bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient and public perception and experience of community pharmacy services post-discharge in the UK: a rapid review and qualitative study
Authors: Khayyat Sarah , Walters Philippa , Whittlesea Cate , Nazar Hamde
Published: March 2021

Objectives

To investigate the perception and experience of patients and the public (PP) about community pharmacy (CP) services and other primary care services after hospital discharge back home.

Design and setting

A rapid review and qualitative study exploring PP perceptions of primary care, focusing on CP services in the UK.

Methods

A mixed-methods approach was adopted including a rapid review undertaken between 24 April and 8 May 2019 across four databases (MEDLINE, EMBASE, PsycINFO and CINAHL). Semistructured interviews were then conducted investigating for shifts in current PP perception, but also nuanced opinion pertaining to CP services. A convenience sampling technique was used through two online PP groups for recruitment. Thematic framework analysis was applied to interview transcripts.

Participants

Any consenting adults ≥18 years old were invited regardless of their medical condition, and whether they had used post-discharge services or not.

Results

Twenty-five studies met the inclusion criteria. Patients were generally supportive and satisfied with primary care services. However, some barriers to the use of these services included: resource limitations; poor communication between healthcare providers or between patient and healthcare providers; and patients’ lack of awareness of available services. From the 11 interviewees, there was a lack of awareness of CP post-discharge services. Nevertheless, there was general appreciation of the benefit of CP services to patients, professionals and wider healthcare system. Potential barriers to uptake and use included: accessibility, resource availability, lack of awareness, and privacy and confidentiality issues related to information-sharing. Several participants felt the uptake of such services should be improved.

Conclusion

There was alignment between the review and qualitative study about high patient acceptance, appreciation and satisfaction with primary care services post-discharge. Barriers to the use of CP post-discharge services identified from interviews resonated with the existing literature; this is despite developments in pharmacy practice in recent times towards clinical and public health services.
Can emergency department clinicians diagnose gamma-hydroxybutyrate (GHB) intoxication based on clinical observations alone?
Authors: Smits Thomas A , Gresnigt Femke MJ , Attema-de Jonge Milly E , Franssen Eric JF
Published: March 2021

Objectives

Gamma-hydroxybutyrate (GHB) is a drug of abuse with central depressing effects, which may cause coma with a GCS score as low as 3. A rapid diagnosis ‘GHB intoxication’ may prevent unnecessary diagnostic work-up and may lead to guided, less invasive, treatment. The aim of this study was to evaluate if ED physicians’ clinical evaluation were sufficient for diagnosis in patients with suspected GHB-intoxication.

Methods

Patients presenting at the ED with a GCS<15 and a potential intoxication with drugs of abuse for whom urine toxicology screen was performed were included consecutively. After a first assessment, the ED physician registered the most likely initial diagnosis in the hospital information system. Urine of these patients was tested with a validated gas chromatography analytical method for GHB (confirmation test). The initial diagnoses were compared for agreement with the results of the confirmation test.

Results

A total of 506 patients were included, 100 patients tested positive for GHB and 406 patients tested negative for GHB. Sensitivity and specificity of the ED physicians compared with the confirmation test to diagnose GHB intoxications were 63% (95% CI 52 to 73) and 93% (95% CI 90 to 95), respectively. The positive predictive value was 67% (95% CI 60 to 77) and the negative predictive value was 92% (95% CI 88 to 94).

Conclusion

Physicians underestimate the presence of GHB intoxication and can fail to diagnose GHB intoxication based on clinical observations alone. In the future, a rapid reliable initial analytical GHB test in addition to clinical judgement could be valuable to reduce false negative diagnosis.
Digital disparities: designing telemedicine systems with a health equity aim
Authors: Samuels-Kalow Margaret , Jaffe Todd , Zachrison Kori
Published: March 2021

The use of telemedicine has grown immensely during the COVID-19 pandemic. Telemedicine provides a means to deliver clinical care while limiting patient and provider exposure to the COVID-19. As such, telemedicine is finding applications in a variety of clinical environments including primary care and the acute care setting and the array of patient populations who use telemedicine continues to grow. Yet as telehealth becomes ubiquitous, it is critical to consider its potential to exacerbate disparities in care. Challenges accessing technology and digital literacy, for example, disproportionately impact older patients and those living in poverty. When implemented with the consideration of health disparities, telemedicine provides an opportunity to address these inequities. This manuscript explores potential mechanisms by which telemedicine may play a role in exacerbating or ameliorating disparities in care. We further describe a framework and suggested strategies with which to implement telemedicine systems to improve health equity.
Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: a cohort nationwide study
Authors: Cifuentes Myriam Patricia , Rodriguez-Villamizar Laura Andrea , Rojas-Botero Maylen Liseth , Alvarez-Moreno Carlos Arturo , Fernández-Niño Julián Alfredo
Published: March 2021

Background

After 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia.

Methods

We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata.

Results

There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68).

Conclusion

Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.
Consolidating the Circuit Model for Addiction
Authors: Lüscher Christian , Janak Patricia H.
Published: March 2021

Addiction is a disease characterized by compulsive drug seeking and consumption observed in 20–30% of users. An addicted individual will favor drug reward over natural rewards, despite major negative consequences. Mechanistic research on rodents modeling core components of the disease has identified altered synaptic transmission as the functional substrate of pathological behavior. While the initial version of a circuit model for addiction focused on early drug adaptive behaviors observed in all individuals, it fell short of accounting for the stochastic nature of the transition to compulsion. The model builds on the initial pharmacological effect common to all addictive drugs—an increase in dopamine levels in the mesolimbic system. Here, we consolidate this early model by integrating circuits underlying compulsion and negative reinforcement. We discuss the genetic and epigenetic correlates of individual vulnerability. Many recent data converge on a gain-of-function explanation for circuit remodeling, revealing blueprints for novel addiction therapies.
Effects of Thiourea and Allyl Thioura on the Electrodeposition and Microstructures of Copper from Methanesulfonic Acid Baths
Authors: Chiang Chi-Haw , Lin Chun-Cheng , Hu Chi-Chang
Published: March 2021

This work mainly focuses on the effects of two additives, thiourea (TU) and allyl thioura (ATU), on the electrodeposition behavior and microstructure development of copper deposits plated from the methane-sulfonic acid (MSA) bath. Three variables, including additive types, additive concentration, and current density, have been investigated in order to observe the variation in the crystallographic texture of Cu deposits. From the polarization behavior through the rotating ring disk electrode (RRDE) voltammograms and chronopotentiometric (CP) steady state electrode potential analyses, TU and ATU show the suppression ability of Cu deposition and the interaction strength between Cu2+ and ATU is weaker than that between Cu2+ and TU. The operating current density range of the preferential (111) Cu deposition becomes wider with the introduction of TU and ATU additives in the plating bath. The influences of TU and ATU on the nucleation and growth of Cu grains are significantly different, leading to the very different surface morphologies and surface roughness of resultant Cu films although both additives are of the similar molecular structures and show a suppression ability on Cu deposition.
Enhancing Ecologically Sustainable Management of Deadwood in Kenya’s Natural Forests
Authors: Chisika Sylvester Ngome , Yeom Chunho
Published: March 2021

The need for ecologically sustainable management of natural forests has assumed greater prominence in conservation and climate change discourses. However, the identification of deadwood, a critical component of natural forests, continues to receive little attention around the world. Through a review of the existing literature, this study sought to promote consciousness and awareness on the value of deadwood using the case of Kenya’s natural forests in the wider context of biodiversity conservation and climate change. Results substantiate that deadwood in natural forests performs a vital function in forest biological and ecological functions. However, forest degradation through the removal of deadwood, even though widely neglected, results in considerable biodiversity loss and might alter natural forest ecosystems, thereby exacerbating the impacts of climate change. In Kenya, despite the recent sophistication of forest management tools, including the development of the Draft Forest Policy, 2020, and enactment of the Forest Conservation and Management Act, 2016, to increasingly recognize the more progressive forest management paradigms such as participatory forest management in natural forest management, the current deadwood management practice is faulty and could yield outcomes contrary to the policy intentions and the wider provisions of ecologically sustainable forest management. It is because major policy documents lack robust and explicit guidelines on achieving ecologically sustainable management of deadwood despite its centrality in providing ecosystem services and as a highly dependable source of energy resources for over 70% of the Kenyan population. Moreover, deadwood management appears to be affected by many complex biological, technical, policy, and socioeconomic factors that appear to be acting together against sustainable deadwood management. Still, perhaps most importantly, the absence of research on the topic is the most outstanding challenge. Therefore, in the future, improving the sustainable management of natural forests will require the restoration of deadwood and increasing consciousness on the value of deadwood through more research studies.
On Becoming a Counselling Psychologist: Making Sense of Presence
Authors: Amari Nicola
Published: March 2021

This reflective essay offers a personal account of my experience during my counselling psychology training. Research highlights that the person of the therapist contributes to clients’ improvement beyond the intervention, advocating the importance of personal development beyond a competency-based model. Consonantly, counselling psychology appreciates how practitioners bring their “self” to the therapeutic relationship, thus valuing their training, wider knowledge, and lived experiences. Accordingly, I will explore significant events that illuminate the personal dimension of my professional practice while also considering the wider empirical knowledge. Furthermore, as the beginning of my training has focused on the person-centered/experiential approach, I will conceptualize my experience within the framework posited by Rogers. Specifically, I will begin by reflecting on the theme of power to expose how personal issues might affect my development as a trainee. Second, I will illustrate how engaging with feedback has brought to awareness aspects of my “self” that relate to the theme of acceptance. Third, I will consider personal strengths that have the potential to enrich my practice and are encapsulated by the theme of lightness. Last, I will suggest the theme of presence as my attempt to make sense of challenges and limitations that I have faced during my training. By presenting these themes, I endeavor to offer a picture of how I have grown into a new place in my development as trainee counselling psychologist.
Political Identity and Preference for Supplemental Educational Programs
Authors: Jung Jihye , Mittal Vikas
Published: March 2021

The market for supplemental educational programs (SEPs)—tutorials, educational materials, summer programs—has burgeoned. Thus, it is important to understand factors that may influence parents’ choices for SEPs. This article examines how parents’ political identity affects their preference for SEPs contingent on their focus on self. Using two main educational orientations—conformance orientation and independence orientation—the authors argue that SEPs with conformance-oriented pedagogy may be preferred more by conservative parents due to their higher need for structure. This association of political identity with preference for SEPs is moderated by self-focus. Counterintuitively, when using political orientation to target messages for SEPs, firms should frame messages to focus parents on themselves for identity-consistent effects to manifest. Five studies, including a field study, test this theorizing and replicate key results using different measures of political identity and self-focus.
Clutter in domestic spaces: Material vibrancy, and competing moralities
Authors: Woodward Sophie
Published: March 2021

Decluttering discourses position clutter as meaningless things as well as, seemingly paradoxically, morally problematic – as signs of laziness or an individual failure to organise the house. This article addresses the lack of academic research on the topic and challenges the mischaracterisation of clutter as meaningless by drawing from ethnographically informed research into clutter in people’s homes in Manchester. The article is situated in, and contributes to, the sociology of ordinary consumption, the unmarked and unnoticed, and materiality. I draw from the theoretical work of Mary Douglas and Michael Thompson that outlines the vibrancy and potential of the unnoticed materials and matter of everyday life. I centre materiality in thinking about the material vibrancy of clutter and draw from Jane Bennett’s notion of assemblages to think through the capacity of clutter to become morally potent. The article makes four main arguments; first, I challenge ideas that clutter is trivial as it includes both meaningless and meaningful things. Second, I argue that clutter is a way people negotiate, reinforce and manage social relationships. Third, I argue moralising discourses around materialism and decluttering interact with existing everyday moralities around consumption, finances and family life which are brought to bear when people deal with their clutter. Fourth, through its materiality, clutter forces people to engage with moral discourse of wastefulness, usefulness, materialism, and everyday familial norms.
Effects of Mobile Drama With Authentic Contexts on English Learning
Authors: Liu Yi-Fan , Hwang Wu-Yuin , Liu Zi-Yan
Published: March 2021

Teaching English in a classroom setting where EFL learners were usually sitting at desks and doing English learning tasks using paper and pencil is inefficient. It has considerable potential problems that could lead to students learning in a passive state. More specifically, the teaching materials are inconsistent with students’ authentic experiences, which decreases the learning efficiency, learning motivation, and levels of interactivity. An annotatable multimedia E-reader (AME) was developed to address these problems. The provided various annotation tools to help students create dramas with authentic contexts. The study participants were 48 junior high school students and divided into the experimental group (EG) and control group (CG). Results revealed that learning English through drama with AME assistance in authentic contexts significantly improved the participants’ learning achievements. In other words, the learning achievements of the EG were superior to those of the CG. Moreover, the results indicated that different learning behaviors were significantly related to different learning achievements. Thus, the greater the diversity of learning behaviors practiced by the students in the drama activity in authentic contexts, the higher the students’ learning scores on different dimensions. Finally, the results indicated that using the AME in authentic contexts was beneficial for English learning through drama.
Intimate Partner Violence Before Pregnancy, During Pregnancy, and After Childbirth: A New Conceptualization Highlighting Individual Changes in Violence Against Pregnant Women Over Time
Authors: Chan Ko Ling , Lo C. K. M. , Lu Y. , Ho Frederick K. , Leung Wing Cheong , Ip Patrick
Published: March 2021

Intimate partner violence (IPV) against pregnant women is a global public health problem. Yet, the trajectory of IPV during pregnancy and its association with health are unclear. This study set out to investigate the trajectory of IPV by categorizing pregnant women according to changes of IPV exposure before, during, and after pregnancy and to examine the predictive factors of these IPV-related categories. During 2016 and 2017, we conducted a longitudinal study with a sample of 1,083 pregnant women in Hong Kong. Pregnant women reported their IPV experiences, depression, and demographics in the baseline survey (at about 24-week gestation), and their IPV experiences, mental health outcomes, social support, and perceived father’s involvement in the follow-up survey (around 4 weeks postpartum). We categorized pregnant women into four groups, including women with (a) sustaining abusive relationship (AR); (b) relationship with decreased violence over pregnancy (DVR); (c) relationship with stress-related violence (SVR); and (d) nonviolent relationship (NVR). Although we found an overall decline of IPV during pregnancy from 24.6% to 14.3%, there were still a considerable proportion of women reporting as a victim of IPV. We observed that a higher proportion of pregnant women were actually suffering from IPV during pregnancy and after childbirth continuously (22.3% of AR and SVR) than experiencing a termination of IPV due to pregnancy (11.4% of DVR). We also observed that more severe maternal depression, lower levels of father’s involvement, and poorer social support were significantly associated with the categories that reflected greater severity of IPV over the course of pregnancy. Our findings reflected that the complexity of IPV related to pregnancy should never be overlooked. Mere reporting of prevalence in an aggregate might not sufficiently explain the problem. Father’s involvement and social support are two important factors that might help reduce IPV related to pregnancy and childbirth.
Infection with antiretroviral-susceptible HIV in an individual adherent to pre-exposure prophylaxis: strategies for treatment initiation
Authors: Hughes Jessica M , Tan Darrell HS , Anderson Peter , Bodhinayake Janani , MacPherson Paul A
Published: March 2021

HIV pre-exposure prophylaxis (PrEP) is effective at preventing sexual acquisition of HIV, and failures in clinical trials are largely attributable to medication nonadherence. We report here a case of infection with a fully susceptible strain of HIV in an individual adherent to PrEP as demonstrated by pharmacy records and intracellular tenofovir diphosphate levels. At diagnosis, the viral load was 90 copies/mL precluding initial genotype testing due to low copy number. While PrEP failure is rare, this case underscores the importance of regular HIV testing for patient on PrEP and prompts discussion regarding the approach to treatment following failure where an initial genotype is not yet available or not possible due to low viral load. Few other case reports of PrEP failure exist in the literature and approaches to treatment varied widely. We suggest the initial viral copy number may guide next steps and discuss the risks and benefits of stopping PrEP, escalating therapy with integrase inhibitors or boosted protease inhibitors, or switching to non-nucleoside antiretroviral treatment regimens.
Asking People to Explain Complex Policies Does Not Increase Political Moderation: Three Preregistered Failures to Closely Replicate Fernbach, Rogers, Fox, and Sloman’s (2013) Findings
Authors: Crawford Jarret T. , Ruscio John
Published: March 2021

Fernbach et al. (2013) found that political extremism and partisan in-group favoritism can be reduced by asking people to provide mechanistic explanations for complex policies, thus making their lack of procedural-policy knowledge salient. Given the practical importance of these findings, we conducted two preregistered close replications of Fernbach et al.’s Experiment 2 (Replication 1a: N = 306; Replication 1b: N = 405) and preregistered close and conceptual replications of Fernbach et al.’s Experiment 3 (Replication 2: N = 343). None of the key effects were statistically significant, and only one survived a small-telescopes analysis. Although participants reported less policy understanding after providing mechanistic policy explanations, policy-position extremity and in-group favoritism were unaffected. That said, well-established findings that providing justifications for prior beliefs strengthens those beliefs, and well-established findings of in-group favoritism, were replicated. These findings suggest that providing mechanistic explanations increases people’s recognition of their ignorance but is unlikely to increase their political moderation, at least under these conditions.
Chemopreventive effect of galangin against benzo(a)pyrene-induced stomach tumorigenesis through modulating aryl hydrocarbon receptor in Swiss albino mice
Authors: Wang L , Xue J , Wei F , Zheng G , Cheng M , Liu S
Published: March 2021

The present study was aimed to evaluate the chemopreventive potential of galangin against benzo(a)pyrene (BaP)-induced stomach carcinogenesis in Swiss albino mice. Stomach cancer was induced in experimental mice using BaP oral administration. The mice were treated with galangin (10 mg/kg b.wt.) before and during BaP administration. Oral administration of galangin at a dose of 10 mg/kg b.wt. significantly (p < 0.05) prevented the tumor incidence, tumor volume in the experimental animals. Further, galangin pretreatment prevents BaP-induced lipid peroxidation and restores BaP-mediated loss of cellular antioxidants status. It has also been found that galangin prevents BaP-induced activation of phase I detoxification enzymes. Furthermore, galangin pretreatment prevented the BaP-induced overexpression of cytochrome P450s isoform genes (CYP1A1, CYP1B1), aryl hydrocarbon receptor system (AhR, ARNT), transcriptional activators (CBP/p300, NF-kB), tumor growth factors, proto-oncogenes, invasion markers (TGFB, SRC-1, MYC, iNOS, MMP2, MMP9) and Phase II metabolic isoenzyme genes (GST) in the stomach tissue homogenate when compared to the control groups. The western blot results confirm that galangin (10 mg/kg. b.wt.) treatment significantly prevented the BaP-mediated expression of ArR, ARNT, and CYP1A1 proteins in the mouse stomach tissue. Therefore, the present results confirm that galangin prevents BaP-induced stomach carcinogenesis probably through modulating ArR and ARNT expression in the experimental mice.
Modeling the process of personal digital archiving through ubiquitous and desktop devices: A systematic review
Authors: Ali Irfan , Warraich Nosheen Fatima
Published: March 2021

The purpose of this study is to explore Personal Digital Archiving, and its practices, reasons, and challenges in desktop and in ubiquitous environment such as desktop computers, laptops, mobile phones or smartphones, tablets, and cloud services. Moreover, it is also aimed to develop a model of Personal Digital Archiving process for desktop and ubiquitous devices. This study used Preferred Reporting Items for the Systematic Review and Meta-Analysis guidelines for searching and devising, and inclusion and exclusion criteria. The Search was conducted from selected repositories, databases, and core journals, potentially containing studies related with Personal Digital Archiving. Consequently, 21 studies were included through identification, screening, eligibility, and inclusion of studies process. It was found that people used multiple devices such as mobile phones or smartphones along with other devices. It was established that people had also used cloud services with different devices including computers and smartphones or tablets for Personal Digital Archiving. Five major categories of individuals’ Personal Digital Archiving practices, that is, backup, replication or duplication, reorganizing and updating, cleaning or removing, and migration of information were found. Moreover, emotional motives, technological causes, alternative access, easy retrieval, and task completion were the reasons to adopt Personal Digital Archiving. On the basis of findings of selected studies, researchers developed a four steps model of Personal Digital Archiving process, consisting of initiation, identification, action, and evaluation constructs. Personal Digital Archiving challenges were also identified such as the individuals had to face through the use of desktop and ubiquitous devices including technical, fragmented and overloaded information, lack of training and expertise, and psychological and miscellaneous challenges. Personal Digital Archiving process model is based on the extracted data from studies published worldwide, and it is useful for both desktop and ubiquitous devices with reference to Personal Information Management context. The findings of the study will be helpful for software designers and android application developers to design and develop users’ centered Personal Information Management software.
Disciplinary power in corporate governance: A Foucauldian analysis of the emergence and development of proxy advisors
Authors: Lambert Damien
Published: March 2021

Prior research in corporate governance has extensively investigated the mechanisms through which a variety of actors (financial analysts, investment managers, shareholder activists) monitor and discipline corporate executives. However, one recently emerged actor has received little attention so far: the proxy advisory firm. Mobilising Foucault’s concept of disciplinary power, this study uses historical analysis to examine the role of proxy advisors in corporate governance. This article shows that proxy advisors actively contributed to developing and implementing disciplinary mechanisms. This involves (1) hierarchical observations of corporations and their executives on a global scale. These observations are made available to institutional investors on proxy advisors’ voting platforms which have Panopticon-like features; (2) normalisation of judgements through the provision of generic voting policies, generic voting recommendations and corporate governance ratings prepared by proxy advisors and delivered to many institutional investors; (3) ritualised examination of the performance of corporations and of their executives during the annual general meeting, including record-keeping of all past voting results.
Abducting Children Abroad: Gender, Power, and Transnational Mobility in Immigrant Family Conflicts
Authors: Liversage Anika
Published: March 2021

Utilizing life story interviews of immigrant women whose children were abducted by abusive (ex-)husbands, the article unpacks a three-part pattern of transnational mobility: first, husbands apply strategies of coercive control to dominate wives in Denmark; second, wives draw on Scandinavian “woman-friendly” state support to challenge men and seek divorce; and third, men try to regain control through abducting children to the Middle East, seeking to blackmail mothers into leaving Denmark and resubmitting themselves to male control. While some wives accede to their husband’s demands, others skillfully manage to “re-abduct” children back to Denmark, thereby belying the trope of the victimized immigrant woman.
May’s law may prevail: Evidence from Sweden
Authors: Bäckersten Oskar Hultin
Published: March 2021

Are party members more radical than voters and party elites? This is the expectation according to May’s Law, which has faced significant challenges from recent scholarship. Utilizing several survey sources covering four levels of all Swedish parliamentary parties between 1985 and 2018, this paper shows that the Swedish case follows May’s propositions with some qualifications. The parties organized along the left-right dimension follow the pattern of the mid-level being more radical in this respect, while on a secondary GAL-TAN dimension the parties that organize along this dimension rather exhibit a pattern of elite polarization. Additionally, the relative order of groups within parties is stable over the considered time period, when party membership is sharply declining. This suggests that party members are not becoming less ideologically representative over time, while they are consistently more radical than respective parties’ voters and elites.
Fucking with homonormativity: The ambiguous politics of chemsex
Authors: Mowlabocus Sharif
Published: March 2021

One would not typically think of chemsex as a practice structured by the same political ideology that spawned ‘the new homonormativity’. For one thing, the gay press (a key mediator of homonormative thinking) has spilt much ink demonizing both the practice and practitioners of chemsex. Chemsex is framed in opposition to the ‘good gays’ that appear on same-sex wedding invitations or in advertisements for furniture stores or travel companies. Meanwhile, scholars have identified the ways in which chemsex embodies a response to both the political-economic landscape of neoliberalism, and the dominant model of homosexuality. From this perspective, chemsex appears antithetical to the political-economy of late capitalism, and to homonormativity. Building on critical discussions of this sexual practice, this article maps the complicated political terrain in which chemsex operates. Drawing on in-depth interviews with active and former practitioners, I suggest that chemsex occupies an ambivalent position in relation to the politics of homonormativity.
Structural performance and section optimization of precast concrete sandwich panels with pin-type GFRP connectors
Authors: Huang Jun-Qi , Jiang Qing , Chong Xun , Zhao Chao-Liang , Wang Zi-Yang
Published: March 2021

A precast concrete sandwich panel (PCSP) offers a good potential in the application of façade wall due to the improved energy efficiency. In this study, the structural performance of PCSP with pin-type glass fiber reinforced polymer (GFRP) connectors was investigated, and an optimization characterized by ribbed structural wythe was proposed and studied. Firstly, the pull-out and shear capacity of the pin-type connector were evaluated through direct tensile test and direct shear test, respectively. Thereafter, seven PCSP specimens were fabricated and tested under four points flexural load. The investigating parameters included the structural wythe thickness, loading direction, insulation bond, and section type of the structural wythe. The load-deflection relationship, crack pattern, failure mode, load-strain relationship, and degree of composite action of the PCSP were studied and compared. It was concluded that: (1) the tested PCSPs presented ductile failures; (2) the structural wythe thickness, loading direction and insulation bond would influence the cracking, yielding, and peak loads of the tested PCSP; (3) the PCSP with pin-type GFRP connectors could be designed as non-composite type owing to the low composite action; and (4) the proposed ribbed structural wythe could achieve a lightweight PCSP while considerable flexural stiffness and capacity could be retained.
Post-Leave (Return to Work) Training Needs and Human Resource Development
Authors: Philpot Denise R. , Gavrilova Aguilar Mariya
Published: March 2021

The Problem

Employee leave is impacted by a variety of laws that address employer obligations and employee responsibilities. While the employee leave process is managed by an organization’s Human Resource Management (HRM) function, in most cases these laws and internal organizational policies and procedures do not address the training needs related to the employee’s return to work and subsequent integration into the workplace. Training, and Development is a component of Human Resource Development (HRD) and thus HRD should be largely involved in the employee’s transition back to work. In addition, supervisors/managers should examine their role in to evaluating the training needs of the employee and facilitating a successful post-leave return to work. The HRD literature can benefit from an integrated model of.

The Solution

This article reviews an important workplace phenomenon existing at the intersection of Human Resource Management (HRM) policies related to employee leave and HRD practices related to addressing training needs upon return to work and emphasizing employee orientation and integration back into the workforce. As a major component of HRD, Organization Development (OD) can also be employed to create a supportive organizational culture for employees on leave. We synthesize existing research on post-leave and rely on the HRD literature to propose solutions that highlight employee training and development interventions. Recommendations for practitioners include how to improve the workplace environment for employees prior to their leave as well as upon return, how to enhance the existence of orientation programs, and how to properly train managers to work well with employees and assess their training needs upon return from leave.

The Stakeholders

HRD practitioners that are looking to improve leave policies and documented practices as they pertain to the performance and training needs of leave-taking employees upon returning to work as well as managers that strive to ensure returning employees have the knowledge and skills necessary to regain previous levels of competence and productivity will be interested in this research.
Excavating the Layers of Trauma in Homelands and Hostlands: Supporting Political Refugees in U.S. Schools
Authors: Akay Mehtap , Jaffe-Walter Reva
Published: March 2021

This article details how a newly arrived Turkish refugee student navigates schooling in the United States. It highlights the trauma purged Turkish families experience in their home country and their challenges as newcomers unfamiliar with their new country’s dominant culture, language, and education system. The case narrative provides insight into how children of Turkish political refugees are often overlooked in the context of U.S. schools, where teachers lack adequate training and supports. By illuminating one refugee family’s experiences in U.S. schools, the case calls for leaders to develop holistic supports and teacher education focused on the needs of refugee students.
Selections From the ABC 2020 Annual Conference, Online: Gathering Around the Cool Fire to Share Business Communication Teaching Innovations
Authors: Whalen D. Joel
Published: March 2021

Readers can explore 13 teaching innovations presented at the 2020 Association for Business Communication (ABC) annual international conference hosted online. Typically held in a large hotel ballroom, this year’s My Favorite Assignment sessions were adapted to an asynchronous virtual conference. These assignments are designed to teach managing complex communication, enhance cross-cultural communication, and building essential technical skills. This article is the second in a two-part series. The first appeared in the June 2021 issue. Additional teaching materials—instructions to students, stimulus materials, slides, grading rubrics, frequently asked questions, and sample student projects—are posted on the ABC website: https://www.businesscommunication.org/page/assignments .
Functional Outcome of Anterior Talofibular Ligament Repair Using Bioabsorbable Suture Anchors
Authors: Cassis Waleed , Nemec Michael S. , Safavi Kiya S. , Jupiter Daniel , Panchbhavi Vinod K.
Published: March 2021

Category:

Ankle; Sports

Introduction/Purpose:

Suture anchors provide an optimal way of fixating injured soft tissue to bone while promoting healing and structural integrity. With recent innovations, the development of biodegradable ultrasonic liquifying suture anchors has been of particular interest. These devices utilize ultrasound energy to liquify a polylactide anchor tip, which is inserted into cancellous bone, at which point it solidifies and fixates within seconds. Mechanical performance testing in comparison to current mainstream devices suggests this method as more suitable for rapid tissue repair and healing. Initial studies have, however, been limited to artificial bone. The current study aims to evaluate surgical and patient-reported outcomes in the use of bio-absorbable suture anchors used for Broström-Gould lateral ankle ligament reconstruction.

Methods:

This study consisted of a single-surgeon, retrospective analysis with Institutional Review Board approval (University of Texas Medical Branch (UTMB), August 2 2019). A database search was conducted for patients who underwent primary or secondary Broström-Gould repair indicated for chronic laxity of the anterior talofibular ligament (ATFL) with bioabsorbable suture anchors between May 2017 and May 2019 at UTMB. Exclusion criteria were patient age under 18, incarcerated patient, and patient being a pharmaceutical company employee. Using patient charts, operative and progress notes were reviewed to assess surgical outcomes, concurrent repairs, and complications. Thereafter, patients were contacted via telephone to obtain Patient- Reported Outcomes Measurement Information System (PROMIS) scores through a series of survey questions concerning their physical health and physical function.

Results:

Twenty-six patients (20 females, 6 males) met inclusion and exclusion criteria. One patient had both ankles repaired separately, therefore 27 ankles were analyzed. Mean age at the time of surgery was 43 years (range 22-63). Preliminary analysis examined the period between surgery and last clinic visit, with a mean of 3.9 months. Mean concurrent repairs was 2.0. There were no intraoperative complications. All patients were compliant with weightbearing protocol. Complications unrelated to device function totaled 29.6% and included cellulitis (18.5%), suture granuloma (7.4%), and tarsal tunnel syndrome (3.7%), which all resolved after proper intervention. Functional complications included recurrent instability in 1 patient (3.7%) at 8.4 months. PROMIS scores are currently being collected and will be compiled by the end of February 2020.

Conclusion:

Preliminary analysis showed a relatively high overall complication rate at 33.3% (n=7), although recurrent instability was reported by 1 patient only (3.7%). The addition of PROMIS scores will be critical in examining longer term functional outcomes in ATFL repair with bioabsorbable suture anchors.
Effect of Distal Tibial Varus and Valgus Deformity on Tibiotalar Joint Contact
Authors: Hong-Mou Zhao
Published: March 2021

Category:

Ankle; Basic Sciences/Biologics

Introduction/Purpose:

To study the effect of different degrees of distal tibial varus and valgus deformities on the tibiotalar joint contact, and to understand the role of fibular osteotomy.

Methods:

Eight cadaveric lower legs were used for biomechanical study. Nine conditions were included: normal ankle joint (group A), 10° varus (group B), 5° varus (group C), 5° valgus (group D), 10° valgus (group E) with fibular preserved, and 10° varus (group F), 5° varus (group G), 5° valgus (group H), and 10° valgus (group I) after fibular osteotomy. The joint contact area, contact pressure, and peak pressure were tested; and the translation of contact force center was observed.

Results:

The joint contact area, contact pressure, and peak pressure had no significant difference between group A and groups B to E (P>0.05). After fibular osteotomy, the contact area decreased significantly in groups F and I when compared with group A (P<0.05); the contact pressure increased significantly in groups F, H, and I when compared with group A (P<0.05); the peak pressure increased significantly in groups F and I when compared with group A (P<0.05). There were two main anterior-lateral and anterior-medial contact centers in normal tibiotalar joint, respectively; and the force center was in anterior-lateral part, just near the center of tibiotalar joint. While the fibula was preserved, the force center transferred laterally with increased varus angles; and the force center transferred medially with increased valgus angles. However, the force center transferred oppositely to the medial part with increased varus angles, and laterally with increased valgus angles after fibular osteotomy.

Conclusion:

Fibular osteotomy facilitates the tibiotalar contact pressure translation, and is helpful for ankle joint realignment in suitable cases.
Ischemic Proliferative Retinopathy as the Presenting Feature of Systemic Sarcoidosis
Authors: Gupta Lalita , Soliman Mohamed Kamel , Ahmad Riaz , Kurup Shree
Published: March 2021

Purpose:

This work reports a case of systemic sarcoidosis presenting with ischemic ocular manifestations without uveitis.

Methods:

This case report describes a 28-year-old White male who presented with pain, redness, and blurry vision of his left eye for 1 month who was found to have proliferative retinopathy and neovascular glaucoma.

Results:

Normal fasting blood glucose and glycated hemoglobin A1c levels warranted further investigation. Abnormal findings from chest x-ray of hilar lymphadenopathy as well as an elevated angiotensin-converting enzyme level were suggestive of sarcoidosis, and they were further confirmed by histopathology derived through bronchoscopy.

Conclusions:

Systemic sarcoidosis may present with rapidly progressing ischemic retinopathy without signs of inflammation, which may obscure the diagnosis. Such presentation may be misdiagnosed, which may result in delayed treatment and poor outcome.
A double-blind randomised controlled trial of protein supplementation to enhance exercise capacity in COPD during pulmonary rehabilitation: a pilot study
Authors: Aldhahir Abdulelah M. , Aldabayan Yousef S. , Alqahtani Jaber S. , Ridsdale Heidi A. , Smith Colette , Hurst John R. , Mandal Swapna
Published: March 2021

Background

Pulmonary rehabilitation is a cost-effective management strategy in chronic obstructive pulmonary disease (COPD) which improves exercise performance and health-related quality of life. Nutritional supplementation may counter malnutrition and enhance pulmonary rehabilitation outcomes but rigorous evidence is absent. We aimed to investigate the effect of high-protein supplementation (Fortisip Compact Protein (FCP)) during pulmonary rehabilitation on exercise capacity.

Methods

This was a double-blind randomised controlled trial comparing FCP (intervention) with PreOp (a carbohydrate control supplement) in COPD patients participating in a pulmonary rehabilitation programme. Participants consumed the supplement twice a day during pulmonary rehabilitation and attended twice-weekly pulmonary rehabilitation sessions, with pre- and post-pulmonary rehabilitation measurements, including the incremental shuttle walk test (ISWT) distance at 6 weeks as the primary outcome. Participants’ experience using supplements was assessed.

Results

68 patients were recruited (intervention n=36 and control n=32). The trial was stopped early due to the COVID-19 pandemic. Although statistical significance was not reached, there was the suggestion of a clinically meaningful difference in the ISWT distance at 6 weeks favouring the intervention group (intervention 342±149 m (n=22)versuscontrol 305±148 m (n=22); p=0.1). Individuals who achieved an improvement in the ISWT had a larger mid-thigh circumference at baseline (responders 62±4 cmversusnonresponders 55±6 cm; p=0.006). 79% of the patients were satisfied with the taste and 43% would continue taking the FCP.

Conclusions

Although the data did not demonstrate a statistically significant difference in the ISWT, high-protein supplementation in COPD during pulmonary rehabilitation may result in a clinically meaningful improvement in exercise capacity and was acceptable to patients. Large, adequately powered studies are justified.
Rapid prediction of adverse outcomes for acute normotensive pulmonary embolism: derivation of the Calgary Acute Pulmonary Embolism score
Authors: Solverson Kevin , Humphreys Christopher , Liang Zhiying , Prosperi-Porta Graeme , Andruchow James E. , Boiteau Paul , Ferland Andre , Herget Eric , Helmersen Doug , Weatherald Jason
Published: March 2021

Background

Acute pulmonary embolism (PE) has a wide spectrum of outcomes, but the best method to risk-stratify normotensive patients for adverse outcomes remains unclear.

Methods

A multicentre retrospective cohort study of acute PE patients admitted from emergency departments in Calgary, Canada, between 2012 and 2017 was used to develop a refined acute PE risk score. The composite primary outcome of in-hospital PE-related death or haemodynamic decompensation. The model was internally validated using bootstrapping and the prognostic value of the derived risk score was compared to the Bova score.

Results

Of 2067 patients with normotensive acute PE, the primary outcome (haemodynamic decompensation or PE-related death) occurred in 32 (1.5%) patients. In simplified Pulmonary Embolism Severity Index high-risk patients (n=1498, 78%), a multivariable model used to predict the primary outcome retained computed tomography (CT) right–left ventricular diameter ratio ≥1.5, systolic blood pressure 90–100 mmHg, central pulmonary artery clot and heart rate ≥100 beats·min−1with a C-statistic of 0.89 (95% CI 0.82–0.93). Three risk groups were derived using a weighted score (score, prevalence, primary outcome event rate): group 1 (0–3, 73.8%, 0.34%), group 2 (4–6, 17.6%, 5.8%), group 3 (7–9, 8.7%, 12.8%) with a C-statistic 0.85 (95% CI 0.78–0.91). In comparison the prevalence (primary outcome) by Bova risk stages (n=1179) were stage I 49.8% (0.2%); stage II 31.9% (2.7%); and stage III 18.4% (7.8%) with a C-statistic 0.80 (95% CI 0.74–0.86).

Conclusions

A simple four-variable risk score using clinical data immediately available after CT diagnosis of acute PE predicts in-hospital adverse outcomes. External validation of the Calgary Acute Pulmonary Embolism score is required.