bluuebunny/crossref_metadata_2025 huggingface dataset:
Political Social Work in the United States
Authors: Powers Jenna , Fisher Robert
Published: September 2019

Political social work (hereafter PSW) is a specific term used to describe early-21st-century social work scholars and practitioners influencing policymaking by exercising power within electoral politics. Aimed at achieving social justice, social work is fundamentally political. The word political, however, has a complexity of meanings that enable both specificity and breadth. Political can be used as it relates specifically to policy practice, which is understood as a macro social work method of practice involved in policymaking processes. Political can also refer to politicized social work more broadly, which utilizes critical theories of power within all methods and fields of practice. While social workers have practiced political methods throughout the profession’s history, the term political social work first emerged in the United States during the 1980s with two distinct definitions—one related closely to policy practice and the other more akin to politicized social work. The contemporary conceptualization of PSW, introduced within the past decade, combines both. This current definition draws from politicized social work’s emphasis on political power and inclusion of all practice levels in order to expand policy practice. Thus, political social workers, whether generalist or specialist, engage with power dynamics across the various aspects of the policymaking process, with an emphasis on electoral politics. PSW involves social workers influencing social policy by exercising their power through policy practice (e.g., lobbying and policy advocacy) and within electoral politics (e.g., voting and voter engagement, working on political campaigns and within legislative offices, and holding elected office). Given the vast amount of social work resources on policy practice (also referred to as policy advocacy) and the relatively limited social work literature regarding electoral politics, this article focuses on PSW’s electoral-related channels that expand policy practice. PSW endorses nonpartisan political practices that are argued to be particularly applicable of social workers’ ethics and expertise related to empowering marginalized individuals and communities. PSW education and scholarship seek to infuse greater focus on social workers’ electoral-related political participation, voter engagement, and seeking elected office. PSW aims to increase the profession’s election-related participation by encouraging practitioners and students to include and improve their knowledge, experience, and perceptions of policy practice and electoral politics as part of their professional social work identities and roles.
Giacomo da Lentini
Authors: Kumar Akash
Published: September 2019

Giacomo da Lentini was the central figure in the formation of the Sicilian school of poetry in the early 13th century at the court of Frederick II. He is plausibly considered to be the inventor of the sonnet and his poetic corpus of sixteen canzoni, twenty-two sonnets, and a discordo amounts to by far the most numerous of any poet associated with Frederick’s court. We might thus say that he is the first major lyric poet of the Italian vernacular tradition. Giacomo demonstrates the influence of the earlier Occitan poetry of courtly love in his borrowings of themes, technical vocabulary, and metrical forms; he also innovates considerably in experimenting with the new sonnet form and crafts a refined poetry that actively distills the intellectual culture of Frederick’s court by way of similes that open up his love poems to science, philosophy, and politics. Giacomo’s influence on the subsequent developments of Italian poetry can be widely felt and perhaps most easily perceived in Dante Alighieri’s mention of him as an illustrious poet in his treatise on vernacular eloquence, De vulgari eloquentia, as well as his occupying the prime position of founding father in the poetic genealogy of Purgatorio 24.
Richard III
Authors: Fletcher Stella
Published: September 2019

The youngest son of Richard, duke of York (b. 1411–b. 1460) and his duchess, Cecily Neville (b. 1415–1495), was born on 2 October 1452, and named after his father: see Reference Works. York’s dynastic claim to the throne of England can be traced in Overviews and was made good by another son, who became King Edward IV in 1461, with Richard being made duke of Gloucester later that year. The duke married his maternal kinswoman Anne Neville (b. 1456–d. 1485), who gave birth to his only legitimate child, Edward of Middleham, at an unknown date. He distinguished himself as a soldier, principally in the Scottish campaign of 1482. Edward IV’s death on 9 April 1483 left the twelve-year-old Edward V as king and power in the hands of his maternal Woodville kinsmen. With the support of his brother-in-law Henry Stafford, duke of Buckingham, Gloucester engineered a coup, destroying the Woodville interest. In late June popular support was gained for the argument that neither Edward V nor his brother Richard, duke of York, were of legitimate birth, and that Gloucester, the only adult male of the ruling house, should assume the throne. He was crowned on 6 July. The fate of the two boys remained unknown while opposition to Richard III’s usurpation mounted, though the duke of Buckingham’s rebellion was quashed. The Contemporary Sources are frustratingly patchy, with rumor and speculation filling the gaps. Richard’s opponents regrouped around the little-known exile Henry Tudor (see the Oxford Bibliographies in Renaissance and Reformation article “Henry VII”), whose invasion in 1485 resulted in Richard’s defeat and death at Bosworth Field on 22 August. The king’s Disputed Reputation saw him cast as a consummate villain in the 15th and 16th Centuries, with a dramatic reassessment following in the 17th–20th Centuries. There are numerous Modern Biographies of Richard and his family, but relatively few that need be employed for academic purposes. As with Overviews, the Journals section of this article features the work of the Richard III Society, while Collections of Papers are the preserve of academic historians. Domestic politics appears here as The King and His Subjects, Religion and Culture is self-explanatory, and Popes and Princes deals with international relations. The popularity and versatility of Shakespeare’s play means that a further section is devoted to Richard III in Popular Culture, and the posthumous history would have ended there had the king’s bones not been discovered in 2012 and reburied “with dignity and honour” three years later, so that archaeological discoveries are brought together from both Bosworth and Leicester.
Positive and Negative Partisanship
Authors: Bankert Alexa
Published: September 2019

Partisanship is omnipresent in American politics. Even in European multiparty systems and emerging democracies in Africa, attachments to political parties form easily, enduringly, and almost instantly. Given its potent role in impacting citizens’ political attitudes and behavior, it is no surprise that political scientists have dedicated a tremendous amount of effort and time to examining the origins, conceptualization, and measurement of partisanship. Yet important questions remain: Is partisanship purely psychological, or is it grounded in strong political attitudes and ideologies? Is partisanship influenced by political preferences, or does partisanship influence political preferences? And how does partisanship influence attitudes toward the out-party? This bibliography will introduce readings that address these questions. At the same time, this entry will go beyond the canonical work on positive partisan attachments and introduce the work on negative partisanship—the notion that citizens increasingly feel lukewarm about their own party and primarily define themselves by which political party they do not belong to. The reader can utilize this overview to identify new research avenues.
Early Childhood Science
Authors: Howitt Christine
Published: September 2019

In this review, early childhood is defined as children from birth to eight years of age. This age range covers before school years, including child care, and the beginning years of formal schooling. These early years of life are considered crucial in shaping a child’s ability to learn and to think creatively. From birth onward, children actively explore their world as they attempt to make sense of what is around them. Due to its capacity to engage and stimulate children, science education in the early years has been recognized for its potential to improve many aspects of their cognitive and social development, including promoting the development of scientific thinking and science skills and encouraging positive attitudes toward science. Recognition of the importance of providing science-related experiences for young children, the acknowledgement of young children’s science competence, the provision of greater voice for young children, and more appropriate methodologies for working with young children that embrace their multiple ways of knowing have seen an increase in research in early childhood science learning since the early 2000s. This bibliography relates to early childhood science in the 21st century and focuses on the teacher, young children, and the environment in relation to the teaching and learning of science. In an attempt to present the wide range of research that has been published in this area, the bibliography covers different contexts, paradigms, and methodologies.
Feminist and Queer Game Studies
Authors: Shaw Adrienne , Agloro Alexandrina , Nguyen Josef , Phillips Amanda , Ruberg Bonnie
Published: September 2019

To date, there are no general overviews of feminist and queer game studies, though there are several core texts, edited collections, and special journal issues. Much of feminist game studies might more rightly be called women’s game studies, as the feminist goals of the work were largely focused on ethnographic and qualitative scholarship on women and girls who play and make games. Research on masculinity in games comprises a much smaller subcategory of research. A related but separate thread of this work includes feminist analyses of game texts, as well as feminist critical game making praxis. Importantly, feminist game studies has existed for as long as game studies has been around (being formally named as such around the year 2000), questioning essentialist and hegemonic approaches to gender differences in game play and production. However, it took several years for feminist game scholarship on the whole to adopt an intersectional approach that could account for how gender presentation, sex, sexuality, race, age, embodiment, and so on shape game play experiences, the game industry, and textual representation. As feminist game scholarship became more intersectional, moreover, queer game studies (which has many overlaps with feminist game studies) coalesced in the early 2010s, owning in part to a slow but increasing acceptance of game analysis in departments more traditionally associated with queer theory (such as comparative literature and film studies departments). Moreover, an increase in mainstream representations and discussions of sexuality, a critical mass of game studies work on gender and sexuality, the rise of a queer indie game movement (due in part to new distribution channels and free design software), and academic conferences such as Different Games and the Queerness and Games Conference, all helped lead to a proliferation of queer game studies work. Similar to the trajectory of earlier feminist game studies, early work in this area focused on analyses of lesbian, gay, bisexual, transgender, and queer (LGBTQ) game content, players, and the game industry. The emergence of queer game studies communities, however, also corresponded with queer game design communities taking a queer approach to games beyond literal forms of representation. Moreover, queer game scholarship has come to represent a new paradigm through which queerness as a lens is used to question norms of design, play, and representation.
Bioethics
Authors: Buchbinder Mara
Published: September 2019

The discipline of bioethics emerged in the United States in the 1960s as a response to several prominent controversies in medical research and practice, including the aftermath of the Tuskegee syphilis experiments and the development of kidney dialysis and associated concerns about resource allocation. Anthropology and bioethics have had a contentious relationship since the field’s inception. Anthropologists have viewed bioethics as ethnocentric, universalizing, and inattentive to the social, cultural, and political contexts of bioethical dilemmas. Anthropologists have challenged foundational bioethical concepts such as autonomy, showing that decision making, in many cases, unfolds in a relational context that is poorly matched to individualized models of informed consent, which lodge decisional authority within a single autonomous patient or research subject. At the same time, anthropology has much to offer the discipline of bioethics. Empirical data can help to address or resolve normative questions, bring unrecognized factors to light, and open up new avenues for further exploration. Anthropology’s characteristic use of cases grounds bioethical debates in contextual details that may change the stakes of discussion. And anthropology can enrich bioethics scholarship with its use of ethnography and social theory to illuminate power structures and relations of inequality, its characteristic dual focus on the micro and the macro, and its capacity for reflexivity. In exchange, bioethics may beckon anthropologists to go outside their comfort zone and develop prescriptive solutions to ethical challenges. On the other hand, debate is ongoing about whether anthropologists should revitalize bioethics and infuse it with more attention to cultural and historical contexts, or, instead, leave bioethics behind entirely and develop their own ethical projects. Moving forward, it may be useful to distinguish between anthropology in bioethics and anthropology of bioethics. The former category of research and scholarship encompasses anthropological studies of bioethically relevant topics, such as end-of-life decision making, organ transplantation, genetic screening, stem cell research, and the globalization of clinical trials. Anthropology of bioethics performs a critical analysis of bioethics as a sphere of knowledge production and professional expertise. This approach acknowledges that bioethics, as an ideology and a practice, may best serve certain kinds of social actors and obscure its limits for other actors and conditions. While these two approaches are by no means mutually exclusive, they can help to structure an understanding of anthropology’s potential contributions to the field.
Young Children’s Imagination
Authors: Stewart Kym , Cant Annabella
Published: September 2019

The following bibliography offers readers a glimpse into the breadth of research on young children and imagination and its impact on culture, research, and education practice. The writings are organized into seven sections: the Intertwining of Imagination and Creativity: A Symbiotic Relationship, Children and Imagination, Teacher Education: Strategies, Lessons, and Practice, Kieran Egan and the Theory of Imaginative Education, Imaginative Education Publications, Journals, and Handbooks. In many disciplines, the ideas of imagination and creativity have been conflated. This bibliography offers some key readings to help distinguish these two terms, while also confirming their interconnectedness. This complexity of definitions and usage of terms is more fully explored in the next section, which presents a variety of research projects looking closely at the role of imagination in early learning, play, and creative endeavors. The importance of imagination for young children’s development is further explored in the teacher-training section, where scholars, researchers, and educators share practical and theoretical suggestion for in-service teachers and current practicing teachers. This focus on education is deepened in the following two sections, focusing on a particular educational philosopher, Kieran Egan, and his educational theory, Imaginative Education—one of the most well-known educational theories. Following the major works about the theory of Imaginative Education written by its designer and creator, Kieran Egan, the bibliography collates articles that directly engage with the theory, in practical and theoretical settings, from early childhood to postsecondary education. Finally, the last two sections offer the reader a list of journals and handbooks about children’s thinking, education, and imagination.
Organizational Control
Authors: Cardinal Laura B. , Kreutzer Markus , Miller C. Chet
Published: September 2019

Organizational control is a key managerial function, and the focus of a great deal of research in the management and organizations field. Research on organizations goes as far back as the 1950s, 1960s, and 1970s, and discussions and advice date back even farther to the ancient Chinese. Organizational control is defined as any process by which managers direct attention, motivate, and encourage organizational members to act in desired ways to meet the firm’s objectives. Control, thus, is central to organizational and strategic management theories. It can be distinguished from other managerial functions by being goal-oriented and being multifaceted, that is, not being represented by a single managerial practice. It comprises a wide myriad of practices that correspond with concepts such as market, clan, and bureaucratic control; formal and informal control; input, behavior, and output control; and belief, boundary, diagnostic, and interactive control.
Competitive Heterogeneity
Authors: Madsen Tammy L.
Published: September 2019

It is widely accepted that positioning for competitive advantage is related to how value is created and captured. Yet, despite substantial theoretical work on competitive advantage, empirical work has been less cohesive and accretive. Contributing factors include, but are not limited to, differences in conceptual definitions, misalignment between theory and operational designs, and variation in analytical approaches. In response, the theory of competitive heterogeneity emerged with the intent of providing a more comprehensive explanation of persistent differences in intra-industry performance, the core focus of the strategy field. Formally, competitive heterogeneity refers to enduring and systematic (superior) differences in strategic positioning—and, in turn, performance—among relatively close rivals, where a firm that produces the largest gap between the value (V) of a good or service to a buyer and the cost (C) of producing that value holds an advantage, or superior position, relative to that of rivals. The theory adopts a bargaining model (Value-Price-Cost) to define superior performance differences independently of resources and capabilities. If resources or capabilities associated with performance heterogeneity are not protectable, then the persistence of an advantage must be associated with something other than costly imitation. It follows, then, that important sources of value and cost differences among firms may lie outside the Resource-Based View’s (RBV’s) boundaries. As such, work on competitive heterogeneity has broader theoretical roots than the RBV. Additionally, research on the factors and conditions promoting persistent and systematic (superior) differences in performance among firms benefits from the integration of multiple theoretical lenses, research methods, and techniques. This diversity informs a wide array of research topics (e.g., the Value-Price-Cost model; value-based strategies; value creation and value capture dynamics; value appropriation; performance heterogeneity; persistent performance heterogeneity; temporary advantage; isolating mechanisms and barriers to imitation; micro and macro influences) and employs a host of analytical techniques (empirical, descriptive, formal theory, mathematical modeling). This bibliography discusses the contributions from these complementary areas but the bibliography’s scope (and page limits) precludes a detailed treatment of all areas that intersect with competitive heterogeneity and its origins. As a result, and guided by the definition of competitive heterogeneity, this annotated bibliography provides an overview of the primary research streams, with specific attention to influential writings and those that detail the scope of contributions in an area. The research topics are presented in a particular order, beginning with the theory’s core, the Value-Price-Cost bargaining model, conceptual definitions, and theoretical insights, and then shifting to empirical studies on performance heterogeneity, persistent advantage, and value creation and capture.
Health behaviors of American pregnant women: a cross-sectional analysis of NHANES 2007–2014
Authors: Francis Ellen C , Zhang Lu , Witrick Brian , Chen Liwei
Published: September 2019

Background

This study examined engagement in five health behaviors among pregnant women in the USA.

Methods

Pregnant women who participated in the National Health and Nutrition Examination Survey 2007–2014 were included in this study. Five health behaviors were examined: adequate fruit and vegetable consumption, prenatal multivitamin use, physical activity, sleep and smoking. Multivariable regressions were used to estimate the odds ratio and 95% confidence interval of characteristics associated with health behaviors.

Results

Among 248 pregnant women, only 10.2% engaged in all five health behaviors and 35.4% consumed adequate fruits and vegetables. For adequate fruit and vegetable consumption, Hispanic and women of ‘other’ race were more likely to meet the recommendation compared to non-Hispanic white (P = 0.01 and P = 0.03, respectively); high school graduates were less likely to meet the recommendation compared to those with at least some college education or more (P = 0.04).

Conclusions

Adequate fruit and vegetable consumption among pregnant women was poor and differed by race/ethnicity and education status. Because of the cross-sectional design, we cannot examine engagement in health behaviors continuously throughout pregnancy. Future research with longitudinal data over the course of pregnancy is needed to confirm these results.
Quantitative associations between objective sleep measures and early-morning mobility in Parkinson’s disease: cross-sectional analysis of the PHASE study
Authors: Kataoka Hiroshi , Saeki Keigo , Yamagami Yuki , Sugie Kazuma , Obayashi Kenji
Published: September 2019

Study Objectives

Previous studies have suggested associations between sleep measures and early-morning akinesia; however, objective evidence is limited. The purpose of this study was to evaluate the associations between objective sleep measures and morning mobility among patients with Parkinson’s disease (PD).

Methods

In this cross-sectional study, we measured objective sleep parameters and morning mobility in 157 patients with PD (mean age, 71.4 years) for six consecutive days using an actigraph placed on the nondominant wrist. Low morning mobility was defined as less than 100 counts/min within the first 2 hours after rising.

Results

The mean duration of low morning mobility was 55.7 minutes (SD, 23.8), and the mean sleep parameters were as follows: sleep efficiency (SE), 72.1% (13.6); wake after sleep onset (WASO), 104.7 minutes (57.9); total sleep time (TST), 343.6 minutes (104.0); and fragmentation index (FI), 3.5 (3.4). Multivariable linear regression analysis adjusted for potential confounders demonstrated significant associations between better objective sleep measures and shorter low morning mobility (SE per %: β, −0.419; 95% CI = −0.635 to −0.204; p < 0.001; WASO per min: β, 0.056; 95% CI = 0.003 to 0.109; p = 0.039; and FI per unit; β, 1.161; 95% CI = 0.300 to 2.023; p = 0.009) but not TST (p = 0.78). These findings were not altered by different cutoff values of mobility (50 counts/min) or duration (1 h after rising).

Conclusions

In patients with PD, better objective sleep measures are significantly associated with shorter low morning mobility. Future studies investigating whether improved sleep reduces symptoms of low morning mobility are required.
Sleep and wake are shared and transmitted between individuals with insomnia and their bed-sharing partners
Authors: Walters Elizabeth M , Phillips Andrew J K , Mellor Alix , Hamill Kellie , Jenkins Melissa M , Norton Peter J , Baucom Donald H , Drummond Sean P A
Published: September 2019

Patients with insomnia frequently report disturbing, or being disturbed by, their bedpartner. We aimed to (1) characterize how individuals with insomnia and their bedpartners influence each other’s sleep and (2) identify characteristics predicting vulnerability to wake transmission. Fifty-two couples (aged 19–82 years), where one individual was diagnosed with insomnia, participated. Sleep/wake patterns were monitored via actigraphy and sleep diaries for seven nights. Minute-by-minute sleep and wake concordance (simultaneous sleep/wake epochs), number of wake transmissions received (awakenings immediately preceded by wakefulness in the bedpartner), percent wake transmissions received (percentage of total awakenings that were transmitted), and percent of bedpartner’s wake minutes resistant to transmission (ability to sleep through bedpartner wakefulness) were calculated. Mixed-effects modeling assessed within-couple bedtime and chronotype differences as predictors of dyadic sleep. We described rates of sleep concordance (MPatient = 63.8%, MPartner = 65.6%), wake concordance (MPatient = 6.6%, MPartner = 6.6%), total transmissions received (MPatient = 5.5, MPartner = 6.9 per night), percent transmissions received (MPatient = 18.5%, MPartner = 23.4% of total awakenings), and percent minutes resistant (MPatient = 56.4%, MPartner = 58.6% of bedpartner’s wake time). Partners received wake transmissions at 1.25 times the rate of patients. Percent transmissions received was increased in couples with concordant bedtimes and individuals with later chronotype than their bedpartner. Patterns of chronotype and bedtime order predicting percent minutes resistant to transmission differed across the length of the rest interval. Transmission provides a novel characterization of how bedpartners influence sleep and provide insight into mechanisms of insomnia generation and maintenance. Understanding modifiable risk factors may provide ways to personalize insomnia treatments.

Clinical Trial Researching Effective Sleep Treatments (Project REST), ANZCTR Registration: ACTRN12616000586415
Wakefulness/sleep architecture and electroencephalographic activity in mice lacking the translational repressor 4E-BP1 or 4E-BP2
Authors: Areal Cassandra C , Cao Ruifeng , Sonenberg Nahum , Mongrain Valérie
Published: September 2019

Sleep and sleep loss are affecting protein synthesis in the brain, but the contribution of translational control to wakefulness and sleep regulation remains poorly understood. Here, we studied the role of two suppressors of protein synthesis, the eukaryotic translation initiation factor 4E-binding proteins 1 and 2 (4E-BP1 and 4E-BP2), in sleep architecture and electroencephalographic (EEG) activity as well as in the EEG and molecular responses to acute sleep loss. The EEG of mice mutant for the genes encoding 4E-BP1 or 4E-BP2 (Eif4ebp1 and Eif4ebp2 knockout [KO] mice) was recorded under undisturbed conditions and following a 6-hour sleep deprivation (SD). The effect of SD on the expression of genes known to respond to SD was also measured in the prefrontal cortex of Eif4ebp1 and Eif4ebp2 KO mice. Eif4ebp1 KO mice differed from wild-type mice in parameters of wakefulness and sleep quantity and quality, and more subtly in the gene expression response to SD. For instance, Eif4ebp1 KO mice spent more time in slow-wave sleep (SWS) and showed altered baseline 24-h time courses of SWS delta (1–4 Hz) activity and sigma (10–13 Hz) activity. Eif4ebp2 KO mice differed from wild-type mice only for wakefulness and sleep quality, expressing changes in EEG spectral activity generally revealed during and after SD. These findings suggest different roles of effectors of translational control in the regulation of wakefulness and sleep and of synchronized cortical activity.
Sleep deprivation undermines the link between identity and intergroup bias
Authors: Zhang Jinxiao , Yang Yang , Hong Ying-Yi
Published: September 2019

This research seeks to bridge two findings—on the one hand, top-down controlled processes inhibit display of intergroup bias; on the other one hand, sleep deprivation impairs cognitive control processes. Connecting these two proven statements, begs the question: would sleep deprivation also influence intergroup bias? This intriguing link has hardly been explored in extant literature. To fill this gap, we theorize through the lens of social identity. Previous research has shown that individuals who share a common identity with an outgroup are more motivated to inhibit biases toward the outgroup than do their counterparts who do not endorse such common identity. We predicted that this motivated inhibition would be compromised by sleep deprivation. Across two studies, as predicted, we found that only when an individual has adequate sleep did common ingroup identity attenuate the display of intergroup bias, whereas individuals with short habitual sleep (study 1) or after one-night sleep deprivation (study 2) displayed equally high levels of intergroup bias regardless of their high or low levels of common ingroup identity. In the global context of incessant intergroup bias and diminishing sleep time, our findings offer new insights for understanding and handling intergroup bias.
Plasma exosomes in OSA patients promote endothelial senescence: effect of long-term adherent continuous positive airway pressure
Authors: Khalyfa Abdelnaby , Marin Jose M , Qiao Zhuanhong , Rubio David Sanz , Kheirandish-Gozal Leila , Gozal David
Published: September 2019

Obstructive sleep apnea (OSA) is associated with increased risk for end-organ morbidities, which can collectively be viewed as accelerated aging. Vascular senescence is an important contributor to end-organ dysfunction. Exosomes are released ubiquitously into the circulation, and transfer their cargo to target cells facilitating physiological and pathological processes. Plasma exosomes from 15 patients with polysomnographically diagnosed OSA at baseline (OSA-T1) after 12 months of adherent continuous positive airway pressure (CPAP) treatment (OSA-T2), 13 untreated OSA patients at 12-month intervals (OSA-NT1, OSA-NT2), and 12 controls (CO1 and CO2) were applied on naïve human microvascular endothelialcells-dermal (HMVEC-d). Expression of several senescence gene markers including p16 (CDKN2A), SIRT1, and SIRT6 and immunostaining for β-galactosidase activity (x-gal) were performed. Endothelial cells were also exposed to intermittent hypoxia (IH) or normoxia (RA) or treated with hydrogen peroxide (H2O2), stained with x-gal and subjected to qRT-PCR. Exosomes from OSA-T1, OSA-NT1, and OSA-NT2 induced significant increases in x-gal staining compared to OSA-T2, CO1, and CO2 (p-value < 0.01). p16 expression was significantly increased (p < 0.01), while SIRT1 and SIRT6 expression levels were decreased (p < 0.02 and p < 0.009). Endothelial cells exposed to IH or to H2O2 showed significant increases in x-gal staining (p < 0.001) and in senescence gene expression. Circulating exosomes in untreated OSA induce marked and significant increases in senescence of naïve endothelial cells, which are only partially reversible upon long-term adherent CPAP treatment. Furthermore, endothelial cells exposed to IH or H2O2 also elicit similar responses. Thus, OSA either directly or indirectly via exosomes may initiate and exacerbate cellular aging, possibly via oxidative stress-related pathways.
Clozapine-associated secondary antibody deficiency
Authors: Ponsford Mark J. , Pecoraro Antonio , Jolles Stephen
Published: September 2019

Purpose of review

Clozapine has recently been described as a novel cause of secondary antibody deficiency (SAD), associated with long-term therapy. Here we critically review the evidence linking clozapine use to an increased infection risk, describe immunological alterations, and discuss potential mechanisms.

Recent findings

Individuals with schizophrenia are at two to five times more likely to develop pneumonia than the general population, in particular, when receiving clozapine. Delayed-onset distinguishes clozapine-associated hypogammaglobulinaemia from agranulocytosis or neutropenia that occur at lesser frequency. Biomarker searches in treatment-resistant schizophrenia highlight an immune signature associated with long-term clozapine use. This includes reduction in class-switched memory B cells, echoing common variable immunodeficiency. Recent identification of a role for dopamine in T follicular helper–B cell interactions may inform future clinical studies.

The detrimental impact of the increased infection risk associated with clozapine necessitates a re-evaluation of the current monitoring strategies as well as further studies to better understand the underlying mechanisms of SAD in this setting. On the basis of available evidence, we suggest simple modifications to clozapine monitoring including integration of routine vaccination, smoking cessation, and assessment of humoral immunity. Further studies are required to understand the role of clozapine in neuroinflammation as well as other potentially autoantibody-mediated diseases.
Mission Drift: Are Medical School Admissions Committees Missing the Mark on Diversity?
Authors: Poole Kenneth G. , Jordan Barbara L. , Bostwick J. Michael
Published: September 2019

Diversity initiatives in U.S. medical education, following the passage of the Civil Rights Act of 1964, were geared toward increasing the representation of African Americans—blacks born in the United States whose ancestors suffered under slavery and Jim Crow laws. Over time, blacks and, subsequently, underrepresented minorities in medicine (URMs), became a proxy for African Americans, Puerto Ricans, Mexican Americans, and Native Americans, thus obscuring efforts to identify and recruit specifically African Americans. Moreover, demographic shifts resulting from the recent immigration of black people from Africa and the Caribbean have both expanded the definition of “African American medical students” and shifted the emphasis from those with a history of suffering under U.S. oppression and poverty to anyone who meets a black phenotype.

Increasingly, research indicates that African American patients fare better when their physicians share similar historical and social experiences. While all people of color risk discrimination based on their skin color, not all have the lived experience of U.S.-based, systematic, multigenerational discrimination shared by African Americans. In the high-stakes effort to increase URM representation in medical school classes, admissions committees may fail to look beyond the surface of phenotype, thus missing the original intent of diversity initiatives while simultaneously conflating all people of color, disregarding their divergent historical and social experiences. In this Perspective, the authors contend that medical school admissions committees must show greater discernment in their holistic reviews of black applicants if historical wrongs and continued underrepresentation of African Americans in medicine are to be redressed.
Racial and Ethnic Disparities in Postcardiac Arrest Targeted Temperature Management Outcomes*
Authors: Jacobs Claire S. , Beers Louis , Park Suna , Scirica Benjamin , Henderson Galen V. , Hsu Liangge , Bevers Matthew , Dworetzky Barbara A. , Lee Jong Woo
Published: September 2019

Objectives:

To evaluate racial and ethnic disparities in postcardiac arrest outcomes in patients undergoing targeted temperature management.

Design:

Retrospective study.

Setting:

ICUs in a single tertiary care hospital.

Patients:

Three-hundred sixty-seven patients undergoing postcardiac arrest targeted temperature management, including continuous electroencephalogram monitoring.

Interventions:

None.

Measurements and Main Results:

Clinical variables examined in our clinical cohort included race/ethnicity, age, time to return of spontaneous circulation, cardiac rhythm at time of arrest, insurance status, Charlson Comorbidity Index, and time to withdrawal of life-sustaining therapy. CT at admission and continuous electroencephalogram monitoring during the first 24 hours were used as markers of early injury. Outcome was assessed as good (Cerebral Performance Category 1–2) versus poor (Cerebral Performance Category 3–5) at hospital discharge. White non-Hispanic (“White”) patients were more likely to have good outcomes than white Hispanic/nonwhite (“Non-white”) patients (34.4 vs 21.7%; p = 0.015). In a multivariate model that included age, time to return of spontaneous circulation, initial rhythm, combined electroencephalogram/CT findings, Charlson Comorbidity Index, and insurance status, race/ethnicity was still independently associated with poor outcome (odds ratio, 3.32; p = 0.003). Comorbidities were lower in white patients but did not fully explain outcomes differences. Nonwhite patients were more likely to exhibit signs of early severe anoxic changes on CT or electroencephalogram, higher creatinine levels and receive dialysis, but had longer duration to withdrawal of lifesustaining therapy. There was no significant difference in catheterizations or MRI scans. Subgroup analysis performed with patients without early electroencephalogram or CT changes still revealed better outcome in white patients.

Conclusions:

Racial/ethnic disparity in outcome persists despite a strictly protocoled targeted temperature management. Nonwhite patients are more likely to arrive with more severe anoxic brain injury, but this does not account for all the disparity.
Hyperosmolar Therapy in Pediatric Severe Traumatic Brain Injury—A Systematic Review
Authors: Stopa Brittany M. , Dolmans Rianne G. F. , Broekman Marike L. D. , Gormley William B. , Mannix Rebekah , Izzy Saef
Published: September 2019

Objectives:

Traumatic brain injury is a leading cause of hospital visits for children. Hyperosmolar therapy is often used to treat severe traumatic brain injury. Hypertonic saline is used predominantly, yet there remains disagreement about whether hypertonic saline or mannitol is more effective.

Data Sources:

Literature search was conducted using Pubmed, Cochrane, and Embase. Systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Study Selection:

Retrospective and prospective studies assessing use of hyperosmolar therapy in pediatric patients with severe traumatic brain injury were included.

Data Extraction:

Two independent authors performed article review. Two-thousand two-hundred thirty unique articles were initially evaluated, 11 were included in the final analysis, with a total of 358 patients. Study quality was assessed using Modified Newcastle-Ottawa Scale and Jadad score.

Data Synthesis:

Of the 11 studies, all evaluated hypertonic saline and four evaluated both hypertonic saline and mannitol. Nine reported that hypertonic saline lowered intracranial pressure and two reported that mannitol lowered intracranial pressure. The studies varied significantly in dose, concentration, and administrations schedule for both hypertonic saline and mannitol. Five studies were prospective, but only one directly compared mannitol to hypertonic saline. The prospective comparison study found no difference in physiologic outcomes. Clinical outcomes were reported using different measures across studies. For hypertonic saline-treated patients, mechanical ventilation was required for 6.9–9 days, decompressive craniectomy was required for 6.25–29.3% of patients, ICU length of stay was 8.0–10.6 days, in-hospital mortality was 10–48%, and 6-month mortality was 7–17%. In mannitol-treated patients, ICU length of stay was 9.5 days, in-hospital mortality was 56%, and 6-month mortality was 19%.

Conclusions:

Both hypertonic saline and mannitol appear to lower intracranial pressure and improve clinical outcomes in pediatric severe traumatic brain injury, but the evidence is extremely fractured both in the method of treatment and in the evaluation of outcomes. Given the paucity of high-quality data, it is difficult to definitively conclude which agent is better or what treatment protocol to follow.
Contrast Sensitivity and Glaucoma
Authors: Ichhpujani Parul , Thakur Sahil , Spaeth George L.
Published: September 2019

Spatial contrast sensitivity decline occurs in different types and stages of glaucoma. In this short review we discuss methods of assessing contrast sensitivity, the role of contrast sensitivity in the pathogenesis of glaucoma and its practical application in clinical practice.
Development and Validity of a Workplace Health Promotion Best Practices Assessment
Authors: Imboden Mary T. , Castle Patricia H. , Johnson Sara S. , Jenkins Kristi Rahrig , Pitts Jennifer S. , Grossmeier Jessica , Mangen David J. , Mason Shawn , Noeldner Steven P.
Published: September 2019

Objective:

To explore the factor structure of the HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer (HERO Scorecard) to develop a reduced version and examine the reliability and validity of that version.

Methods:

A reduced version of the HERO Scorecard was developed through formal statistical analyses on data collected from 845 organizations that completed the original HERO Scorecard.

Results:

The final factors in the reduced Scorecard represented content pertaining to organizational and leadership support, program comprehensiveness, program integration, and incentives. All four implemented practices were found to have a strong, statistically significant effect on perceived effectiveness. Organizational and leadership support had the strongest effect (β = 0.56), followed by incentives (β = 0.23).

Conclusion:

The condensed version of the HERO Scorecard has the potential to be a promising tool for future research on the extent to which employers are adopting best practices in their health and well-being (HWB) initiatives.
Impact of nurse practitioner navigation on access to care for patients with refractory gastroesophageal reflux disease
Authors: Nandwani Monica , Clarke John O. , Kuriakose Clair , Stevenson Eleanor
Published: September 2019

Background:

Gastroesophageal reflux disease (GERD) is a common digestive complaint that can negatively affect patients' quality of life and have serious complications if inadequately treated.

Local problem:

Facilitating prompt and efficient access to digestive care is imperative especially given the current burden of gastrointestinal diseases such as GERD.

Methods:

A clinical team conducted a quality improvement study in which a nurse practitioner (NP) navigator performed a preconsultation chart review for patients with refractory GERD referred to an Esophagus Center between August and December 2018.

Interventions:

Based on preconsultation chart review, the NP navigator arranged for diagnostic testing and follow-up. Days from consultation to testing completion and establishment of plan were tracked and compared with historic controls. The NP navigator documented time spent for chart review and care coordination.

Results:

The median number of days from consultation to testing completion for patients who underwent NP navigation and required diagnostic testing (n = 26) was 33.5 as compared with 64.5 for historic controls who required testing but received usual care (n = 28) (p = .005). The median number of days from consultation to establishment of a management plan was 52 for patients who underwent NP navigation as compared with 97 for historic controls who did not (p = .005). The mean amount of time spent by the NP navigator for chart review and care coordination was 17.5 min (n = 30).

Conclusions:

Incorporation of NP navigators into gastroenterology practices offers a potential solution for timelier patient care delivery.
A checklist for faculty and preceptor to enhance the nurse practitioner student clinical experience
Authors: Pitts Courtney , Padden Diane , Knestrick Joyce , Bigley Mary B.
Published: September 2019

The National Organization of Nurse Practitioner Faculties and the American Association of Nurse Practitioners collaborated to develop a document outlining expectations when establishing clinical experiences for nurse practitioner (NP) students. A literature review explored the beliefs of clinical preceptors and NP faculty in relation to the process of the establishment and completion of successful clinical experiences. From the literature, the development of two guidance checklists addressed the expectations and responsibilities of the NP faculty and clinical preceptor during the clinical placement process. In light of challenges to secure clinical sites for NP students, it is imperative that the clinical placement process is standardized and the communicative pathway between the NP faculty and clinical preceptor improved.
Split dose versus full single-dose regimen of polyethylene glycol for bowel preparation in pediatric colonoscopy: a pilot study of randomized controlled trial
Authors: Sriphongphankul Hansa , Tanpowpong Pornthep , Lertudomphonwanit Chatmanee , Treepongkaruna Suporn
Published: September 2019

Objectives

Previous meta-analyses in adults comparing a full single dose vs. split doses of polyethylene glycol with electrolyte solution demonstrated that the split-dose group had a higher rate of successful bowel preparation. To date, no similar study in children has been conducted. Therefore, we compared the efficacy of bowel preparation between the two regimens of polyethylene glycol with electrolyte solution in pediatric colonoscopy. The secondary outcomes were tolerability, acceptability, and compliance.

Methods

An investigator-blinded randomized controlled trial was conducted to enroll children aged 2–18 years who underwent an elective colonoscopy at a teaching hospital between March 2018 and February 2019. Patients were randomly assigned to receive polyethylene glycol with electrolyte solution as a full single dose or two split doses. The Boston Bowel Preparation Scale was used for the efficacy (i.e. successful bowel preparation if score ≥ 6). Secondary outcomes were evaluated by using a standardized questionnaire.

Results

A total of 45 colonoscopies (22 in the full single-dose and 23 in the split-dose group) were performed. Mean age was 9.2 years old (SD 4.4). We noted a higher rate of successful bowel preparation in the split-dose group (95% vs. 72%, P = 0.047). Significant higher rate of willingness to repeat the same protocol (83% vs. 36%, P = 0.002) and a trend of lower rate of nausea/vomiting (39% vs. 68%, P = 0.051) in the split-dose group were found.

Conclusion

The split-dose regimen of polyethylene glycol with electrolyte solution for bowel preparation suggests superior efficacy, potential tolerability, and acceptability as compared to the traditional full single-dose regimen.