	The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team. This qualitative study combined ethnographic observations of a palliative care team with discourse analysis. Eighteen palliative care patients with cancer diagnoses, six family physicians, and two nurses were involved in the study. Multiple interactions were observed between each patient and health care providers over the course of 1 year, for a total of 101 consultations, 24 of which were audio-recorded. The analysis consisted in looking for the interpretive repertoires (i.e., familiar lines of argument used to justify actions) that were used to justify patient participation in decision-making during clinical interactions, as well as exploring their implications for decision roles and end-of-life care. Patients and their health care providers seldom addressed their decision-making roles explicitly. Rather, they constructed patient participation in palliative care decisions in a covert manner. Four interpretive repertoires were used to justify patient participation: (1) exposing uncertainty, (2) co-constructing patient preferences, (3) affirming patient autonomy, and finally (4) upholding the authority of health care providers. The results demonstrate how patients and health care providers used these arguments to negotiate their respective roles in decision-making. In conclusion, patients and health care providers used a variety of interpretive repertoires to covertly negotiate their roles in decision-making, and to legitimize decisions that shaped patients' dying trajectories. Discourse analysis encourages awareness of the role of language in either promoting or hindering patient participation in decision-making.
27882823	The appropriate access to public information is very important for healthcare system stakeholders. The goal of this study was to examine how the execution of the formally existing right to public information on the HTA-based recommendations on reimbursement of new health technologies from public funds has been changing in Poland.All recommendations published within two predefined equal periods of time between 2013 and 2015 were analyzed. The gathered data was subjected to statistical analysis.	The frequency and intensity of censoring the published HTA-based recommendations on the pharmaceutical reimbursement has diminished. The text readability and clarity of message has improved, although the degree of decisiveness of the recommendations has dropped.	The positive changes in the public communication policy should be continued. The transparency of the HTA-based recommendations should be increased further in some areas in the future.	
27881815	Environmental cues, such as pictures, could be helpful in improving room-finding and wayfinding abilities among older patients. The aim of this study was to identify picture categories that are preferred and easily remembered by older patients and cognitively impaired patients and which therefore might be suitable for use as environmental cues in acute care settings.Twelve pictures were presented to a sample of older patients ( n = 37). The pictures represented different categories: familiarity (familiar vs. unfamiliar), type of shot (close-up vs. wide shot), and picture content (nature vs. animal vs. urban). We tested the patients' votes of preference and abilities to identify and immediately recall pictures. Cognitively impaired patients ( n = 14) were assessed by the abbreviated mental test and the mini mental state examination and were compared with patients without cognitive impairments ( n = 23) using a repeated measures analysis of variance.	The results showed a main effect of familiarity on positive vote and recall of pictures. The absence of interaction effects of familiarity and group indicated an overall impact of familiarity on the sample. Within cognitively impaired patients, a significant difference in recall of picture content between urban (20%) and animal (9%) was found.	Pictures, which patients were able to relate to in terms of familiarity and the characteristics urban and nature, seem to be suitable for use as environmental cues. Besides functioning as such, we assume, based on literature, that pictures could further enhance the ambiance or serve as prompts for communication and interaction.	
27881248	Children's understanding of HIV and death in epidemic regions is under-researched. We investigated children's death-related questions post maternal HIV-disclosure. Secondary aims examined characteristics associated with death-related questions and consequences for children's mental health.HIV-infected mothers (N = 281) were supported to disclose their HIV status to their children (6-10 years) in an uncontrolled pre-post intervention evaluation. Children's questions post-disclosure were collected by maternal report, 1-2 weeks post-disclosure. 61/281 children asked 88 death-related questions, which were analysed qualitatively. Logistic regression analyses examined characteristics associated with death-related questions. Using the parent-report Child Behaviour Checklist (CBCL), linear regression analysis examined differences in total CBCL problems by group, controlling for baseline.	Children's questions were grouped into three themes: 'threats'; 'implications' and 'clarifications'. Children were most concerned about the threat of death, mother's survival, and prior family deaths. In multivariate analysis variables significantly associated with asking death-related questions included an absence of regular remittance to the mother (AOR 0.25 [CI 0.10, 0.59] p = 0.002), mother reporting the child's initial reaction to disclosure being "frightened" (AOR 6.57 [CI 2.75, 15.70] p=<0.001) and level of disclosure (full/partial) to the child (AOR 2.55 [CI 1.28, 5.06] p = 0.008). Controlling for significant variables and baseline, all children showed improvements on the CBCL post-intervention; with no significant differences on total problems scores post-intervention (β -0.096 SE1.366 t = -0.07 p = 0.944).	The content of questions children asked following disclosure indicate some understanding of HIV and, for almost a third of children, its potential consequence for parental death. Level of maternal disclosure and stability of financial support to the family may facilitate or inhibit discussions about death post-disclosure. Communication about death did not have immediate negative consequences on child behaviour according to maternal report.	In sub-Saharan Africa, given exposure to death at young ages, meeting children's informational needs could increase their resilience.	
27881120	The Chinese Medical Doctors Association (CMDA) adopted the Charter of Medical Professionalism in the New Millennium (Charter) and published the Chinese Medical Doctor Declaration (Declaration). This is an important step to re-building medical professionalism in China at a time when the commercialization of health care has led to a decline in physician accountability and public trust in the profession. In response, authors have begun to examine and promote medical professionalism in China. This study aims to present the key research themes, identify research gaps and offer recommendations from reviewing the increasing pool of Chinese-language literature on medical professionalism.A scoping review of Chinese language papers was conducted using the China National Knowledge Infrastructure (including China Academic Journals Full-text Database, China Doctoral Dissertations Full-text Database, Masters' Theses Full-text Database, China Core Newspapers Full-text Database, and China Yearbooks Full-text Database) (CNKI) database.	Four major research themes were identified in Chinese discourse: (1) teaching professionalism, (2) practicing professionalism, (3) conceptualizing professionalism and (4) assessing professionalism. Overall, authors were concerned with the cultivation of humanism in physicians and emphasized the importance of communication skills to improve the physician-patient relationship in China. They explored the role of traditional Chinese values, such as Confucian and Taoist values, as well as the Communist Party's political values, in promoting professional behaviour.	Authors demonstrate increasing interest in medical professionalism in China. The literature is of variable quality and further empirical studies are required in order to evaluate teaching interventions and guide professionalism assessment. A common professionalism framework is absent and could be developed with consideration to China's socio-cultural context.	
27880814	The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care.Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis.	The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients.	The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety of challenges and do not seem confident enough that they can provide good quality care when cross-cultural interaction is at stake.	
27880776	Gaze is one of the most important cues for human communication and social interaction. In particular, gaze contact is the most primary form of social contact and it is thought to capture attention. A very early-differentiated brain response to direct versus averted gaze has been hypothesized. Here, we used high-density electroencephalography to test this hypothesis. Topographical analysis allowed us to uncover a very early topographic modulation (40-80 ms) of event-related responses to faces with direct as compared to averted gaze. This modulation was obtained only in the condition where intact broadband faces-as opposed to high-pass or low-pas filtered faces-were presented. Source estimation indicated that this early modulation involved the posterior parietal region, encompassing the left precuneus and inferior parietal lobule. This supports the idea that it reflected an early orienting response to direct versus averted gaze. Accordingly, in a follow-up behavioural experiment, we found faster response times to the direct gaze than to the averted gaze broadband faces. In addition, classical evoked potential analysis showed that the N170 peak amplitude was larger for averted gaze than for direct gaze. Taken together, these results suggest that direct gaze may be detected at a very early processing stage, involving a parallel route to the ventral occipito-temporal route of face perceptual analysis.
27879607	Social media use is growing inexorably, and there is public appetite for evidence-based information. Little is known about engagement by plastic surgeons with social media. The aim of this study was to examine posting about plastic surgery on Twitter, to best inform how board-certified plastic surgeons could use the hashtag #PlasticSurgery as a tool to educate patients and the public.A prospective analysis of 2880 "tweets" containing the words "plastic surgery" was performed. The following were assessed: identity of author, use of the hashtag #PlasticSurgery, subject matter, whether link to study was provided, and whether posts by surgeons were self-promotional or educational.	Social media posting about plastic surgery is dominated by the public, accounting for 70.6 percent of posts versus only 6.0 percent by plastic surgeons. Only 5.4 percent of all tweets contained the hashtag #PlasticSurgery, although almost half of those that did were by plastic surgeons. Of these, 61.3 percent of posts by plastic surgeons were about aesthetic surgery; additional posts were about basic science, patient safety, and reconstruction (13.9, 4.0, and 2.3 percent, respectively). Eighteen scientific articles were referenced, with a link to the Journal site posted in two tweets. Of posts by plastic surgeons, 37.0 percent were self-promotional.	The American Society of Plastic Surgeons and its Journal have recognized that social media may be used to educate and engage. Board-certified plastic surgeons have a great opportunity to promote evidence-based plastic practice by means of #PlasticSurgery in the interests of supporting patients and the profession.	
27879262	By convention, scientific naming of angiosperm species began in 1753; it is estimated that 10-20% of species remain undescribed. To complete this task before rare, undescribed species go extinct, a better understanding of the description process is needed. The South American Cerrado biodiversity hotspot was considered a suitable model due to a high diversity of plants, habitats, and social history of species description.A randomized sample of 214 species (2% of the angiosperm flora) and 22 variables were analyzed using multivariate analyses and analysis of variance.	Plants with wide global distributions, recorded from many areas, and above 2.6 m were described significantly earlier than narrowly distributed, uncommon species of smaller stature. The beginning of the career of the botanist who first collected the species was highly significant, with an average delay between first collection and description of 29 yr, and between type collection and description 19 yr; standard deviations were high and rose over time. Over a third of first collections were not cited in descriptions. Trends such as scientific specialization and decline of undescribed species were highlighted. Descriptions that involved potential collaboration between collectors and authors were significantly slower than those that did not.	Results support four recommendations to hasten discovery of new species: (1) preferential collecting of plants below 2.6 m, at least in the Cerrado; (2) access to undetermined material in herbaria; (3) fieldwork in areas where narrow-endemic species occur; (4) fieldwork by knowledgeable botanists followed by descriptive activity by the same.	
27878937	Despite international bodies calling for increased patient and family involvement, these concepts remain poorly defined within literature on critical and intensive care settings.This scoping review investigates the extent and range of literature on patient and family involvement in critical and intensive care settings. Methodological and empirical gaps are identified, and a future agenda for research into optimizing patient and family involvement is outlined.	Searches of MEDLINE, CINAHL, Social Work Abstracts and PsycINFO were conducted. English-language articles published between 2003 and 2014 were retrieved. Articles were included if the studies were undertaken in an intensive care or critical care setting, addressed the topic of patient and family involvement, included a sample of adult critical care patients, their families and/or critical care providers. Two reviewers extracted and charted data and analysed findings using qualitative content analysis.	A total of 892 articles were screened, 124 were eligible for analysis, including 61 quantitative, 61 qualitative and 2 mixed-methods studies. There was a significant gap in research on patient involvement in the intensive care unit. The analysis identified five different components of family and patient involvement: (i) presence, (ii) having needs met/being supported, (iii) communication, (iv) decision making and (v) contributing to care.	Three research gaps were identified that require addressing: (i) the scope, extent and nature of patient involvement in intensive care settings; (ii) the broader socio-cultural processes that shape patient and family involvement; and (iii) the bidirectional implications between patient/family involvement and interprofessional teamwork.	
27878840	Considerable variation has been reported in the prevalence and correlates of challenging behaviour (CB) in adults with intellectual disabilities (ID). To provide a robust estimate of prevalence, we identified the entire administrative population of adults with ID in a defined geographical area and used a behaviour assessment tool with good psychometric properties.Data from 265 adults who were known to services were collected using a demographic survey tool and the Behavior Problems Inventory - Short Form. The prevalence of self-injurious, aggressive/destructive, stereotyped, and overall CB was evaluated. We explored the potential of developing cumulative risk indices (CRI) to inform longitudinal research and clinical practice.	The prevalence of overall CB was 18.1% (95% CI: 13.94-23.19%). The prevalence of self-injurious behaviour was 7.5% (95% CI: 4.94-11.37%), aggressive-destructive behaviour 8.3% (95% CI: 5.54-12.25%), and stereotyped behaviour 10.9% (95% CI: 7.73-15.27%). Communication problems and severity of ID were consistently associated with higher risk of CBs. CRIs were significantly associated with CBs, and the five methods of CRI development produced similar results.	Findings suggest a multi-element response to CB is likely to be required that includes interventions for communication and daytime activity. Exploratory analyses of CRIs suggested these show promise as simple ways to capture cumulative risk in this population. Subject to longitudinal replication, such a tool may be especially useful in clinical practice to identify adults who are priority for interventions and predict future demand on services.	The prevalence of challenging behaviour (CB) was 18.1% in this total population study. Stereotypy was the most frequent type of CB. Communication difficulties and severe-profound intellectual disabilities were most systematically related to the presence of CB. Establishing the effect of multiple risk factors is likely to identify people who are priority for interventions. Addressing multiple, rather than singular risks, is likely to be more efficacious. We tested five different methods of putting together a multiple risk index. All methods provided a reasonable association with CB. The most user-friendly method was the additive cumulative risk index (CRI). Limitations This is a cross-sectional design which enabled factors currently associated with CB to be identified for the whole cohort, but these variables may not be those conferring risk for the development or maintenance of CB over time. Future longitudinal research is required to replicate these CRI analyses before concluding about the CRI method with the highest predictive validity.	
27878739	Although social-communication difficulties and repetitive behaviors are hallmark features of autism spectrum disorder (ASD) and persist across the lifespan, very few studies have compared age-related differences in these behaviors between youth with ASD and same-age typically developing (TD) peers. We examined this issue using SRS-2 (Social Responsiveness Scale-Second Edition) measures of social-communicative functioning and repetitive behaviors in a stratified cross-sectional sample of 324 youth with ASD in the absence of intellectual disability, and 438 TD youth (aged 4-29 years). An age-by-group interaction emerged indicating that TD youth exhibited age-related improvements in social-communication scores while the ASD group demonstrated age-related declines in these scores. This suggests that adolescents/adults with ASD may fall increasingly behind their same-age peers in social-communicative skills.
27878123	The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.
27877212	Early integration of palliative care in oncology practice ("simultaneous care", SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members.A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care.	Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist.	SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.	
27876688	Online communities are used as platforms by parents to verify developmental and health concerns related to their child. The increasing public awareness of autism spectrum disorders (ASD) leads more parents to suspect ASD in their child. Early identification of ASD is important for early intervention.To characterize the symptoms mentioned in online queries posed by parents who suspect that their child might have ASD and determine whether they are age-specific. To test the efficacy of machine learning tools in classifying the child's risk of ASD based on the parent's narrative.	To this end, we analyzed online queries posed by parents who were concerned that their child might have ASD and categorized the warning signs they mentioned according to ASD-specific and non-ASD-specific domains. We then used the data to test the efficacy with which a trained machine learning tool classified the degree of ASD risk. Yahoo Answers, a social site for posting queries and finding answers, was mined for queries of parents asking the community whether their child has ASD. A total of 195 queries were sampled for this study (mean child age=38.0 months; 84.7% [160/189] boys). Content text analysis of the queries aimed to categorize the types of symptoms described and obtain clinical judgment of the child's ASD-risk level.	Concerns related to repetitive and restricted behaviors and interests (RRBI) were the most prevalent (75.4%, 147/195), followed by concerns related to language (61.5%, 120/195) and emotional markers (50.3%, 98/195). Of the 195 queries, 18.5% (36/195) were rated by clinical experts as low-risk, 30.8% (60/195) as medium-risk, and 50.8% (99/195) as high-risk. Risk groups differed significantly (P<.001) in the rate of concerns in the language, social, communication, and RRBI domains. When testing whether an automatic classifier (decision tree) could predict if a query was medium- or high-risk based on the text of the query and the coded symptoms, performance reached an area under the receiver operating curve (ROC) curve of 0.67 (CI 95% 0.50-0.78), whereas predicting from the text and the coded signs resulted in an area under the curve of 0.82 (0.80-0.86).	Findings call for health care providers to closely listen to parental ASD-related concerns, as recommended by screening guidelines. They also demonstrate the need for Internet-based screening systems that utilize parents' narratives using a decision tree questioning method.	
27876638	In aversive or dangerous situations, adult rats emit long characteristic ultrasonic calls, often termed "22-kHz calls," which have been suggested to play a role of alarm calls. Although the playback experiment is one of the most effective ways to investigate the alarming properties of 22-kHz calls, clear behavioral evidence showing the anxiogenic effects of these playback stimuli has not been directly obtained to date. In this study, we investigated whether playback of 22-kHz calls or synthesized sine tones could change the acoustic startle reflex (ASR), enhancement of which is widely considered to be a reliable index of anxiety-related negative affective states in rats. Playback of 22-kHz calls significantly enhanced the ASR in rats. Enhancement effects caused by playback of 22-kHz calls from young rats were relatively weak compared to those after calls from adult rats. Playback of synthesized 25-kHz sine tones enhanced ASR in subjects, but not synthesized 60-kHz tones. Further, shortening the individual call duration of synthesized 25-kHz sine tones also enhanced the ASR. Accordingly, it is suggested that 22-kHz calls induce anxiety by socially communicated alarming signals in rats. The results also demonstrated that call frequency, i.e., of 22kHz, appears important for ultrasonic alarm-signal communication in rats.
27876321	To explore how a sample of Mexican American mothers with preschool-aged children recruited from a Midwestern Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic obtained information about 4 behaviors associated with childhood obesity risk: eating, physical activity, screen time, and sleep.One-on-one structured interviews in which participants were asked how they communicated with family, learned to take care of their first infant, and obtained information about the 4 targeted behaviors for their preschool-aged child.	An urban WIC clinic in the Midwest.	Forty Mexican-descent mothers enrolled in WIC with children aged 3-4 years.	Exposure to information about the 4 targeted behaviors among Mexican-descent mothers participating in WIC.	Quantitative and qualitative data were used to characterize and compare across participants.	Participants primarily obtained information from their child's maternal grandmother during their first child's infancy and from health professionals for their preschool-aged child. Participants typically obtained information through interpersonal communication, television, and magazines. Participants were most interested in healthy eating information and least interested in screen time information. Some participants did not seek information.	Participants engaged in different patterns of information seeking across their child's development and the 4 behaviors, which suggests that future research should be behaviorally specific. Findings from this study suggest several hypotheses to test in future research.	
27876018	With a maternal mortality ratio of 789 per 100,000 live births, and a contraceptive prevalence rate of 4.7%, South Sudan has one of the worst reproductive health situations in the world. Understanding the social norms around sexuality and reproduction, across different ethnic groups, is key to developing and implementing locally appropriate public health responses.A qualitative study was conducted in the state of Western Bahr el Ghazal (WBeG) in South Sudan to explore the social norms shaping decisions about family planning among the Fertit community. Data were collected through five focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel.	Among the Fertit community, the social norm which expects people to have as many children as possible remains well established. It is, however, under competitive pressure from the existing norm which makes spacing of pregnancies socially desirable. Young Fertit women are increasingly, either covertly or overtly, making family planning decisions themselves; with resistance from some menfolk, but also support from others. The social norm of having as many children as possible is also under competitive pressure from the emerging norm that equates taking good care of one's children with providing them with a good education. The return of peace and stability in South Sudan, and people's aspirations for freedom and a better life, is creating opportunities for men and women to challenge and subvert existing social norms, including but not limited to those affecting reproductive health, for the better.	The sexual and reproductive health programmes in WBeG should work with and leverage existing and emerging social norms on spacing in their health promotion activities. Campaigns should focus on promoting a family ideal in which children become the object of parental investment, rather than labour to till the land - instead of focusing directly or solely on reducing family size. The conditions are right in WBeG and in South Sudan for public health programmes to intervene to trigger social change on matters related to sexual and reproductive health; this window of opportunity should be leveraged to achieve sustainable change.	
27875654	Biological risk management in public health focuses on the impact of outbreaks on health, the economy, and other systems and on ensuring biosafety and biosecurity. To address this broad range of risks, the International Health Regulations (IHR, 2005) request that all member states build defined core capacities, risk communication being one of them. While there is existing guidance on the communication process and on what health authorities need to consider to design risk communication strategies that meet the requirements on a governance level, little has been done on implementation because of a number of factors, including lack of resources (human, financial, and others) and systems to support effective and consistent capacity for risk communication. The international conference on "Risk communication strategies before, during and after public health emergencies" provided a platform to present current strategies, facilitate learning from recent outbreaks of infectious diseases, and discuss recommendations to inform risk communication strategy development. The discussion concluded with 4 key areas for improvement in risk communication: consider communication as a multidimensional process in risk communication, broaden the biomedical paradigm by integrating social science intelligence into epidemiologic risk assessments, strengthen multisectoral collaboration including with local organizations, and spearhead changes in organizations for better risk communication governance. National strategies should design risk communication to be proactive, participatory, and multisectoral, facilitating the connection between sectors and strengthening collaboration.
27875605	Our objective was to identify factors that sustain family physicians practicing in Milwaukee's underserved urban areas.Family physicians with clinical careers in Milwaukee's urban, underserved communities were identified and invited to participate in a 45-60 minute interview using a literature-based semi-structured protocol. Each interview was transcribed and de-identified prior to independent analysis using a grounded theory qualitative approach by two authors to yield sustaining themes. The project was determined not human subjects research per Aurora Health Care IRB.	Sixteen family physicians were identified; six of 11 who met inclusion criteria agreed to interview. Four general domains central to sustaining family physicians working with underserved populations were identified: (1) cognitive traits and qualities (trouble shooting, resilience, flexibility), (2) core values (medicine as mechanism to address social justice), (3) skills (self-care, communication, clinical management), and (4) support systems (supportive family/employer, job flexibility, leadership opportunities, staff function as team). The formation of these personal attributes and skills was partly shaped by experiences (from childhood to medical training to work experience) and by personal drivers that varied by individual. Common was that the challenges of providing care in urban underserved settings was seen as rewarding in and of itself and aligned with these physicians' values and skills.	Family physicians working with underserved populations described possessing a combination of values, cognitive qualities, skill sets, and support systems. While family physicians face complex challenges in quality care goals in urban underserved settings, training in the personal and professional skill sets identified by participants may improve physician retention in such communities.	
27875018	To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy.Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements.	The project used a descriptive approach within a quality implementation framework.	The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications.	A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given.	There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements.	Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning clinical placement procurement, and assisting in decision-making and developing strategies and processes for practice.	
27874982	To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses.Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses.	The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches.	Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding).	Theoretical saturation occurred after 17 interviews. The core category identified from the data was 'nursing presence' Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors - enablers, constraints and compensation.	Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care.	Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care.	
27874980	To identify reporting practices that feature in studies of nurses' shift reports across diverse nursing specialities. The objectives were to perform an exhaustive systematic literature search and to critically review the quality and findings of qualitative field studies of nurses' shift reports.Nurses' shift reports are routine occurrences in healthcare organisations that are viewed as crucial for patient outcomes, patient safety and continuity of care. Studies of communication between nurses attend primarily to 1:1 communication and analyse the adequacy and accuracy of patient information and feature handovers at the bedside. Still, verbal reports between groups of nurses about patients are commonplace. Shift reports are obvious sites for studying the situated accomplishment of professional nursing at the group level. This review is focused exclusively on qualitative field research for nuanced and contextualised insights into nurses' everyday shift reporting practices.	The study is a systematic literature search and critical review of qualitative field analyses of nurses' shift reports. We searched in the databases CIHAHL, PubMed and PsycINFO and identified and reviewed 19 articles published 1992-2014. Data were systematically extracted using criteria for the evaluation of qualitative research reports.	The studies described shift report practices and identified several factors contributing to distribution of clinical knowledge. Shift report practices were described as highly conventionalised and locally situated, but with occasional opportunities for improvisation and negotiation between nurses. Finally, shift reports were described as multifunctional meetings, with individual and social effects for nurses and teams.	Innovations in between-shift communications can benefit from this analysis, by providing for the many functions of handovers that are revealed in field studies.	Leaders and practising nurses may consider what are the best opportunities for nurses to work up clinical knowledge and negotiate care.	
27874297	 Some anecdotal evidence has suggested that organizational infrastructure may affect the quality of life of athletic trainers (ATs). To compare ATs' perspectives on work-life balance, role strain, job satisfaction, and retention in collegiate practice settings within the various models.	 Cross-sectional and qualitative study.	 National Collegiate Athletic Association Divisions I, II, and III.	 Fifty-nine ATs from 3 models (athletics = 25, medical = 20, academic = 14) completed phase I. A total of 24 ATs (15 men, 9 women), 8 from each model, also completed phase II.	 Participants completed a Web-based survey for phase I and were interviewed via telephone for phase II. Quantitative data were analyzed using statistical software. Likert-scale answers (1 = strongly disagree, 5 = strongly agree) to the survey questions were analyzed using the Kruskal-Wallis, Mann-Whitney U, and Cohen f tests. Qualitative data were evaluated using a general inductive approach. Multiple-analyst triangulation and peer review were conducted to satisfy data credibility.	 Commonalities were communication, social support, and time management and effective work-life balance strategies. Quantitative data revealed that ATs employed in the athletics model worked more hours (69.6 ± 11.8 hours) than those employed in the medical (57.6 ± 10.2 hours; P = .001) or academic (59.5 ± 9.5 hours; P = .02) model, were less satisfied with their pay (2.68 ± 1.1; χ2 = 7.757, P = .02; f = 0.394), believed that they had less support from their administrators (3.12 ± 1.1; χ2 = 9.512, P = .009; f = 0.443), and had fewer plans to remain in their current positions (3.20 ± 1.2; χ2 = 7.134, P = .03; f = 0.374). Athletic trainers employed in the academic model believed that they had less support from coworkers (3.71 ± 0.90; χ2 = 6.825, P = .03; f = 0.365) and immediate supervisors (3.43 ± 0.90; χ2 = 6.006, P = .050; f = 0.340). No differences in role conflict were found among the models.	 Organizational infrastructure may play a role in mediating various sources of conflict, but regardless of facilitators, ATs need to be effective communicators, have support networks in place, and possess time-management skills.	
27874271	Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder mainly showed atypical social interaction, communication, and restricted, repetitive patterns of behavior, interests and activities. Now clinic diagnosis of ASD is mostly based on psychological evaluation, clinical observation and medical history. All these behavioral indexes could not avoid defects such as subjectivity and reporter-dependency. Therefore researchers devoted themselves to seek relatively stable biomarkers of ASD as supplementary diagnostic evidence. The goal of present study is to generate relatively stable predictive model based on anatomical brain features by using machine learning technique. Forty-six ASD children and thirty-nine development delay children aged from 18 to 37 months were evolved in. As a result, the predictive model generated by regional average cortical thickness of regions with top 20 highest importance of random forest classifier showed best diagnostic performance. And random forest was proved to be the optimal approach for neuroimaging data mining in small size set and thickness-based classification outperformed volume-based classification and surface area-based classification in ASD. The brain regions selected by the models might attract attention and the idea of considering biomarkers as a supplementary evidence of ASD diagnosis worth exploring. Autism Res 2017, 0: 000-000. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 620-630. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
27873140	Diagnosing Autism Spectrum Disorders (ASD) is important throughout the lifespan. The objective was to investigate the transcultural diagnostic validity of the Social Communication Questionnaire (SCQ) in a clinical sample of 451 adults with Intellectual Developmental Disorder (IDD) with and without ASD in Germany, the U.S.A. and Great Britain. Variables associated with higher SCQ sum-scores were higher levels of IDD, male gender, a diagnosis of ASD and the study site (Germany > U.S.A > G.B.). An ROC analysis revealed a cut-score of 13, which resulted in a sensitivity of 0.87 and a specificity of 0.58. It is recommended to adjust the cut-score according to level of IDD and gender. Further research is needed to align diagnostic assignment of ASD across different sites and countries.

27871920	Adolescents face barriers to accessing youth-friendly family planning services, specifically long-acting reversible contraception (LARC). School-based health centers (SBHCs) can provide youth-friendly care. A quality improvement project was undertaken to assess quality of care before, during, and after LARC services at 3 SBHCs, and to identify specific strategies for improving these LARC services.We interviewed 18 female adolescents who received LARC services. Two independent reviewers coded deidentified verbatim transcripts; discrepancies were resolved by consensus with a third reviewer. A guide of themes was structured corresponding to Ambresin's domains of youth-friendly services. From these domains, we identified emerging themes using grounded theory, with a focus on practical suggestions for improving LARC services in SBHCs.	Interviewees ranged in age from 15 to 19 (average: 17) years. Most had insertions (12 levonorgestrel intrauterine system (LNG-IUS); Mirena®), 1 copper intrauterine device (Paragard®), 5 contraceptive implant (Nexplanon®). Overall, participants were highly satisfied with SBHC LARC services. Within the domain of communication, 2 key themes emerged: balancing need for information with concerns about being overwhelmed by information; and interest in information that directly addresses misconceptions about LARCs. Suggested strategies included providing postprocedure "care packages" with information and supplies, and supporting a peer-based network of adolescent LARC users and previous patients to serve as a resource for new patients.	This quality improvement project, conducted in a unique setting, gave adolescents a voice. The identified strategies for improving health education, social support, and outreach might be generalizable to other SBHCs. Future research could explore the effect of implementing these suggested strategies on reproductive health care use and outcomes at SBHCs.	
27871235	The concept of frailty, a relative state of weakness reflecting multiple functional and health domains, continues to receive attention within the geriatrics field. It offers a summary of key personal characteristics, providing perspective on an individual's life course. There have been multiple attempts to measure frailty, some focusing on physiologic losses, others on specific diseases, disabilities or health deficits. Recently, multidimensional approaches to measuring frailty have included cognition, mood and social components. The purpose of this project was to develop and evaluate a Home Care Frailty Scale and provide a grounded basis for assessing a person's risk for decline that included functional and cognitive health, social deficits and troubling diagnostic and clinical conditions.A secondary analysis design was used to develop the Home Care Frailty Scale. The data set consisted of client level home care data from service agencies around the world. The baseline sample included 967,865 assessments while the 6-month follow-up sample of persons still being served by the home care agencies consisted of 464,788 assessments. A pool of 70 candidate independent variables were screened for possible inclusion and 16 problem outcomes referencing accumulating declines and clinical complications served as the dependent variables. Multiple regression techniques were used to analyze the data.	The resulting Home Care Frailty Scale consisted of a final set of 29 items. The items fall across 6 categories of function, movement, cognition and communication, social life, nutrition, and clinical symptoms. The prevalence of the items ranged from a high of 87% for persons requiring help with meal preparation to 3.7% for persons who have experienced a recent decline in the amount of food eaten.	The interRAI Home Care Frailty Scale is based on a strong conceptual foundation and in our analysis, performed as expected. Given the use of the interRAI Home Care Assessment System in multiple, diverse countries, the Home Care Frailty Scale will have wide applicability to support program planning and policy decision-making impacting home care clients and their formal and informal caregivers throughout the world.	
27871207	Gesture during speech can promote or diminish recall for conversation content. We explored effects of cognitive load on this relationship, manipulating it at two scales: individual-word abstractness and social constraints to prohibit gestures. Prohibited gestures can diminish recall but more so for abstract-word recall. Insofar as movement planning adds to cognitive load, movement amplitude may moderate gesture effects on memory, with greater permitted- and prohibited-gesture movements reducing abstract-word recall and concrete-word recall, respectively. We tested these effects in a dyadic game in which 39 adult participants described words to confederates without naming the word or five related words. Results supported our expectations and indicated that memory effects of gesturing depend on social, cognitive, and motoric aspects of discourse.
27870409	The X chromosome has played a critical role in the development of sexually selected characteristics for over 300 million years, and during that time it has accumulated a disproportionate number of genes concerned with mental functions. There are relatively specific effects of X-linked genes on social cognition, language, emotional regulation, visuospatial, and numerical skills. Many human X-linked genes outside the X-Y pairing pseudoautosomal regions escape X-inactivation. Dosage differences in the expression of such genes (which constitute at least 15% of the total) are likely to play an important role in male-female neural differentiation, and in cognitive deficits and behavioral characteristics, particularly in the realm of social communication, that are associated with sex chromosome aneuploidies. © 2016 Wiley Periodicals, Inc.
27870319	The mass media have held an ongoing debate about stem cell research. However, few studies have investigated how individuals obtain information on stem cell research and whether this affects their knowledge and perspectives on stem cell research.This study aims to investigate whether (i) cancer-diagnosed and non-diagnosed individuals differ in terms of their acquisition of stem cell research information, (ii) whether this information acquisition is associated with stem cell research knowledge and perspectives and (iii) whether having had a cancer diagnosis moderates these associations.	A standardised, cross-sectional survey was conducted among a convenience sample of 621 cancer-diagnosed and 1387 non-diagnosed individuals in Flanders (Belgium).	The results indicate that stem cell research information acquisition explains a significant part of the variance of stem cell research knowledge (8.9%) and of the societal benefits of stem cell research (6.7%) and of embryonic stem cell research evaluation (3.9%) and morality (2%). These associations did not differ between cancer-diagnosed and non-diagnosed individuals but cancer-diagnosed individuals did seek more stem cell research information.	Acquiring stem cell research information, both intentionally and unintentionally, is positively related to stem cell research knowledge and perspectives. Future research should further identify ways to promote health information acquisition behaviour because it is associated with better knowledge and more positive opinion formation.	
27869914	Chagas disease is a neglected chronic condition that presents high morbidity and mortality burden, with considerable psychological, social, and economic impact. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on collaboration and contribution of renowned Brazilian experts with vast knowledge and experience on various aspects of the disease. It is the result of close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. This document shall strengthen the development of integrated control measures against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research.
27869569	Expressed emotion (EE) has been associated with poor outcomes in anorexia nervosa (AN); however, whether changes in EE predict superior treatment outcomes is unknown. The current study examined whether decreases in EE during an open trial of a novel family-based treatment for AN predicted symptoms at end of treatment. Forty-seven adolescents (12-18 years of age) with AN or sub-threshold AN and their parents (mothers: n = 47, fathers: n = 39) participated in 6 months of family treatment. Measures of AN symptomatology (Eating Disorder Examination completed by adolescent and end of treatment recovery status) and parental EE (Family Questionnaire completed by parents which measures two facets of EE: critical communication [CC] and emotional over-involvement [EOI]) were collected at baseline and end of treatment. Parental EOI, but not CC, significantly decreased during the course of treatment. Change in mothers', but not fathers', EE accounted for additional variance in AN symptomatology at end of treatment above baseline EE and baseline AN symptom levels. Findings suggest a greater emphasis on parent support during treatment may improve outcomes.
27869501	Shared decision-making (SDM) is a means of allowing people with dementia to take part in making choices, be autonomous and participate in social activities. Involving them in SDM is an important way of promoting social health. However, including families and dementia residents in decision-making can be challenging for care staff working in nursing homes. The objective of this study was to identify barriers and facilitators regarding the implementation of an SDM framework for care planning in two nursing homes, one in Italy and one in the Netherlands.Focus group interviews were conducted with healthcare professionals who, after being trained, applied the SDM framework. Content analysis was used to analyze the data.	Six months after the feasibility trial, focus group interviews with healthcare professionals (n = 10 in Italy; n = 9 in the Netherlands) were held. We found 6 themes and 15 categories. Within these themes, facilitators and barriers were identified. The categories of team collaboration, communication skills and nursing home policy were found to be facilitators to the implementation process, whereas regulations, lack of funding and of involvement of family caregivers were the main barriers. Family attitudes towards SDM could be both. The main difference between countries concerned the residents' cognitive status that influenced their degree of involvement.	Communication skills training for professionals, training of family caregivers, and involvement of the management in the implementation process seem to be crucial factors in successfully implementing SDM in nursing homes, and increasing the involvement of families and dementia residents in decision-making.	
27869409	En general, los pediatras son los primeros profesionales de la atención médica encargados de dar el diagnóstico inicial de síndrome de Down (SD) a las familias. Sin embargo, cuando un bebé nace con SD, la mayoría de los padres no se sienten satisfechos con el contenido de la información brindada ni con la forma en que la recibieron. Los residentes de pediatría deberían participar en intervenciones educativas para ayudar a los padres a superar estos problemas y brindarles informaciónprecisa. El objetivo de este estudio es evaluar los niveles de comodidad de los residentes de pediatría y la necesidad de capacitación para comunicarse con los padres de niños que nacen con SD.El Inventario de la situación diagnóstica (ISD) es una escala de calificación de diez preguntas que evalúa el nivel de incomodidad. Se envió una encuesta a todos los residentes de pediatría del país a través de la telefonía celular, sitios web y todos los medios sociales disponibles. También se registraron los factores sociodemográficos, incluida la información sobre los requisitos de capacitación.	Entre los 326 participantes, el nivel de incomodidad medio total fue del 30,22 sobre 50, el puntaje más alto del ISD. El nivel de incomodidad fue significativamente más alto entre las mujeres (p= 0,033). Se observó que ser mujer (p= 0,014), estar en uno de los primeros años de residencia (p= 0,028), haber examinado a una menor cantidad de pacientes con SD (p= 0,025) y sentir un nivel mayor de incomodidad (p= 0,001) son factores relacionados con una mayor necesidad de capacitación. El 84% de los residentes indicaron que necesitan capacitación adicional.	Este estudio mostró que los residentes de pediatría tuvieron un nivel de incomodidad alto cuando comunicaban el diagnóstico de SD a los padres del recién nacido. Las residentes tuvieron un nivel de incomodidad significativamente mayor que los residentes.	Generally, pediatricians are the first health caregivers to deliver initial diagnosis of Down syndrome (DS) to the families. However, most of the parents are not satisfied with the contents and how they receive information when their child is born with DS. Pediatric residents should target educational interventions to help parents to overcome with these issues and to provide accurate information. The objective is to assess comfort levels and training requirements of pediatric residents to communicate with parents of babies born with Down syndrome.	Diagnostic Situations Inventory (DSI) is a rating scale which included ten questions to assess discomfort level. A survey was sent via mobile, websites and all the social media which were available to all pediatrics residents in the country. Socio-demographic factors including information about training requirement were collected as well.	From the 326 participants, total mean discomfort level was 30.22 in DSI out of 50 which was the highest score. Discomfort level was significantly increased in female participants (p= 0.033). Being female (p= 0.014), having less residency level (p= 0.028), examining less number of patients with Down syndrome (p= 0.025) and having higher discomfort levels (p= 0.001) were found to be related with increased training requirement. From the residents, 84% declared the need for additional training.	This study showed that pediatric residents had a high level of discomfort when communicating with parentes of newborn with Down Syndrome. Female residentes had a discomfort level significantly higher than male residentes.	
27868309	To examine how alcohol brands use sport in their communication activities on social media. Despite extensive research exploring alcohol advertising and sponsorship through sport, minimal attention has been given to digital platforms.This study undertakes a qualitative content analysis to examine the social media activity of alcohol brands sponsoring the three largest spectator sports in Australia: Australian rules football, rugby league and cricket.	Four sport-related social media strategies are identified through which alcohol brands solicit interaction with consumers, often involving co-creation of content and social activation. These strategies act as 'calls to action' and through the association of sport and alcohol encourage consumers to engage in competition, collaboration, celebration and consumption. These strategies are further strengthened by communications which draw upon themes of identity and camaraderie to resonate with the consumer.	Sport-linked social media strategies utilised by alcohol brands extend beyond just promoting their product. They seek higher levels of engagement with the consumer to amplify and augment the connection between alcohol and the sport spectator experience. The discussion highlights the powerful combination of sport and social media as a mechanism by which these brands seek to interact with consumers and encourage them to both create and promote content to their social networks. These strategies allow alcohol brands to extend their marketing efforts in a manner which can elude alcohol codes and prove difficult for regulators to identify and control. [Westberg K, Stavros C, Smith ACT, Munro G, Argus K. An examination of how alcohol brands use sport to engage consumers on social media. Drug Alcohol Rev 2016;00:000-000].	
27868264	Recent research suggests that around 16% to 18% of children with Down syndrome (DS) also meet diagnostic criteria for autism spectrum disorder (ASD). However, there are indications that profiles of autism symptoms in this group may vary from those typically described in children with ASD.Rates of autism symptoms and emotional and behavioural problems among children with DS who screened positive for ASD on the Social Communication Questionnaire (SCQ) (n = 183) were compared with a group of children with clinical diagnoses of ASD (n = 189) attending specialist schools in the UK. Groups were matched for age and approximate language level (use of phrase speech).	Profiles of autistic symptoms in the two groups were generally similar, but children with DS meeting ASD cut-off on the SCQ tended to show fewer problems in reciprocal social interaction than those in the ASD group. They also showed slightly lower rates of emotional and peer-related problems. The results mostly confirm findings from a previous study in which the original validation sample for the SCQ was used as a comparison group.	Findings suggest that children with DS who meet screening criteria for ASD show similar profiles of communication and repetitive behaviours to those typically described in autism. However, they tend to have relatively milder social difficulties. It is important that clinicians are aware of this difference if children with DS and ASD are to be correctly diagnosed and eligible for specialist intervention and education services.	
27868201	Rehabilitation research investigating activity participation has been largely conducted in a realist tradition that under-theorises the relationship between persons, technologies, and socio-material places. In this Canadian study we used a post-critical approach to explore activity/setting participation with 19 young people aged 14 to 23 years with complex communication and/or mobility impairments. Methods included integrated photo-elicitation, interviews, and participant observations of community-based activities. We present our results using the conceptual lens of assemblages to surface how different combinations of bodies, social meanings, and technologies enabled or constrained particular activities. Assemblages were analysed in terms of how they organised what was possible and practical for participants and their families in different contexts. The results illuminate how young people negotiated activity needs and desires in particular 'spacings' each with its own material, temporal, and social constraints and affordances. The focus on assemblages provides a dynamic analysis of how dis/abilities are enacted in and across geotemporal spaces, and avoids a reductive focus on evaluating the accessibility of static environmental features. In doing so the study reveals possible 'lines of flight' for healthcare, rehabilitation, and social care practices.
27868194	Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children.This study is a double-blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3-10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25-hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and the Autism Treatment Evaluation Checklist (ATEC).	UMIN-CTR Study Design: trial number: UMIN000020281.	Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4-month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD.	This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide-scale studies are needed to critically validate the efficacy of vitamin D in ASD.	
27867363	Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a wide spectrum of deficits in social interaction, communication, and behavior. There is a significant genetic component to ASD, yet no single gene variant accounts for >1% of incidence. Posttranscriptional mechanisms such as microRNAs (miRNAs) regulate gene expression without altering the genetic code. They are abundant in the developing brain and are dysregulated in children with ASD. Patterns of miRNA expression are altered in the brain, blood, saliva, and olfactory precursor cells of ASD subjects. The ability of miRNAs to regulate broad molecular pathways in response to environmental stimuli makes them an intriguing player in ASD, a disorder characterized by genetic predisposition with ill-defined environmental triggers. In addition, the availability and extracellular stability of miRNAs make them an ideal candidate for biomarker discovery. Here, we discuss 27 miRNAs with overlap across ASD studies, including 3 miRNAs identified in 3 or more studies (miR-23a, miR-146a, and miR-106b). Together, these 27 miRNAs have 1245 high-confidence mRNA targets, a significant number of which are expressed in the brain. Furthermore, these mRNA targets demonstrate over-representation of autism-related genes with enrichment of neurotrophic signaling molecules. Brain-derived neurotrophic factor, a molecule involved in hippocampal neurogenesis and altered in ASD, is targeted by 6 of the 27 miRNAs of interest. This neurotrophic pathway represents one intriguing mechanism by which perturbations in miRNA signaling might influence central nervous system development in children with ASD.
27867283	The use of sperm donation by single women has provoked public, professional and political debate. Newspapers serve as a critical means of both broadcasting this debate and effecting a representation of this user group within the public sphere. This study uses the theory of social representations to examine how single motherhood by sperm donation has been represented in the UK news over time. The study sampled news coverage on this topic in eight British newspapers during three 4-year periods between the years 1988 and 2012. The dataset of news reports (n = 406) was analysed using a qualitative approach. Findings indicated that UK media reports of single women using donor sperm are underpinned by conventional categories of the 'personal', the 'traditional' and the 'natural' that when paired with their corollaries produce a representation of this user group as the social 'other'. The amount of coverage on this topic over time was found to vary according to the political orientation of different media sources. Using key concepts from social representations theory, this article discusses the relationship between themata and anchoring in the maintenance of representations of the social 'other' in mass mediated communication. Findings are explained in relation to theoretical conceptions of the mass media and its position within the public sphere. It is argued that the use of personal narratives in news reports of single mothers by sperm donation may have significant implications for public understandings of this social group. © 2016 The Authors. Journal of Community & Applied Social Psychology published by John Wiley & Sons Ltd.
27867218	Several message topic selection approaches propose that messages based on beliefs pretested and found to be more strongly associated with intentions will be more effective in changing population intentions and behaviors when used in a campaign. This study aimed to validate the underlying causal assumption of these approaches which rely on cross-sectional belief-intention associations. We experimentally tested whether messages addressing promising themes as identified by the above criterion were more persuasive than messages addressing less promising themes. Contrary to expectations, all messages increased intentions. Interestingly, mediation analyses showed that while messages deemed promising affected intentions through changes in targeted promising beliefs, messages deemed less promising also achieved persuasion by influencing nontargeted promising beliefs. Implications for message topic selection are discussed.
27866793	Black women have a higher rate of BRCA1 and BRCA2 (BRCA) mutations, compared with other populations, that increases their risk for hereditary breast and ovarian cancer (HBOC). However, Black women are less likely to know about HBOC and genetic testing. Based on a request from a community advisory panel of breast cancer survivors, community leaders and healthcare providers in the Black community, our team developed a culturally targeted educational brochure to promote awareness of HBOC among Black women.To reach the target population we utilized a passive dissemination strategy. Using Diffusion of Innovations (DOI) as a framework, we traced dissemination of the brochure over a five year period using self-addressed postcards contained inside the brochure that included several open-ended questions about the utility of the brochure, and a field for written comments. Closed-ended responses were analyzed using descriptive statistics and thematic analysis was conducted on the open-ended responses.	DOI captured the proliferation of the brochure among Black women across the US.	The use of passive dissemination strategies among pre-existing social networks proved to be a useful and sustainable method for increasing knowledge of HBOC among Black women.	
27866451	In the medical profession, activities related to ensuring access to care, navigating the system, mobilizing resources, addressing health inequities, influencing health policy and creating system change are known as health advocacy. Foundational concepts in health advocacy include social determinants of health and health inequities. The social determinants of health (i.e. the conditions in which people live and work) account for a significant proportion of an individual's and a population's health outcomes. Health inequities are disparities in health between populations, perpetuated by economic, social, and political forces. Although it is clear that efforts to improve the health of an individual or population must consider "upstream" factors, how this is operationalized in medicine and medical education is controversial. There is a lack of clarity around how health advocacy is delineated, how physicians' scope of responsibility is defined and how teaching and assessment is conceptualized and enacted. Numerous curricular interventions have been described in the literature; however, regardless of the success of isolated interventions, understanding health advocacy instruction, assessment and evaluation will require a broader examination of processes, practices and values throughout medicine and medical education. To support the instruction, assessment and evaluation of health advocacy, a novel framework for health advocacy is introduced. This framework was developed for several purposes: defining and delineating different types and approaches to advocacy, generating a "roadmap" of possible advocacy activities, establishing shared language and meaning to support communication and collaboration across disciplines and providing a tool for the assessment of learners and for the evaluation of teaching and programs. Current approaches to teaching and assessment of health advocacy are outlined, as well as suggestions for future directions and considerations.
27866351	The purpose of this study was to understand the social referencing behaviors of children with and without autism spectrum disorder (ASD) while visually attending to a videogame stimulus depicting both the face of the videogame player and the videogame play action. Videogames appear to offer a uniquely well-suited environment for the emergence of friendships, but it is not known if children with and without ASD attend to and play videogames similarly. Eyetracking technology was used to investigate visual attention of participants matched based on chronological age. Parametric and nonparametric statistical analyses were used and results indicated the groups did not differ on percentage of time spent visually attending to any of the areas of interest, with one possible exception.
27865987	The present study investigated whether engaging in sexy self-presentations on social network sites (SNSs) or exposure to sexy self-presentations on SNSs predicts the willingness to engage in sexting. A second aim of the present study was to investigate whether adolescent girls demonstrate stronger relationships between (exposure to) sexy online self-presentations on SNSs and willingness to sext than adolescent boys and young adult men and women. A two-wave panel survey among 953 Dutch adolescents (13-17 years old, 50.7% male) and 899 Dutch young adults (18-25 years old, 43.9% male) showed that engaging in sexy self-presentations on SNSs increased the willingness to engage in sexting, but only among adolescent girls. Exposure to sexy self-presentations of others did not predict the willingness to engage in sexting. The findings call for more research on the role of gender and age in the link between sexy self-presentation and sexting.
27865968	Consistent evidence suggests that emotional facial expressions are better recognized when the expresser and the perceiver belong to the same social group (in-group advantage). In this study, we used transcranial magnetic stimulation (TMS) to investigate the possible causal involvement of the dorsomedial prefrontal cortex (dmPFC) and of the right temporo-parietal junction (TPJ), two main nodes of the mentalizing neural network, in mediating the in-group advantage in emotion recognition. Participants performed an emotion discrimination task in a minimal (blue/green) group paradigm. We found that interfering with activity in the dmPFC significantly interfered with the effect of minimal group-membership on emotion recognition, reducing participants' ability to discriminate emotions expressed by in-group members. In turn, rTPJ mainly affected emotion discrimination per se, irrespective of group membership. Overall, our results point to a causal role of the dmPFC in mediating the in-group advantage in emotion recognition, favoring intragroup communication.
27865924	To increase the efficacy of agri-environmental schemes (AES), as well as farmers' environmental engagement, practitioners are increasingly turning to collective forms of agri-environmental management. As yet, empirical evidence from such approaches is relatively scarce. Here, we examined a farmland bird conservation project coordinated by BirdLife Sweden, the Swedish Volunteer & Farmer Alliance (SVFA). The key features of the SVFA were farmland bird inventories from volunteering birdwatchers and on-farm visits to individual farmers from conservation advisors for guidance on AES as well as unsubsidised practices. Using an ex-post application of the theory of planned behaviour across project participants and a randomly sampled control group of farmers we assessed how SVFA affected behavioural intentions relating to AES and unsubsidised conservation, and how the behaviour was affected by attitudes, perceived social norms and perceived behavioural control. We also included a measure of self-identity as a conservationist to assess its importance for behavioural intentions, and if SVFA stimulated this self-identity. SVFA farmers reported greater commitment to implementing AES and unsubsidised conservation, as compared to the control group. However, greater commitment was associated with more positive attitudes for unsubsidised conservation only and not for AES, underlining the inability of existing AES to prompt intrinsic motivation. There were also differences between farmers within SVFA, where farmers applying to the project were motivated by social influences, while farmers recruited by project managers were motivated by their personal beliefs regarding nature conservation. Finally, farmers' self-perceived ability to perform practices (i.e. perceived behavioural control) was important for their commitment to implementing AES as well as unsubsidised practices. Therefore, increasing farmers' awareness regarding the availability and, not least, practicability of available conservation options may be the key to successful biodiversity conservation in agricultural systems.

27865229	The effects of three anti-stigma strategies for stuttering-contact (hearing personal stories from an individual who stutters), education (replacing myths about stuttering with facts), and protest (condemning negative attitudes toward people who stutter)-were examined on attitudes, emotions, and behavioral intentions toward people who stutter.Two hundred and twelve adults recruited from a nationwide survey in the United States were randomly assigned to one of the three anti-stigma conditions or a control condition. Participants completed questionnaires about stereotypes, negative emotional reactions, social distance, discriminatory intentions, and empowerment regarding people who stutter prior to and after watching a video for the assigned condition, and reported their attitude changes about people who stutter. Some participants completed follow-up questionnaires on the same measures one week later.	All three anti-stigma strategies were more effective than the control condition for reducing stereotypes, negative emotions, and discriminatory intentions from pretest to posttest. Education and protest effects for reducing negative stereotypes were maintained at one-week follow-up. Contact had the most positive effect for increasing affirming attitudes about people who stutter from pretest to posttest and pretest to follow-up. Participants in the contact and education groups, but not protest, self-reported significantly more positive attitude change about people who stutter as a result of watching the video compared to the control group.	Advocates in the field of stuttering can use education and protest strategies to reduce negative attitudes about people who stutter, and people who stutter can increase affirming attitudes through interpersonal contact with others.	
27863928	LEGO® therapy uses children's natural interest in play to help motivate behavioural change and may be an effective teaching tool to increase social competency and communication skills. Although the literature is growing it has not been synthesized.To review the literature on the role of LEGO® therapy on social skills and inclusion among children and youth with Autism Spectrum Disorder (ASD).	A scoping review was conducted, involving comprehensive searches of international databases. Eligible articles included: (a) youth aged 19 or younger, with ASD; (b) empirical research on LEGO® therapy interventions; (c) published from 1996 to 2016 in a peer-reviewed journal, conference proceedings, or dissertation.	Of the 6964 studies identified, 15 articles-involving 293 participants, aged 5-16 (mean age 8.7 years), across five countries-met the inclusion criteria. Although the outcomes of the LEGO® therapy varied across the studies, 14 studies reported at least one improvement in social and communication skills (e.g., building friendships, improved social interactions and social competence), ASD-specific behaviors, belonging, family relationships, coping, and reductions in playing alone.	Although LEGO® therapy shows promise as an intervention for children and youth with ASD, more rigorously designed studies are needed to fully understand its impact.	
27863589	In the United States, health care providers have diagnosed 29.1 million people with diabetes. Uncontrolled diabetes is the main reason for limb loss. This review addresses the lack of psychological support after limb loss. Few scholarly sources analyze the psychological aspects of limb loss before and after amputation. These sources report that patients do not have a clear understanding of their disease process and that patients often report a lack of empathy and communication from health care providers. There is no standardization of postoperative care instructions causing great confusion and increasing anxiety for both the patient and the caregivers. Individuals with limb amputation express increased depression and body image disturbance along with social embarrassment after amputation. Postoperatively, patients report a decrease in resources once discharged home. Some studies suggest psychiatric consultation preamputation and postamputation. The literature also suggests increased communication between the patient undergoing amputation and their health care provider preoperatively and postoperatively.
27863498	For women of refugee background, the increased risk of mental illness associated with pregnancy is compounded by pre- and post-settlement stressors. In Australia, antenatal screening for depression and anxiety symptoms using the Edinburgh Postnatal Depression Scale is recommended for all women. Despite this, screening is not routinely implemented and little is known about barriers and enablers to implementation for women of refugee background.Semi-structured interviews were conducted with a range of health professionals (n = 28: midwives, obstetricians, perinatal mental health and refugee health experts, interpreters) and women of refugee background (n = 9). Themes generated from thematic analysis were examined in relation to the Theoretical Domains Framework and Cultural Competence Conceptual Framework, followed by identification of effective behaviour change techniques to address the barriers and enablers identified by participants. These techniques formed the basis of recommendations to inform sustainable implementation of screening and referral.	Almost all participants perceived perinatal mental health screening to be necessary and most recognised the importance of post-traumatic stress disorder (PTSD) screening. Barriers and enablers were identified and related to eight domains: knowledge, skills, professional roles, beliefs about capabilities and consequences, environmental context, social influences and behavioural regulation.	This research clarifies how mental health screening may be integrated into routine antenatal care for women of refugee background, in order to improve provision of recommended care. These theory-informed recommendations include an inter-disciplinary approach, coordinating care within and across services, addition of PTSD screening, and effective communication with women.	
27863234	Getting together to exchange ideas, forge collaborations, and disseminate knowledge is a long-standing tradition of scientific communities. How conferences are serving the community, what their current challenges are, and what is in store for the future of conferences are the topics covered in this Commentary.
27862757	The proliferation of "accessible information" for people with intellectual disabilities in UK health care has accelerated in recent years, underpinned by policy guidance alongside the recent introduction of mandatory standards. However, questions have been raised as to the impact of such resources as a means of enhancing involvement in health care and addressing health inequalities.To review and synthesize the evidence from different approaches used to evaluate the impact of accessible information for people with intellectual disabilities using a meta-narrative approach.	Literature searches were iterative and incorporated formal databases, grey literature and hand searches alongside more intuitive and opportunistic methods.	Included English language papers published before December 2015 described the design and evaluation of written information adapted for adults with intellectual disabilities.	We organized the papers into five groups according to similarity in authors' writing styles and presentation, epistemology and theoretical foundations, aims and methodologies, professional and organizational identities.	The 42 included papers in the five groupings occupied diverse positions on (i) public communication vs individualized materials, (ii) literacy as decontextualized skills vs social practices and (iii) the expertise of patients vs professionals. There was limited evidence for the impact of accessible health information, notwithstanding the potential benefits associated with their creation.	Individually tailored information is more likely to meet personalized health information needs for people with intellectual disabilities. The emergence of different social formations in the creation of accessible information has potential for advancing engagement of diverse groups.	
27862704	There is controversial information on outcome of school age individuals who lose the diagnosis of autism and achieve "optimal outcome" (OO). The present study assessed the autism symptoms and other psychiatric disorders in a group of children with a past history of autism.The subjects consisted of 26 individuals who had lost the diagnosis of autism 2-8 years previously. Clinical assessment was done with both parents and children. Diagnostic and Statistical Manual of Mental Disorders (5th edn; DSM-V) criteria were used for diagnosis of autism spectrum disorder (ASD). In addition, Childhood Autism Rating Scale and Social Communication Questionnaire (current version) were used. Psychiatric disorders were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version (K-SADS-PL).	None of the participants met the criteria for ASD. Ninety-two percent had a lifetime diagnosis and 81% had a present psychiatric disorder based on the K-SADS. Attention-deficit hyperactivity disorder, specific phobia and obsessive-compulsive disorder were the most common disorders.	Improved status with regard to autism symptomatology is maintained over time, but these individuals are vulnerable to developing other psychiatric disorders. It is crucial to maintain psychiatric follow up of children who move off the autism spectrum.	
27862512	Recent studies have indicated an increased risk of autism, behavioural and emotional problems and attention-deficit/hyperactivity disorder in individuals with Down syndrome.In a large-scale survey-based study, we examined the rates of these problems and their relationship to age and gender, in a sample of 674 individuals (4-18 years) with Down syndrome. The relationship with IQ level was also explored in a subsample (n = 175). The Strengths and Difficulties Questionnaire and the Social Communication Questionnaire were used to assess behavioural and emotional problems and autism traits.	On the Strengths and Difficulties Questionnaire, peer problems were the most frequently reported difficulty (48% > cut-off), followed by hyperactivity/inattention (34% > cut-off). On the Social Communication Questionnaire, 37% scored at or above cut-off (≥15) for autism spectrum disorder; 17% were at or above the suggested cut-off (≥22) for autism. Little association between age and behavioural or emotional problems or with severity of autistic symptomatology was found. However, peer problems were more common in adolescents than in junior school children (P < 0.001); Hyperactivity/inattention was less prevalent among adolescents (P < 0.001).	High rates of autistic features, emotional and behavioural problems are documented. These problems are related to age, gender and degree of intellectual disability.	
27862186	The aim of this study was to synthesize the qualitative evidence investigating adolescents' views on heterosexual readiness.Adolescents' understandings of sexual readiness are often missing in research and debates on sexual health and related concepts like sexual consent. Research to date has predominantly focussed on age and socio-cultural predictors of sexual debut, thus failing to explain how adolescents themselves conceptualize their readiness for heterosexual relations.	A systematic review and thematic synthesis of qualitative evidence.	CINAHL, Psychinfo, PubMed, Web of science were searched, 1985-Feb 2016.	Critical Appraisal Skills Programme checklist was used to assess methodological quality. A thematic synthesis focused on commonalities and variations in the data from included studies on adolescents' perspectives of their readiness for sex.	Sixteen studies were included. Themes identified were: social learning, relationships and implications for sexual health promotion and practice.	Adolescents may not view initiating sex as problematic, focusing instead on the rewards sex brings and less on health concerns. Adolescents tend to reproduce dominant gender norms of masculinity and femininity in communication about sexual decision-making, which are sometimes influenced by social scripts of career aspirations and ethnic identity. Age was also significant in adolescents' accounts. Early adolescence is a critical period when understandings of gender equality become embedded, thus an opportunity to engage adolescents in critiquing ideas about gender equality and sexual rights. Further research exploring adolescents' understandings of sexual readiness is required. We recommend a participatory approach to support the inclusion of adolescent voices to inform contextually relevant sexual health promotion strategies.	
27862155	The recurrence of menstrual symptoms markedly interferes with the daily life, social functioning, work disability and quality of life of women. Patient perception of healthcare services is underexplored but crucial for understanding how to efficiently develop healthcare practices.To identify and describe the different patterns of treatment expectation and physician-patient relationships perceived by women receiving traditional Chinese medicine treatment for menstrual symptoms.	A two-stage data collection design was used. In the first stage, in-depth interviews with 40 participants were conducted; the interview data were used for content analysis. Q statements were developed on the basis of the content analysis results. In the second stage, a series of Q sorts was performed by 60 other participants to subjectively rank the Q statements.	The results of factor analysis revealed that four factors retained in the final model accounted for 56% of total variance. Women associated with Factor 1 had experienced few negative physician-patient interactions; these women were relatively young (31.6 years) and had mild perimenstrual mood discomfort (6.4). Women who loaded on Factor 2 preferred physician guidance and encountered few barriers to adherence; these participants were older (38.6 years) and had the most severe perimenstrual mood discomfort (9.5) among the four groups. The women in agreement with Factor 3 tended to patiently wait for treatment effects; these participants had the highest scores for both cyclic pelvic pain (4.9) and perimenstrual physical discomfort (8.8). The women associated with Factor 4 demanded effective treatment and had the lowest scores for both cyclic pelvic pain (3.8) and perimenstrual physical discomfort (6.8).	The exploration of clustering patients according to their perspectives could influence healthcare providers to acknowledge patient expectations and enable effective communication between physicians and patients.	
27862140	The aim of this study was to examine the role and responsibilities of intensive care unit (ICU) nurses regarding the spiritual aspects of end-of-life care in the ICU, from the chaplains' perspectives.An explorative study including inductive thematic analysis was used. Two focus group interviews with in total eleven chaplains working in several Dutch ICUs were performed.	The focus group interviews resulted in five themes: (i) awareness of ICU nurses, (ii) communication, (iii) nursing interventions, (iv) multidisciplinary care and (v) education. In total, twenty recommendations were formulated.	This explorative study provides an overview of the perspectives of chaplains about the role of ICU nurses during end-of-life care, specified to spiritual care. Chaplains mentioned different roles, responsibilities and competences which are needed for ICU nurses to give spiritual care. These roles, responsibilities and competences included giving spiritual care to patients and families as standard care. Chaplains agreed that ICU nurses should start and maintain a dialogue with patient and families, but that it is also important to be aware of one's own spiritual background. However, education about spiritual care is needed to establish this. It could be recommended to educate ICU nurses during their ICU training or retraining about spiritual care and reflection.	
27861058	Rationale and key points This article encourages nurses to use Twitter to engage in professional discussions, share information and raise awareness of alternative views to enhance practice and patient care. Twitter is an online social media service that enables users to send and read 140-character messages called tweets. » Twitter is free and accessible across multiple platforms and devices, providing immediate contact with professionals, organisations and the public worldwide. » Many healthcare professionals use Twitter to share ideas and information. » Responsible use of Twitter creates opportunities to access information, discuss issues and challenge misconceptions to support professional nursing behaviours. Reflective activity 'How to' articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How you could develop your use of Twitter for professional learning and interaction with healthcare professionals and others. 2. How you could support a colleague to use Twitter for the first time.
27860520	Unlike most desert-dwelling animals, Cataglyphis ants do not attempt to escape the heat; rather, they apply their impressive heat tolerance to avoid competitors and predators. This thermally defined niche has promoted a range of adaptations both at the individual and colony levels. We have also recently discovered that within the genus Cataglyphis there are incredibly diverse social systems, modes of reproduction, and dispersal, prompting the tantalizing question of whether social diversity may also be a consequence of the harsh environment within which we find these charismatic ants. Here we review recent advances regarding the physiological, behavioral, life-history, colony, and ecological characteristics of Cataglyphis and consider perspectives on future research that will build our understanding of organic adaptive responses to desertification.
27859970	Guidelines for patients with knee osteoarthritis (OA) are suboptimally implemented in clinical care. To improve guideline adherence, patients' perceived barriers and facilitators in current care were investigated.Eleven patients with knee OA were extensively interviewed using a semistructured script based on quality indicators. Directed content analysis, within the framework of Grol and Wensing, was performed to describe barriers and facilitators in 6 domains: guideline, health care professional, patient, social environment, organization, and financial context. Data were analyzed using NVIVO 10 software.	In total, 38 barriers, at all 6 domains, were identified. The most frequently mentioned barriers were in the domains of the patient and the health care professional, namely, patients' disagreement with guidelines recommendations, negative experience with drugs, patients' limited comprehension of the disease process, and poor communication by the health care professional. The patients' disagreement with recommendations is further explained by the following barriers: "insistence on medical imaging," "fear that physiotherapy aggravates pain," and "perception that knee OA is not a priority health issue". Patients also reported 20 facilitators, all of which are listed as opposing barriers.	Patients indicate that both personal factors and factors related to health care professionals play an important role in nonadherence. An interview script, based on quality indicators, was a significant aid to structurally formulate barriers and facilitators in the perceived knee OA care. Future guideline implementation strategies should take the identified barriers and facilitators into account.	
27859876	To explore experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings. Specifically, we explored how social and institutional discourses shape power relations during the negotiation process.The hospital system is embedded in a hierarchical structure where the voice of the healthcare provider as expert is often given more importance than the patient. This system has been criticised as being oppressive to patients who are perceived to be lower in the hierarchy. In this study, we illustrate how the hospital's hierarchical system is not always oppressing but can also create moments of empowerment for patients.	A feminist poststructuralist approach informed by the teaching of Foucault was used to explore power relations between nurses and patients when negotiating patient care in hospital settings.	Eight individuals who suffered from chronic illness shared their stories about how they negotiated their care with nurses in hospital settings. The interviews were tape-recorded. Discourse analysis was used to analyse the data.	Patients recounted various experiences when their voices were not heard because the current hospital system privileged the healthcare provider experts' advice over the patients' voice. The hierarchical structure of hospital supported these dynamics by privileging nurses as gatekeepers of service, by excluding the patients' input in the nursing notes and through a process of self-regulation. However, patients in this study were not passive recipients of care and used their agency creatively to resist these discourses.	Nurses need to be mindful of how the hospital's hierarchical system tends to place nurses in a position of power, and how their authoritative position may positively or adversely affect the negotiation of patient care.	
27859798	Our study aims to test the effectiveness of binding communication based interventions (vs classical persuasive communication based ones) inciting non-donors to act in favour of blood donation.The implementation of effective communication interventions represents a major public health issue. Nevertheless, persuasive media campaigns appear to have little effect on behaviours. Even though non-donors hold a positive attitude towards blood donation, they are not inclined to donate. As an alternative to producing behavioural changes, many recent studies have shown the superiority of binding communication over persuasive communication.	All participants, non-donors, were randomly assigned to one of four experimental conditions of a 2 (type of communication: persuasive vs binding) × 2 (source credibility: low vs high) factorial design. Then, they were asked to report their intention to donate blood, and their intention to distribute leaflets regarding blood donation.	Binding communication is a more effective strategy for increasing intention towards blood donation compared with persuasive communication, especially when combined with high credibility source.	Accordingly this study calls for more consideration of knowledge of social psychology to design effective communication interventions and increase the number of donations.	
27859450	The preoperative education, which occurs in preoperative patient consultations, is an important part of the surgical nurse's profession. These consultations may be the building blocks of a partnership that facilitates communication between patient and nurse.The aim of the study was to describe topics and structure and documentation in preoperative nursing consultations with patients undergoing surgery for colorectal cancer.	The study was based on analysis of consultations between seven patients and nurses at a Swedish university hospital. The preplanned preoperative consultations were audio-recorded and transcribed verbatim. The structure of the consultations was described in terms of phases and the text was analysed according to a manifest content analysis RESULTS: The consultations were structured on an agenda that was used variously and communicating different topics in an equally varied manner. Seven main topics were found: Health status, Preparation before surgery, Discovery, Tumour, Operation, Symptoms and Recovery after surgery. The topic structure disclosed a high number of subtopics. The main topics 'Discovery', 'Tumour' and 'Symptoms' were only raised by patients and occupied only 11% of the discursive space. Documentation was sparse and included mainly task-oriented procedures rather than patients' worries and concerns.	There was no clear structure regarding preoperative consultation purpose and content. Using closed questions instead of open is a hindrance of developing a dialogue and thus patient participation. Preoperative consultation practice needs to be strengthened to include explicit communication of the consultations' purpose and agenda, with nurses actively discussing and responding to patients' concerns and sensitive issues. The results of the study facilitate the development of methods and structure to support person-centred communication where the patient is given space to get help with the difficult issues he/she may have when undergoing surgery.	
27858585	Within the context of a pandemic flu, this experiment investigated whether source (government officials or physicians), severity condition (high or low), and mention of self-efficacy method (mention present or absent) in H1N1 health news affected participants' (a) perception of media influence on self and others and (b) intentions to get vaccinated. Results found support for third-person effects, and the magnitude of the effects grew with social distance. Main effect of source, as well as interaction effects among the independent variables on third-person effect and vaccination intentions, were also found.
27858529	How the media frames issues of environmental health may affect mothers' views of who is responsible for addressing environmental risks to pediatric health and, ultimately, their protective behaviors. This article describes how information-oriented media sources attribute responsibility for such risks and examines associations between mothers' routine media exposure, or scanning, and perceptions of responsibility. First, a content analysis was conducted on a sample of 474 media stories (i.e., Associated Press, parenting magazines, and websites) about childhood exposure to environmental chemicals over a 6-month period (September 2012-February 2013). We found that media stories attributed responsibility most frequently to parents, though significant differences were observed across media sources, such that websites focused more on parents and general news more on government agencies and manufacturers. Next, we conducted an online survey of mothers (N = 819) and revealed that website scanning during the prior 6 months was significantly associated with perceived personal responsibility, even after we adjusted for potential confounders. Scanning general news was also significantly associated with perceived government and manufacturer responsibility. Understanding media framing of these issues highlights opportunities for health communicators to offset pressure placed on mothers by encouraging greater social and policy support in and exposure to certain media.
27858525	Narrative communication is effective in increasing public awareness while generating dialogue about varied health topics. The current study utilized narrative communication in the form of a 15-minute motivational film titled La CLAve to help Latinos recognize symptoms of psychosis and begin a discussion about serious mental illness. The study aimed to explore the participants' response to the film and whether the film led to further dialogue about psychosis. Four focus groups were conducted with 40 Spanish-speaking participants, mostly foreign-born Latinas, with a mean age of 49 years. Results indicate that participants engaged with the film as reflected in their ability to recall the storyline in detail. Reports of psychosis knowledge gains included recognition of key symptoms, such as hallucinations and disorganized speech. Participants attributed symptoms of psychosis, observed in a film character, to social stressors and other previously constructed views of mental illness. Many participants discussed the content of the film within their immediate social networks. Other findings include discussions of key barriers and facilitators to seeking mental health treatment among Latino families, such as denial and family support. Results suggest that narrative films offer a promising strategy to stimulate dialogue about serious mental illness among Latinos.
27858470	Social media have recently gained attention as a potential health campaign tool. This study examines this line of expectation concerning the role social media may play in health campaigns by testing an integrated health campaign model that combines insights from research on social media-specific perceptions and communicative behaviors in order to predict health behaviors. Specifically, this study aims to (a) develop a more holistic social media campaign model for predicting health behaviors in the social media context, (b) investigate how social media channel-related perceptions affect preventive health behaviors, and (c) investigate how communicative behaviors mediate perceptions and behavioral intention. The study conducted an online survey of 498 females who followed the Purple Ribbon Twitter campaign (@pprb), a cervical cancer prevention campaign. The results indicated that information acquisition mediated perceived risk's effect on intention. Information acquisition also mediated the relationships between intention and information selection and information transmission. On the other hand, social media-related perceptions indirectly impacted behavioral intention through communicative behaviors. The findings' theoretical and practical implications are discussed.
27858469	Previous studies have demonstrated the role of social networks, social capital, and social support in individuals' well-being. However, the ways in which these related constructs simultaneously influence one's well-being outcomes and relate to one another have not been closely examined. This study pays particular attention to the structural characteristics of personal networks, distinction between offline and online social capital, and different indicators of well-being outcomes. Based on survey data collected from 574 college students, the study found that two dimensions of personal networks-density and gender homophily-and social capital in the form of offline bonding capital explained perceived social support. Further, perceived social support consistently predicted well-being outcomes and played a mediating role between personal network density and well-being, as well as between offline bonding capital and well-being. The results offer implications for a more nuanced understanding of the role of individuals' interpersonal and social environments in well-being outcomes.
27858464	The past decade has witnessed a rapid increase in the use of Social Networking Sites (SNSs) in health communication campaigns seeking to achieve an ambitious range of health-related impacts. This article provides a review of 40 studies and research protocols, with a focus on two key factors that differentiate SNSs from more traditional health communication approaches of the past. The first is the potential dualism between message sender and receiver, in which receivers become receiver-sources who forward and amplify the content and reach of health messages. The second is the potential dualism between message and message impact, in which the act of forwarding and modifying messages by receiver-sources itself becomes a measure of message impact. Each of these dualisms has implications for the design and evaluation of contemporary health communication campaigns. The review concludes with a series of observations and recommendations for future health communication research.
27858322	Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer.Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study.	Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients' sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience.	Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed.	Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.	
27857988	Social media, through the Internet and other web-based technologies, have become a means of communication and knowledge-sharing. In this article, we provide details about the social media traffic of various scientific activities, the organizations of which we have played an active role in. We also provide information in our native language through our FOAMed website, which has been published for about 30 months, with us acting as editors. We are comparing these local and limited ventures with examples from the world and aim to remind that social media sources play a very important role in sharing knowledge in medical training and encouraging local initiatives, like ours, with limited resources.
27857939	Bangladesh is currently a low human immunodeficiency virus (HIV) prevalent country. However, the risk factors are widespread and the number of at-risk population is also rising, which warrants special policy attention. The risks of transmission were shown to be correlated with the level of HIV knowledge of individuals. In this study, we aimed to explore the level and influencing factors of HIV knowledge among adult men in Bangladesh.Data for the present study were collected from the sixth round of Bangladesh Demographic and Health Survey. Participants were 3305 men between 15 and 54 years of age regardless of HIV status. The primary outcome variable was the HIV knowledge score, which was calculated by responses to questions regarding general concepts and the mode of transmission of HIV. Association between the HIV knowledge score and the explanatory variables were analyzed by binary logistic regression methods.	The mean HIV knowledge score was 7.2 (SD 1.3). Results indicate that being an urban resident [p < 0.001; odds ratios (OR) = 0.56, 95% confidence intervals (CI) = 0.48-0.64], having secondary/higher educational level (p < 0.001 OR = 0.56, 95%CI = 0.48-0.64), reading newspaper [p = 0.006; OR = 0.76, 95%CI = 0.62-0.92], and communication with community health workers (CHWs) (p = 0.05; OR = 0.77, 95%CI = 0.60-10.00) were significantly associated with a high (equal or above mean value) HIV knowledge level.	The level of HIV knowledge among Bangladeshi men is low. Leveraging HIV awareness programs targeting adult men to prevent future expansion of the epidemic should be a high priority. Revitalization and restructuring of the education sector and strengthening CHW's engagement to improve knowledge about HIV transmission among men could generate beneficial returns for HIV prevention programs.	
27857100	Objectives The aim of this paper is to identify the factors that affect the complexity of implant restoration and to explore the indices that help us to assess it. With this knowledge the growing number of clinicians restoring dental implants will have a better understanding of the available guidance and evidence base, and the differing levels of competence required.Study design A literature review was conducted. The selection of publications reporting on complexity was based on predetermined criteria and was agreed upon by the authors. After title and abstract screening 17 articles were reviewed. The articles that were utilised to form the ITI SAC tool and Cologne Risk Assessment we also included.Assessing complexity Two key guides are available: International Team for Implantology's Straight-forward Advanced Complex tool and the Cologne ABC risk score. While these guides help identify treatment complexity they do not provide a strong enough evidence base from which to solely base clinical decisions. The key patient factors are expectation, communication, the oral environment, aesthetic outcome, occlusion, soft tissue profile and the intra-arch distance, whereas the key technical factors are impression taking, type of retention, loading protocol and the need for provisional restorations. Human factors also have a significant effect on complexity, specifically, the experience and training of the clinician, team communication and the work environment.Conclusions There are many interconnecting factors that affect the complexity of dental implant restoration. Furthermore the two widely used indices for the assessment of complexity have been investigated, and although these offer a good guideline as to the level of complexity, there is a lack evidence to support their use. The development of evidence-based treatment and protocols is necessary to develop the current indices further, and these need to be expanded to include other critical areas, such as human factors. A practical guide to aid practitioners in reducing complexity has been proposed.
27857002	Torture survivors face multiple problems, including psychological difficulties, whether they are refugees or remain in the country where they were tortured. Provision of rehabilitation varies not only with the needs of survivors and resources available, but also with service models, service provider preferences and the local and country context. Despite increasing efforts in research on effectiveness of psychological interventions with torture survivors, results are inconclusive.We undertook a Cochrane systematic review of psychological, social and welfare provision, with meta-analysis to best estimate efficacy. The process raised conceptual, methodological and ethical issues of relevance to the wider field.	We searched very widely, but rejected hundreds of papers which recommended treatment without providing evidence. We found nine randomised controlled trials, from developed and under-resourced settings. All conceptualised survivors' problems in psychiatric terms, using outcomes of post-traumatic stress symptoms, distress, and quality of life, by self-report, with or without translation or unstandardised interpretation, and with little mention of cultural or language issues. None used social or welfare interventions. Four related studies used narrative exposure therapy (NET) in a brief form, and without ensuring a safe setting as recommended. Five used mixed methods, including exposure, cognitive behavioural therapy, and eye movement desensitisation. Combined, the studies showed no immediate improvement in PTSD, distress, or quality of life; at six months follow-up, a minority showed some improvement in PTSD and distress, although participants remained severely affected.	While applauding researchers' commitment in running these trials, we raise ethical issues about exposure in particular, and about the effects of shortcomings in methodology, particularly around assessment using unfamiliar cultural frameworks and language, and the lack of concern about dropout which may indicate harm. The issues addressed aid interpretation of existing research, and guide clinical practice as well as future studies evaluating its effectiveness.	
27856551	The scientific process is nonlinear, unpredictable, and ongoing. Assessing the nature of science is difficult with methods that rely on Likert-scale or multiple-choice questions. This study evaluated conceptions about the scientific process using student-created visual representations that we term "flowcharts." The methodology, Scientific Process Flowchart Assessment (SPFA), consisted of a prompt and rubric that was designed to assess students' understanding of the scientific process. Forty flowcharts representing a multidisciplinary group without intervention and 26 flowcharts representing pre- and postinstruction were evaluated over five dimensions: connections, experimental design, reasons for doing science, nature of science, and interconnectivity. Pre to post flowcharts showed a statistically significant improvement in the number of items and ratings for the dimensions. Comparison of the terms used and connections between terms on student flowcharts revealed an enhanced and more nuanced understanding of the scientific process, especially in the areas of application to society and communication within the scientific community. We propose that SPFA can be used in a variety of circumstances, including in the determination of what curricula or interventions would be useful in a course or program, in the assessment of curriculum, or in the evaluation of students performing research projects.
27856360	Autism is a heterogeneous developmental disorder characterized by impaired social interaction, impaired communication skills, and restricted and repetitive behavior. The abnormal behaviors of these patients can make their anesthetic and perioperative management difficult. Evidence in the literature suggests that some patients with autism or specific autism spectrum disorders (ASD) exhibit altered responses to pain and to anesthesia or sedation. A genetic mouse model of one particular ASD, Phelan McDermid Syndrome, has been developed that has a Shank3 haplotype truncation (Shank3+/Δc). These mice exhibit important characteristics of autism that mimic human autistic behavior. Our study demonstrates that a Shank3+/ΔC mutation in mice is associated with a reduction in both the MAC and RREC50 of isoflurane and down regulation of NR1 in vestibular nuclei and PSD95 in spinal cord. Decreased expression of NR1 and PSD95 in the central nervous system of Shank3+/ΔC mice could help reduce the MAC and RREC50 of isoflurane, which would warrant confirmation in a clinical study. If Shank3 mutations are found to affect anesthetic sensitivity in patients with ASD, better communication and stricter monitoring of anesthetic depth may be necessary.
27856093	This study aimed to assess teachers' voice symptoms and noise in schools in Upper Egypt and to study possible differences between teachers in public and private schools.A cross-sectional analysis via questionnaire was carried out.	Four schools were chosen randomly to represent primary and preparatory schools as well as public and private ones. In these schools, a total of 140 teachers participated in the study. They answered a questionnaire on vocal and throat symptoms and their effects on working and social activities, as well as levels and effects of experienced noise.	Of all teachers, 47.9% reported moderate or severe dysphonia within the last 6 months, and 21.4% reported daily dysphonia. All teachers reported frequent feelings of being in noise, with 82.2% feeling it sometimes or always during the working day, resulting in a need to raise their voice. Teachers in public schools experienced more noise from nearby classes.	The working conditions and vocal health of teachers in Upper Egypt, especially in public schools, are alarming.	
27855484	Two hypotheses, gaze aversion and gaze indifference, are commonly cited to explain a diagnostic hallmark of autism: reduced attention to others' eyes. The two posit different areas of atypical brain function, different pathogenic models of disability, and different possible treatments. Evidence for and against each hypothesis is mixed but has thus far focused on older children and adults. The authors evaluated both mechanistic hypotheses in two sets of experiments at the time of initial diagnosis.Eye-tracking data were collected in 86 2-year-olds: 26 with autism, tested at initial diagnosis; 38 matched typically developing children; and 22 matched developmentally delayed children. In two experiments, the authors measured response to direct and implicit cueing to look at the eyes.	When directly cued to look at the eyes, 2-year-olds with autism did not look away faster than did typically developing children; their latency varied neither categorically nor dimensionally by degree of eye cueing. Moreover, direct cueing had a stronger sustained effect on their amount of eye-looking than on that of typically developing children. When presented with implicit social cues for eye-looking, 2-year-olds with autism neither shifted their gaze away nor more subtly averted their gaze to peripheral locations.	The results falsify the gaze aversion hypothesis; instead, at the time of initial diagnosis, diminished eye-looking in autism is consistent with passive insensitivity to the social signals in others' eyes.	
27855266	Ever since the emergence of social networking sites (SNSs), it has remained a question without a conclusive answer whether SNSs make people more or less lonely. To achieve a better understanding, researchers need to move beyond studying overall SNS usage. In addition, it is necessary to attend to personal attributes as potential moderators. Given that SNSs provide rich opportunities for social comparison, one highly relevant personality trait would be social comparison orientation (SCO), and yet this personal attribute has been understudied in social media research. Drawing on literature of psychosocial implications of social media use and SCO, this study explored associations between loneliness and various Instagram activities and the role of SCO in this context. A total of 208 undergraduate students attending a U.S. mid-southern university completed a self-report survey (Mage = 19.43, SD = 1.35; 78 percent female; 57 percent White). Findings showed that Instagram interaction and Instagram browsing were both related to lower loneliness, whereas Instagram broadcasting was associated with higher loneliness. SCO moderated the relationship between Instagram use and loneliness such that Instagram interaction was related to lower loneliness only for low SCO users. The results revealed implications for healthy SNS use and the importance of including personality traits and specific SNS use patterns to disentangle the role of SNS use in psychological well-being.
27855104	To investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC).Case study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities.	UK standardised packaging policy debate 2011-2013.	Organisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents.	Excluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities.	The multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control.	
27854527	To evaluate the effectiveness of the Acceptance Journeys social marketing campaign to reduce homophobia in the Black community in Milwaukee, Wisconsin.We assessed the campaign's effectiveness using a rolling cross-sectional survey. Data were collected annually online between 2011 and 2015. Each year, a unique sample of Black and White adults, aged 30 years and older, were surveyed in the treatment city (Milwaukee) and in 2 comparison cities that did not have antihomophobia campaigns (St. Louis, MO, and Cleveland, OH; for total sample, n = 3592).	Black self-identification and Milwaukee residence were significantly associated with exposure to the campaign, suggesting successful message targeting. The relationship between exposure and acceptance of gay men was significantly mediated through attitudes toward gay men, perceptions of community acceptance, and perceptions of the impact of stigma on gay men, but not through rejection of stereotypes. This model accounted for 39% of variance in acceptance.	This evidence suggests that the Acceptance Journeys model of social marketing may be a promising strategy for addressing homophobia in US Black communities.	
27853919	High rates of hospital readmissions have been shown within 12 months post-discharge from inpatient rehabilitation following stroke. Multiple studies coupled with our previous work indicate a need for care support for stroke survivors' transitions to the community. The Kentucky Care Coordination for Community Transitions (KC3T) program was developed to provide access to medical, social, and environmental services to support community transitions for individuals with neurological conditions and their caregivers living in Kentucky. This program assessment was conducted to determine the effectiveness of using a specially trained community health worker to support community transitions. Thirty acute stroke survivors were enrolled in this program between July 2015 and May 2016. Data collection included: incidence of comorbidities; access to healthcare, insurance, medical equipment (DME), and medications; type of follow-up education provided; and number of 30-day rehospitalizations and Emergency Department (ED) visits. Participants required navigation in their home and community transition with support in: patient-provider communication; insurance support; accessing follow-up care; education on managing chronic health conditions, the stroke process, transfers and mobility; and accessing DME and essential medications. There were no 30-day ED visits for the KC3T participants and only one 30-day hospital readmission, which was not stroke-related. Individuals returning to rural communities following a stroke require, but often don't receive, follow-up education on chronic disease management, support in navigating the healthcare system and accessing essential resources. KC3T's navigator program appears to be effective in supporting the community transitions of individuals poststroke.
27853854	With each additional accumulative exposure to severe and traumatic stressors, the likelihood of developing mental health problems and physical diseases increases. Displaced individuals have usually experienced a number of serious threats to health due to organized violence in their home country or attacks during the flight. Frequently, domestic violence adds additional strain to the stressors experienced. The resulting impairments in psychosocial functioning reduce the resources needed for social adjustment and integration. Social exclusion then in turn often further aggravates the existing mental health complications. For the treatment of trauma spectrum disorders, different evidence-based psychotherapies are available. In high-income countries, trained and licensed psychotherapists are typically in positions to apply such interventions; however, even an advanced system with a high capacity, such as the psychotherapeutic care offered in Germany, severely struggles to manage the demands associated with the rapid addition of hundreds of thousands of displaced people. Germany's mental healthcare system at present lacks the resources, both human and technological, to effectively manage the present demands. Systematic scientific studies in resource-poor regions of war and conflict have demonstrated that the dissemination of effective treatment to local personnel, even with limited training, results in substantial improvements in the mental health challenges within the community: Organized as a cascade model, members of the refugee community learn to identify weakened fellow citizens requiring in-depth diagnostic interviews. Educated, bilingual individuals acquainted with their country's healthcare system (e. g. nurses, teachers and social workers) receive training to conduct structured interviews and evidence-based interventions under the supervision of centrally organized licensed psychotherapists. More complex cases are referred to local psychotherapists, psychiatrists or specialized treatment centers. These humanitarian efforts are based on the convention for the protection of human rights and secure the safety, freedom and dignity of these persons.
27853853	The classical concept of social support has recently become of relevance again, particularly in the context of traumatized patient groups, which include refugees and migrants. This article summarizes the evidence from social support research, e. g. different types of positive effects as well as context, gender and cultural aspects. These aspects are highlighted by means of studies stemming from applied healthcare research and thus describe a wide range of health effects, e.g. increased well-being and reduced depressive symptoms, improved functional abilities, better immune status and longevity. Two new trauma-specific differentiations of the social support concept are introduced: societal acknowledgement as a trauma survivor and disclosure of traumatic experiences. Against this background several implications for working with refugees arise: promotion of self-efficacy and posttraumatic maturation as well as the treatment of mental disorders show considerable benefits from focusing on social support. Finally, possibilities emerging from digital communication media are discussed, which are particularly relevant in this context.
27853603	Social play is a frequent behaviour in great apes and involves sophisticated forms of communicative exchange. While it is well established that great apes test and practise the majority of their gestural signals during play interactions, the influence of demographic factors and kin relationships between the interactants on the form and variability of gestures are relatively little understood. We thus carried out the first systematic study on the exchange of play-soliciting gestures in two chimpanzee (Pan troglodytes) communities of different subspecies. We examined the influence of age, sex and kin relationships of the play partners on gestural play solicitations, including object-associated and self-handicapping gestures. Our results demonstrated that the usage of (i) audible and visual gestures increased significantly with infant age, (ii) tactile gestures differed between the sexes, and (iii) audible and visual gestures were higher in interactions with conspecifics than with mothers. Object-associated and self-handicapping gestures were frequently used to initiate play with same-aged and younger play partners, respectively. Our study thus strengthens the view that gestures are mutually constructed communicative means, which are flexibly adjusted to social circumstances and individual matrices of interactants.
27852945	The environment in which young people are growing up has changed significantly with the growth in social communication, changes in migration patterns and the proliferation of gangs. These changes pose a real and present danger to the health and well-being of young people in the UK and around the world. However, recognition of the safeguarding needs for this group continues to lag behind those of younger children and services often remain patchy and incomplete. We present a review of current safeguarding concerns as well as practical suggestions on their recognition and response for professionals working with young people in all branches of healthcare as well as education and wider society.
27852869	In this study, 432 television advertisements from Hong Kong, Japan, and South Korea were analyzed to determine their representations of older people. Findings demonstrate that in East Asian advertisements, older people are highly underrepresented, appear in major roles, mostly alongside younger people, and older men clearly outnumber older women. The other variables investigated (i.e., setting and product categories) led to no conclusive findings for the three societies. In short, our study, employing ethnolinguistic vitality theory to analyze television advertisements, demonstrates how East Asian societies greatly marginalize older people. Potential effects of such representations are discussed using social cognitive theory and cultivation theory.
27852819	Advance care planning (ACP) is an iterative, complex, and dynamic process of discussion, decision-making, and documentation about end-of-life care. The extent to which this process takes place in older adults in diverse socioeconomic settings is not well documented. The aim of this study was to assess the knowledge, attitudes, and beliefs about ACP among older adults in two socioeconomically diverse settings to identify the individual and contextual factors that influence behaviors regarding end-of-life care.A cross-sectional survey design was used.	An affordable independent continuing care retirement community and a high-income eligible (HIE) independent continuing care retirement community.	Individuals aged 55 years and older who resided in independent living.	A 61-item survey was administered. Simple descriptive statistics were used to examine the responses, and inferential statistics were used to evaluate which items were associated with key outcomes between the 2 settings.	Seventy-seven older adults completed the survey. Significant differences in familiarity of terminology and knowledge of ACP, as well as significant differences in completion of advance directives and communication, were found between the 2 communities. No differences were found in attitudes and beliefs about end-of-life issues.	Higher levels of knowledge and engagement in ACP were reported at the HIE community as compared to the affordable housing community. These findings provide insight into the influence of the contextual forces that encourage and support ACP.	
27852721	Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them.16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14-17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed.	Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as 'fun' and having 'great flavourings'. Seeing websites or social media featuring e-cigarettes, especially YouTube 'vaping tricks', prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit.	Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers.	
27852712	In most developed countries, substantial disparities exist in access to mental health services for black and minority ethnic (BME) populations. We sought to determine perceived barriers to accessing mental health services among people from these backgrounds to inform the development of effective and culturally acceptable services to improve equity in healthcare.Qualitative study in Southeast England.	26 adults from BME backgrounds (13 men, 13 women; aged >18 years) were recruited to 2 focus groups. Participants were identified through the registers of the Black and Minority Ethnic Community Partnership centre and by visits to local community gatherings and were invited to take part by community development workers. Thematic analysis was conducted to identify key themes about perceived barriers to accessing mental health services.	Participants identified 2 broad themes that influenced access to mental health services. First, personal and environmental factors included inability to recognise and accept mental health problems, positive impact of social networks, reluctance to discuss psychological distress and seek help among men, cultural identity, negative perception of and social stigma against mental health and financial factors. Second, factors affecting the relationship between service user and healthcare provider included the impact of long waiting times for initial assessment, language barriers, poor communication between service users and providers, inadequate recognition or response to mental health needs, imbalance of power and authority between service users and providers, cultural naivety, insensitivity and discrimination towards the needs of BME service users and lack of awareness of different services among service users and providers.	People from BME backgrounds require considerable mental health literacy and practical support to raise awareness of mental health conditions and combat stigma. There is a need for improving information about services and access pathways. Healthcare providers need relevant training and support in developing effective communication strategies to deliver individually tailored and culturally sensitive care. Improved engagement with people from BME backgrounds in the development and delivery of culturally appropriate mental health services could facilitate better understanding of mental health conditions and improve access.	
27852270	The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013.In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan's method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age.	Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly.	By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies at the regional level is essential to provide health care to all persons in need, reduce risk exposures, support prevention policies for adoption of healthy behaviors. Such strategies should prioritize population groups that will experience the greatest impact from such interventions.	
27852269	The Brazilian Unified Health System is a public healthcare system that has universal and equitable access among its main principles, but the continental size of the country and the complexity of the public health system complicate the task of providing equal access to all. We aim to investigate the factors associated with inequities in healthcare utilization in Brazil.We employed data from a nationally representative cross-sectional study (2013 National Health Survey; n = 60,202). The outcome was underutilization of healthcare by adults, defined as lack of utilization of one or more of these services: physician or dentist consultation, and blood glucose or blood pressure screening. A logistic regression model, considering the complex sample, was employed (alpha = 5 %).	0.7 % of the sample never visited a physician, 3.3 % never visited a dentist, 3 % never underwent blood pressure screening, 11.5 % never underwent blood glucose screening, and 15 % never utilized at least one of these services. Multivariate models showed a higher likelihood of underutilization of healthcare among individuals of the lowest social class "E" (AOR = 6.31, 95 % CI = 3.76-10.61), younger adults (Adjusted Odds Ratio, or AOR = 4.40, 95 % CI = 3.78-5.12), those with no formal education or incomplete primary education (AOR = 2.93, 95 % CI = 2.30-3.74), males (AOR = 2.16, 95 % CI = 1.99-2.35), and those without private health insurance (AOR = 2.11, 95 % CI = 1.83-2.44). Individuals self-classified as "white" were less likely to report underutilization (AOR = 0.82, 95 % CI = 0.75-0.90).	Despite recent expansion of primary healthcare and oral health programs in Brazil, we observed gaps in healthcare utilization among the most vulnerable segments of the population.	
27852240	Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care.We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014.	The top three problems were incomplete reconciliation of medication during patient 'hand-overs', inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score.	Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method, and merits further exploration with a view to becoming a part of a routine preventative patient safety monitoring mechanism.	
27852025	The temporal lobe of the cerebrum consists of several spatially segregated functional regions. There are discrete regions of the temporal lobe where auditory (primary, secondary and tertiary), visual (motion detection and object recognition) and meta-cognitive (memory and social communication) functions are processed. The subcortical amygdala and hippocampal-complex can also be considered temporal structures. Several nomenclature systems have been promoted over the years resulting in multiple names for most individual gyri and sulci. Herein we review the historical naming systems for cerebral temporal structures and describe their relationship to the functional regions in the temporal lobe. Neuronal populations that process auditory information are located primarily in the medial region of the temporal lobe (the belt and parabelt). The object-recognition prefrontal cortical stream (the "What" pathway) projects through the rostral superior temporal gyrus while the place-related prefrontal cortical stream (the "Where" Pathway) projects through the caudal superior temporal gyrus. The dorsal part of the superior temporal sulcus receives projections from both auditory regions (superior temporal gyrus) and visual processing areas including the motion-recognition related midtemporal area (MT), the fundus of the superior temporal sulcus (FST), and the caudal inferotemporal cortex (TEO). This convergence could be related to dynamic integration of audio-visual information. The ventral part of the superior temporal sulcus also receives projections from motion-detection regions as well as object recognition areas (TE, TEO). This area could be involved in interpretation of dynamic moving objects, especially biological motion.
27851759	More men are studying and working in science fields than women. This could be an effect of the prevalence of gender stereotypes (e.g., science is for men, not for women). Aside from the media and people's social lives, such stereotypes can also occur in education. Ways in which stereotypes are visible in education include the use of gender-biased visuals, language, teaching methods, and teachers' attitudes. The goal of this study was to determine whether science education resources for primary school contained gender-biased visuals. Specifically, the total number of men and women depicted, and the profession and activity of each person in the visuals were noted. The analysis showed that there were more men than women depicted with a science profession and that more women than men were depicted as teachers. This study shows that there is a stereotypical representation of men and women in online science education resources, highlighting the changes needed to create a balanced representation of men and women. Even if the stereotypical representation of men and women in science is a true reflection of the gender distribution in science, we should aim for a more balanced representation. Such a balance is an essential first step towards showing children that both men and women can do science, which will contribute to more gender-balanced science and technology fields.
27851741	Avian communication has been traditionally believed to be mainly mediated by visual and auditory channels. However, an increasing number of studies are disclosing the role of olfaction in the interaction of birds with their social environment and with other species, as well as in other behaviors such as nest recognition, food location and navigation. Olfaction has also been suggested to play a role in parent-offspring communication not only in the post- but also in the pre-hatching period. Volatile compounds produced during embryogenesis and passively released through the eggshell pores may indeed represent the only cue at parents' disposal to assess offspring quality, including the sex composition of their clutch before hatching. In turn, sex identification before hatching may mediate adaptive strategies of allocation to either sex. In the present study, we analyzed odour composition of barn swallow eggs incubated in their nest in order to identify any sex-related differences in volatile compounds emitted. For the first time in any bird species, we also investigated whether odour composition is associated with relatedness. The evidence of differences in odour composition among eggs containing embryos of either sex indicates that parents have a cue to identify their brood sex composition even before hatching which can be used to modulate their behavior accordingly. Moreover, odour similarity within nests may represent the prerequisite for kin recognition in this species.
27849547	Molecular communication (MC) is a new paradigm for developing communication systems that exchanges information through the transmission and reception of molecules. One proposed model for MC is using bacteria to carry information encoded into DNA plasmids, and this is termed bacterial nanonetworks. However, a limiting factor in the models that have been studied so far is the environment considered only in ideal conditions with a single population. This is far from realistic in natural environments, where bacteria coexist in multiple populations of same and different species, resulting in a very complex social community. This complex community has social interactions that include cooperation, cheating, as well as competition. In this paper, the effects of these social interactions on the information delivery in bacterial nanonetworks are studied in terms of delay, attenuation and data rate. The numerical results show that the cooperative behavior of bacteria improves the performance of delay and attenuation leading to a higher data rate, and this performance can be degraded once their behavior switches towards cheating. The competitive social behavior shows that the performance can degrade delay as well as attenuation leading to slower data rates, as the population with the encoded DNA plasmids are prevented from reaching the receiver. The analysis of social interactions between the bacteria will pave the way for efficient design of bacterial nanonetworks enabling applications such as intrabody sensing, drug delivery, and environmental control against pollution and biological hazards.
27849405	In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents.This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14-17 years old (N = 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents.	Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use.	These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use.	
27849357	This study investigated how Facebook's spiral of silence influences political participation. For doing so, this study focused on the roles of politically expressive activities on Facebook and individuals' levels of partisan strength. An online survey (N = 277) was conducted with Facebook users. Results showed that a perceived hostile opinion climate on Facebook was negatively associated with political expression on Facebook, which, in turn, was positively related with political participation. This indirect relationship was conditioned by the degree of Facebook users' partisan strength. Those with weak or moderate levels of partisan strength were less likely to express their minority views, which led to decrease their political participation in the real world. Such indirect relationship was not the case for those with high levels of partisan strength. Theoretical and political implications of these findings were discussed.
27849291	This article retrieved the publications from the Revista de Saúde Pública journal (from 1967 to 2015) on violence and health, on the SciELO and PubMed bases, by searching for the terms "violence", "suicide", "aggression", "bullying", and "external causes", registered in any part of the text. We found 130 articles (the first one published in 1974). We observed: increase of publications over time, with decrease in the last five years; similar production volume in lethal and non-lethal violence; later publication of the latter; few studies in qualitative research; mostly descriptive production; and visualization of the problem more by the acts than by contexts or motivations and aggressors. Social markers were little approached, appearing, from largest to smallest frequency, social class, gender, race/ethnicity, and generation. Human rights were little used and only recently used as analytical framework, connected more to gender than to social class. Although Revista de Saúde Pública has registered the theme in its publications, consolidating it as scientific production line, there is still great explanatory theoretical rarefaction and little intersectionality between violence, social inequalities, and human rights. RESUMO A produção da Revista de Saúde Pública (de 1967 até 2015) sobre violência e saúde foi recuperada nas bases SciELO e PubMed utilizando-se os termos "violência", "suicídio", "agressões", "bullying" e "causas externas", registrados em qualquer parte do texto. Foram encontrados 130 artigos (o primeiro deles publicado em 1974). Constatou-se: aumento das publicações no tempo, com decréscimo nos últimos cinco anos; volume similar de produção em violência letal e não letal; publicação mais tardia desta última; poucos estudos em pesquisa qualitativa; produção majoritariamente descritiva; e visibilização do problema, mais pelos atos que pelos contextos ou motivações e agressores. Os marcadores sociais foram pouco tematizados, aparecendo da maior para a menor frequência, classe social, gênero, raça/etnia e geração. Direitos humanos foi pouco, e apenas recentemente, usado como referencial analítico, conectado mais ao gênero do que à classe social. Embora a Revista de Saúde Pública tenha inscrito o tema em suas publicações, consolidando-o como linha de produção científica, há, ainda, grande rarefação teórica explicativa e pouca interseccionalidade entre violência, desigualdades sociais e direitos humanos.
27848740	The 2016 Report Card on Physical Activity for Children and Youth, the first of its kind, aims to set baseline physical activity (PA) indicators using the Active Healthy Kids Global Alliance grading system.A research work group analyzed and selected data for the grade assignment meeting (GAM). During the GAM, 17 leading researchers and policy experts from Estonia assessed the data and assigned grades for each of the 9 PA indicators. In addition, recommendations were provided for further actions to improve the grades.	Grades from A (highest) to F (lowest) were assigned as follows: 1) Overall PA (F); 2) Organized Sport (C); 3) Active Play [incomplete data (INC)]; 4) Active Transportation (INC); 5) Sedentary Behaviors (F); 6) Family and Peers (C); 7) School (C); 8) Community and the Built Environment (B); and 9) Government (C). An indicator was marked as incomplete (INC) when there was a lack of representative quality data.	Evidence suggests that PA levels of Estonian children remain very low, despite moderately supportive social, environmental, and regulatory factors. There are many challenges to overcome in supporting and promoting PA of children and youth (eg, cross-sectional cooperation, implementing interventions, changing social norms, empowerment of parents and educational institutions).	
27848253	The general purpose of TELL ME study was to give an insight into the experiences of European family physicians with management of H1N1 pandemic flu.Qualitative research methods (focus group discussions, one-to-one interviews, and online data collection) were used to explore family doctors' opinion and suggestions. Overall 158 family physicians took part in the study from six European countries.	Family doctors' most important experience was that the official campaign was not able to compensate negative effects of the mass media. Due to the poor evidence-based information about new vaccines, it was difficult to convince the public and some health care professionals too. Lack of unified directives - under unclear circumstances - made the routine patient care more difficult and hampered the collaboration between different health care providers. Family physicians felt a pressure from health authorities to achieve high immunization rate, but got only a little support from them. Despite the difficulties, vaccination program was a success, mainly among high-risk population. For better handling of a future pandemic, Hungarian family physician made many general and practical suggestions.	
27848010	We aim to translate the Glasgow benefit inventory (GBI) questionnaire into Arabic language and assess its reliability in scoring the benefit of patients after otolaryngology interventions. This is a pilot study of an ongoing prospective cohort study. The original GBI questionnaire was translated into Arabic language and back-translated into English by two different experts. The questionnaire was given to patients who were asked to fill it themselves. A group of consecutive adult patients were included in the study. Fifty-one patients were included. Reliability using Cronbach's α was higher than 0.70 for total score and the three subscales. Five loading factors explained 72.9% of the variance reached. The mean benefit of the GBI total score was 30.0 ± 36.37. Subscales scores were as follows: 35.21 ± 25.98 for the general health, 25.81 ± 45.98 for the physical benefit and 29.08 ± 34.45 for the social support. The Arabic GBI questionnaire is reliable to evaluate the quality of life after otolaryngology interventions for Arabic speaking population.
27846406	the purpose of this study was to conduct a preliminary exploration of the language used by midwifery professional bodies to define the scope of practice of midwives in relation to woman-centred care.this is a qualitative study in which Critical Discourse Analysis and Transitivity Analysis from the Systemic Functional Linguistics tradition were used. Data were sampled from nine international midwifery professional bodies.	three general types of definitions of scope of practice were identified; a formal type which focused on midwifery practice in which the midwife and woman were largely absent as agents, a second, less formal type which focused on the midwife as agent, from which the woman was largely absent as an active participant and one exception to the pattern which featured the woman as agent. The main type of verb used in the definitions was Doing Processes such as monitor, diagnose. Saying (advise), Sensing (identify), and Being (be able to) processes were much less frequent in the data. The definitions of scope of practice explored in this study (with one exception) revealed a general lack of woman-centeredness and more of a focus on an orientation to birth as a medically managed event.	definitions of scope of practice statements by professional bodies are systematically developed through much conscious thought and discussion by the writers on behalf of a community of practice and are formulated specifically for the purpose of being available to the general public as well as midwives. It can be assumed that the choices of wording and content are carefully constructed with public dissemination in mind. These ideologies communicated via the professional body texts emanate from a socio-cultural context that varies from country to country and professional bodies construct the definitions by drawing on the available, circulating discourses. Although woman-centred care is a key focus in contemporary maternity care, many definitions of scope of practice reveal a continuing orientation to a medical model of pregnancy and birth and a synonymisation of midwife-led care with woman centred care.	by analysing statements of scope of practice by professional bodies and the contexts in which they are produced, we can continue to reveal the underlying social, political, and historical forces that influence midwifery practice. This paper examines some key examples of the professional discourse of midwifery in relation to the definition of the midwife and scope of practice in order to reflect on what these examples may tell us about the professional culture of midwifery and the implications for woman-centred care.	
27846124	Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support.The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors.	Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program.	Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies.	Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors.	The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered.	Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate.	Both quantitative and qualitative data were independently extracted by two reviewers using standardized data extraction tools from the JBI-MAStARI and the JBI-QARI, respectively, including qualitative and quantitative details about setting of interventions, phenomena of interest, participants, study methods and outcomes or findings.	For quantitative findings, statistical pooling was not possible due to differences in interventions and outcome measures. Findings were presented in narrative form. Qualitative findings were aggregated into categories based on similarity of meaning from which synthesized findings were generated.	Quantitative results from two RCTs demonstrated positive impacts of peer-led home visiting parent support programs including more positive parenting attitudes and beliefs, and more child preventative health care visits.Fifteen qualitative findings from two studies were aggregated into five categories from which two synthesized findings emerged. Parents and home visitors identified similar components as contributing to their program's success, these being quality of relationships between parents and home visitors with elements being mutual respect, trust and being valued within the partnership. In addition, home visitors identified importance of enabling strategies to develop relationships. They also needed supportive working environments with clinical staff and management.	The current review indicates a positive impact of peer-led home visiting parent support programs, incorporating a framework of partnership between parents and home visitors, on mother-infant dyads. Positive changes in parenting attitudes and beliefs, and increased number of child preventative healthcare visits are supported by the quality of the relationship between parent and home visitor, and home visitors' working environments.	The essential characteristics of an effective parent support program are strategies for relationship building between parents and home visitors; ongoing staff and home visitor education to enhance communication, collaboration and working in partnership; supervision by team leaders; and continuous quality improvement.	The focus of further research should be on confirmatory studies using an action research methodology and the cost-effectiveness of these models.	
27845779	Autism spectrum disorders (ASDs) are common yet complex neurodevelopmental disorders, characterized by social, communication and behavioral deficits. Behavioral interventions have shown favorable results-however, the promise of precision medicine in ASD is hampered by a lack of sensitive, objective neurobiological markers (neurobiomarkers) to identify subgroups of young children likely to respond to specific treatments. Such neurobiomarkers are essential because early childhood provides a sensitive window of opportunity for intervention, while unsuccessful intervention is costly to children, families and society. In young children with ASD, we show that functional magnetic resonance imaging-based stratification neurobiomarkers accurately predict responses to an evidence-based behavioral treatment-pivotal response treatment. Neural predictors were identified in the pretreatment levels of activity in response to biological vs scrambled motion in the neural circuits that support social information processing (superior temporal sulcus, fusiform gyrus, amygdala, inferior parietal cortex and superior parietal lobule) and social motivation/reward (orbitofrontal cortex, insula, putamen, pallidum and ventral striatum). The predictive value of our findings for individual children with ASD was supported by a multivariate pattern analysis with cross validation. Predicting who will respond to a particular treatment for ASD, we believe the current findings mark the very first evidence of prediction/stratification biomarkers in young children with ASD. The implications of the findings are far reaching and should greatly accelerate progress toward more precise and effective treatments for core deficits in ASD.
27845490	Cognitive disability linked to neurodegenerative diseases and in particular to Alzheimer's disease, remains an increasing cause for concern through a dramatic prevalence increment and associated socio-economic burdens. Initially Alzheimer's disease develops asymptomatically with primary clinical signs, such as memory impairment, decline of spatial and perceptual abilities, occurring at a later stage. This delay implies the possibility of promoting early interventions during the pre-symptomatic stage of the disease. Different strategies have been applied in order to prevent/delay onset of Alzheimer's disease or at least to improve quality of life and health conditions of Alzheimer's disease patients and their caregivers, especially in the absence of current viable therapies. Multidomain interventions, aimed at affecting several risk factors simultaneously, offer a versatility that may attain improved outcomes in comparison with single-domain prevention trials. These multidomain interventions involve diet, physical exercise, cognitive training and social activities, while music therapy, improving self-consciousness and reducing neurofibrils, may contribute to deceleration/delay onset of Alzheimer's disease progression. Information and Communication Technology (ICT) provides broad applications to improve quality of life and well-being of Alzheimer's disease patients and caregivers, suffering from psychological distress, as well as reducing additional public health costs.
27845188	Approaches for the development of preclinical models of depression extensively use adult and male animals owing to the discrepancies arising out of the hormonal flux in adult females and adolescents during attainment of puberty. Thus the increased vulnerability of females towards clinical depression and anxiety-related disorders remains incompletely understood. Development of clinical models of depression in adolescent females is essential in order to evolve effective treatment strategies for adolescent depression. In the present study, we have examined the anxiety and depressive-like profiles in a putative animal model of childhood depression, the Wistar Kyoto (WKY) rat, during early adolescence (∼postnatal day 30) and mid-adolescence (∼postnatal day 40). Female adolescent WKY rats, tested on a series of behavioural tests modelling anxiety- and depressive-like behaviours with age-matched Wistars as controls, demonstrated marked differences during early adolescence in a strain- and age-specific manner. Anxiety indices were obtained from exposure to the elevated plus maze, where social communication vide 50-kHz ultrasonic vocalizations was also assessed, while immobility and other parameters in the forced swim test were screened for depressive-like profiles. Sucrose preference, used as a measure of anhedonia in animals, was lower in WKYs at both ages tested and decreased with age. Anxiety-related behaviours were prominent in WKY rats only during early adolescence. WKY female rats are anxious during early adolescence and exhibit anhedonia as a core symptom of depression during early- and mid-adolescence, thus indicating that inclusion of female animals in preclinical trials is essential and will contribute to gender-based approaches to diagnosis and treatment of adolescent depression in females.
27844325	Intimate partner violence directed at women by men continues to be a global concern. However, little is known about the factors associated with perpetrating intimate partner violence among heterosexual men.History of childhood sexual abuse and other sociodemographic variables were examined as potential factors associated with severe intimate partner violence perpetration toward women in a sample of heterosexual men in South Africa.	Longitudinal logistic generalized estimating equations examined associations of childhood sexual abuse and sociodemographic variables at baseline with intimate partner violence perpetration at subsequent time points.	Among participants with a steady female partner, 21.81 % (190/ 871) reported perpetrating intimate partner violence in the past year at baseline. Having a history of childhood sexual abuse (p < .001), binge drinking (p = .002), being employed (p = .050), and more difficulty controlling sexual impulses in order to use a condom (p = .006) at baseline were associated with self-reported intimate partner violence perpetration in the past year at subsequent time points.	With high levels of recent severe physical and/or sexual intimate partner violence perpetration in South Africa, comprehensive interventions are urgently needed. To more fully address gender-based violence, it is important to address associated factors, including exposure to childhood sexual abuse that could impact behavior later in life and that have long-lasting and deleterious effects on men and their female partners.	
27843544	Social media can act as an important platform for debating, discussing, and disseminating information about vaccines. Our objectives were to map and describe the roles played by web-based mainstream media and social media as platforms for vaccination-related public debates and discussions during the Polio crisis in Israel in 2013: where and how did the public debate and discuss the issue, and how can these debates and discussions be characterized?Polio-related coverage was collected from May 28 to October 31, 2013, from seven online Hebrew media platforms and the Facebook groups discussing the Polio vaccination were mapped and described. In addition, 2,289 items from the Facebook group "Parents talk about Polio vaccination" were analyzed for socio-demographic and thematic characteristics.	The traditional media mainly echoed formal voices from the Ministry of Health. The comments on the Facebook vaccination opposition groups could be divided into four groups: comments with individualistic perceptions, comments that expressed concerns about the safety of the OPV, comments that expressed distrust in the Ministry of Health, and comments denying Polio as a disease. In the Facebook group "Parents talk about the Polio vaccination", an active group with various participants, 321 commentators submitted 2289 comments, with 64 % of the comments written by women. Most (92 %) people involved were parents. The comments were both personal (referring to specific situations) and general in nature (referring to symptoms or wide implications). A few (13 %) of the commentators were physicians (n = 44), who were responsible for 909 (40 %) of the items in the sample. Half the doctors and 6 % of the non-doctors wrote over 10 items each. This Facebook group formed a unique platform where unmediated debates and discussions between the public and medical experts took place.	The comments on the social media, as well as the socio-demographic profiles of the commentators, suggest that social media is an active and versatile debate and discussion-facilitating platform in the context of vaccinations. This paper presents public voices, which should be seen as authentic (i.e. unmediated by the media or other political actors) and useful for policy making purposes. The policy implications include identifying social media as a main channel of communication during health crises, and acknowledging the voices heard on social media as authentic and useful for policy making. Human and financial resources need to be devolved specifically to social media. Health officials and experts need to be accessible on social media, and be equipped to readily provide the information, support and advice the public is looking for.	
27843371	Children with systemic juvenile idiopathic arthritis (SJIA) often encounter a delay between symptom onset and disease diagnosis, partly due to the broad differential of fever and lack of symptom recognition by providers. Families often seek multiple medical opinions and post on social media about their frustrations. This linguistic analysis observed the changing language patterns and social media posting behaviors of parents in the time leading to, during, and after SJIA diagnosis.Public social media sites were manually reviewed by a linguistic team to evaluate posts about SJIA from US-based parents.	A total of 3,979 posts between July 2001 and January 2015 were reviewed from 108 sites. Pre-SJIA diagnosis parents sought answers and shared status updates on social media, focusing primarily on the following three site types: alternative/natural lifestyle forums (39%), Facebook (27%), and disease-specific forums (17%). Posts during early prediagnosis phases were characterized by expressive language showing confidence in health care providers and trust in parental instincts. At later prediagnosis stages, parents continued to use social media, but the posts demonstrated increased frustration with delays in diagnosis and gaps in communication with providers. More objective symptom descriptions and a greatly reduced child-centered emotional focus were observed as parents shifted into caregiving roles. Once the diagnosis of SJIA was confirmed, parents used straightforward, less expressive language, and Facebook (47%) to make "announcement" posts and increased their use of SJIA websites (30%). With treatment initiation, the posts demonstrated a slow return of expressive language and an increased parental understanding of the "new normal".	Parents use different language styles, frames of reference, and websites before and after SJIA diagnosis. Gaps in parent-provider communication, especially before diagnosis, and their new roles as caregivers lead to parental use of social media to express frustration with the health care process. Providers should tailor their discussions with parents to address these issues.	
27843324	Reablement is an early and time-limited home-based rehabilitation intervention that emphasizes intensive, goal-oriented, and multidisciplinary assistance for people experiencing functional decline. Few empirical studies to date have examined the experiences of the integrated multidisciplinary teams involved in reablement. Accordingly, the aim of this study was to explore and describe how an integrated multidisciplinary team in Norway experienced participation in reablement.An integrated multidisciplinary team consisting of health care professionals with a bachelor's degree (including a physiotherapist, a social educator, occupational therapists, and nurses) and home-based care personnel without a bachelor's degree (auxiliary nurses and nursing assistants) participated in focus group discussions. Qualitative content analysis was used to analyze the resulting data.	Three main themes emerged from the participants' experiences with participating in reablement, including "the older adult's goals are crucial", "a different way of thinking and acting - a shift in work culture", and "a better framework for cooperation and application of professional expertise and judgment". The integrated multidisciplinary team and the older adults collaborated and worked in the same direction to achieve the person's valued goals. The team supported the older adults in performing activities themselves rather than completing tasks for them. To facilitate cooperation and application of professional expertise and judgment, common meeting times and meeting places for communication and supervision were necessary.	Structural factors that promote integrated multidisciplinary professional decisions include providing common meeting times and meeting places as well as sufficient time to apply professional knowledge when supervising and supporting older persons in everyday activities. These findings have implications for practice and suggest future directions for improving health care services. The shift in work culture from static to dynamic service is time consuming and requires politicians, community leaders, and health care systems to allocate the necessary time to support this approach to thinking and working.	
27843150	Recent studies have revealed that the gut microbiota modulates brain development and behavior, but the underlying mechanisms are still poorly understood. Here, we show that bacterial peptidoglycan (PGN) derived from the commensal gut microbiota can be translocated into the brain and sensed by specific pattern-recognition receptors (PRRs) of the innate immune system. Using expression-profiling techniques, we demonstrate that two families of PRRs that specifically detect PGN (that is, PGN-recognition proteins and NOD-like receptors), and the PGN transporter PepT1 are highly expressed in the developing brain during specific windows of postnatal development in both males and females. Moreover, we show that the expression of several PGN-sensing molecules and PepT1 in the developing striatum is sensitive to manipulations of the gut microbiota (that is, germ-free conditions and antibiotic treatment). Finally, we used the PGN-recognition protein 2 (Pglyrp2) knockout mice to examine the potential influence of PGN-sensing molecules on brain development and behavior. We demonstrate that the absence of Pglyrp2 leads to alterations in the expression of the autism risk gene c-Met, and sex-dependent changes in social behavior, similar to mice with manipulated microbiota. These findings suggest that the central activation of PRRs by microbial products could be one of the signaling pathways mediating the communication between the gut microbiota and the developing brain.
27843003	Craniopharyngioma is a rare, benign central nervous system tumor, which may be a source of multiple complications, from endocrinology to vision, neurology and neurocognitive functions. This morbidity can lead to reduced participation in life activities, as described in the International Classification of Functioning, Disability, and Health. The primary objective of this study was to measure participation in life activities in a population of children and young adults affected by childhood craniopharyngioma, using the LIFE-H questionnaire (Assessment of Life Habits), validated as a social participation measurement tool in various pediatric disabilities. We also describe complications in our population and examined the potential links between tumor characteristics, complications, and participation in life activities.This was a descriptive study, including all patients having presented childhood craniopharyngioma (before 18 years of age), followed in the Lyon region between 2007 and 2013. The main criterion was the LIFE-H results, completed by the patient or the carer.	Of 21 patients included in the study, 14 completed the questionnaire, a mean 6.7 years after the diagnosis (SD: 3.9 years). The mean total LIFE-H score was 8.4 (SD: 1.03) for a normal score estimated at 10 in the general population. The lowest scores affected the nutrition, community life, and recreation dimensions. No patient had a normal score on all dimensions; 57% of the patients had more than three dimensions affected. The variability of the results between patients was lower for some dimensions with high means (fitness, personal care, communication, housing, mobility, responsibilities, and education) than in others (nutrition, interpersonal relationships, community life, employment, and recreation) with rather low means. All patients had an endocrinological deficit, 19% hypothalamic syndrome, 52% an impaired fulfillment feeling, 76% visual impairment, 14% neurologic impairment, and 91% neurocognitive impairment. In the entire group of patients, 57% were able to attend a normal school (of which 38% needed a personal helper), 43% had to enter a specialized school. In patients in a specialized school, the LIFE-H results were significantly lower in the nutrition, communication, housing, and recreation dimensions. Girls also had significantly better results in many dimensions than boys.	Heavy comorbidity goes with childhood craniopharyngioma and affects patients' participation in life activities, which is not very low but multidimensional (more than three affected dimensions). This participation is mainly affected in social dimensions, whereas in cerebral palsy, where the LIFE-H has been tested several times, the daily activities dimensions are more affected.	Patients with childhood craniopharyngioma are affected in their participation in daily activities, mainly in the social dimensions. This could be improved with systematic diagnosis of these participation impairments, with the goal of adapted multidisciplinary management.	
27842974	Few studies on social skills training essentially based on ABA techniques are dedicated to children with autism aged 5 to 10 years whereas autistic disorders can be diagnosed in very early childhood. Generally, the main criticisms about these social skills training are: shortness of programs (around 20 sessions), no manual with precise descriptions of sessions and used techniques, and a lack of generalization of the learned skills in everyday life.To describe the evolution (before/after) of symptoms and sociocommunicative skills of 7 children with autism and no mental retardation (mean age=7.08) who participated in 90 sessions (during 3 years) in a learning group of communication and socialization (or LGCS).	To develop these sessions, we referred to intellectual and verbal levels obtained by the children on The Wechsler Intelligence Scales. We proposed activities such as open discussion, telling about events or vacations, learning of and communicative social rules, social games, outdoor exercises at home or in parks/shops/supermarkets/restaurants with known/unknown children/adults/sellers. To target the social and communicative skills, we also referred to their intellectual level and to Assessment of basic language and learning skills (ABBLS). To practice these sessions, we referred to: (1) TEACCH cognitive ergonomics principles (Treatment and education of autistic and related communication handicapped children developed by Schopler); and especially (2) ABA techniques (Applied behavior analysis) which are rarely mentioned as such. In particular, we used techniques such as: (a) concrete reinforcements which were frequently evaluated; (b) precise levels of verbal incentives and (c) error corrections. To measure the changes, we assessed children with psychometric tests before and after 90 sessions (ADOS and VABS).	The scores show significant improvements in autistic symptoms related to communication (ADOS, P=0.03) and significant improvements in both socialization and communication domains (VABS, P=0.00). From a symptomatic point of view (ADOS), we clinically observe better conversation skills and more social initiatives. About socialization and communication behaviors, parents reported (VABS): better listening, better verbal expression, more social relationships and a start of friendship for most of the children.	This three-year longitudinal follow-up is the first known study about the evolution of children with autistic disorders after a great number of sessions of social skills training. It shows that it is possible to adapt social skills training to young children. In addition, our program and our results (VABS) show clear examples of generalization which is targeted as a weakness in the specialized studies. However, the absence of a control group and of a base line strongly limit our results in terms of effectiveness.	
27842717	Genes of the major histocompatibility complex (MHC) have been shown to influence communication in many vertebrates, possibly with context-specific MHC-correlated reactions. Here we test for MHC-linked female preferences in the polygynous horse (Equus caballus) by repeatedly exposing 19 mares to a group of seven sexually experienced stallions. Each mare was tested four times during two consecutive reproductive cycles, twice during estrus and twice during diestrus. Male plasma testosterone concentrations were determined from weekly blood samples, and equine leukocyte antigen (ELA) class I and II alleles were determined serologically at the end of the experiments. Perception of male attractiveness was strongly dependent on estrous cycle: mean preference scores did not correlate for mares in diestrus and estrus and varied more during estrus than during diestrus. We found elevated female interests for MHC-dissimilar stallions, but only during diestrus, not during estrus. Female preferences were not significantly predicted by mean male testosterone plasma concentrations. However, testosterone concentrations changed during the 11 weeks of the experiment. By the end of the experiment, average testosterone concentration was significantly correlated to the average number of MHC alleles the stallions shared with the mares. We conclude that the MHC affects female preferences for stallions, but non-MHC linked male characteristics can overshadow effects of the MHC during estrus.
27842269	Clinical research highlights the importance of massed practice in the rehabilitation of chronic post-stroke aphasia. However, while necessary, massed practice may not be sufficient for ensuring progress in speech-language therapy. Motivated by recent advances in neuroscience, it has been claimed that using language as a tool for communication and social interaction leads to synergistic effects in left perisylvian eloquent areas. Here, we conducted a crossover randomized controlled trial to determine the influence of communicative language function on the outcome of intensive aphasia therapy.Eighteen individuals with left-hemisphere lesions and chronic non-fluent aphasia each received two types of training in counterbalanced order: (i) Intensive Language-Action Therapy (ILAT, an extended form of Constraint-Induced Aphasia Therapy) embedding verbal utterances in the context of communication and social interaction, and (ii) Naming Therapy focusing on speech production per se. Both types of training were delivered with the same high intensity (3.5 h per session) and duration (six consecutive working days), with therapy materials and number of utterances matched between treatment groups.	A standardized aphasia test battery revealed significantly improved language performance with ILAT, independent of when this method was administered. In contrast, Naming Therapy tended to benefit language performance only when given at the onset of the treatment, but not when applied after previous intensive training.	The current results challenge the notion that massed practice alone promotes recovery from chronic post-stroke aphasia. Instead, our results demonstrate that using language for communication and social interaction increases the efficacy of intensive aphasia therapy.	
27841745	The study employs a dialogic public relations framework to explore the utilization of the Internet for fundraising by nonprofit health care organizations-specifically, NCI-designated cancer centers. Cancer centers have been noted for effective websites and for being highly engaged in fundraising, which is characterized as relationship marketing. Results indicate all but one cancer center use websites and social media for fundraising but are limited in capacity for two-way symmetrical dialogue. Results are discussed and recommendations are made for future research.
27841736	This research expands on prior research into the effects of religious disclosures on interpersonal attraction by drawing from social identification theory to explain attributions stemming from religious disclosures in professionals' e-mail signature blocks. Participants (N = 268) were randomly exposed to one of three experimental conditions (a Christian, Islamic, or secular quotation in a signature block) and completed measures of social identification and perceptions of professionalism. Results indicate that, contrary to prior research, merely disclosing one's religion does not increase attributions; rather, attributions of a sender's professionalism are positively derived from the receiver's social identification with the sender's religion. Implications of these findings are discussed with regard to social identity theory, as well as for professional practice in developing signature blocks as a means of self-presentation.
27841475	We study the dynamical properties of human communication through different channels, i.e., short messages, phone calls, and emails, adopting techniques from neuronal spike train analysis in order to characterize the temporal fluctuations of successive interevent times. We first measure the so-called local variation (LV) of incoming and outgoing event sequences of users and find that these in- and out-LV values are positively correlated for short messages and uncorrelated for phone calls and emails. Second, we analyze the response-time distribution after receiving a message to focus on the input-output relationship in each of these channels. We find that the time scales and amplitudes of response differ between the three channels. To understand the effects of the response-time distribution on the correlations between the LV values, we develop a point process model whose activity rate is modulated by incoming and outgoing events. Numerical simulations of the model indicate that a quick response to incoming events and a refractory effect after outgoing events are key factors to reproduce the positive LV correlations.
27841117	This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It identifies the current evidence base and role of health-related quality of life assessment for this group of patients. Recommendations • Health-related quality of life is integral to treatment planning, refining treatment protocols, and more personalised follow-up support. (G) • Health-related quality of life and patient concerns should be regularly assessed during patient care. (G) • Health-related quality of life assessment and patient concerns on an individual patient basis can be helpful to trigger multi-professional support and interventions. (G).
27841113	This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and interventions for the psychological management in this patient group. Recommendations • Audit of information supplied to patients and carers should be conducted on an annual basis to update and review content and media presentation. (G) • Patients and carers should be invited to discuss treatment options and relate possible outcomes to functional retention or loss to provide a patient-centred approach. (G) • Clinical staff should inspect their systems of assessment to make them sensitive enough to identify patients with psychological difficulties. (G) • Flexibility, rather than rigid formulation is required to assess patients frequently, and to allow for change in circumstances to be noted. (G) • Multidisciplinary teams should determine the supportive care services available and commission extra assistance to provide patients and carers with timely information, education or brief supportive advice. (G) • Multidisciplinary teams need to inspect specialist services for mental health interventions at structured and complex levels for the small proportion of patients with more serious, but rarer, psychological difficulties. (G) • Clinical staff at all levels should receive communication skills training to raise and maintain consultation expertise with difficult patient and/or carer interactions. (G).
27841105	We integrate recent findings from the linguistics literature with the organizational justice literature to examine how the language used to encode justice violations influences fairness perceptions. The study focused on the use of non-agentive syntax to encode mistakes in Spanish ("The vase was broken") versus using agentive syntax in English ("She broke the vase") influences event fairness perceptions. We hypothesized that when justice violations are encoded using Spanish, because the non-agentive syntax makes the responsible party less salient, the event would be perceived as less unfair. In Study 1 (n = 111), English-speaking participants rated the fairness of an event in which a mistake was made and an employee received a negative outcome. They rated it as more unfair (p < .01, η2 = .06) when the scenario was presented in agentive syntax. Experiment 2 (n = 70) used native English- and Spanish-speakers who watched a video of manager making a mistake. We found that Spanish-speakers used less agentive syntax (p < .01, η2 = .21), perceived the event as less unfair (p < .001, η2 = .23), and were more willing to help the manager who made the mistake. In Experiment 3 (n = 101) we replicated this effect controlling for cross-cultural differences and native language; further, we found an interaction between entity fairness (event vs. entity) and native language (Spanish vs. English) on citizenship intentions (p < .01, η2 = .08). These results extend our understanding of how language may influence relevant workplace attitudes.
27841098	Autism spectrum disorder (ASD) is characterized by impairments in social communication as well as restricted, repetitive behaviors. Evidence suggests that some individuals with ASD have cognitive impairments related to weak central coherence and hyperrestricted processing. Reducing noradrenergic activity may improve aspects of network processing and thus improve cognitive abilities, such as verbal problem solving, in individuals with ASD. The present pilot study explores the effects of acute administration of the beta-adrenergic antagonist propranolol on verbal problem solving in adults and adolescents with ASD. In a within-subject crossover-design, 20 participants with ASD received a single dose of propranolol or placebo on one of two sessions in a double-blinded, counterbalanced manner. Verbal problem solving was assessed via an anagram task. Baseline measurements of autonomic nervous system functioning were obtained, and anxiety was assessed at baseline and following drug administration. Participants solved the anagrams more quickly in the propranolol condition, as compared to the placebo condition, suggesting a potential cognitive benefit of this agent. Additionally, we observed a negative linear relationship between response to propranolol on the anagram task and two measures of baseline autonomic activity, as well as a positive linear relationship between drug response and baseline anxiety. These relationships propose potential markers for treatment response, as propranolol influences both autonomic functioning and anxiety. Further investigation is needed to expand on the present single-dose psychopharmacological challenge and explore the observed effects of propranolol in a serial-dose setting.
27840816	Reaching young adults with health messages has been a documented challenge in public health. Public health researchers have initiated studies to assess how social media are changing health communication. In 2014, the Centers for Disease Control and Prevention (CDC) launched social media-based health education initiatives on Facebook to increase knowledge of breast health and breast cancer among women under age 45 and those at higher risk for developing the disease. The current study used digital analytics and metrics to describe the impact of these social media efforts on health communication.Engagement rate was calculated by taking the average engagement rate for 574 posts published by the CDC Breast Cancer Facebook page in multiple categories, including CDC campaign specificity, content type, time of day, and year posted. Linear regression was used to model the effect of campaign content.	Engagement rate (ER) was highest for content shared for the Know:BRCA campaign posts (ER=6.4), followed by the non-campaign related posts (ER=5.5), and the Bring Your Brave posts (ER=4.6). Overall engagement rate decreased from 2014-2016. Photos consistently produced the most significant engagement rate overall.	We found that users were more likely to click, share, comment, or like the content of the post that had photos. These data suggest that that branded, visual content is more effective in facilitating engagement. These findings will be used to adjust both free and paid social media efforts for the CDC Breast Cancer Facebook page.	
27840812	Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social communication skills as well as repetitive, restricted or stereotyped behaviors (1). Early interventionists are often found at the forefront of assessment, evaluation, and early intervention services for children with ASD. The role of an early intervention specialist may include assessing developmental history, providing group and individual counseling, working in partnership with families on home, school, and community environments, mobilizing school and community resources, and assisting in the development of positive early intervention strategies (2, 3). The commonality among these roles resides in the importance of providing up-to-date, relevant information to families and children. The purpose of this review is to provide pertinent up-to-date knowledge for early interventionists to help inform practice in working with individuals with ASD, including common behavioral models of intervention.
27840338	It is unclear whether knowing of current HIV status is associated with change in injecting behaviors among people who inject drugs (PWID) in Iran. The objective of the present study was to determine whether awareness of HIV positive status is associated with a reduction in injecting risk behaviors, after matching for socio-demographic characteristics.Five hundred male PWID were recruited in 2014 from two drop-in centers (DICs) in Kermanshah west of Iran. Trained interviewers collected data on socio-demographic characteristics, HIV testing and drug-related risk behaviors over the last month prior to interview using a structured questionnaire. Our primary exposure of interest was awareness of HIV status, used to group participants into three categories: positive, negative, unaware. We used coarsened exact matching to make the three groups statistically equivalent based on age, place of residence, education and income, and then compared them regarding the proportion of borrowing, lending and reuse of syringes.	Matched sample (n=320) had a mean age ± standard deviation (SD) of 33.5 ±7.6 yr. Overall, 25% (95% CI: 14%, 32%) of participants reported "borrowing a syringe" in the past month and 15% (95% CI: 7%, 22%) of them reported "lending a used syringe" to others in the past month. In comparison to PWID who were unaware of their HIV status, those knew they were HIV positive (OR 1.68, CI95%1.32-2.81) or negative (OR 1.54; 95% CI: 1.28, 2.71) were both more likely to report borrowing syringes in past month.	PWID WHO know they are positive for HIV are more likely to borrow another person's syringe, to report reuse of their own used syringes and less likely to report lending their syringes to others. Strategies to scale up HIV testing and counseling for PWID, which also increase awareness of HIV status, may decrease injecting related the risk behaviors.	
27840047	Biologically-based complementary medicines (BB-CMs) including herbal, vitamin, mineral and nutritional supplements are frequently taken by people living with cancer. Pharmacists play an important and clearly defined role in the provision of standard cancer treatment. Due to the non-prescription status and easy access to BB-CMs, the role of the pharmacist in communicating to people living with cancer about their use is less clearly defined.To explore the role of the pharmacist in communicating to people living with cancer about their use of BB-CMs.	Eligible studies were identified in PubMed, Medline, EmBase, International Pharmaceutical Abstracts and Google Scholar. Articles published between 2003 and 2016 were included searching for "Complementary OR Herbal medicine OR vitamin OR nutritional supplement"; and "cancer OR oncology patient"; and "pharmacist role OR attitude OR belief OR communication".	BB-CM use is prevalent among people living with cancer for the management of side effects and are taken under the belief they are safe, natural and holistic. Fifty per cent of cancer patients do not disclose their BB-CM use to their physicians due to a perception that it will be discouraged and/or their physician will not be knowledgeable about BB-CMs. There are known drug-herb/nutrient interactions but interestingly pharmacists are the least consulted health care professional (HCP).	With adequate knowledge about BB-CMs, pharmacists are well positioned as medication specialists to fill the current communication gap between people living with cancer and HCPs. Further research that informs the development of specific BB-CM guidelines for pharmacists in the management of cancer are required.	
27839889	The aim of the present study is to describe and analyse significant factors of disease-related everyday communication of persons with RMDs in a nationwide project in Germany funded by the Deutsche Rheumaliga Bundesverband e.V. (German League against Rheumatism).In this participatory research project four persons with RMDs are involved. An online questionnaire addressing context, difficulties, and burden of disease-related everyday communication was answered by 1.015 persons with RMDs. Social and communication skills were recorded by questionnaires to capture social insecurity and patient communication competence.	More than half of the participants reported difficulties in disease-related conversations across various situations. The majority of these persons suffer from this experience particularly in conversations at the work environment or with staff members of authorities. They feel unconfident especially in situations which require saying "no". Furthermore, compared to the general population persons with RMDs have more anxiety about contact with others.	Strengthening the social skills of persons with RMDs in conversations related to everyday situations can promote a self-determined life and contribute to the maintenance of social participation.	Based on the results, a communication skills training for persons with RMDs will be developed.	
27839792	Communication campaigns are employed as an important tool to promote road safety practices. Researchers maintain road safety communication campaigns are more effective when their persuasive appeals, which are central to their communicative strategy, are based on explicit theoretical frameworks. This study's main objectives were to develop a detailed categorization of persuasive appeals used in road safety communication campaigns that differentiate between appeals that appear to be similar but differ conceptually, and to indicate the advantages, limitations and ethical issues associated with each type, drawing on behavior change theories. Materials from over 300 campaigns were obtained from 41 countries, mainly using road safety organizations' websites. Drawing on the literature, five types of main approaches were identified, and the analysis yielded a more detailed categorizations of appeals within these general categories. The analysis points to advantages, limitations, ethical issues and challenges in using different types of appeals. The discussion summarizes challenges in designing persuasive-appeals for road safety communication campaigns.
27839573	Infectious diseases have complex transmission cycles, and effective public health responses require the ability to monitor outbreaks in a timely manner. Space-time statistics facilitate the discovery of disease dynamics including rate of spread and seasonal cyclic patterns, but are computationally demanding, especially for datasets of increasing size, diversity and availability. High-performance computing reduces the effort required to identify these patterns, however heterogeneity in the data must be accounted for. We develop an adaptive space-time domain decomposition approach for parallel computation of the space-time kernel density. We apply our methodology to individual reported dengue cases from 2010 to 2011 in the city of Cali, Colombia. The parallel implementation reaches significant speedup compared to sequential counterparts. Density values are visualized in an interactive 3D environment, which facilitates the identification and communication of uneven space-time distribution of disease events. Our framework has the potential to enhance the timely monitoring of infectious diseases.
27838858	Lack of access to care, funding limitations, cultural, and social barriers are challenges specific to tribal communities that have led to adverse cancer outcomes among American Indians/Alaska Natives (AI/AN). While the cancer navigator model has been shown to be effective in other underserved communities, it has not been widely implemented in Indian Country. We conducted in-depth interviews with 40 AI/AN patients at tribal clinics in Idaho and Oregon. We developed the survey instrument in partnership with community members to ensure a culturally appropriate semi-structured questionnaire. Questions explored barriers to accessing care, perceptions of the navigator program, satisfaction, and recommendations. AI/AN cancer patients reported physical, emotional, financial, and transportation barriers to care, but most did not feel there were any cultural barriers to receiving care. Navigator services most commonly used included decision making, referrals, transportation, scheduling appointments, and communication. Satisfaction with the program was high. Our study provides a template to develop a culturally appropriate survey instrument for use with an AI/AN population, which could be adapted for use with other indigenous patient populations. Although our sample was small, our qualitative analysis facilitated a deeper understanding of the barriers faced by this population and how a navigator program may best address them. The results reveal the strengths and weakness of this program, and provide baseline patient satisfaction numbers which will allow future patient navigator programs to better create evaluation benchmarks.
27838159	Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods.
27837795	Public health surveillance is the systematic and continuous collection, analysis, dissemination and interpretation of health-related data for planning, implementation and evaluation of public health initiatives. Apart from the health system, social determinants of health include the circumstances in which people are born, grow up, live, work and age, and they go a long way to explaining health inequalities. A surveillance system of the social determinants of health requires a comprehensive and social overview of health. This paper analyses the importance of monitoring social determinants of health and health inequalities, and describes some relevant aspects concerning the implementation of surveillance during the data collection, compilation and analysis phases, as well as dissemination of information and evaluation of the surveillance system. It is important to have indicators from sources designed for this purpose, such as continuous records or periodic surveys, explicitly describing its limitations and strengths. The results should be published periodically in a communicative format that both enhances the public's ability to understand the problems that affect them, whilst at the same time empowering the population, with the ultimate goal of guiding health-related initiatives at different levels of intervention.
27837794	The main objective of health reports is to contribute to the health improvement of a specific population. They are an essential support tool for the design and planning of health policies and can also be used for accountability and evaluation. This study assesses various types of health report, including that used by the City of Barcelona (Spain), with a focus on social determinants, as well as an international health report more centred on the impact of health services. Some suggestions are proposed about the appropriateness and best use of these documents, including: the need for effective communication between technical professionals and politicians through meetings and dialogue; commitment to transparency, both authors (by means of the declaration of interests) and in terms of the information reported and with the maximum level of participation; to promote the use of a conceptual framework of social determinants of health; a focus on health inequalities; the inclusion of information relevant to policy action; the organisation of information in such a way that it allows comparison or benchmarking with similar areas and prospectively; presenting the information in an attractive way using elements such as rankings, maps or other tools; and the design of communication strategies adapted to key stakeholders.
27837568	We introduce a novel platform for interactive studies, that is, any form of study in which participants' experiences depend not only on their own responses, but also on those of other participants who complete the same study in parallel, for example a prisoner's dilemma or an ultimatum game. The software thus especially serves the rapidly growing field of strategic interaction research within psychology and behavioral economics. In contrast to all available software packages, our platform does not handle stimulus display and response collection itself. Instead, we provide a mechanism to extend existing experimental software to incorporate interactive functionality. This approach allows us to draw upon the capabilities already available, such as accuracy of temporal measurement, integration with auxiliary hardware such as eye-trackers or (neuro-)physiological apparatus, and recent advances in experimental software, for example capturing response dynamics through mouse-tracking. Through integration with OpenSesame, an open-source graphical experiment builder, studies can be assembled via a drag-and-drop interface requiring little or no further programming skills. In addition, by using the same communication mechanism across software packages, we also enable interoperability between systems. Our source code, which provides support for all major operating systems and several popular experimental packages, can be freely used and distributed under an open source license. The communication protocols underlying its functionality are also well documented and easily adapted to further platforms. Code and documentation are available at https://github.com/psynteract/ .
27836819	Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sign Language interpreters (SASLIs) is also insufficient to meet the demand of the Deaf population in the country. Our research team, in collaboration with the Deaf communities in Cape Town, devised a mobile health app called SignSupport to bridge the communication gaps in health care contexts. We consequently plan to extend our work with a Health Knowledge Transfer System (HKTS) to provide Deaf people with accessible, understandable, and accurate health information. We conducted an explorative study to prepare the groundwork for the design and development of the system.To investigate the current modes of health information distributed to Deaf people in Cape Town, identify the health information sources Deaf people prefer and their reasons, and define effective techniques for delivering understandable information to generate the groundwork for the mobile health app development with and for Deaf people.	A qualitative methodology using semistructured interviews with sensitizing tools was used in a community-based codesign setting. A total of 23 Deaf people and 10 health professionals participated in this study. Inductive and deductive coding was used for the analysis.	Deaf people currently have access to 4 modes of health information distribution through: Deaf and other relevant organizations, hearing health professionals, personal interactions, and the mass media. Their preferred and accessible sources are those delivering information in signed language and with communication techniques that match Deaf people's communication needs. Accessible and accurate health information can be delivered to Deaf people by 3 effective techniques: using signed language including its dialects, through health drama with its combined techniques, and accompanying the information with pictures in combination with simple text descriptions.	We can apply the knowledge gained from this exploration to build the groundwork of the mobile health information system. We see an opportunity to design an HKTS to assist the information delivery during the patient-health professional interactions in primary health care settings. Deaf people want to understand the information relevant to their diagnosed disease and its self-management. The 3 identified effective techniques will be applied to deliver health information through the mobile health app.	
27836818	Efforts to involve parents and families in all aspects of research, from initiating the question through to dissemination and knowledge exchange, are increasing. While social media as a method for health communication has shown numerous benefits, including increasing accessibility, interactions with others, and access to health care information, little work has been published on the use of social media to enhance research partnerships.Our objective was to describe the development and evaluation of a Web-based research advisory community, hosted on Facebook and connecting a diverse group of parents of special needs children with researchers at CanChild Centre for Childhood Disability Research. The goal of this community is to work together and exchange knowledge in order to improve research and the lives of children and their families.	The Web-based Parents Participating in Research (PPR) advisory community was a secret Facebook group launched in June 2014 and run by 2 parent moderators who worked in consultation with CanChild. We evaluated its success using Facebook statistics of engagement and activity (eg, number of posts, number of comments) between June 2014 and April 2015, and a Web-based survey of members.	The PPR community had 96 participants (2 parent moderators, 13 researchers, and 81 family members) as of April 1, 2015. Over 9 months, 432 original posts were made: 155 (35.9%) by moderators, 197 (45.6%) by parents, and 80 (18.5%) by researchers. Posts had a median of 3 likes (range 0-24) and 4 comments (range 0-113). Members, rather than moderators, generated 64% (277/432) of posts. The survey had a 51% response rate (49/96 members), with 40 (82%) being parent members and 9 (18%) being researchers. The initial purpose of the group was to be an advisory to CanChild, and 76% (28/37) of parents and all the researchers (9/9) identified having an impact on childhood disability research as their reason for participating. A total of 58% (23/40) of parents and 56% (5/9) of researchers indicated they felt safe to share sensitive or personal information. While researchers shared evidence-based resources and consulted with families to get guidance on specific issues, there was an unexpected benefit of gaining an understanding of what issues were important to families in their daily lives. Parents felt a sense of belonging to this community where they could share their stories but also wanted more researcher participation and clarity on the purpose of the group.	The PPR community grew from inception to an established community with active engagement and knowledge exchange. Both parents and researchers described valuable experiences. Researchers should consider social media as a means of engaging families in all phases of research to ensure that research and its outcomes are meaningful to those who need it most.	
27836078	To analyze the sociocultural determinants that influence the attitude and practices of men toward contraceptive use in Guinea.A sequential, mixed methods, qualitative and quantitative study was carried out in two regions of Guinea with a low rate of contraceptive prevalence, and in the capital city of Conakry. A total of 1170 people (men and women) were interviewed.	Findings showed a positive perception of family planning overall, but reluctance to use modern contraception. The reasons for non-use of contraceptive methods were primarily the hope of having many children and religious prohibition associated with customs. Making decisions on contraceptive use within a couple represents a major cause of misunderstanding between spouses. Communication within a couple on the use of contraception is quickly declined by men.	The findings demonstrate the need to develop communication strategies within a couple to improve the use of contraceptives.	
27836048	The aim of this study was to determine practices, attitudes and experiences of UK prescribers of anthelmintics for horses and livestock. A questionnaire was sent by direct email to groups licenced to prescribe these medicines. These were veterinarians, Suitably Qualified Persons (SQPs, registered with the Animal Medicines Training Regulatory Authority) and veterinary pharmacists. The survey was also advertised through social media. It comprised questions relating to demographics, training experiences, current prescribing practices, as well as personal opinions on anthelmintic selection, diagnostics and anthelmintic resistance. A total of 193 veterinarians and 326 SQPs were included in final analysis. Pharmacists were excluded from detailed analysis due to the low numbers that responded (n=3). The results indicated that SQP participants were more likely to receive post-certification parasitology training than the veterinarians, and that both channels consulted similar sources for information about helminths and their control (paper articles in journals, online sources). The SQP participants stated a higher frequency of face-to-face interactions with clients/customers (96.1%) than the veterinarians (76.4%), who stated a higher frequency of telephone interactions (55.1% and 73.5%, respectively). Veterinarians were more likely to state that there were specific factors that limited interactions with their clients (54.1%) than SQPs (19.6%), such as competition from other suppliers. SQP participants considered a wider range of factors as important when deciding on which anthelmintic to recommend (i.e. knowledge of specific parasites, knowledge of specific anthelmintics, discussion of measures to avoid anthelmintic resistance and time to talk with clients/customers); however, the veterinarian participants were more likely to consider the results of diagnostic tests. While discussions about anthelmintic resistance were stated with similar frequency in both groups, less frequent were specific discussions about anthelmintic sensitivity testing. In-house faecal egg count analysis was more likely to be available from those that prescribed anthelmintics for equines alone, compared to prescribers who dispensed anthelmintics for livestock alone or livestock and equines. The SQP participants indicated that they felt a large number of organisations were responsible for ensuring that anthelmintics are used responsibly, whilst veterinarian participants were more likely to place responsibility on the prescribers alone. Taken together, these findings provide an insight into how prescribers of anthelmintics in the UK interact with their clients/customers before and at the point of sale and act as a unique source of information on how best practice advice pertaining to sustainable helminth control is disseminated by the various prescribing channels.
27835945	Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient's lifestyle, social network and adherence to treatment.Design: External validation of scales, open and prospective cohort study in primary care.	36 health centres in 6 European high, medium and low income countries.	477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse.	Detailed patient history, exacerbations, lung function test and questionnaires at baseline.	Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment.	Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis.	The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients.	ISRCTN52402811 . Date: 15/01/2015. Prospectively registered.	
27835749	It is unclear if positive, negative, or neutral emotional expressions have an advantage in short-term recognition. Moreover, it is unclear from previous studies of working memory for emotional faces whether effects of emotions comprise response bias or sensitivity. The aim of this study was to compare how schematic emotional expressions (sad, angry, scheming, happy, and neutral) are discriminated and recognized in an updating task (2-back recognition) in a representative sample of birth cohort of young adults. Schematic facial expressions allow control of identity processing, which is separate from expression processing, and have been used extensively in attention research but not much, until now, in working memory research. We found that expressions with a U-curved mouth (i.e., upwardly curved), namely happy and scheming expressions, favoured a bias towards recognition (i.e., towards indicating that the probe and the stimulus in working memory are the same). Other effects of emotional expression were considerably smaller (1-2% of the variance explained)) compared to a large proportion of variance that was explained by the physical similarity of items being compared. We suggest that the nature of the stimuli plays a role in this. The present application of signal detection methodology with emotional, schematic faces in a working memory procedure requiring fast comparisons helps to resolve important contradictions that have emerged in the emotional perception literature.
27835704	The Intensive Care Unit (ICU) is a stressful environment for families of critically ill patients and these individuals are at risk to develop persistent psychological morbidity. Our study objective was to identify individual differences in coping with stress and information presentation preferences of respondents exposed to a simulated ICU experience.Participants were recruited from a university and two community populations. Participants completed questionnaires that measured demographic information and characteristics that may be relevant to an individual's ICU experience. Quality of life was measured by the EQ-5D, personality dimensions were examined with the abbreviated Big Five inventory, coping with stress was assessed with Brief COPE. Shared decision making preferences were assessed by the Degner Control Preferences Scale (CPS) and information seeking style was assessed with the Miller Behavioral Style Scale (MBSS). Social support was examined using an abbreviated version of the Social Relationship Index. Participants also completed a vignette-based simulated ICU experience, in which they made a surrogate decision on behalf of a loved one in the ICU.	Three hundred forty-three participants completed the study. Three distinct coping profiles were identified: adaptive copers, maladaptive copers, and disengaged copers. Profiles differed primarily on coping styles, personality, quality of their closest social relationship, and history of anxiety and depression. Responses to the simulated ICU decision making experience differed across profiles. Disengaged copers (15%) were more likely to elect to refuse dialysis on behalf of an adult sibling compared to adaptive copers (7%) or maladaptive copers (5%) (p = 0.03). Notably, the MBSS and the CPS did not differ by coping profile.	Distinct coping profiles are associated with differences in responses to a simulated ICU experience. Tailoring communication and support to specific coping profiles may represent an important pathway to improving ICU experience for patients and families.	
27835675	This research aims to explore the neural correlates involved in altruistic punishment, parochial altruism and anti-social punishment, using the Third-Party Punishment (TPP) game. In particular, this study considered these punishment behaviors in in-group vs. out-group game settings, to compare how people behave with members of their own national group and with members of another national group. The results showed that participants act altruistically to protect in-group members. This study indicates that norm violation in in-group (but not in out-group) settings results in increased activity in the medial prefrontal cortex and temporo-parietal junction, brain regions involved in the mentalizing network, as the third-party attempts to understand or justify in-group members' behavior. Finally, exploratory analysis during anti-social punishment behavior showed brain activation recruitment of the ventromedial prefrontal cortex, an area associated with altered regulation of emotions.
27834237	To increase understanding of what Americans think about personal and public health, a national survey of US adults was conducted in 2015-16 to develop a typology of values and beliefs. The survey was commissioned by the Robert Wood Johnson Foundation for its Culture of Health initiative. Six specific population groupings, or segments, were identified. Three segments included people who supported an active government role in health, two segments were characterized by people who were skeptical toward government, and one segment was characterized by people with conflicted attitudes toward government in health. One of the segments, labeled "supportive," included people who had broad concerns about equity and social solidarity and believed in health disparities and the importance of the social determinants of health. People in two of the other segments that supported an active government role in health shared some of these concerns. There is clearly the potential to mobilize all three of these segments in efforts to improve population health and health equity in the United States. For people whose beliefs put them in the more skeptical segments, a focus on building healthier communities at the local level may garner significant support as long as there is private-sector leadership for the effort.
27833546	This paper shortly reviews the measures used to estimate neural synchronization in experimental settings. Our focus is on multivariate measures of dependence based on the Granger causality (G-causality) principle, their applications and performance in respect of robustness to noise, volume conduction, common driving, and presence of a "weak node." Application of G-causality measures to EEG, intracranial signals and fMRI time series is addressed. G-causality based measures defined in the frequency domain allow the synchronization between neural populations and the directed propagation of their electrical activity to be determined. The time-varying G-causality based measure Short-time Directed Transfer Function (SDTF) supplies information on the dynamics of synchronization and the organization of neural networks. Inspection of effective connectivity patterns indicates a modular structure of neural networks, with a stronger coupling within modules than between them. The hypothetical plausible mechanism of information processing, suggested by the identified synchronization patterns, is communication between tightly coupled modules intermitted by sparser interactions providing synchronization of distant structures.
27833070	Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps.This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support.	We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist.	Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern contraceptives, and some use of evidence-based adolescent best practices, gaps remain in the implementation of the majority of adolescent best practices and user interface features. Of the 8 best practices for teen pregnancy prevention operationalized through mCAPP, the most commonly implemented best practice was the provision of information on how to use contraceptives to prevent pregnancy (15/22), followed by provision of accurate information on pregnancy risk of sexual behaviors (13/22); information on SRH communication, negotiation, or refusal skills (10/22); and the use of persuasive language around contraceptive use (9/22).	The quality and scope of apps for adolescent pregnancy prevention varies, indicating that developers and researchers may need a supportive framework. mCAPP can help researchers and developers consider mobile-relevant evidence-based best practices for adolescent SRH as they develop teen pregnancy prevention apps. Given the novelty of the mobile approach, further research is needed on the impact of mCAPP criteria via mobile channels on adolescent health knowledge, behaviors, and outcomes.	
27832929	Governance silos are settings in which different organizations work in isolation and avoid sharing information and strategies. Siloes are a fundamental challenge for environmental planning and problem solving, which generally requires collaboration. Siloes can be overcome by creating governance networks. Studying the structure and function of these networks is important for understanding how to create institutional arrangements that can respond to the biophysical dynamics of a specific natural resource system (i.e., social-ecological, or institutional fit). Using the case of salmon restoration in a sub-basin of Puget Sound, USA, we assess network integration, considering three different reasons for network collaborations (i.e., mandated, funded, and shared interest relationships) and analyze how these different collaboration types relate to productivity based on practitioner's assessments. We also illustrate how specific and targeted network interventions might enhance the network. To do so, we use a mixed methods approach that combines quantitative social network analysis (SNA) and qualitative interview analysis. Overall, the sub-basin's governance network is fairly well integrated, but several concerning gaps exist. Funded, mandated, and shared interest relationships lead to different network patterns. Mandated relationships are associated with lower productivity than shared interest relationships, highlighting the benefit of genuine collaboration in collaborative watershed governance. Lastly, quantitative and qualitative data comparisons strengthen recent calls to incorporate geographic space and the role of individual actors versus organizational culture into natural resource governance research using SNA.
27832465	The objective of this study was to understand the social elements of clinical and organizational interactions of the key stakeholders in the specific context of an electronic dashboard used by the emergency department (ED) and inpatient medicine teams at the time of clinical referral and handover. An electronic handover function is utilised at the ED-inpatient interface at this institution and has given clinicians the ability to better communicate, monitor the department and strive to improve patient safety in streamline the delivery of care in the acute phase. This study uses an ethnographic qualitative research design incorporating semistructured interviews, participant observation on the ED floor and fieldwork notes. The setting for this research was in the ED at a tertiary University affiliated hospital. Triangulation was used to combine information obtained from multiple sources and information from fieldwork and interviews refined into useable chunks culminating in a thematic analysis. Thematic analysis yielded five central themes that reflected how the clinical staff utilised this IT system and why it had become embedded in the culture of clinical referral and handover. Efficient time management for improved patient flow was demonstrated, value added communication (at the interpersonal level), the building trust at the ED-inpatient interface, the maintenance of mutual respect across medical cultures and an overall enhancement of the quality of ED communication (in terms of the information available). A robust electronic handover process, resulted in an integrated approach to patient care by removing barriers to admission for medical inpatients, admitted via ED. The value proposition for patients was a more complete information transfer, both within the ED and between departments.
27832185	Bats are associated with conflicting perceptions among humans, ranging from affection to disgust. If these attitudes can be associated with various factors among the general public (e.g. social norms, lack of knowledge), it is also important to understand the attitude of scientists who study bats. Such reflexive information on the researchers community itself could indeed help designing adequate mixed communication tools aimed at protecting bats and their ecosystems, as well as humans living in their vicinity that could be exposed to their pathogens. Thus, we conducted an online survey targeting researchers who spend a part of their research activity studying bats. Our aim was to determine (1) how they perceive their object of study, (2) how they perceive the representation of bats in the media and by the general population, (3) how they protect themselves against pathogen infections during their research practices, and (4) their perceptions of the causes underlying the decline in bat populations worldwide. From the 587 completed responses (response rate of 28%) having a worldwide distribution, the heterogeneity of the scientists' perception of their own object of study was highlighted. In the majority of cases, this depended on the type of research they conducted (i.e. laboratory versus field studies) as well as their research speciality. Our study revealed a high level of personal protection equipment being utilised against pathogens during scientific practices, although the role bats play as reservoirs for a number of emerging pathogens remains poorly known. Our results also disclosed the unanimity among specialists in attributing a direct role for humans in the global decline of bat populations, mainly via environmental change, deforestation, and agriculture intensification. Overall, the present study suggests the need for better communication regarding bats and their biology, their role within the scientific community, as well as in the general public population. As a consequence, increased knowledge regarding scientists' perceptions of bats should improve the role scientists play in influencing the perception of bats by the general public.
27831758	Previous studies have reported conflicting results regarding the relationship between individuality and social identity, indicating this area requires further examination. This study constructed a research model to help understand the positive role of individualized behavior and social identity in virtual communities. The results of an online survey conducted to assess our theoretical research model indicated that social identity can be expressed in two ways: self-categorization and social identification. Furthermore, we found individualized behavior was positively related to social identification, while self-categorization was directly derived from social identification.
27831729	Traumatic brain injury (TBI) in adolescence has well documented effects on social competence. Few studies have examined the effects of behavioral interventions on social competence or identified factors associated with changes in social competence after injury. Research Method/Design: Adolescents with moderate to severe TBI ages 12-17 years were randomized within 6 months of injury to either a problem solving and communication (CAPS) group that received online counseling (n = 65) or an Internet resources comparison (IRC) group (n = 67) for a comparative effectiveness trial. Parent-report measures of social competence (Child Behavior Checklist, CBCL; Home and Community Social Behavior Scales, HCSBS; Behavioral and Emotional Rating Scale, BERS-2) were administered at baseline (preintervention) and approximately 6 months later. Analyses examined these measures in relation to treatment group, TBI severity, and age. Regression analyses were also conducted to examine baseline measures of cognition as predictors of social competence after TBI.CAPS had a more positive effect than the comparison condition on the HCSBS and BERS-2 for younger teens with moderate TBI and older teens with severe TBI. More parent-rated executive dysfunction at baseline was related to both lower concurrent levels of social competence and less positive gains in competence over time, whereas higher baseline IQ predicted greater gains in competence.	CAPS may be effective for improving social competence for teens after TBI, with benefits dependent on the teen's age and injury severity. Parent-rated executive dysfunction, moreover, has utility in predicting both lower concurrent levels of social competence and subsequent postinjury gains in competence. (PsycINFO Database Record	
27830950	Potential support providers may rely on observable behaviours (e.g. resisting a cigarette vs. smoking) to determine how much and what kind of support to provide. We evaluated the effect of smokers' salient behaviour on partners' likelihood of providing positive and negative support.Partners of smokers (N = 131) were randomly assigned to recall a time when their partner either successfully resisted a cigarette, failed to resist a cigarette or a control condition (no recall). All participants reported the likelihood of providing positive and negative support to their partner. Perceived commitment to quitting smoking was measured as a potential mediator.	The main outcome was intention to provide support for a quit attempt.	Participants who recalled their partners' past failures reported more intentions to engage in negative support and smaller ratios of positive to negative intended support than did participants in the success or control condition. These effects were partially mediated by perception of commitment to quitting.	Lapses in a quit attempt may change the nature of the support quitters receive. Interventions to improve communication between partners about the smoker's commitment to quitting and experienced challenges may result in better support.	
27830930	The Internet may be conceptualized as a social laboratory, providing freedom to experiment with different presentations of self. Adolescence is an important time in the development of self-concept; however, little is known about how clarity of self-concept relates to online behavior. The principal aim of this study was to test the hypothesis that self-concept clarity would be associated with adolescents' inclination to experiment with online self-presentation. One hundred forty-eight participants aged 13-18 completed the Self-Concept Clarity Scale, the Facebook Intensity Scale, and the Presentation of Online Self Scale (POSS). Adolescents possessing a less stable sense of self reported experimenting with online self-presentation more regularly, presenting an idealized version of self and a preference for presenting themselves online. Adolescents with a more stable self-concept reported presenting an online self which was more consistent with their offline self-presentation. Younger adolescents were more likely to present an inconsistent self, whereas older adolescents presented themselves more consistently across different communication contexts. Finally, adolescents who spent more time on Facebook and had fewer Facebook friends were more likely to present multiple versions of self while online. The implications of these findings will be discussed in terms of the development of self-concept during adolescence and the potential for the online world to facilitate flexible identity construction and self-presentation.
27830645	This Perspective offers a summary of the recommendations in the Institute of Medicine report Dying in America How we die is a deeply personal issue that each of us will face. However, the approach to end-of-life (EOL) care in the United States needs improvement. Too frequently, healthcare delivery is uncoordinated and has many providers who are not adequately prepared to have meaningful conversations about EOL planning. This is amplified by payment systems and policies that create impediments, misunderstanding, and sometimes misinformation. Dying in America made five recommendations to improve quality and honor individual preferences near the EOL beginning with making conversations with providers and families something that occurs during various phases of the life cycle and not just when one is facing serious illness or possible EOL. It was recommended (i) that public and private payers and care delivery organizations cover the provision of comprehensive care that is accessible and available to individuals on a 24/7 schedule; (ii) that professional societies and other entities establish standards for clinician patient communication and advance care planning and that payers and care delivery organizations adopt them; (iii) that educational institutions, credentialing bodies, accrediting boards, state regulatory agencies, and care delivery organizations establish palliative care training, certification, and/or licensure requirements; (iv) that public and private payers and care delivery organizations integrate the financing of health and social services; and (v) that public and private organizations should engage their constituents and provide fact-based information to encourage advance care planning and informed choice.
27830622	When you go to a conference you look forward to finding nuggets of brilliance to squirrel away to your workplace. Highlighter pen poised, you scan conference programmes for presentations to enhance your practice. But conference programmes cannot indicate what you gain by talking to people.
27830481	The blogosphere is full of personalities with masks, or pseudonyms. Although not a desired state of public communication, one could excuse the use of pseudonyms in blogs and social media, which are generally unregulated or weakly regulated. However, in science publishing, there are increasingly strict rules regarding the use of false identities for authors, the lack of institutional or contact details, and the lack of conflicts of interest, and such instances are generally considered to be misconduct. This is because these violations of publishing protocol decrease trust and confidence in science and bring disrepute to those scientists who conform to the rules set out by journals and publishers and abide by them. Thus, when cases are encountered where trust and protocol in publishing are breached, these deserve to be highlighted. In this letter, I focus on Neuroskeptic, a highly prominent science critic, primarily on the blogosphere and in social media, highlighting the dangers associated with the use of pseudonyms in academic publishing.
27830264	This study investigated the communicative use of eye gaze and gestures in females with Rett syndrome.Data on 151 females with Rett syndrome participating in the Australian Rett Syndrome Database was used in this study. Items from the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (Wetherby & Prizant, 2002) were used to measure communication. Relationships between the use of eye gaze and gestures for communication were investigated using logistic regression. The influences of MECP2 mutation type, age, and level of motor abilities on the use of eye gaze and gestures were investigated using multivariate linear regression.	Both eye gaze and the use of gestures predicted the ability to make requests. Women aged 19 years or older had the lowest scores for eye gaze. Females with better gross motor abilities had higher scores for the use of eye gaze and gestures. The use of eye gaze did not vary across mutation groups, but those with a C-terminal deletion had the highest scores for use of gestures.	Eye gaze is used more frequently than gestures for communication, and this is related to age, MECP2 mutation type, and gross motor abilities.	
27830061	Ultrasonic vocalisation is a broadly used proxy to evaluate social communication in mouse models of neuropsychiatric disorders. The efficacy and robustness of testing these models suffer from limited knowledge of the structure and functions of these vocalisations as well as of the way to analyse the data. We created mouseTube, an open database with a web interface, to facilitate sharing and comparison of ultrasonic vocalisations data and metadata attached to a recording file. Metadata describe 1) the acquisition procedure, e.g., hardware, software, sampling frequency, bit depth; 2) the biological protocol used to elicit ultrasonic vocalisations; 3) the characteristics of the individual emitting ultrasonic vocalisations ( e.g., strain, sex, age). To promote open science and enable reproducibility, data are made freely available. The website provides searching functions to facilitate the retrieval of recording files of interest. It is designed to enable comparisons of ultrasonic vocalisation emission between strains, protocols or laboratories, as well as to test different analysis algorithms and to search for protocols established to elicit mouse ultrasonic vocalisations. Over the long term, users will be able to download and compare different analysis results for each data file. Such application will boost the knowledge on mouse ultrasonic communication and stimulate sharing and comparison of automatic analysis methods to refine phenotyping techniques in mouse models of neuropsychiatric disorders.
27828677	The article analyzes the configuration and trends in institutions of Higher Education and their relationship as components of the Health Economic-Industrial Complex (HEIC). The expansion of higher education is part of the transition from elite to mass systems, with tensions between quantitative and qualitative aspects. Such changes reflect different cultures and are related to international phenomena such as globalization, economic transformations, the development of new information and communication technologies, and the emergence of an international knowledge network. The scale and content of these changes vary according to the expansion and institutional reconfiguration of educational systems, as well as the link between state and society. Market expansion for private higher education stirs competition, shapes business clusters, modifies training processes, and raises new public policy challenges. Resumo: Este artigo analisa a configuração e as tendências das instituições de Ensino Superior de saúde no seu relacionamento enquanto componentes do Complexo Econômico Industrial da Saúde (CEIS). A expansão do Ensino Superior é parte da transição de sistemas de elite para sistemas de massa, com tensionamentos entre aspectos quantitativos e qualitativos. Essas mudanças refletem diferentes culturas e se relacionam com fenômenos de escopo mundial como globalização, transformações econômicas, desenvolvimento de novas tecnologias de comunicação e informação, e emergência de uma rede internacional de conhecimento. A escala e o conteúdo dessas mudanças variam com a ampliação dos sistemas de ensino e na reconfiguração institucional, bem como na articulação entre Estado e sociedade. A ampliação do mercado privado no ensino acirra a competitividade, conformando conglomerados empresariais, alterando processos de formação e forjando novos desafios para as políticas públicas.
27827823	Granulocyte colony-stimulating factor (G-CSF) is widely used for peripheral blood stem/progenitor mobilization. G-CSF causes low-grade fever that is ameliorated by nonsteroidal anti-inflammatory drugs (NSAIDs), suggesting the activation of arachidonic acid (AA) cascade. How G-CSF regulated this reaction was assessed. G-CSF treatment in mice resulted in fever, which was canceled in prostaglandin E synthase (mPGES-1)-deficient mice. Mobilization efficiency was twice as high in chimeric mice lacking mPGES-1, specifically in hematopoietic cells, suggesting that prostaglandin E2 (PGE2) from hematopoietic cells modulated the bone marrow (BM) microenvironment. Neutrophils from steady-state BM constitutively expressed mPGES-1 and significantly enhanced PGE2 production in vitro by β-adrenergic stimulation, but not by G-CSF, which was inhibited by an NSAID. Although neutrophils expressed all β-adrenergic receptors, only β3-agonist induced this phenomenon. Liquid chromatography-tandem mass spectrometry traced β-agonist-induced PGE2 synthesis from exogenous deuterium-labeled AA. Spontaneous PGE2 production was highly efficient in Gr-1high neutrophils among BM cells from G-CSF-treated mice. In addition to these in vitro data, the in vivo depletion of Gr-1high neutrophils disrupted G-CSF-induced fever. Furthermore, sympathetic denervation eliminated both neutrophil priming for PGE2 production and fever during G-CSF treatment. Thus, sympathetic tone-primed BM neutrophils were identified as one of the major PGE2 producers. PGE2 upregulated osteopontin, specifically in preosteoblasts, to retain progenitors in the BM via EP4 receptor. Thus, the sympathetic nervous system regulated neutrophils as an indispensable PGE2 source to modulate BM microenvironment and body temperature. This study provided a novel mechanistic insight into the communication of the nervous system, BM niche components, and hematopoietic cells.
27827568	Metaphors, and the frames they evoke, potently influence how people understand issues. These concepts of discourse, metaphor, and framing have been productively used in a range of studies including in the field of addiction. In public health and clinical discourse on people who use drugs, use of terms such as "targeting," "surveilling," and "capturing," along with "war on drugs" frames and referring to drug treatment as "substitution" may reinforce negative perceptions of people who use drugs. Avoiding military metaphors and explicitly leveraging metaphors that emphasize humanity, social cohesion, and agency have the potential to improve public health for people who use drugs.
27826267	Increasing evidence suggests that ostensive-communicative signals in social learning situations enable observers to focus their attention on the intrinsic features of an object (e.g., color) at the expense of ignoring transient object properties (e.g., location). Here we investigated whether off-line social cues, presented as social primes, have the same power to modulate attention allocation to stable and transient object properties as on-line ostensive-communicative cues. The first part of the experiment consisted of a pre-treatment phase, where adult male participants either received intensive social stimulation or were asked to perform non-social actions. Then, they participated in a change detection test, where they watched pairs of pictures depicting an array of five objects. On the second picture, a change occurred compared to the first picture. One object changed either its location (moving forward or backward) or was replaced by another object, and participants were required to indicate where the change had happened. We found that participants detected the change more successfully if it had happened in the location of the object; however, this difference was reduced following a socially intense pre-treatment phase. The results are discussed in relation to the claims of the natural pedagogy theory.
27825963	Surveillance of patients with cirrhosis increases early detection of hepatocellular carcinoma (HCC) and prolongs survival. However, its effectiveness is limited by underuse, particularly among racial/ethnic minorities and individuals of low socioeconomic status. We compared the effectiveness of mailed outreach strategies, with and without patient navigation, in increasing the numbers of patients with cirrhosis undergoing surveillance for HCC in a racially diverse and socioeconomically disadvantaged cohort.We performed a prospective study of patients with documented or suspected cirrhosis at a large safety-net health system from December 2014 through March 2016. Patients were assigned randomly (1:1:1) to groups that received mailed invitations for an ultrasound screening examination (n = 600), mailed invitations for an ultrasound screening examination and patient navigation (barrier assessment and motivational education for patients who declined screening; n = 600), or usual care (visit-based screening; n = 600). Patients who did not respond to outreach invitations within 2 weeks received up to 3 reminder telephone calls. The primary outcome was completion of abdominal imaging within 6 months of randomization.	Baseline characteristics were similar among groups. Cirrhosis was documented, based on International Classification of Diseases, 9th revision, codes, for 79.6% of patients, and suspected, based on noninvasive markers of fibrosis, for 20.4%. In an intent-to-treat analysis, significantly greater proportions of patients who received the mailed invitation and navigation (47.2%) or the mailed invitation alone (44.5%) underwent HCC screening than patients who received usual care (24.3%) (P < .001 for both comparisons). However, screening rates did not differ significantly between outreach the outreach groups (P = .25). The effects of the outreach program were consistent in all subgroups, including Caucasian vs non-Caucasian race, documented vs suspected cirrhosis, Child-Pugh A vs B cirrhosis, and receipt of gastroenterology care.	
27825935	Social behavior is evolutionary conserved, and is thought to be evolved since it increased reproductive and survival fitness of living species. In humans, disturbances of social behavior are a peculiar pathological trait of neurodevelopmental disorders, namely autism spectrum disorder (ASD). ASD is defined by deficits in two core domains (social interaction/communication and repetitive/restrictive behaviors), which emerge during early postnatal development. ASD has a strong genetic component: copy number variations, de novo and familial mutations, as well as epigenetic modifications have been reported in a huge number of genes. Recent studies in mice demonstrate that mutations in a wide variety of ASD-associated genes can cause neurodevelopmental defects, which subsequently result in social behavior disturbances during early postnatal age and adulthood. From these studies, it clearly emerges that functionally interrelated cellular mechanisms underlie social behavior and its disturbances in ASD. Indeed, most of ASD-associated genes control neuronal differentiation and migration, growth of neuronal connections and synaptic function. Here we will present the recent advances in understanding the genetic determinants of social behavior, as they emerge from the study of ASD mouse models, and discuss the importance of these studies for the development of novel therapeutic approaches to overcome social disturbances in ASD.
27825934	Proposing a framework for the study of core functions is valuable for understanding how they are altered in multiple mental disorders involving prefrontal dysfunction, for understanding genetic influences and for testing therapeutic compounds. Social and communication disabilities are reported in several major psychiatric disorders, and social communication disorders also can occur independently. Being able to study social communication involving interactions and associated acoustic vocalizations in animal models is thus important. All rodents display extensive social behaviors, including interactions and acoustic vocalizations. It is therefore important to pinpoint potential genetic-related strain differences -and similarities- in social behavior and vocalization. One approach is to compare different mouse strains, and this may be useful in choosing which strains may be best suitable in modeling psychiatric disorders where social and communication deficits are core symptoms. We compared social behavior and ultrasonic acoustic vocalization profiles in males of four mouse strains (129S2/Sv, C57BL/6J, DBA/2, and CD-1) using a social interaction task that we previously showed to rely on prefrontal network activity. Our social interaction task promotes a high level of ultrasonic vocalization with both social and acoustic parameters, and further allows other measures of social behaviors. The duration of social contact, dominance and aggressiveness varied with the mouse strains. Only C57BL/6J mice showed no attacks, with social contact being highly affiliative, whereas others strains emitted aggressive attacks. C57BL/6J mice also exhibited a significantly higher rate of ultrasonic vocalizations (USV), especially during social interaction.
27825692	The 5-year survival of patients with low socioeconomic status (SES) and esophageal cancer is significantly lower than that in patients with high SES. It is poorly understood what causes these worse outcomes. We hypothesized that a qualitative approach could elucidate the underlying causes of these differences.Patients with a diagnosis of esophageal cancer were recruited through flyers in regional cancer centers as well as through Facebook advertisements in cancer support groups and newspapers; they participated in a 1-hour semistructured interview or completed an online survey. Patients were stratified into low- and high-SES groups and were surveyed about their health history and access to cancer care. Data were coded into common themes based on participant responses.	Eighty patients completed the interviews or surveys, with 38 in the high-SES group and 42 in the low-SES group. There were no clinically significant differences between the groups in comorbidities and cancer staging. Patients with low SES were offered operative treatment at significantly lower rates (19 of 42 [44.7%] versus 29 of 38 [76.3%]; p = 0.0048), had a decreased rate of second opinions (10 of 42 [23.8%] versus 25 of 38 [65.8%]; p = 0.00016), and were more likely to lose their jobs (14 of 42 [33.3%] versus 1 of 38 [2.6%]; p = 0.00044) than their high-SES counterparts. Thematic analysis found that communication difficulties, lack of understanding of treatment, and financial troubles were consistently reported more prominently in the lower-SES groups. Having a facilitator (eg, social worker) improved care by helping patients navigate complex treatments and financial concerns.	Financial and communication barriers exist, which may lead to disparities in cancer outcomes for patients with low SES. There is a critical need for medical advocates to assist patients with limited resources.	
27825590	U.S. Latinas experience disproportionately high rates of unintended pregnancy and low rates of consistent contraception use. Not well known are Latinas' perspectives about how primary care physicians (PCPs) might facilitate or deter contraceptive decision making. The theory of planned behavior has been used previously to explain contraceptive behaviors. This study used the theory of planned behavior as a guide to help describe Latinas' perspectives regarding specific factors that influence their contraceptive decision making and to describe their perspectives about the role of PCPs in the decision making.We conducted focus groups (n = 3) and interviews (n = 8) of Latinas ages 15 to 24 years, recruited from urban primary care sites in Baltimore, Maryland. Concepts from the theory of planned behavior were used to develop a coding scheme and guide identification of themes.	Sixteen Latinas participated; all were immigrants.	The desire to avoid unintended pregnancy is dominant and, not surprisingly, is the main driver of contraceptive intentions. The role of PCPs in contraceptive decision making is to build strong patient relationships through heightened communication and trust. PCPs should develop trust and foster communication by using a shared decision-making approach in contraceptive counseling. Religious norms rarely operate as barriers to contraceptive use, yet positive reinforcement from family, friends, and schools is viewed as supportive.	For this group of young, immigrant Latinas, there is a pervasive desire for effective communication and trusting relationships with PCPs. Findings suggest that providers can facilitate contraceptive decision making for this population by using a shared decision-making approach to contraceptive counseling.	
27825383	The analysis of scientific networks has been applied in health research to map and measure relationships between researchers and institutions, describing collaboration structures, individual roles, and research outputs, and helping the identification of knowledge gaps and cooperation opportunities. Driven by dengue continued expansion in Brazil, we explore the contribution, dynamics and consolidation of dengue scientific networks that could ultimately inform the prioritisation of research, financial investments and health policy.Social network analysis (SNA) was used to produce a 20-year (1995-2014) retrospective longitudinal evaluation of dengue research networks within Brazil and with its partners abroad, with special interest in describing institutional collaboration and their research outputs.	The analysis of institutional co-authorship showed a significant expansion of collaboration over the years, increased international involvement, and ensured a shift from public health research toward vector control and basic biomedical research, probably as a reflection of the expansion of transmission, high burden and increasing research funds from the Brazilian government. The analysis identified leading national organisations that maintained the research network connectivity, facilitated knowledge exchange and reduced network vulnerability.	SNA proved to be a valuable tool that, along with other indicators, can strengthen a knowledge platform to inform future policy, planning and funding decisions. The paper provides relevant information to policy and planning for dengue research as it reveals: (1) the effectiveness of the research network in knowledge generation, sharing and diffusion; (2) the near-absence of collaboration with the private sector; and (3) the key central organisations that can support strategic decisions on investments, development and implementation of innovations. In addition, the increase in research activities and collaboration has not yet significantly affected dengue transmission, suggesting a limited translation of research efforts into public health solutions.	
27825330	Research suggests that there may be bereavement experiences and support needs which are specific to family caregivers providing end of life care (EoLC), although this remains an under-researched area. This paper focuses on themes relating to bereavement which were derived from an analysis of free text survey responses collected in a research priority setting exercise for palliative and EoLC.The priority setting exercise involved a public survey, designed to generate research priorities. Rather than identify research topics, many people instead described their experiences and raised more general questions relating to palliative and end of life care. To explore these experiences and perspectives a supplementary thematic analysis was conducted on the survey responses. 1403 respondents took part, including patients, current and bereaved carers, health and social care professionals, volunteers and members of the public.	Several grief issues were identified, which seem specific to the experiences of family caregivers. Responses demonstrated a relationship between death experiences, feelings of guilt and bereavement outcomes for some family caregivers, as well as caregiver experiences of a "void" created by the withdrawal of professional support after death. Communication and support needs were also identified by participants.	This analysis provides further evidence of some of the specific effects that caring for a loved one at the end of life can have on bereavement experiences. Finding ways of improving communication around the time of death and effective follow up approaches post death could help to address some of these issues.	
27824730	Fragile X syndrome is a neurodevelopmental disorder caused by a trinucleotide (CGG) hyperexpansion in the FMR1 gene, functionally silencing transcription of the fragile X mental retardation protein (FMRP). This disorder is characterized by impaired cognition, communication, and social behavior. The aim of this study was to investigate the development of ultrasonic vocalization (USV) behavior in a Fmr1-deficient mouse model. On postnatal days (PD) 9-14, separate cohorts of FVB/NJ pups were removed from their homecage and isolation-induced USVs were recorded. There were significant genotype-dependent and sex-dependent differences in USV behavior across the different testing days. Fmr1 knockout (KO) mice showed a significant reduction in vocalizations across all days. There was also a significant difference in vocalizations between male and female mice. We found a significant decrease in the total number of calls for KO males on PD9 and PD13 as well as an increase in the total number of calls for KO males on PD12. The KO males also showed a significant increase in the total call duration on PD12 and a reduction on PD13. The KO female showed a significant decrease in the total number of calls on PD9 and PD10. They also showed a significant decrease in the total call duration on PD9 and a marginal decrease in the total call duration on PD10. These results provide additional evidence for communication deficits in Fmr1 deficient mice and provide new insight suggesting sexually dimorphic vocalizations during the neonatal period.
27824514	Palliative care consultation improves quality of care through symptom management, communication, care coordination, and earlier hospice referral, and it may decrease burdensome hospital readmissions at the end of life.To compare 30-day readmission rates for patients admitted with exacerbation of congestive heart failure (CHF) receiving palliative care consultation services compared with controls.	Retrospective cohort study using propensity score matching. A secondary, subgroup analysis compared patients with palliative care consults and patients with an incomplete consult order. Settings/Subjects: Single-center study in an academic acute inpatient setting. Of a pool of 8215 admissions from January 1, 2011 to April 6, 2014, 356 included a palliative care consultation, and 356 matched controls were found.	The 30-day readmission rate was 50.8% for admissions including a palliative care consult and 36.0% for controls (OR 1.8, 95% CI 1.4-2.5). Those with a completed consult had fewer readmissions compared with those with an incomplete order, but this difference was not statistically significant (43% vs. 53%, χ2 = 1.9, p = 0.171).	No reduction in the risk of 30-day readmission was observed in the palliative care group, suggesting that palliative care services may not have the same effect on readmission rates in CHF patients compared with others. The subgroup analysis suggests that the difference between palliative care and control groups may reflect residual confounding, possibly due to critical social variables that are not captured in the electronic medical record, highlighting the difficulty in studying this population.	
27824305	Most studies on the impact of restrictive abortion laws have focused on patient-level outcomes. To better understand how such laws affect providers, we conducted a qualitative study of 27 abortion providers working under a restrictive law in North Carolina. Providers derived professional identity from their motivations, values, and experiences of pride related to abortion provision. The law affected their professional identities by perpetuating negative characterizations of their profession, requiring changes to patient care and communication, and creating conflicts between professional values and legal obligations. We conclude that a holistic understanding of the impact of abortion laws should include providers' perspectives.
27824257	This study investigates how social support and family relationship perceptions influence breast cancer patients' online communication networks in a computer-mediated social support (CMSS) group. To examine social interactions in the CMSS group, we identified two types of online social networks: open and targeted communication networks. The open communication network reflects group communication behaviors (i.e., one-to-many or "broadcast" communication) in which the intended audience is not specified; in contrast, the targeted communication network reflects interpersonal discourses (i.e., one-to-one or directed communication) in which the audience for the message is specified. The communication networks were constructed by tracking CMSS group usage data of 237 breast cancer patients who participated in one of two National Cancer Institute-funded randomized clinical trials. Eligible subjects were within 2 months of a diagnosis of primary breast cancer or recurrence at the time of recruitment. Findings reveal that breast cancer patients who perceived less availability of offline social support had a larger social network size in the open communication network. In contrast, those who perceived less family cohesion had a larger targeted communication network in the CMSS group, meaning they were inclined to use the CMSS group for developing interpersonal relationships.
27824231	A randomized controlled trial tested an interactive normative feedback-based intervention-codenamed "FITSTART"-delivered to groups of 50-100 parents of matriculating college students. The 60-min session motivated parents to alter their alcohol-related communication by correcting normative misperceptions (e.g., about how approving other parents are of student drinking) with live-generated data. Then, tips were provided on discussing drinking effectively. Incoming students (N = 331; 62.2% female) completed baseline measures prior to new-student orientation. Next, at parent orientation in June, these students' parents were assigned to either FITSTART or a control session. Finally, 4 months later, students completed a follow-up survey. Results revealed that students whose parents received FITSTART during the summer consumed less alcohol and were less likely to engage in heavy episodic drinking (HED) during the first month of college. These effects were mediated by FITSTART students' lower perceptions of their parents' approval of alcohol consumption. Further, FITSTART students who were not drinkers in high school were less likely to initiate drinking and to start experiencing negative consequences during the first month of college, where FITSTART students who had been drinkers in high school experienced fewer consequences overall and were significantly more likely to report that they did not experience any consequences whatsoever during the first month of college. Importantly, FITSTART is the first parent-based intervention to impact HED, one of the most well-studied indicators of risky drinking. Thus, interactive group normative feedback with parents is a promising approach for reducing college alcohol risk. (PsycINFO Database Record
27823101	As the population ages and the incidence of chronic diseases and lifestyle-related conditions rises, nurses are increasingly required to provide care for people with a range of chronic (long-term) conditions. The healthcare needs of patients are often complicated by comorbid conditions. Nurses deliver healthcare in the context of the patient's medical conditions, treatment regimens, the healthcare system, and the individual's socioeconomic, personal and family factors, which may include the challenges of social isolation and geographic distance. In such complex circumstances, patients may be perceived as 'difficult' or 'challenging', however, the challenge is not the patient themselves, but the relationship between the nurse and the patient. Communication difficulties can occur between nurses and patients, which may affect the therapeutic relationship and the quality of care provided. This article discusses the communication skills that nurses require to interact effectively with patients who have complex and chronic comorbid conditions. It focuses on therapeutic communication strategies and the nurse-patient relationship, while emphasising the need for nurses to be self-aware when caring for patients with complex healthcare needs.
27822969	To examine the long-term impact of health counselling among middle-aged men at high risk of CVD.An observational study with a 5-year follow-up.	All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011.	Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits.	Lifestyle and CVD risk score change.	All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI -1.6 to -0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI -1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI -0.5 to 0.4]).	These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTS Studies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals. Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging. Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential to initiate lifestyle changes that support risk reduction. Attaining a sustainable reduction in CVD risk requires a willingness to engage in risk-related communication from both health care providers and the individual at high risk.	
27822775	Over two decades, the director task has increasingly been employed as a test of the use of Theory of Mind in communication, first in psycholinguistics and more recently in social cognition research. A new version of this task was designed to test two independent hypotheses. First, optimal performance in the director task, as established by the standard metrics of interference, is possible by using selective attention alone, and not necessarily Theory of Mind. Second, pragmatic measures of Theory-of-Mind use can reveal that people actively represent the director's mental states, contrary to recent claims that they only use domain-general cognitive processes to perform this task. The results of this study support both hypotheses and provide a new interactive paradigm to reliably test Theory-of-Mind use in referential communication.
27822458	Advance care planning (ACP) is a process of reflection and communication of a person's future health care preferences, and has been shown to improve end-of-life (EOL) care for patients. The aim of this systematic review is to present an evidence-based overview of ACP in patients with primary malignant brain tumors (pmBT). A comprehensive literature search was conducted using medical and health science electronic databases (PubMed, Cochrane, Embase, MEDLINE, ProQuest, Social Care Online, Scopus, and Web of Science) up to July 2016. Manual search of bibliographies of articles and gray literature search were also conducted. Two independent reviewers selected studies, extracted data, and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. All studies were included irrespective of the study design. A meta-analysis was not possible due to heterogeneity amongst included studies; therefore, a narrative analysis was performed for best evidence synthesis. Overall, 19 studies were included [1 randomized controlled trial (RCT), 17 cohort studies, 1 qualitative study] with 4686 participants. All studies scored "low to moderate" on the methodological quality assessment, implying high risk of bias. A single RCT evaluating a video decision support tool in facilitating ACP in pmBT patients showed a beneficial effect in promoting comfort care and gaining confidence in decision-making. However, the effect of the intervention on quality of life and care at the EOL were unclear. There was a low rate of use of ACP discussions at the EOL. Advance directive completion rates and place of death varied between different studies. Positive effects of ACP included lower hospital readmission rates, and intensive care unit utilization. None of the studies assessed mortality outcomes associated with ACP. In conclusion, this review found some beneficial effects of ACP in pmBT. The literature still remains limited in this area, with lack of intervention studies, making it difficult to identify superiority of ACP interventions in pmBT. More robust studies, with appropriate study design, outcome measures, and defined interventions are required to inform policy and practice.
27822447	The family-school relationship is a crucial component in achieving the optimum scholastic experience of pupils. Such a relationship is often described in somewhat reductive binary terms of collaboration/non-collaboration. However, the significant presence of families from different cultural backgrounds in Italy since the 1990s demonstrates how multiple types of rapport with schools can generate effective styles of relationship. Infant schools constitute a privileged location where such dynamics can be investigated. Firstly, because they exhibit the highest percentage of families that have moved to Italy from other countries (33.9%); secondly, because they represent the initial stage when school and family first come into contact, playing an "imprinting role" for all subsequent scholastic phases. Based on in-depth interviews with infant school teachers and parents of pupils coming from different backgrounds, this research investigated different factors that influence family-school relations: (1) interpersonal factors, that include listening skills, emotions and relational styles of parents or teachers; (2) structural factors, that are related to the living conditions of families and to the whole social welfare system in Italy; (3) cultural factors, that bring together values, lifestyles and educational cultures of both parents and teachers.The idea regarding the inadequate distinction based on a dichotomy between Italian and migrant families seemed to be confirmed: Italian families and migrant families are characterized by many common features as well as by many inner differentiations. The results of this study suggest that the family-school relationship evolves into a communication framework that encompasses both obstacles and resources.	The results of our research suggest that the relationship between parents and teachers in Italian infant schools is influenced by different factors, not only cultural ones. All of these factors are related to both parents and teachers, and they should be taken into account when investigating this topic.	
27822316	Emerging evidence suggests that a subset of FMR1 premutation carriers is at an increased risk for cognitive, emotional, and medical conditions. However, because the premutation is rarely diagnosed at birth, the early developmental trajectories of children with a premutation are not known.This exploratory study examined the cognitive, communication, and social-behavioral profiles of 26 infants with a premutation who were identified through participation in a newborn screening for fragile X syndrome pilot study. In this study, families whose newborn screened positive for an FMR1 premutation were invited to participate in a longitudinal study of early development. Twenty-six infants with the premutation and 21 matched, screen-negative comparison babies were assessed using validated standardized measures at 6-month intervals starting as young as 3 months of age. The babies were assessed up to seven times over a 4-year period.	The premutation group was not statistically different from the comparison group on measures of cognitive development, adaptive behavior, temperament, or overall communication. However, the babies with the premutation had a significantly different developmental trajectory on measures of nonverbal communication and hyperresponsivity to sensory experiences. They also were significantly more hyporesponsive at all ages than the comparison group. Cytosine-guanine-guanine repeat length was linearly associated with overall cognitive development.	These results suggest that infants with a premutation may present with subtle developmental differences as young as 12 months of age that may be early markers of later anxiety, social deficits, or other challenges thought to be experienced by a subset of carriers.	
27822277	Obesity is one of the most common chronic diseases with important medical effects, as well as mental and social health problems. Bariatric surgery is one of the most effective treatments of morbid obesity.Because of the possible psychological changes, and its effects on weight loss after surgery, the current study aimed to compare marital satisfaction and self-confidence in patients with obesity before and after bariatric surgery in Rasoul-e-Akram hospital in 2013.	This prospective observational study was conducted on 69 candidates for bariatric surgery. Marital satisfaction and self-confidence were assessed before and six months after the surgery by Enrich marital satisfaction scale and Coopersmith self-esteem inventory. Descriptive statistics and T-tests were utilized to analyze data. Values of P ≤ 0.01 were considered statistically significant.	Despite the improvement of sexual relationship, marital satisfaction scores significantly decreased from141.26 ± 12.75 to 139.42 ± 12.52 six months after the surgery (P = 0.002). Satisfaction in scales of conflict resolution and communication showed a descending pattern (P < 0.001). No significant difference was found between self-esteem before and after the surgery (P = 0.321).	Weight loss after bariatric surgery did not improve self-esteem and marital satisfaction six months post operatively; therefore, psychiatric assessment of patients before and after the surgery is crucial; since even if they are not associated with prognosis of the surgery, it is important to provide treatment for psychiatric problems. Prospective studies are recommended to assess post-operative changes of other psychological aspects.	
27822273	The aim of the present study was to test a structural model of hypothesized relationships between spiritual well-being, intervening variables of personal worth of self and others, commitment to relationship stability, commitment to relationship growth, positive interaction/appreciation, communication/conflict resolution, time spent together, and, the dependent variable, dyadic adjustment.Two hundred and sixty eight (171 females and 97 males) married parent subjects were selected by convenience sampling from three universities in Mazandaran, Iran, to take part in this study. They were all volunteers and were not paid and their age range was 23 to 47 (31.07 ± 4.37 years). All participants were asked to complete the spiritual well-being scale (SWBS), family strengths scale (FSS) and revised dyadic adjustment scale (RDAS).	The results from structural equation modeling confirmed a hierarchy for the development of family strengths, and indicated that spiritual well-being and strength in most characteristics affected dyadic adjustment, positively (P <0.05).	Couples' level of dyadic adjustment is increased when they have higher spiritual well-being, value each other, have commitment to each other, communicate well, enjoy being with each other, and spend time together.	
27822189	Gaze is instrumental in coordinating face-to-face social interactions. But little is known about gaze use when social interactions co-occur with other joint activities. We investigated the case of walking while talking. We assessed how gaze gets allocated among various targets in mobile conversations, whether allocation of gaze to other targets affects conversational coordination, and whether reduced availability of gaze for conversational coordination affects conversational performance and content. In an experimental study, pairs were videotaped in four conditions of mobility (standing still, talking while walking along a straight-line itinerary, talking while walking along a complex itinerary, or walking along a complex itinerary with no conversational task). Gaze to partners was substantially reduced in mobile conversations, but gaze was still used to coordinate conversation via displays of mutual orientation, and conversational performance and content was not different between stationary and mobile conditions. Results expand the phenomena of multitasking to joint activities.
27821161	This study aims to examine bidirectional relationships between children's language skills and Inattention/Hyperactivity (IH) symptoms during preschool.Children (N = 1459) from the EDEN mother-child cohort were assessed at ages 3 and 5.5 years. Language skills were evaluated using the WPPSI-III, NEPSY and ELOLA batteries. Children's behavior, including IH symptoms, was assessed using the parent-rated Strengths & Difficulties Questionnaire (SDQ). Using a Structural Equation Modeling (SEM) approach, we examined the relationship between language skills and IH symptoms, as well as potential mediating processes.	SEM analyses indicated a small negative effect of language skills at 3 years on ADHD symptoms at 5.5 years after adjusting for IH symptoms at 3 years (β =-0.12, SE = 0.04, p-value = 0.002). Interpersonal difficulties did not mediate the relationship between early language skills and later IH symptoms, nor was this association reduced after adjusting for a broad range of pre- and postnatal environmental factors and performance IQ. Among different language skills, receptive syntax at 3 years was most strongly related to IH symptoms at 5.5 years.	Poor language skills at age 3 may predict IH symptoms when a child enters primary school. Implications for the understanding and the prevention of the co-occurrence of language disorders and ADHD are discussed.	
27821138	The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one's hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility.The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated.	Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual's own physical function.	LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.	
27821121	Approximately 29 million individuals are expected to enroll in health insurance using the Patient Protection and Affordable Care Act (ACA) Marketplace by 2022. Those seeking health insurance struggle to understand insurance options and choose a plan that best suits their needs.We interviewed stakeholders to identify the challenges associated with the ACA Marketplace health insurance enrollment and elicited feedback about what to include in health insurance decision support tools. Interviews were transcribed and themes were identified using inductive thematic analysis.	Stakeholders stated that consumers felt frustrated by unclear terminology, high plan costs, and complex calculations required to assess costs. Consumers felt anxious about making the wrong choice and being unable to change plans within a calendar year. Stakeholders recommended using plain language tables defining complex terms, grouping information, and using engaging graphics to communicate information about health insurance. Stakeholders thought that narratives of how others made decisions about insurance might be helpful to consumers, but recommended that they be tailored to the needs of specific consumers.	Strategies that clarify health insurance terms using plain language and graphics, acknowledge concern associated with making the wrong choice, calculate and enable cost comparison, and tailor information to consumers' unique needs could benefit those enrolling in ACA Marketplace plans, Narratives developed should be simple and inclusive enough for diverse populations.	
27821112	This paper discusses the establishment of a clinical trial of an Ebola vaccine candidate in Kambia District, Northern Sierra Leone during the epidemic, and analyses the role of social science research in ensuring that lessons from the socio-political context, the recent experience of the Ebola outbreak, and learning from previous clinical trials were incorporated in the development of community engagement strategies. The paper aims to provide a case study of an integrated social science and communications system in the start-up phase of the clinical trial.The paper is based on qualitative research methods including ethnographic observation, interviews with trial participants and key stakeholder interviews.	Through the case study of EBOVAC Salone, the paper suggests ways in which research can be used to inform communication strategies before and during the setting up of the trial. It explores notions of power, fairness and trust emerging from analysis of the Sierra Leonean context and through ethnographic research, to reflect on three situations in which social scientists and community liaison officers worked together to ensure successful community engagement. Firstly, a section on "power" considers the pitfalls of considering communities as homogeneous and shows the importance of understanding intra-community power dynamics when engaging communities. Secondly, a section on "fairness" shows how local understandings of what is fair can help inform the design of volunteer recruitment strategies. Finally, a section on "trust" highlights how historically rooted rumours can be effectively addressed through active dialogue rather than through an approach focused on correcting misinformation.	The paper firstly emphasises the value of social science in the setting up of clinical trials, in terms of providing an in depth understanding of context and social dynamics. Secondly, the paper suggests the importance of a close collaboration between research and community engagement to effectively confront political and social dynamics, especially in the context of an epidemic.	
27820864	Parkinson's disease (PD) is a neurodegenerative disease that affects the motor system and cognitive and behavioral functions. Due to these impairments, PD patients also have problems in using the computer. However, using computers and the Internet could help these patients to overcome social isolation and enhance information search. Specifically, avatars (defined as virtual representations of humans) are increasingly used in online environments to enhance human-computer interaction by simulating face-to-face interaction. Our laboratory experiment investigated how PD patients behave in a trust game played with human and avatar counterparts, and we compared this behavior to the behavior of age, income, education and gender matched healthy controls. The results of our study show that PD patients trust avatar faces significantly more than human faces. Moreover, there was no significant difference between initial trust of PD patients and healthy controls in avatar faces, while PD patients trusted human faces significantly less than healthy controls. Our data suggests that PD patients' interaction with avatars may constitute an effective way of communication in situations in which trust is required (e.g., a physician recommends intake of medication). We discuss the implications of these results for several areas of human-computer interaction and neurological research.
27820729	This randomized controlled clinical trial aimed to investigate the effect of dance in the functionality and psychosocial adjustment of young subjects with cerebral palsy (CP).Twenty-six young subjects with CP, GMFCS (Gross Motor Function Classification System) levels from II to V, were randomized into two intervention groups: kinesiotherapy and dance (n = 13 each). Twenty-four sessions (1 hour, twice a week) were performed in both groups. Functional Independence Measure (FIM) and World Health Organization Disability Assessment Schedule (WHODAS) by International Classification of Functioning, Disability and Health (ICF) were used before and after each intervention.	Dance increased the classification of functioning (P = 0.001), independence function (P = 0.004), self-care (P = 0.01), mobility (P = 0.008), locomotion (P = 0.01), communication (P = 0.02), psychosocial adjustments (P = 0.04), and cognitive function (P = 0.03). Intergroup analysis evidenced significantly greater improvements in classification of functioning (P = 0.0002), independence function (P = 0.0006), self-care (P = 0.01), mobility (P = 0.001), locomotion (P = 0.002), communication (P = 0.0001), psychosocial adjustments (P = 0.002), and cognitive function (P = 0.0001) in dance group.	It was shown that this approach could have an influence on basic common points in the body and motion, including emotional and social aspects, supporting the concept of complex multimodal psychomotor adjustments. Dance promoted enhancement on functionality and social activities regarding psychosocial adjustments in cerebral palsy young subjects.	
27820594	The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10%-15% of the US population remains uninsured.To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant.	Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013.	A total of 2742 US residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel.	Self-reported health insurance status and type as of spring 2015.	Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared with low financial literacy, and 9.2 percentage points higher with high compared with low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance through Medicaid or the Marketplaces compared with being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates.	A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics.	


27819774	Entre el 19 y el 21 de agosto la Facultad de Medicina de la UNAM celebró la Feria del Libro de las Ciencias de la Salud en el Palacio de Medicina (Ciudad de México). En ella estuvieron presentes Archives of Medical Research, la Revista Médica del IMSS y Saber IMSS, tres de los principales instrumentos de difusión de conocimiento del Instituto Mexicano del Seguro Social.Between August 19 and 21, the Feria del Libro de las Ciencias de la Salud (Healthcare Book Fair) took place in the Palacio de Medicina in Mexico City. Archives of Medical Research, Revista Médica del IMSS, and Saber IMSS, three of the main instruments of knowledge diffusion of the Instituto Mexicano del Seguro Social, assisted to this book fair, which was organized by the Facultad de Medicina of UNAM.	
27819619	"Nicht von schlechten Eltern - NischE": A Family Orientated Collaborative Care Approach to Support Children in Families with Mentally Ill Parents The present work describes the setting- and multi-professional offer "NischE" in Gütersloh, a systemic approach for the care of children and their mentally ill parents. Children of mentally ill parents are a special risk group for developing their own mental illness. The aim of the collaborative care model between child and adolescent psychiatry, youth services and adult psychiatry is to enable affected families in terms of family-focused practice a low threshold access to different services. For this purpose, two positions have been created to advise the affected families and support access to the help system in the sense of a systemic case management in a project. The article describes the background and the need for the development of the offer, the current scientific knowledge base on the subject and illustrates the procedure using a case study from practice.
27819486	Thousands of people affected by or caring for someone affected by Crohn's disease or ulcerative colitis participate in online social support groups today. The diseases, which are often discussed in conjunction due to being similar in nature, have no cure and yet affect over 1 million people in the United States alone. There is a need for health communication scholarship to examine the nature of the messages in Crohn's and UC groups, which can lend insight into the unique struggles and psychosocial benefits that members gain from group participation. To develop an in-depth understanding of social support exchanges on these groups, 2000 posts within a 2-year period were randomly selected and content analyzed. Using a taxonomy of social support, several categories and subcategories of social support emerged. Results showed that informational support (41.1%) and emotional support (36.1%) were most frequently exchanged, followed by esteem support (14.3%) and network support (14.2%). Data suggested that several exchanges, such as symptom management and remission, experiences of extraintestinal manifestations, and relational support, may be contextually unique due to the variety of symptoms and treatments unique to Crohn's and UC. Recommendations are provided for researchers to collaborate with health practitioners and educators, including developing interventions and patient-centered practices to better serve patients and caregivers of Crohn's and UC. Further avenues for research in social support are also recommended.
27819246	In an era when the number of expedited and conditional review pathways for newly available brand-name drugs and biosimilar medicines to treat serious and life-threatening diseases is increasing, defining pharmacovigilance has never been more crucial. 21st century pharmacovigilance is not merely about uncovering, reporting, and addressing adverse events associated with already approved and marketed agents, but can be described as the systematic monitoring of the process of pre-market review and post-market surveillance, which includes the use of medicines in everyday practice. Pharmacovigilance identifies previously unrecognised adverse events or changes in the patterns of these effects, the quality and adequacy of drug supply, and should ensure effective communication with the public, health-care professionals, and patients about the optimum safety and effective use of medicines. In this paper, the first in a Series of three about drug safety in oncology, we discuss evolving challenges in the purview, roles, and responsibilities of the US Food and Drug Administration and the European Medicines Agency with respect to pharmacovigilance efforts, with a special emphasis on oncology treatment.
27819204	The death of a child from cancer is an intense and life-changing loss for a parent. Guided by the principles of patient- and family-centered care, hospital-based caregivers developed a program to provide bereavement support for parents through phone calls and mailings. The aim of the present qualitative phenomenological study was to understand how parents experienced participating in this bereavement program.A total of eight parents from six families participated in a focus-group evaluation of the two-year hospital-based bereavement program. Two social work clinicians/researchers independently analyzed the transcript of the focus group to define themes.	Four themes were identified: (1) lived experience of grief, (2) importance of relationships with the hospital-based team, (3) bereavement support from hospital-based providers, and (4) extending bereavement care.	Participants indicated the value of ongoing communication and connection with members of the healthcare team, who were often central to a family's life for years during their child's cancer treatment. Parents also provided suggestions for extending bereavement support through continued contact with providers and informal annual gatherings, as well as through a peer (parent-to-parent) support program.	
27819199	Shifting towards a more sustainable food consumption pattern is an important strategy to mitigate climate change. In the past decade, various studies have optimised environmentally sustainable diets using different methodological approaches. The aim of the present review was to categorise and summarise the different approaches to operationalise the health aspects of environmentally sustainable diets.Conventional keyword and reference searches were conducted in PubMed, Scopus, Web of Knowledge and CAB Abstracts. Inclusion criteria were: (i) English-language publication; (ii) published between 2005 and October 2015; (iii) dietary data collected for the diet as a whole at the national, household or individual level; (iv) comparison of the current diet with dietary scenarios; and (v) for results to consider the health aspect in some way.	Consumer diets.	Adult population.	We reviewed forty-nine studies that combined the health and environmental aspects of consumer diets. Hereby, five approaches to operationalise the health aspect of the diet were identified: (i) food item replacements; (ii) dietary guidelines; (iii) dietary quality scores; (iv) diet modelling techniques; and (v) diet-related health impact analysis.	Although the sustainability concept is increasingly popular and widely advocated by nutritional and environmental scientists, the journey towards designing sustainable diets for consumers has only just begun. In the context of operationalising the health aspects, diet modelling might be considered the preferred approach since it captures the complexity of the diet as a whole. For the future, we propose SHARP diets: environmentally Sustainable (S), Healthy (H), Affordable (A), Reliable (R) and Preferred from the consumer's perspective (P).	
27818610	Serious crashes are more likely when teenage drivers have teenage passengers. One likely source of this increased risk is social influences on driving performance. This driving simulator study experimentally tested the effects of peer influence (i.e., risk-accepting compared to risk-averse peer norms reinforced by pressure) on the driving risk behavior (i.e., risky driving behavior and inattention to hazards) of male teenagers. It was hypothesized that peer presence would result in greater driving risk behavior (i.e., increased driving risk and reduced latent hazard anticipation), and that the effect would be greater when the peer was risk-accepting.Fifty-three 16- and 17-year-old male participants holding a provisional U.S., State of Michigan driver license were randomized to either a risk-accepting or risk-averse condition. Each participant operated a driving simulator while alone and separately with a confederate peer passenger. The simulator world included scenarios designed to elicit variation in driving risk behavior with a teen passenger present in the vehicle.	Significant interactions of passenger presence (passenger present vs. alone) by risk condition (risk-accepting vs. risk-averse) were observed for variables measuring: failure to stop at yellow light intersections (Incident Rate Ratio (IRR)=2.16; 95% Confidence Interval [95CI]=1.06, 4.43); higher probability of overtaking (IRR=10.17; 95CI=1.43, 73.35); shorter left turn latency (IRR=0.43; 95CI=0.31,0.60); and, failure to stop at an intersection with an occluded stop sign (IRR=7.90; 95CI=2.06,30.35). In all cases, greater risky driving by participants was more likely with a risk-accepting passenger versus a risk-averse passenger present and a risk-accepting passenger present versus driving alone.	Exposure of male teenagers to a risk-accepting confederate peer passenger who applied peer influence increased simulated risky driving behavior compared with exposure to a risk-averse confederate peer passenger or driving alone. These results are consistent with the contention that variability in teenage risky driving is in part explained by social influences.	
27818397	The coeditors of an American Annals of the Deaf special issue on deaf-blindness introduce readers to critical issues surrounding children and youth who are deafblind. These issues-early identification, communication, social-emotional needs, family and multicultural issues, universal design and assistive technology, transition planning, and personnel preparation-are explored further in the articles that follow. By way of introduction, the present article provides definitions of deafblindness and a discussion of the heterogeneous nature of the population. The history of the field of deafblindness is then explored in terms of three distinct population shifts, from (a) individuals of the 18th and 19th centuries who became deafblind due to illness, to (b) the influx of individuals with congenital rubella syndrome in the 1960s who had disabilities besides deafblindness, and

27817962	In late 2014, a measles outbreak beginning in California received significant media attention. To better understand the impact of this outbreak, we conducted a survey to assess and compare among vaccine hesitant and non-hesitant new mothers how this outbreak affected vaccine knowledge, attitudes, vaccination plans, and media use.A cross-sectional email survey of English-speaking women with a child ⩽1year old using a convenience sample of women from nine obstetrics and gynecology (OB/GYN) practices in Colorado assessed vaccine hesitancy, knowledge and attitudes about MMR vaccines and the outbreak, MMR vaccination plans before and after the outbreak, and use of and trust for media sources related to the outbreak.	The response rate was 50% (351/701). Knowledge about the outbreak was high and vaccination attitudes were mostly favorable. Forty-eight percent of respondents thought MMR vaccine was more important after the outbreak. Online news (76%), television news (75%), and social media (68%) were the most frequently used media sources, yet were highly trusted by only 18%, 22%, and 1% of respondents respectively. Government websites (34%) and information from a doctor's office (34%) were infrequently used, but were highly trusted by 62% and 60% of respondents. Knowledge of the outbreak was lower among vaccine-hesitant respondents. Few mothers changed MMR vaccination plans after the outbreak.	New mothers had high levels of knowledge and favorable attitudes about vaccination after the 2014-15 measles outbreak. Media sources used the most are not the most trusted. Communication about outbreaks of vaccine-preventable diseases should include spread of accurate information to new media sources and strengthening of existing trust in traditional media.	
27817959	As part of a survey of about vaccination beliefs, a nationally representative sample of parents of young children answered a series of tradeoff questions that asked them to choose between two vaccination approaches that differed in terms of risks of vaccine complications, number of injections, and/or vaccine effectiveness. Most parents were willing to have their children endure more injections, and many were willing to forgo disease protection, in order to reduce the rare chance of febrile seizures. Yet, most parents were unwilling to trade disease protection to reduce the risk of fever alone, even though this is correlated with the risk of febrile seizures. Vaccine risk communications need to address the heightened emotional weight that parents give to febrile seizure risk, even when the rarity of such events is explicit.
27817123	Ulcerative colitis (UC) negatively impacts patients' health-related quality of life (HRQoL).The UC-LIFE survey aimed to evaluate the perceived everyday and emotional impact of UC on patients attending outpatient clinics in Spain and explored patient-physician communication.	Gastroenterologists handed the survey to consecutive unselected UC patients aged ≥18 years. Patients described their perception on the burden of symptoms and disease severity, social and emotional impact of UC on everyday life, disease knowledge and sources of information about the disease, and patient-physician communication.	A total of 585 patients received the survey, and 436 returned it (74.5% response rate; mean age 46 years, 53% men). Most patients perceived that UC prevented them from leading a normal life (79.3%) and impaired sleep quality (76.1%). Most patients described an emotional impact due to UC, mainly feelings of depression and anxiety, and some 38% perceived that UC decreased their self-confidence. Despite most patients believing that their physician listened/asked about UC symptoms, many perceived that emotional/psychological support was lacking.	Findings support the need for a more patient-centered approach to the care of UC patients, to include psychological, emotional, and social aspects. Improved patient-physician communication would be beneficial and may contribute to better HRQoL in UC patients.	
27817073	This study explores the influence of bilingualism on the cognitive processing of language and music. Specifically, we investigate how infants learning a non-tone language perceive linguistic and musical pitch and how bilingualism affects cross-domain pitch perception. Dutch monolingual and bilingual infants of 8-9 months participated in the study. All infants had Dutch as one of the first languages. The other first languages, varying among bilingual families, were not tone or pitch accent languages. In two experiments, infants were tested on the discrimination of a lexical (N = 42) or a violin (N = 48) pitch contrast via a visual habituation paradigm. The two contrasts shared identical pitch contours but differed in timbre. Non-tone language learning infants did not discriminate the lexical contrast regardless of their ambient language environment. When perceiving the violin contrast, bilingual but not monolingual infants demonstrated robust discrimination. We attribute bilingual infants' heightened sensitivity in the musical domain to the enhanced acoustic sensitivity stemming from a bilingual environment. The distinct perceptual patterns between language and music and the influence of acoustic salience on perception suggest processing diversion and association in the first year of life. Results indicate that the perception of music may entail both shared neural network with language processing, and unique neural network that is distinct from other cognitive functions.
27816565	A collaborative patient-pharmacist interaction is fundamental to greater patient satisfaction with pharmacy care and improved medication adherence. Effective pharmacist-patient communication occurs when both pharmacist and patient are able to successfully attend to not only the typical tasks and goals of the interaction but also basic face needs that underlie all social interaction; autonomy, competence or esteem, and fellowship. Addressing face needs occurs through conventional and strategic communication strategies that respond to the emerging needs throughout an interaction. Pharmacist-patient interactions are not just about transfer of information and medications. Both parties assess the situation, the others' intentions within the context of their own goals and this influences how they choose to act throughout the interaction. Face-work Theory provides a framework to understand these interaction processes in pharmacist-patient communication.The aim of this study was to determine face needs, threats and the strategic communication strategies used to address these within community pharmacist-patient interactions.	This exploratory descriptive study drew upon principles of ethology to first describe naturally occurring behaviour and then to interpret this behaviour within the context of Face-work theory. Twenty-five audio-recorded community pharmacist-patient interactions were collected and analyzed. The average length of these interactions was 3:67 min with a range of 0.39 s-9:35 min.	Multiple face needs for both pharmacist and patient were evident in most interactions. Autonomy, competence and fellowship face needs were negotiated in the following contexts: participative relationships, concordant role expectations, sensitive topics, and negotiating expertise and knowledge. Competence face needs for both parties were the most dominant need found in negotiating role expectations. The most common communication strategies used to support face were solidarity based strategies while indirect and depersonalized questions were commonly employed to mitigate face threat.	Face-work Theory is a novel approach to understand processes and outcomes of patient-pharmacist interactions in community pharmacies. Linking speech acts with face needs and threats may help to elucidate how pharmacist-patient interactions achieve both task oriented and interpersonal goals.	
27816315	To investigate whether the medical interview in the pediatric context generates a stressful response in parents in form of heightened cortisol activity, and whether pediatricians' empathetic communication is able to attenuate this stress response.68 parents were recruited at pediatric out-patient and in-patient consultations. Salivary samples were collected between 60 and 30min prior to the consultation, shortly before the consultation, 20min as well as 45min after the consultation. 19 pediatricians participated in the study and effectuated the medical visit as usual. We videotaped the consultations and coded pediatricians' affective communication using the RIAS and the Four Habits Coding Scheme.	Parents' cortisol increased during the medical visit with a peak at 20min after the medical encounter. Furthermore, multilevel analysis revealed a lesser increase in parents' cortisol response associated with pediatricians' levels in supportive communication behaviors.	As indicated by their humoral stress responses, the medical encounter was stressful for the parents. Pediatricians' affective communication modulated this stress response in that more supportive communication was related to smaller cortisol increases.	Pediatricians' affective communication behavior during the medical visit can alleviate parents' distress and anxiety, representing a source of social and emotional support.	
27815241	Bats vocalize extensively within different social contexts. The type and extent of information conveyed via their vocalizations and their perceptual significance, however, remains controversial and difficult to assess. Greater tube-nosed bats, Murina leucogaster, emit calls consisting of long rectangular broadband noise burst (rBNBl) syllables during aggression between males. To experimentally test the behavioral impact of these sounds for feeding, we deployed an approach and place-preference paradigm. Two food trays were placed on opposite sides and within different acoustic microenvironments, created by sound playback, within a specially constructed tent. Specifically, we tested whether the presence of rBNBl sounds at a food source effectively deters the approach of male bats in comparison to echolocation sounds and white noise. In each case, contrary to our expectation, males preferred to feed at a location where rBNBl sounds were present. We propose that the species-specific rBNBl provides contextual information, not present within non-communicative sounds, to facilitate approach towards a food source.
27815169	Nursing homes are an important site for end-of-life care, yet little is known about the perspectives of the frontline staff who provide a majority of this care.To describe, from the staff perspective, positive/negative experiences related to caring for dying residents.	Qualitative analysis using survey data from staff working in 52 Indiana nursing homes.	A total of 707 frontline staff who provide nursing, nurse aide, and social work services responded to open-ended prompts. Study data included responses to open-ended prompts asking participants to describe one positive experience and one negative experience caring for a dying patient. A thematic content analysis was conducted using the constant-comparative method. Respondents were largely female (93%), white (78%), 31-50 years (42%), and 53% had >5 years of nursing home work experience. Experiences were described from three perspectives: 1) first-hand experiences, 2) observed experiences of dying patients, and 3) observed experiences of family members. Selected themes for positive experiences include the following: creating close bonds; good patient care; involvement of hospice; being prepared; and good communication. Selected themes for negative experiences consisted of the following: challenging aspects of care; unacknowledged death; feeling helpless; uncertainty; absent family; painful emotions; and family discord.	Findings reveal the richness and many complexities of providing end-of-life care in nursing homes and have implications for improving staff knowledge, coordination of care with hospice, and social support for patients.	
27813256	Effective co-practice is essential to deliver services for children with speech, language and communication needs (SLCN). The necessary skills, knowledge and resources are distributed amongst professionals and agencies. Co-practice is complex and a number of barriers, such as 'border disputes' and poor awareness of respective priorities, have been identified. However social-relational aspects of co-practice have not been explored in sufficient depth to make recommendations for improvements in policy and practice. Here we apply social capital theory to data from practitioners: an analytical framework with the potential to move beyond descriptions of socio-cultural phenomena to inform change.Co-practice in a local authority site was examined to understand: (1) the range of social capital relations extant in the site's co-practice; (2) how these relations affected the abilities of the network to collaborate; (3) whether previously identified barriers to co-practice remain; (4) the nature of any new complexities that may have emerged; and (5) how inter-professional social capital might be fostered.	A qualitative case study of SLCN provision within one local authority in England and its linked NHS partner was completed through face-to-face semi-structured interviews with professionals working with children with SLCN across the authority. Interviews, exploring barriers and facilitators to interagency working and social capital themes, were transcribed, subjected to thematic analysis using iterative methods and a thematic framework derived.	We identified a number of characteristics important for the effective development of trust, reciprocity and negotiated co-practice at different levels of social capital networks: macro-service governance and policy; meso-school sites; and micro-intra-practitioner knowledge and skills. Barriers to co-practice differed from those found in earlier studies. Some negative aspects of complexity were evident, but only where networked professionalism and trust was absent between professions. Where practitioners embraced and services and systems enabled more fluid forms of collaboration, then trust and reciprocity developed.	Highly collaborative forms of co-practice, inherently more complex at the service governance, macro-level, bring benefits. At the meso-level of the school and support team network there was greater capacity to individualize co-practice to the needs of the child. Capacity was increased at the micro-level of knowledge and skills to harness the overall resource distributed amongst members of the inter-professional team. The development of social capital, networks of trust across SLCN support teams, should be a priority at all levels-for practitioners, services, commissioners and schools.	
27812922	When people are confronted with a potentially life-threatening disease such as cancer, they are likely to feel an urgent need for information about the disease and support from peers. Studies have shown that the mass media contain a lot of experiential information (i.e., peer stories) about cancer, either from real individuals or from fictional characters. To date, most studies have focused on using the Internet for peer support. This study aimed to extend this line of research by investigating (1) whether cancer-diagnosed individuals use both television and the Internet to access peer stories, (2) whether exposure to these stories results in different emotional outcomes, and (3) whether this differs depending on gender. A cross-sectional survey among 621 cancer-diagnosed individuals in Flanders (Belgium) showed that both television and the Internet were used as a source for following peer stories. Respondents indicated feeling fearful and concerned when following peer stories on entertainment television, but following peer stories on online forums was associated with feeling supported. These different emotional responses could be the result of the differences between these two content categories (i.e., fictional versus non-fictional peer stories). Future research should further examine these relationships by investigating the role of mass media content and how different psychological coping styles and personality traits moderate these associations.
27812859	The scope of palliative care includes goal setting, symptom management, and care of the care giver. Palliative care is essential for patient-centered care of the older cancer patients. The diversity of this population in terms of life expectancy, treatment tolerance, function, disability, and social support mandates personalized treatment plans. The assessment of physiologic age is currently based on a comprehensive geriatric assessment (CGA). A number of biologic markers of aging including the inflammatory index, the genomic clock, the expression of p16INKa4, and the circulating levels of vitamin D may complement the CGA and fine-tune the determination of physiologic age. Goal setting in older patients may be complicated by communication difficulties related to hearing, cognition, expectation, and culture. Cancer-related pain is a major hindrance to the maintenance of functional independence and fatigue is harbinger of disability and death. The article explores the assessment and the management of the most common and debilitating symptoms in older cancer patients.
27812797	Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved resources management.
27812723	This study measured bullying roles across an academic year and examined how change in bullying experiences is associated with symptoms of depression, psychological distress, and suicidal ideation among adolescents in Vietnam.1424 students in middle and high schools completed two self-administered questionnaires, six months apart in 2014-2015.	Students who were victimised often and those who were classified as highly involved as both victims and bullies at one or both survey times showed significantly higher levels of depression, psychological distress, and suicidal ideation than other students. The mental health of adolescents who were involved in bullying as a victim or bully remained at low levels was generally similar to those not involved in any bullying. However, females who had stable but low level in victimisation or bully-victim status had worse mental health than males with stable-low-level exposure.	This is the first longitudinal analysis of bullying among adolescents in Vietnam. Persistent and frequent bullying was strongly linked with poor mental health for males and females. A new observation is that Vietnamese girls appear to be more sensitive to low level but long-term bullying involvement than were boys.	
27812680	The number of patients using the internet to obtain health information is growing. This material is unregulated and heterogeneous and can influence patient decisions.To compare the quality, readability, and technical aspects of online information about neck-lifts provided by private practice websites vs academic medical centers and reference sources.	In this cross-sectional analysis conducted between November 2015 and January 2016, a Google search of the term neck-lift was performed, and the first 45 websites were evaluated. The websites were categorized as private practice vs other. Private websites (PWs) included sites created by private practice physicians. Other websites (OWs) were created by academic medical centers or reference sources.	Quality, readability, and technical aspects of online websites related to neck-lifts. Quality was assessed using the DISCERN criteria and the Health on the Net principles (HONcode). Readability was assessed using 7 validated and widely used criteria. Consensus US reading grade level readability was provided by a website (readabilityformulas.com). Twelve technical aspects were evaluated based on criteria specified by medical website creators.	Forty-five websites (8 OWs [18%] and 37 PWs [82%]) were analyzed. There was a significant difference in quality between OWs and PWs based on the DISCERN criteria and HONcode principles. The DISCERN overall mean (SD) scores were 2.3 (0.5) for OWs and 1.3 (0.3) for PWs (P < .001). Of a total possible score of 14 using the HONcode analysis, the mean (SD) was 8.6 (1.8) (range, 5-11) for OW, and the mean (SD) was 5.8 (1.7) (range, 2-9) for PW. The mean (SD) readability consensus reading grade level scores were 11.7 (1.9) for OWs and 10.6 (1.9) for PWs. Of a total possible score of 12, the mean (SD) technical scores were 6.3 (1.8) (range, 4-9) for OWs and 6.4 (1.5) (range, 3-9) for PWs.	Compared with PWs, OWs had a significantly higher quality score based on both the DISCERN criteria and HONcode principles. The mean readability for OWs and PWs was grade 11 and grade 10, respectively, significantly higher than the grade 7 level recommended by the National Institutes of Health. Assessment of technical criteria demonstrated room for improvement in providing links to social media and blogs and reducing advertisements. Improving the quality and readability of online information may result in increased patient understanding, more active patient involvement, and ultimately better outcomes. Enhancing the technical aspects of websites may increase website traffic and patient volume.	NA.	
27812345	In this paper, we review evidence from infants, toddlers, and preschoolers to tackle the question of how individuals orient preferences and actions toward social partners and how these preferences change over development. We aim at emphasizing the importance of language in guiding categorization relatively to other cues such as age, race and gender. We discuss the importance of language as part of a communication system that orients infants and older children's attention toward relevant information in their environment and toward affiliated social partners who are potential sources of knowledge. We argue that other cues (visually perceptible features) are less reliable in informing individuals whether others share a common knowledge and whether they can be source of information.
27812327	Prenatal exposure to sodium valproate (VPA), a widely used anti-epileptic drug, is related to a series of dysfunctions, such as deficits in language and communication. Clinical and animal studies have indicated that the effects of VPA are related to the concentration and to the exposure window, while the neurobehavioral effects of VPA have received limited research attention. In the current study, to analyze the neurobehavioral effects of VPA, zebrafish at 24 h post-fertilization (hpf) were treated with early chronic exposure to 20 μM VPA for 7 h per day for 6 days or with early acute exposure to 100 μM VPA for 7 h. A battery of behavioral screenings was conducted at 1 month of age to investigate social preference, locomotor activity, anxiety, and behavioral response to light change. A social preference deficit was only observed in animals with chronic VPA exposure. Acute VPA exposure induced a change in the locomotor activity, while chronic VPA exposure did not affect locomotor activity. Neither exposure procedure influenced anxiety or the behavioral response to light change. These results suggested that VPA has the potential to affect some behaviors in zebrafish, such as social behavior and the locomotor activity, and that the effects were closely related to the concentration and the exposure window. Additionally, social preference seemed to be independent from other simple behaviors.
27811164	The complexity of the childhood obesity epidemic requires the application of community-based participatory research (CBPR) in a manner that can transcend multiple communities of stakeholders, including youth, the broader community, and the community of health care providers.To (a) describe participatory processes for engaging youth within context of CBPR and broader community, (b) share youth-engaged research findings related to the use of digital communication and implications for adolescent obesity intervention research, and (c) describe and discuss lessons learned from participatory approaches.	CBPR principles and qualitative methods were synergistically applied in a predominantly African American part of the city that experiences major obesity-related issues. A Youth Research Advisory Board was developed to deeply engage youth in research that was integrated with other community-based efforts, including an academic-community partnership, a city-wide obesity coalition, and a primary care practice research network. Volunteers from the youth board were trained to apply qualitative methods, including facilitating focus group interviews and analyzing and interpreting data with the goal of informing a primary care provider-based obesity reduction intervention.	The primary results of these efforts were the development of critical insights about adolescent use of digital communication and the potential importance of messaging, mobile and computer apps, gaming, wearable technology, and rapid changes in youth communication and use of digital technology in developing adolescent nutrition and physical activity health promotion.	The youth led work helped identify key elements for a digital communication intervention that was sensitive and responsive to urban youth. Many valuable lessons were also learned from 3 years of partnerships and collaborations, providing important insights on applying CBPR with minority youth populations.	
27810850	patient empowerment, through which patients become self-determining agents with some control over their health and healthcare, is a common theme across health policies globally. Most care for older people is in the acute setting, but there is little evidence to inform the delivery of empowering hospital care.we aimed to explore challenges to and facilitators of empowerment among older people with advanced disease in hospital, and the impact of palliative care.	we conducted an ethnography in six hospitals in England, Ireland and the USA. The ethnography involved: interviews with patients aged ≥65, informal caregivers, specialist palliative care (SPC) staff and other clinicians who cared for older adults with advanced disease, and fieldwork. Data were analysed using directed thematic analysis.	analysis of 91 interviews and 340 h of observational data revealed substantial challenges to empowerment: poor communication and information provision, combined with routinised and fragmented inpatient care, restricted patients' self-efficacy, self-management, choice and decision-making. Information and knowledge were often necessary for empowerment, but not sufficient: empowerment depended on patient-centredness being enacted at an organisational and staff level. SPC facilitated empowerment by prioritising patient-centred care, tailored communication and information provision, and the support of other clinicians.	empowering older people in the acute setting requires changes throughout the health system. Facilitators of empowerment include excellent staff-patient communication, patient-centred, relational care, an organisational focus on patient experience rather than throughput, and appropriate access to SPC. Findings have relevance for many high- and middle-income countries with a growing population of older patients with advanced disease.	
27810484	Cancer screening is below targets in Ontario, Canada. Our objective was to identify and quantify the barriers and facilitators for breast, cervical and colorectal cancer screening for under and never screened (UNS) residents living in Ontario between 2011 and 2013.We used a multi-phased mixed methods study design. Results from thematic analysis of focus group discussions with health care providers and UNS community members were used to develop an on-line, province-wide, cross-sectional survey to estimate the prevalence of barriers and facilitators for the provincial population. Adjusted prevalence odds ratios and 95% confidence intervals were estimated for UNS compared to regularly screened participants using logistic regression.	Four focus groups were held with health service providers and sixteen with UNS community members. Top barriers and facilitators themed around provider-patient communication, fear and embarrassment, history of physical or sexual abuse, social determinants of health (including low literacy, lack of awareness, and health insurance), symptoms appearing, and family and friends. 3075 participants completed the online survey. Compared to regularly screened participants, UNS had significantly higher odds of reporting: no regular health care provider; not feeling comfortable talking about screening; or the Doctor or Nurse Practitioner not suggesting screening. UNS also had significantly higher odds of reporting the facilitators: the test being less scary/painful or uncomfortable; friend/family insisting on getting screened; starting to have symptoms; or an easier test that could be done at home.	Interventions addressing fear through individual, interpersonal and structural facilitators may increase cancer screening.	
27810221	All health workers should take responsibility for infection prevention and control (IPC). Recent reduction in key reported healthcare-associated infections in the UK is impressive, but the determinants of success are unknown. It is imperative to understand how IPC strategies operate as new challenges arise and threats of antimicrobial resistance increase.The authors undertook a retrospective, independent evaluation of an action plan to enhance IPC and 'ownership' (individual accountability) for IPC introduced throughout a healthcare organization. Twenty purposively selected informants were interviewed. Data were analysed inductively. Normalization Process Theory (NPT) was applied to interpret the findings and explain how the action plan was operating.	Six themes emerged through inductive analysis. Theme 1: 'Ability to make sense of ownership' provided evidence of the first element of NPT (coherence). Regardless of occupational group or seniority, informants understood the importance of IPC ownership and described what it entailed. They identified three prerequisites: 'Always being vigilant' (Theme 2), 'Importance of access to information' (Theme 3) and 'Being able to learn together in a no-blame culture' (Theme 4). Data relating to each theme provided evidence of the other elements of NPT that are required to embed change: planning implementation (cognitive participation), undertaking the work necessary to achieve change (collective action), and reflection on what else is needed to promote change as part of continuous quality improvement (reflexive monitoring). Informants identified barriers (e.g. workload) and facilitators (clear lines of communication and expectations for IPC).	Eighteen months after implementing the action plan incorporating IPC ownership, there was evidence of continuous service improvement and significant reduction in infection rates. Applying a theory that identifies factors that promote/inhibit routine incorporation ('normalization') of IPC into everyday health care can help explain the success of IPC initiatives and inform implementation.	
27809821	The PHQ-9 and the GAD-7 assess depression and anxiety respectively. There are standardised, reliability-tested versions in BSL (British Sign Language) that are used with Deaf users of the IAPT service. The aim of this study is to determine their appropriate clinical cut-offs when used with Deaf people who sign and to examine the operating characteristics for PHQ-9 BSL and GAD-7 BSL with a clinical Deaf population.Two datasets were compared: (i) dataset (n = 502) from a specialist IAPT service for Deaf people; and (ii) dataset (n = 85) from our existing study of Deaf people who self-reported having no mental health difficulties. Parameter estimates, with the precision of AUC value, sensitivity, specificity, positive predicted value (ppv) and negative predicted value (npv), were carried out to provide the details of the clinical cut-offs. Three statistical choices were included: Maximising (Youden: maximising sensitivity + specificity), Equalising (Sensitivity = Specificity) and Prioritising treatment (False Negative twice as bad as False Positive). Standard measures (as defined by IAPT) were applied to examine caseness, recovery, reliable change and reliable recovery for the first dataset.	The clinical cut-offs for PHQ-9 BSL and GAD-7 BSL are 8 and 6 respectively. This compares with the original English version cut-offs in the hearing population of 10 and 8 respectively. The three different statistical choices for calculating clinical cut-offs all showed a lower clinical cut-off for the Deaf population with respect to the PHQ-9 BSL and GAD-7 BSL with the exception of the Maximising criteria when used with the PHQ-9 BSL. Applying the new clinical cut-offs, the percentage of Deaf BSL IAPT service users showing reliable recovery is 54.0 % compared to 63.7 % using the cut-off scores used for English speaking hearing people. These compare favourably with national IAPT data for the general population.	The correct clinical cut-offs for the PHQ-9 BSL and GAD-7 BSL enable meaningful measures of clinical effectiveness and facilitate appropriate access to treatment when required.	
27809819	Being a mentor in any setting brings challenges in addition to recognised benefits. Working in a low-income country confers specific challenges including logistical and communication issues. The need to adequately support UK-based international health volunteers prior to, during and after their trip is recognised at government level. Whilst the need to support mentors is recognised little is known about their support needs. This study aims to explore the lived experience of mentorship in a low-income country and gain insight into mentors' support and information needs and the barriers and facilitators to mentoring.Purposive sampling was used to recruit UK-employed, palliative care clinicians: four consultants, two specialty trainees, and two nurses, who were mentors with an international palliative care project. Semi-structured telephone interviews were recorded and analysed using interpretive phenomenological analysis.	Participants became mentors to help others. Uncertainty about their achievements constituted a significant challenge. This study highlights the need to prepare mentors before their in-country visits by exploring motivation, describing the reality of international volunteering and ensuring realistic expectations. Post-trip debriefing is important for reducing uncertainty around trip outcomes and maximising transferable impacts. Challenges to mentoring were logistical, related to the concept of mentorship and cultural. Facilitators included shared passion, mentor credibility and serendipity.	Awareness of the support needs of mentors and the facilitators and challenges to mentoring can improve mentor preparation and support. This may minimise potential negative emotional impact of being a mentor, maximise positive personal and professional impacts and improve in-country project impact.	
27809814	The aim was to develop and evaluate a training program for physicians for communicating with breast cancer patients about complementary medicine (CM).In a cluster-randomized pilot trial eight breast cancer centers (two physicians per center) were randomized to either a complementary communication training program (9 h e-learning + 20 h on-site skills training) or to a control group without training. Each physician was asked to consult ten patients for whom he or she is not the physician in charge. We used mixed methods: Quantitative outcomes included physicians' assessments (empathy, complexity of consultation, knowledge transfer) and patients' assessments (satisfaction, empathy, knowledge transfer). For qualitative analyses, 15 (eight in the training and seven in the control group) videotaped consultations were analyzed based on grounded theory, and separate focus groups with the physicians of both groups were conducted.	A total of 137 patients were included. Although cluster-randomized, physicians in the two groups differed. Those in the training group were younger (33.4 ± 8.9 vs. 40.0 ± 8.5 years) and had less work experience (5.4 ± 8.9 vs. 11.1 ± 7.4 years). Patient satisfaction with the CM consultation was relatively high on a scale from 0 to 24 and was comparable in the two groups (training group: 19.4 ± 4.6; control group 20.5 ± 4.1). The qualitative findings showed that physicians structured majority of consultations as taught during the training. Comparing only the younger and less CM experienced physicians, those trained in CM communication felt more confident discussing CM-related topics than those without training.	A CM communication-training program might be especially beneficial for physicians with less consulting experience when communicating about CM-related issues. A larger trial using more suitable quantitative outcomes needs to confirm this.	
27809698	Occupational therapists need to be cognizant of evidence-based role balance advice and strategies that women with multigenerational caring responsibilities can implement independently or with minimal assistance, as role balance may not be the primary goal during many encounters with this population. Hence, this study aimed to identify the viewpoints on the most helpful role balance strategies for working sandwich generation women, both from their own perspectives and from the perspective of occupational therapists. This was achieved through a Q methodology study, where 54 statements were based on findings from interviews, sandwich generation literature and occupational therapy literature. In total, 31 working sandwich generation women and 42 occupational therapists completed the Q sort through either online or paper administration. The data were analysed using factor analysis with varimax rotation and were interpreted through collaboration with experts in the field. The findings revealed similarities between working sandwich generation women and occupational therapists, particularly in terms of advocating strategies related to sleep, rest and seeking practical assistance from support networks. Differences were also present, with working sandwich generation women viewpoints tending to emphasize strategies related to coping with a busy lifestyle attending to multiple responsibilities. In contrast, occupational therapy viewpoints prioritized strategies related to the occupational therapy process, such as goal setting, activity focused interventions, monitoring progress and facilitating sustainable outcomes.
27693537	Autism is a neurodevelopmental disorder categorized by qualitative impairments in social interaction, communication, and repetitive stereotypic behavior. Emerging evidence increasingly suggests that chemokine receptors have a pivotal role in the central nervous system and are involved in the pathogenesis of numerous neuroinflammatory diseases. Resveratrol is widely used to treat neurodegenerative diseases, but its effect on autism has not been investigated. We investigated the effect of resveratrol (20 and 40mg/kg) in the spleen and brain tissues of BTBR T+tf/J (BTBR) and C57BL/6J (B6) mice as well as on the C-C chemokine receptor (CCR) and C-X-C motif chemokine receptor (CXCR) (CCR3+, CCR5+, CCR7+ and CCR9+, CXCR3+ and CXCR5+) in cluster of differentiation 4-positive (CD4+) T cells in the spleen. We also assessed the mRNA expression of CCR and CXCR receptors in the spleen and brain tissues. Our study revealed that the BTBR and B6 control mice showed different immune profiles. The BTBR mice showed characteristic higher levels of both CCR and CXCR production and expression in CD4+ T cells than the B6 control mice did. Treatment of B6 and BTBR mice with resveratrol (20 and 40mg/kg) induced a substantial decrease in the CCR and CXCR production and expression in CD4+ T cells compared with the respective untreated control groups. Moreover, resveratrol treatment decreased the mRNA expression levels of CCR and CXCR in the spleen and brain tissues. Resveratrol downregulated the chemokine receptor levels, which might provide unique targets for future therapies for autism.
27664539	The Ebola outbreak of 2014-2015 raised concerns about the disease's potential spread in the U.S. and received significant news media coverage. Prior research has shown that news media coverage of policy options can influence public opinion regarding those policies, as well as public attitudes toward the broader social issues and target populations addressed by such policies. To assess news media coverage of Ebola policies, the content of U.S.-focused news stories (n=1262) published between July 1 and November 30, 2014 from 12 news sources was analyzed for 13 policy-related messages. Eight-two percent of news stories mentioned one or more policy-related messages. The most frequently appearing policy-related messages overall were those about isolation (47%) and quarantine (40%). The least frequently mentioned policy-related message described dividing potentially exposed persons into distinct groups based on their level of Ebola risk in order to set different levels of restrictions (5%). Message frequency differed depending on whether news sources were located in an area that experienced an Ebola case or controversy, by news sources' political ideological perspective, and by type of news source (print and television). All policy-related messages showed significant increases in frequency after the first case of Ebola was diagnosed in the U.S. on September 30, 2014, with the exception of messages related to isolation, which showed a significant decrease. Results offer insight into how the news media covers policies to manage emerging disease threats.
27638451	Autism spectrum disorder (ASD) is an immensely challenging developmental disorder characterized primarily by two core behavioral symptoms of social communication deficits and restricted/repetitive behaviors. Investigating the etiological process and identifying an appropriate therapeutic target remain as formidable challenges to overcome ASD due to numerous risk factors and complex symptoms associated with the disorder. Among the various mechanisms that contribute to ASD, the maintenance of excitation and inhibition balance emerged as a key factor to regulate proper functioning of neuronal circuitry. Interestingly, our previous study involving the valproic acid animal model of autism (VPA animal model) has demonstrated excitatory-inhibitory imbalance (E/I imbalance) due to enhanced differentiation of glutamatergic neurons and reduced GABAergic neurons. Here, we investigated the potential of agmatine, an endogenous NMDA receptor antagonist, as a novel therapeutic candidate in ameliorating ASD symptoms by modulating E/I imbalance using the VPA animal model. We observed that a single treatment of agmatine rescued the impaired social behaviors as well as hyperactive and repetitive behaviors in the VPA animal model. We also observed that agmatine treatment rescued the overly activated ERK1/2 signaling in the prefrontal cortex and hippocampus of VPA animal models, possibly, by modulating over-excitability due to enhanced excitatory neural circuit. Taken together, our results have provided experimental evidence suggesting a possible therapeutic role of agmatine in ameliorating ASD-like symptoms in the VPA animal model of ASD.
27591487	Toddlers learn about their social world by following visual and verbal cues from adults, but they have difficulty transferring what they see in one context to another (e.g., from a screen to real life). Therefore, it is important to understand how the use of matched pedagogical cues, specifically adult eye gaze and language, influence toddlers' imitation from live and digital presentations. Fifteen- and 18-month-old toddlers (N=123) were randomly assigned to one of four experimental conditions or a baseline control condition. The four experimental conditions differed as a function of the interactive cues (audience gaze with interactive language or object gaze with non-interactive language) and presentation type (live or video). Results indicate that toddlers' successfully imitate a task when eye gaze was directed at the object or at the audience and equally well when the task was demonstrated live or via video. All four experimental conditions performed significantly better than the baseline control, indicating learned behavior. Additionally, results demonstrate that girls attended more to the demonstrations and outperformed the boys on the imitation task. In sum, this study demonstrates that young toddlers can learn from video when the models use matched eye gaze and verbal cues, providing additional evidence for ways in which the transfer deficit effect can be ameliorated.
27530377	Prostate cancer, the second most common cancer among men, typically onsets in middle or older age. Gay/bisexual men have different social networks and unique social support needs, particularly as it pertains to health care access and prostate side effects. Few studies have investigated the availability and provision of social support for gay and bisexual men with prostate cancer (GBMPCa).This study used qualitative data from in-depth, semistructured, one-on-one telephone interviews with 30 GBMPCa recruited from a national cancer support group network, Malecare. Inductive and deductive codes were used to identify themes about social support provided to GBMPCa during diagnosis and treatment.	GBMPCa reported help from friends, family (parents and siblings), ex-partners, and paid caregivers. Men in relationships reported varying levels of reliance on their partners for support, in part due to relationship dynamics and living arrangements. Single men showed a theme of independence ("I turned down all help," "My friends don't want to be bothered"). After diagnosis, many men reported seeking informational and emotional support from prostate cancer support groups; most expressed wanting more support groups specifically for GBMPCa. During or after treatment, men reported receiving a range of instrumental support, largely a function of relationship status and treatment type.	GBMPCa received variable, but generally low, social support during diagnosis and treatment and from a diverse social network, including a prominence of friends and family. Clinicians should be aware of GBMPCa's distinct patterns of social support needs and providers.	
27525957	Studies have shown that advanced care planning improves communication and reduces suffering for patients and their bereaved caregivers. Despite this knowledge, the rates of advance care plans are low and physicians, as the primary gatekeepers, have made little progress in improving their rates. Through the lens of critical social theory, we examine these forces and identify the ideologies, assumptions, and social structures that curtail completion of advanced care plans such as Preserving Life, Ageism, Paternalism, and Market-Driven Healthcare System. A critical discourse provides suggestions to eliminate oppressive ideologies that act as barriers to advanced care planning.
27450992	Sustainable remediation requires a balanced decision-making process in which environmental, economic and social aspects of different remediation options are all considered together and the optimum remediation solution is selected. More attention has been paid to the evaluation of environmental and economic aspects, in particular to reduce the human and environmental risks and the remediation costs, to the exclusion of social aspects of remediation. This paper investigates how social aspects are currently considered in sustainability assessments of remediation projects. A selection of decision support tools (DSTs), used for the sustainability assessment of a remediation project, is analyzed to define how social aspects are considered in those tools. The social indicator categories of the Sustainable Remediation Forum - United Kingdom (SuRF-UK), are used as a basis for this evaluation. The consideration of social aspects in the investigated decision support tools is limited, but a clear increase is noticed in more recently developed tools. Among the five social indicator categories defined by SuRF-UK to facilitate a holistic consideration of social aspects of a remediation project only "Human health and safety" is systematically taken into account. "Neighbourhood and locality" is also often addressed, mostly emphasizing the potential disturbance caused by the remediation activities. However, the evaluation of 'Ethics and Equality', Communities and community involvement', and 'Uncertainty and evidence' is often neglected. Nevertheless, concrete examples can be found in some of the investigated tools. Specific legislation, standard procedures, and guidelines that have to be followed in a region or country are mainly been set up in the context of protecting human and ecosystem health, safety and prevention of nuisance. However, they sometimes already include some of the aspects addressed by the social indicators. In this perspective the use of DST to evaluate the sustainability of a site remediation project, should be tuned to the legislation, guidelines and procedures that are in force in a specific country or region.
26751124	Patients with cancer are reported to experience high anxiety and depression related to their medical status. The current study aimed to investigate the effects of avoidance of cancer communication and of social support from family and medical professionals on the patients' anxiety and depression.A national survey was conducted through regional branches of the National Cancer Center of South Korea, which yielded 296 patient-caregiver dyads. Patients' medical records complemented their self-report survey data.	Patients' anxiety was predicted by the family's avoidance of cancer communication and the level of emotional support from family. Patients' depression was predicted by the stage of cancer (Surveillance, Epidemiology, and End Results), the family's avoidance of cancer communication, the emotional support from family, and the medical professionals' respect. Interaction effects were not statistically significant.	The implications of the findings are discussed in terms of the psycho-oncological and psycho-social interventions. Copyright © 2016 John Wiley & Sons, Ltd.	
26632424	Studies regarding natural caregivers' burden (CB) in palliative situations, as well as its determinants and consequences, have been numerous during the last 20 years. Yet, studies regarding how terminally ill cancer patients perceive their CB (self-perceived burden, SPB) are less common. This study aims to assess the links between CB and SPB evaluated by means of the very same items. It also aims at identifying the determinants of potential differences between CB and SPB and their consequences on emotional distress among both members of the dyad.Sixty cancer patients from a palliative care unit and their principal natural caregiver completed questionnaires concerning the subjective burden of the caregiver, their own personal emotional distress and that of the other member of the dyad.	Globally, patients had a good perception of their CB, although a little overestimated, except for their difficulties in managing their time. Caregivers overestimated patients' distress. The minimisation by patients of CB was a source of emotional distress for the latter, and the perception of being a burden to others was a source of depression for patients. These results did not depend on the nature of the relationship between patients and their caregivers.	This data confirmed the need to study the experiences of the patient-caregiver dyad as well as their communication of their respective experiences, with a prospect to offer clinical interventions to optimise the quality of life and health of patients and their close relatives.Copyright © 2015 John Wiley & Sons, Ltd.	
26581063	The contraceptive pill is widely used. An accurate knowledge is necessary for correct use.This study sheds light on adolescents' knowledge, attitude and behavior in regard to contraceptive use, in the year 2014. The goal is to provide general practitioners (GP) with information about the potential gaps in knowledge concerning contraceptive use in order to give better counseling and prevent high-risk behavior in adolescents.	A quantitative descriptive study was carried out among 14-25-year-old female and male adolescents. Data were collected through a web-based survey using the online survey software Qualtrics (Qualtrics, Provo, UT, USA) and was distributed via the social networking site Facebook.	The survey was started by 1185 participants. The most popular contraceptive method among females is the oral contraceptive pill (63.7%). Four out of ten females (42.6%) do not know that when using an emergency pill, they must still take their regular contraceptive pill on the same day. The majority of female respondents (80.0%) go to their general practitioner for a prescription for the pill. Ninety-five percent (95.1%) of the females would feel comfortable asking their GP for extra information about the drug. The sex of the GP does not influence the likelihood of female patients seeking more information. The Internet also seems to serve as an important source of information. We defined a female subgroup, called "vulnerable". The majority of females in the non-vulnerable group (70.4%) protected themselves before their first sexual contact instead of only half of the members in the vulnerable group (51.0%).	The level of knowledge among adolescents about contraception is not alarming, but there are a few blind spots. Eliminating these gaps should be the aim of the doctor and pharmacologist.	
27808084	The PEGASO Project aims to design a technological system aimed at European adolescents to promote healthy lifestyles. The objective was to explore teenagers and their parents and teachers perceptions with regards to mobile technology use in promoting a healthier lifestyle, in terms of food and physical activity.Qualitative study based on primary data obtained through four focus groups analysis (three teenager groups between 13 and 15 y and 1 parent/teacher group). Verbatim transcriptions have been analysed following content analysis perspective.	Four different categories were identified: 1: social and cultural context, 2: adolescents and health, 3: role of technology in teenagers' lives and 4: use of technology to acquire healthier habits. Each category helped to arise various subcategories linked to the relation between teens and health: holistic health concept, health/disease perception directly related with feeling physically fit and social acceptance. With regards to technology, the arisen themes were: feeling connected with others, importance of entertainment/games, omnipresent use of Smartphones and risk of excessive dependence on technology. The difference between teens and adults with regards to health and technology categories were not significant.	Both teens and adults think that for technology to be effective in acquiring healthier habits it has to help teens to improve and maintain their self-esteem, in an entertaining way and using their own communication codes, mainly audio-visual ones, always under the umbrella of a holistic and integrated perception of health.	
27808027	Concerns about rising costs and the sustainability of our healthcare system have led to a drive for innovative solutions and accountability for performance. Integrated Home Care, Calgary Zone, Alberta Health Services went beyond traditional accountability measures to use evaluation methodology to measure the progress of complex innovations to its organization structure and service delivery model. This paper focuses on the first two phases of a three-phase evaluation. The results of the first two phases generated learning about innovation adoption and sustainability, and performance accountability at the program-level of a large publicly funded healthcare organization.
27807946	Sensory-based conservation harnesses species' natural communication and signalling behaviours to mitigate threats to wild populations. To evaluate this emerging field, we assess how sensory-based manipulations, sensory mode, and target taxa affect success. To facilitate broader, cross-species application of successful techniques, we test which behavioural and life-history traits correlate with positive conservation outcomes. We focus on seabirds, one of the world's most rapidly declining groups, whose philopatry, activity patterns, foraging, mate choice, and parental care behaviours all involve reliance on, and therefore strong selection for, sophisticated sensory physiology and accurate assessment of intra- and inter-species signals and cues in several sensory modes. We review the use of auditory, olfactory, and visual methods, especially for attracting seabirds to newly restored habitat or deterring birds from fishing boats and equipment. We found that more sensory-based conservation has been attempted with Procellariiformes (tube-nosed seabirds) and Charadriiformes (e.g. terns and gulls) than other orders, and that successful outcomes are more likely for Procellariiformes. Evolutionary and behavioural traits are likely to facilitate sensory-based techniques, such as social attraction to suitable habitat, across seabird species. More broadly, successful application of sensory-based conservation to other at-risk animal groups is likely to be associated with these behavioural and life-history traits: coloniality, philopatry, nocturnal, migratory, long-distance foraging, parental care, and pair bonds/monogamy.
27807466	Peer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.	Four of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.	PMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.	
27807264	In jawed vertebrates, genes of the major histocompatibility complex (MHC) play a key role in immunity by encoding cell-surface proteins that recognize and bind non-self antigens. High variability at MHC suggests that these loci may also function in social signalling such as mate choice and kin recognition. This requires that MHC genotype covaries with some perceptible phenotypic trait. In mammals and fish, MHC is signalled chemically through volatile and non-volatile peptide odour cues, facilitating MHC-dependent mate choice and other behaviours. In birds, despite evidence for MHC-dependent mating, candidate mechanisms for MHC signalling remain largely unexplored. However, feather preen wax has recently been implicated as a potential source of odour cues. We examined whether the chemical composition of preen wax correlates with MHC class IIβ genotypes of wild song sparrows (Melospiza melodia). Pairwise chemical distance reflected amino acid distance at MHC for male-female dyads, although not for same-sex dyads. Chemical diversity did not reflect MHC diversity. We used gas chromatography-mass spectrometry (GC-MS) to characterize preen wax compounds, and identified four wax esters that best reflect MHC similarity. Provided songbirds can detect variation in preen wax composition, this cue may allow individuals to assess MHC compatibility of potential mates.
27807171	Regular physical exercise reduces the risk for obesity, cardiovascular diseases, and disability and is associated with longer lifespan expectancy (Taylor et al., 2004; Pahor et al., 2014; Anton et al., 2015; Arem et al., 2015). In contrast, decreased physical function is associated with hearing loss among older adults (Li et al., 2013; Chen et al., 2015). Here, we investigated the effects of long-term voluntary wheel running (WR) on age-related hearing loss (AHL) in CBA/CaJ mice, a well established model of AHL (Zheng et al., 1999). WR activity peaked at 6 months of age (12,280 m/d) and gradually decreased over time. At 24 months of age, the average WR distance was 3987 m/d. Twenty-four-month-old runners had less cochlear hair cell and spiral ganglion neuron loss and better auditory brainstem response thresholds at the low and middle frequencies compared with age-matched, non-WR controls. Gene ontology (GO) enrichment analysis of inner ear tissues from 6-month-old controls and runners revealed that WR resulted in a marked enrichment for GO gene sets associated with immune response, inflammatory response, vascular function, and apoptosis. In agreement with these results, there was reduced stria vascularis (SV) atrophy and reduced loss of capillaries in the SV of old runners versus old controls. Given that SV holds numerous capillaries that are essential for transporting oxygen and nutrients into the cochlea, our findings suggest that long-term exercise delays the progression of AHL by reducing age-related loss of strial capillaries associated with inflammation.Nearly two-thirds of adults aged 70 years or older develop significant age-related hearing loss (AHL), a condition that can lead to social isolation and major communication difficulties. AHL is also associated with decreased physical function among older adults. In the current study, we show that regular exercise slowed AHL and cochlear degeneration significantly in a well established murine model. Our data suggest that regular exercise delays the progression of AHL by reducing age-related loss of strial capillaries associated with inflammation.	
27806924	Patients increasingly use online health communities to exchange health information and peer support. During the progression of health discussions, a change of topic-topic drift-can occur. Topic drift is a frequent phenomenon linked to incoherence and frustration in online communities and other forms of computer-mediated communication. For sensitive topics, such as health, such drift could have life-altering repercussions, yet topic drift has not been studied in these contexts.Our goals were to understand topic drift in online health communities and then to develop and evaluate an automated approach to detect both topic drift and efforts of community members to counteract such drift.	We manually analyzed 721 posts from 184 threads from 7 online health communities within WebMD to understand topic drift, members' reaction towards topic drift, and their efforts to counteract topic drift. Then, we developed an automated approach to detect topic drift and counteraction efforts. We detected topic drift by calculating cosine similarity between 229,156 posts from 37,805 threads and measuring change of cosine similarity scores from the threads' first posts to their sequential posts. Using a similar approach, we detected counteractions to topic drift in threads by focusing on the irregular increase of similarity scores compared to the previous post in threads. Finally, we evaluated the performance of our automated approaches to detect topic drift and counteracting efforts by using a manually developed gold standard.	Our qualitative analyses revealed that in threads of online health communities, topics change gradually, but usually stay within the global frame of topics for the specific community. Members showed frustration when topic drift occurred in the middle of threads but reacted positively to off-topic stories shared as separate threads. Although all types of members helped to counteract topic drift, original posters provided the most effort to keep threads on topic. Cosine similarity scores show promise for automatically detecting topical changes in online health discussions. In our manual evaluation, we achieved an F1 score of .71 and .73 for detecting topic drift and counteracting efforts to stay on topic, respectively.	Our analyses expand our understanding of topic drift in a health context and highlight practical implications, such as promoting off-topic discussions as a function of building rapport in online health communities. Furthermore, the quantitative findings suggest that an automated tool could help detect topic drift, support counteraction efforts to bring the conversation back on topic, and improve communication in these important communities. Findings from this study have the potential to reduce topic drift and improve online health community members' experience of computer-mediated communication. Improved communication could enhance the personal health management of members who seek essential information and support during times of difficulty.	
27793986	Humans can communicate even with few existing conventions in common (e.g., when they lack a shared language). We explored what makes this phenomenon possible with a nonlinguistic experimental task requiring participants to coordinate toward a common goal. We observed participants creating new communicative conventions using the most minimal possible signals. These conventions, furthermore, changed on a trial-by-trial basis in response to shared environmental and task constraints. Strikingly, as a result, signals of the same form successfully conveyed contradictory messages from trial to trial. Such behavior is evidence for the involvement of what we term joint inference, in which social interactants spontaneously infer the most sensible communicative convention in light of the common ground between them. Joint inference may help to elucidate how communicative conventions emerge instantaneously and how they are modified and reshaped into the elaborate systems of conventions involved in human communication, including natural languages.
27623627	Haematological cancer often necessitates that individuals make significant lifestyle and behaviour changes to protect themselves against infections. It is essential that haematological cancer survivors receive the support and information they require to adjust to such changes. This cross-sectional survey of 259 haematological cancer survivors found that over two thirds of haematological cancer survivors would like to receive more detailed information or help with: diet and nutrition that takes into account their diagnosis and treatment, how to manage the symptoms from the cancer and/or treatment, signs and symptoms to be aware of that may indicate a possible infection and appropriate exercise. Over a third of survivors reported that they had to make changes to reduce their chance of infection, with social restriction the most commonly reported area of change survivors made. Improving communication and access to care and providing additional emotional support may assist survivors in making these additional changes. Healthcare providers should use this information to better support haematological cancer survivors in dealing with the effects haematological cancer has on their life.
27538958	Autism spectrum disorder (ASD) is a developmental disorder characterized by impairments in social and communication abilities, as well as by restricted and repetitive behaviors. The BTBR T + Itpr3 tf (BTBR) mice have emerged as a well characterized and widely used mouse model of a range of ASD-like phenotype, showing deficiencies in social behaviors and unusual ultrasonic vocalizations as well as increased repetitive self-grooming. However, the inherited neurobiological changes that lead to ASD-like behaviors in these mice are incompletely known and still under active investigation. The aim of this study was to further evaluate the structure and neurotransmitter release of the glutamatergic synapse in BTBR mice. C57BL/6J (B6) mice were used as a control strain because of their high level of sociability. The important results showed that the evoked glutamate release in the cerebral cortex of BTBR mice was significantly lower than in B6 mice. And the level of vesicle docking-related protein Syntaxin-1A was reduced in BTBR mice. However, no significant changes were observed in the number of glutamatergic synapse, level of synaptic proteins, density of dendritic spine and postsynaptic density between BTBR mice and B6 mice. Overall, our results suggest that abnormal vesicular glutamate activity may underlie the ASD relevant pathology in the BTBR mice.