bluuebunny/crossref_metadata_2025 huggingface dataset:
A pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy (CIPN).
Authors: Lopez Gabriel , Eng Cathy , Overman Michael J. , Liu Wenli , Cohen Lorenzo , Ramirez David Luis , Beinhorn Curtiss M , Sumler Pamela A , Chen Minxing , Bruera Eduardo , Prinsloo Sarah , Li Yisheng
Published: May 2019

e23067

Background: Short- and long-term toxicity of platinum compounds and taxanes includes development of CIPN. Although anti-neuropathic medications are available, there is increased interest by health care providers and patients (pts) regarding the role of complementary approaches for symptom control. Therefore, we explored the role of massage therapy for symptomatic relief of chronic CIPN. Methods: This pilot study evaluated the optimum treatment schedule and initial efficacy of two treatment schedules of a standardized Swedish massage technique to treat lower extremity (LE) CIPN. Inclusion criteria: LE neuropathy attributed to oxaliplatin, paclitaxel, or docetaxel, no other history of attributable causes (concurrent upper extremity neuropathy allowed); self-reported neuropathy score ≥3, 0-10 scale; ≥ 6 months since last chemotherapy treatment; age ≥ 18. Pts were randomized to one of four groups: 1) LE massage 3 times (3X) week for 4 weeks; LE massage 2X week for 6 weeks; 3) head/neck/shoulder (control) massage 3X week for 4 weeks; or 4) control massage 2X week for 6 weeks. Massage completion rate was examined and symptoms of CIPN measured with the Pain Quality Assessment Scale [PQAS (Range: 0-10); subscales of PQAS-SP (surface pain), PQAS-DP (deep pain), and PQAS-PP (paroxysmal pain)] at baseline and at 10 weeks. Results: 71 pts fulfilled inclusion criteria: 77.5% women; 57.7% (breast cancer), and 42.3% (GI cancer); mean age 60.3 y/o (range: 40-77). Average length of time since the end of chemotherapy was > 3 yrs. Mean massage completion rates (max = 12) were 8.9 (SD 4.2) for 3X week and 9.8 (4.0) for 2X week with no statistical differences. There were no statistically significant differences in PQAS scores at follow-up between site-specific massage groups (lower extremity vs controls). Pts who had massage 3X week reported statistically and clinically significantly improved PQAS scores versus those who had massage 2X week (change scores: PQAS-SP: -2.3 vs. -0.6, p = 0.001; PQAS-DP: -2.1 vs. -0.9, p = 0.008; PQAS-PP: -2.3 vs. -1.0, p = 0.025), with sustained improvement maintained in the 3X week group, but minimal change in the 2X week group. Conclusions: We observed sustained reduction in pts with long-term CIPN up to 6 weeks after treatment completion for the more intensive 3X week massage group, regardless of massage treatment site. A large-scale efficacy trial is warranted to validate the role of oncology massage therapy for CIPN. Clinical trial information: NCT02221700.
Percutaneous pericardiocentesis versus pericardial window: A retrospective subset analysis in a cancer population.
Authors: Hofeld Benjamin C , Widlansky Michael , Gitter Michael
Published: May 2019

e23093

Background: Malignant pericardial effusions (PEs) must often, and for a multitude of reasons, be managed invasively. Options for intervention include percutaneous or surgical drainage. There is a paucity of data directly comparing efficacy of these interventions. This study compares efficacy of surgical pericardial window (PW) percutaneous pericardiocentesis (PP) in cancer subjects with PEs, with respect to mortality, readmission, and repeat procedure. Methods: We performed a 5 year, retrospective, single center study at a major academic center. 79 patients were selected using ICD codes for PP (n = 19) and PW (n = 59) and grouped by first procedure performed. Log Rank Regression of Kaplan-Meier Curves was performed for major adverse events, as defined by repeat procedure, readmission, or mortality during the surveillance period. Results: Log Rank Tests of readmission and mortality were not statistically significant (P = 0.54, 0.656 respectively). Single Variate Log Rank Test of repeat procedure favored PW (P = 0.008, event rates: PP 21.1% vs PW 3.4%. Multivariate Log Rank Test of and all 3 events was not statistically significant (P = 0.168). Fig 1: Kaplan-Meier Analysis of PP (0) vs PW (1) by any event (repeat procedure, readmission, or mortality). Event Rate = 89.5% PC, 89.5% PW. Conclusions: PW patients had a lower incidence of repeat procedures. There were no differences in readmission, mortality, or a composite of all 3 events. Future aims will identify risk factors associated with repeat procedures in PCs and PWs.
Defining cardiotoxicity of doxorubicin and trastuzumab.
Authors: Khan Abir , Amidi Omid , Hess Kenneth R. , Ewer Michael S. , Yusuf Wamique , Banchs Jose , Palaskas Nicolas
Published: May 2019

e23097

Background: Doxorubicin and trastuzumab have been described to cause clinical heart failure and asymptomatic declines in left ventricular ejection fraction (LVEF). Initial studies of doxorubicin in the 1970’s defined cardiotoxicity by the clinical syndrome of heart failure without imaging for LVEF determination. Trials with adjuvant trastuzumab used various LVEF cut-offs that were arbitrarily determined. This study aims to compare the predictive value of commonly used definitions of cardiotoxicity associated with chemotherapy for the development of clinical heart failure. Methods: A retrospective chart review was performed on an IRB approved cohort of 638 patients with breast cancer who received doxorubicin, trastuzumab, or both and who had baseline and follow up echocardiograms, collecting LVEF values for each echocardiogram. Clinical heart failure was determined by formal cardiology evaluations denoting clinical heart failure in patients. Four different definitions of cardiotoxicity were compared; American Society of Echocardiography (ASE), Cardiac Review and Evaluation Committee (CREC), Alexander et al, and Schwartz et al (Table). Results: Only 8 patients (1.25%) developed clinical heart failure. The sensitivity, specificity, positive predictive value, and negative predictive value of each definition of cardiotoxicity are listed in the table. Conclusions: Overall there is a low threshold for detection of clinical heart failure in breast cancer therapy. While the ASE definition has the highest combination of sensitivity, specificity, and positive predictive value, it has a sensitivity of only 62.5%. Thus, cardiologists and oncologists should collaborate to develop a definition of cardiotoxicity better correlated to clinical outcomes. [Table: see text]
Patient experience of an intervention combining nurse navigators and e-Health technologies for use of oral anticancer agents.
Authors: Ferrua Marie , YATIM FATIMA , Fourcade Aude , Lacaze Marilène Guillet , Minvielle Etienne , Mir Olivier
Published: May 2019

e23149

Background: An intervention (named CAPRI) combining Nurse Navigators (NN) and a mobile application dedicated to patients treated with oral anticancer agents was implemented in 2016 at Gustave Roussy (Villejuif, France). NN provide regular telephone follow-ups to manage patients' symptoms and assess toxicities, adherence to treatment and supportive care needs. Patients can have access to a mobile application to record tracking data, contact NN via secure messaging, view therapy and side effect information or store documents. Methods: A questionnaire was addressed to patients after using for 5 months the CAPRI intervention in order to assess their experience with the device. In parallel, interviews were conducted with patients. To determine patient utilization of the mobile application, data were extracted over a 24-month period. Results: 148 patients completed the evaluation (response rate = 81%). 15 interviews were conducted. Patients' experience with CAPRI intervention is very positive: The open-ended comments on the questionnaires and interviews with patients highlighted the importance of listening, having a contact person who is easily reachable, available and empathetic. 83% of patients preferred contacting NN by phone rather than through the mobile application. Only 50% (n = 74) of patients reported having tried to connect to the mobile application and 38% reported monitoring data at least once. Conclusions: Patients' experience is highly positive about the intervention. However, the application is poorly used, patients seems to prefer human contact. In perspective, results from the randomized trial currently conducted will evaluate the impact of the intervention on clinical criteria.[Table: see text]
Improve: A community-based physical activity intervention to improve functional and health outcomes in older breast cancer survivors: Rationale, design, and methods.
Authors: Owusu Cynthia , Nock Nora , Hergenroeder Paul , Austin Kris , Bennett Beth , Cerne Stephen , Moore Halle C. F. , Petkac Jean , Schluchter Mark D. , SCHMITZ KATHRYN H. , Atkins Lindsay , Asagba Oghenerukeme , Wimbley Leonard , Berger Nathan A.
Published: May 2019

TPS11629

Background: African-Americans (AA) and lower socioeconomic status (SES) older breast cancer survivors (BCS) are more likely to experience poor functional and health outcomes. Promotion of healthy behaviors, such as physical activity (PA), is critical to addressing these health disparities. Here we describe the rationale, design and methods of a randomized controlled trial testing the effectiveness of a physical activity intervention among older BCS from diverse racial and SES backgrounds. Methods: The IMPROVE Study is a community-based randomized-controlled trial designed to recruit 320 BCS, 80 in each of four strata defined by race (AA vs. Non-Hispanic Whites [NHW]) and SES (low vs. high). Participants are aged ≥ 65 years, AA or NHW and are within five years from treatment completion for stage I-III breast cancer. Participants are recruited utilizing the Ohio Cancer Incidence and Surveillance System database or directly from three area hospitals in Cleveland, Ohio and randomized to one of two arms: a 52-week moderate intensity aerobic and resistance group training intervention (n = 160) versus attention-control (support group sessions), (n = 160). The first 20 weeks of the PA intervention includes 3x per week 60-minute supervised sessions. The last 32 weeks of the PA intervention are unsupervised. Each of the 60-minute supervised PA sessions include 30 minutes of moderate intensity aerobic activity at 50%-70% of HRmax (maximum heart rate) and 30 minutes of resistance training based on 1-RM (repetition maximum) for chest and leg press. The attention-control group attend a once per week 60-minute support group session for the first 20 weeks and have unsupervised group sessions during the last 32 weeks. Exit interviews are being conducted at 52 weeks. The primary outcome is change in Short Physical Performance Battery (SPPB) Scores at 20 weeks. Secondary outcomes include change in SPPB scores at 52 weeks, and change in body composition and biomarkers of breast cancer prognosis at 20 and 52 weeks. One hundred and seventy-four participants have been enrolled as of 02/07/2019. Discussion: This study includes three underserved populations, (older BCS in general, older AA BCS and older low SES BCS) in one study. Results may contribute to a better understanding of factors associated with recruitment, sustained participation and acceptability, and will inform physical activity programs that will optimally improve the functional and health outcomes for older women during breast cancer survivorship. Clinical trial information: CNCT02763228.
Randomized open-label study of M7824 versus pembrolizumab as first-line (1L) treatment in patients with PD-L1 expressing advanced non-small cell lung cancer (NSCLC).
Authors: Ahn Myung-Ju , Barlesi Fabrice , Felip Enriqueta , Garon Edward B. , Martin Claudio Marcelo , Mok Tony S. K. , Vokes Everett E. , Ojalvo Laureen S. , Koenig Andre , Dussault Isabelle , Paz-Ares Luis G.
Published: May 2019

TPS9114

Background: Transforming growth factor β (TGF- β) promotes tumor progression via immune- and non–immune-related processes. M7824 is an innovative first-in-class bifunctional fusion protein composed of 2 extracellular domains of TGF-βRII (a TGF-β “trap”) fused to a human IgG1 monoclonal antibody against PD-L1. Targeting these independent and complementary pathways may restore and enhance antitumor responses. An expansion cohort of the NCT02517398 study of patients with advanced NSCLC (n = 80) treated with M7824 in the second-line setting presented at ESMO 2018 showed an objective response rate of 86% in the subgroup with high PD-L1 tumor expression at the recommended phase 2 dose (1200 mg intravenously [IV] every 2 weeks [Q2W]). Observed data support the hypothesis that M7824 may be superior to other PD-(L)1 inhibitors, including pembrolizumab, for the treatment of NSCLC. Based on the promising antitumor activity and manageable safety profile, this study will evaluate M7824 treatment in patients with advanced NSCLC in the 1L setting. Methods: Here we present a global, randomized trial comparing M7824 vs pembrolizumab in the 1L treatment of patients with metastatic NSCLC with high PD-L1 expression levels. Patients in this study must have a histologically confirmed diagnosis of advanced NSCLC with high PD-L1 expression on tumor cells (defined as either ≥80% by the Dako 73-10 pharmDx kit or ≥50% by the Dako 22C3 pharmDx kit since both assays are expected to select a similar patient population at their respective cut-offs). ECOG performance status must be 0 or 1. Patients must not have received prior systemic treatment for advanced NSCLC. Patients with tumors with actionable mutations (for which targeted therapy is locally approved) are not eligible. Patients will receive 1200 mg Q2W or pembrolizumab 200 mg Q3W as an IV infusion until confirmed disease progression, unacceptable toxicity, or trial withdrawal. Dual primary endpoints are progression-free survival and best overall response; key secondary endpoints include overall survival, duration of response, and safety. Estimated enrollment is 300 patients. Clinical trial information: NCT03631706.
ATALANTE-1 randomized phase III trial, OSE 2101 versus standard treatment as second- or third-line in HLA-A2 positive advanced non-small cell lung cancer (NSCLC) patients.
Authors: Felip Enriqueta , Giaccone Giuseppe , Dziadziuszko Rafal , Denis Fabrice , Moran Teresa , Debieuvre Didier , Cobo Manuel , Galetta Domenico , Vanel François Roger , Romano Giampiero , Madroszyk Anne , Chouaid Christos , Ferrand Francois-Regis , Hilgers Werner , Cappuzzo Federico , Masson Philippe , Peled Nir , Vasseur Berangere , Remon Jordi , Besse Benjamin
Published: May 2019

TPS9121

Background: New treatment strategies are needed for advanced NSCLC patients who progress on treatment with immune checkpoint inhibitors (ICI). Tedopi (OSE2101) is a neoepitope vaccine restricted to HLA-A2 positive patients (45%) targeting five tumor-associated antigens frequently expressed in lung cancer cells, ACE, HER2, MAGE2, MAGE3 and P53. Previously, in a phase II trial (Barve et al. JCO 2008), Tedopi showed a median overall survival (OS) of 17.3 months with a manageable safety profile in advanced NSCLC patients. ATALANTE-1 (NCT02654587) is a randomized, open-label, phase 3 study comparing the efficacy and safety of TEDOPI with standard of care (SoC) treatment in HLA-A2 positive patients with advanced NSCLC, as second- or third-line therapy. Methods: Patients with advanced NSCLC without EGFR-sensitizing mutations or ALK rearrangements; progressive disease to platinum-based chemotherapy (ChT) with sequential or concurrent ICI; HLA-A2 positivity (blood test); ECOG PS 0-1; with treated and asymptomatic brain metastases,, are randomized 2:1 to receive 5mg Tedopi subcutaneously Q3W for 6 cycles, then Q8W for the reminder of the year and finally Q12W, or SoC treatment with: docetaxel 75 mg/m2 Q3W or pemetrexed 500 mg/m2 Q3W (in non-squamous and pemetrexed-naïve patients). Treatment continues until progression, intolerable toxicity or consent withdrawal, in both arms. Patients are stratified by histology, best response to first line, and line rank of ICI. Tumor assessment is performed every 6 weeks (RECIST 1.1). Primary endpoint is OS. Secondary end points are PFS, ORR, DCR, and duration of response, quality of life and safety. This is a superiority study with a hazard ratio of 0.7, two-sided alpha 5% and power 80%, after 278 events are observed. An independent analysis (1year OS rate) is planned in the first 84 patients treated with Tedopi. Last trial review by the DMC in June 18 suggested that the trial continues as planned. Translational research will be performed evaluating pharmacodynamic markers of efficacy such as immunogenicity response against Tedopi vaccine neoantigens, as well as parameters in liquid and tissue biopsies. End January 19, 87 patients (51 Tedopi, 36 Soc) have been enrolled. Clinical trial information: NCT02654587.
Insecurities of Expulsion
Authors: Hundle Anneeth Kaur
Published: May 2019

This article examines citizenship formations and political practices in relation to racialized and gendered postcolonial insecurities for the “Asian community” in contemporary Uganda. After disaggregating the notion of Asian community, it examines (1) how formalistic, liberal, and legal-juridical conceptions of citizenship and political practice are ineffective analytics in the context of Africanization efforts and racialized expulsion in Uganda; and (2) the tendency to erase people of South Asian descent from the study of normative state-society relations and political engagement via civil society in mainstream scholarship. It argues for a productive synthesis of Indian and African postcolonial theories of democratic agency and political practice by analyzing the possibilities and limitations of Partha Chatterjee's notion of “political society” relative to local community governance and the cultural politics of informal citizenship practices in contemporary Uganda. Contemporary citizenship formations are richly textured practices that can be both democratic and antidemocratic in nature, often characterized by disavowal of liberal, legal-juridical forms of citizenship. Finally, by closely examining domains of gender-based activism and coalition building within and across racialized communities, this essay explores the possibilities for popular politics and democratic, inclusionary multiracial and gendered citizenship in the post-Asian-expulsion context of Uganda.
BetweenQasbasand Cities
Authors: Orsini Francesca
Published: May 2019

The cultural memory of Awadh is almost exclusively identified with Urdu poetry and courtesan culture, and already in the colonial period it came to stand as the epitome of the “last phase of Oriental culture” (‘Abdul Halim Sharar). But if instead of taking a retrospective, nostalgic view we approach literary culture in Awadh prospectively and multilingually and broaden our lens to consider not just the capitals, Faizabad and Lucknow, but also the qasbas (small towns), the small rural courts, the nearby growing city of Banaras, and the colonial capital of Calcutta, a different set of literary dynamics and shifts comes into view. The prevalent image of Awadh as identified with Urdu and Lucknow is not wrong, of course, but it does obscure the other stories, trajectories, and languages. This essay considers some of them. A multilingual and prospective approach helps us consider the circulation of literary tastes across the colonial divide and recognize the production of forgetfulness and ignorance that accompanied modern narratives of languages and literary histories, both colonial and Indian, and that made a host of texts “homeless” (Mohamad Tavakoli-Targhi).
Gridlock Politics
Authors: Barak On
Published: May 2019

Anwar Sadat's “open door” policy involved the forceful promotion of an American-inspired car society. This essay traces the development of Egypt's motorscape by recounting the first eight decades of automobility in Egypt. Focusing on the 1970s, it suggests that the increasing number of vehicles on the road and consequent congestion were the result, and apparently also the driving force, of politics at every level: from class and gender to geopolitics. In particular, the adoption of the car during the infitah was informed by a discourse of demographic and urban crisis that it was meant to solve yet actually aggravated. Contrasting the private car to the public bus—and stressing zahma, population control, and regulation of sexuality—brought to the fore gendered aspects of automobility and especially sexual harassment rather than issues such as energy efficiency, traffic accidents, and environmental pollution, which would describe the car as the more dangerous vehicle. This contextualization helped neutralize the immoral connotations cars carried over from the prerevolutionary era. Against this background, Egypt's motorscape was partitioned into public and private, dangerous and safe, humiliating and respectable, in a way that made the bus stand for all the former connotations and the car for all the latter.
Developmental origins for semilunar valve stenosis identified in mice harboring congenital heart disease-associated GATA4 mutation
Authors: LaHaye Stephanie , Majumdar Uddalak , Yasuhara Jun , Koenig Sara N. , Matos-Nieves Adrianna , Kumar Rahul , Garg Vidu
Published: May 2019

Congenital heart defects affect ∼2% of live births and often involve malformations of the semilunar (aortic and pulmonic) valves. We previously reported a highly penetrant GATA4 p.Gly296Ser mutation in familial, congenital atrial septal defects and pulmonic valve stenosis and showed that mice harboring the orthologous G295S disease-causing mutation display not only atrial septal defects, but also semilunar valve stenosis. Here, we aimed to characterize the role of Gata4 in semilunar valve development and stenosis using the Gata4G295Ski/wt mouse model. GATA4 is highly expressed in developing valve endothelial and interstitial cells. Echocardiographic examination of Gata4G295Ski/wt mice at 2 months and 1 year of age identified functional semilunar valve stenosis predominantly affecting the aortic valve with distal leaflet thickening and severe extracellular matrix (ECM) disorganization. Examination of the aortic valve at earlier postnatal timepoints demonstrated similar ECM abnormalities consistent with congenital disease. Analysis at embryonic timepoints showed a reduction in aortic valve cushion volume at embryonic day (E)13.5, predominantly affecting the non-coronary cusp (NCC). Although total cusp volume recovered by E15.5, the NCC cusp remained statistically smaller. As endothelial to mesenchymal transition (EMT)-derived cells contribute significantly to the NCC, we performed proximal outflow tract cushion explant assays and found EMT deficits in Gata4G295Ski/wt embryos along with deficits in cell proliferation. RNA-seq analysis of E15.5 outflow tracts of mutant embryos suggested a disease state and identified changes in genes involved in ECM and cell migration as well as dysregulation of Wnt signaling. By utilizing a mouse model harboring a human disease-causing mutation, we demonstrate a novel role for GATA4 in congenital semilunar valve stenosis.

This article has an associated First Person interview with the joint first authors of the paper.
Three-dimensional radiographic features of ameloblastoma and cystic lesions in the maxilla
Authors: Meng Yuan , Zhao Ya-Ning , Zhang Ya-Qiong , Liu Deng-Gao , Gao Yan
Published: May 2019

Objectives:

To characterize the radiographic features of maxillary ameloblastoma (AM), odontogenic keratocyst (OKC) and dentigerous cyst (DC) comparatively by using spiral CT and cone beam CT (CBCT).

Methods:

Clinical records, histopathological reports, and nonenhanced spiral CT or CBCT images of 191 consecutive patients with primary maxillary AMs, OKCs, or DCs were retrospectively acquired, and radiographic features were analyzed.

Results:

The study included 118 males and 73 females (age: 5–84 years). 72.0% of AMs and 84.3% of OKCs originated from the posterior maxilla, while 69.6% of DCs occurred in the anterior maxilla. Among 25 AMs, 44.0% were of desmoplastic type, with honey-combed appearance. 84.0% of AMs were circular or oval in shape, 84.0% expanded buccally, and 36.0% invade the nasal floor. Among 89 OKCs of 88 patients, 61.8% were circular or oval, 58.4% expanded buccally, 49.4% were dentigerous, 41.6% nearly filled the maxillary sinus, and 13.5% invaded the nasal floor. 93.7% (74/79) of DCs enveloped a single tooth, and the tooth–cyst relationship was centripetal in 35, eccentric in 30, and circumferential in 9. Moreover, 98.2% (55/56) of the cysts enveloping a supernumerary tooth were DCs, while 80.9% (38/47) of the cysts enveloping the third molar were OKCs.

Conclusions:

Maxillary AMs tend to grow with buccal expansion and invade the nasal floor, and DAs with honey-combed lobularity are common. Maxillary OKCs have variant shapes and tend to invaginate the maxillary sinus. The tooth–cyst relationship of dentigerous OKCs and DCs can be centripetal, eccentric, or circumferential.
Representing antibiotic relationships using measurements of efficacy against clinical isolates
Authors: Shaw Liam
Published: May 2019

Introduction. Antimicrobial resistance (AMR) is a worrying and confusing problem for both patients and medical professionals. Current antimicrobial nomenclature makes it difficult to understand how different antibiotics are related to one another, and their empirical uses and efficacy. Here, I attempt to address this problem by using experimental data from hundreds of thousands of clinical isolates to infer relationships between antibiotics and represent them with simple diagrams.

Methods. The minimum inhibitory concentration (MIC) of a bacterial isolate for a given antibiotic is defined as the lowest concentration that prevents visible growth. Measuring MICs for multiple antibiotics using the same isolate implicitly records the relationships of the antibiotics for a given species. The basic principle is that antibiotics with similar activities have similar mechanisms of action. Therefore, they should produce similar resistances, so should have correlated MICs. This information can then be used to calculate distances between antibiotics based on pairwise correlations of their rank-ordered MICs. I apply this approach to a large historical AMR surveillance dataset (the Pfizer ATLAS surveillance dataset, 2004-2017).

Results. I demonstrate that clustering antibiotics in this way allows a simple visual comparison of how similar antibiotics are to each other based on their efficacy within a species. The resulting visualizations broadly recapitulate antibiotic classes. They also clearly show the dramatic effects of combination therapies, as well as highlighting antibiotics which have unexpected correlations in MICs that are not predicted from their chemical similarities alone (i.e. suggesting co-occurring resistance mechanisms).

Conclusion. Large AMR surveillance datasets can be used in a hypothesis-free manner to show relationships between antibiotics based on their real-world efficacy. The resulting 'data-driven' diagrams could be used as simple visual aids to explain the complexity of antibiotic relationships and AMR.
The Learning Journal Bridge: From Classroom Concepts to Leadership Practices
Authors: Maellaro Rosemary
Published: May 2019

The value of reflective writing assignments as learning tools for business students has been well-established. While the management education literature includes numerous examples of such assignments that are based on Kolb’s (1984) experiential learning model, many of them engage only the first two phases of the model. When students do not move through the complete model, they are less likely to take what they learn from the classroom to the workplace. This article describes a graduate learning journal assignment that incorporates all phases of Kolb’s model. The assignment’s success in creating a bridge between simply learning about leadership and actually putting leadership knowledge into practice is grounded in three learning theories.
Texas FFA Officer Perceptions of Good Followership
Authors: Ferrell Susan Kate , Boyd Barry L. , Rayfield John
Published: May 2019

This study examines Texas FFA officers’ perceptions regarding the traits and characteristics that good followers possess. A content analysis of officer responses to an open-ended question found that these young leaders have a limited level of understanding of what constitutes a good follower. Furthermore, female respondents placed a greater emphasis on supporting the leader and being respectful, whereas male respondents emphasized being a team player. Males also emphasized being involved in the chapter as a desirable trait more often than females. This suggests that females are more focused on ideas that are leader-supportive and males are more action driven. Males focused more on being a team and achievement. The study demonstrates a need to emphasize followership in leader development and education curricula. Youth organizations with similar leadership development programs can better equip their future leaders with the knowledge needed to be a follower-focused leader by teaching them how to identify good followership. As youth organizations become more follower-focused, failure to introduce followership instruction into the leadership classroom is a disservice to students.
Vision and Leadership: Problem-based Learning as a Teaching Tool
Authors: Archbald Douglas
Published: May 2019

We read and hear frequently about the role of vision in leadership. Standards for leadership education programs typically emphasize vision as a core component of leadership education and published accounts of successful leadership usually extol the leader’s vision. Given the prevalence of this term in discourse on leadership, it is surprising how little literature exists with specific discussions of how to teach it. In this article I discuss the potential of problem-based pedagogy for teaching the concept of vision. This paper draws on literature, theory, and my professional experience as a faculty member for 20 years in a graduate-level education leadership program.
Using Involvement Theory to Examine the Relationship between Undergraduate Participation in Extracurricular Activities and Leadership Development
Authors: Foreman Elizabeth A. , Retallick Michael S.
Published: May 2019

This study examined the relationship between extracurricular involvement and leadership outcomes among traditional-age college seniors in the College of Agriculture and Life Sciences at Iowa State University. We collected data related to quantitative (i.e., how much time a student spends on an activity) and qualitative (i.e., how focused the student is on the activity) aspects of involvement in extracurricular organizations. We measured leadership, as an outcome, using the individual values scale of the Socially Responsible Leadership Scale (SRLS-R2). The number of clubs in which a student participated and served as an officer was associated with higher leadership scores. We identified a threshold of involvement that suggests the optimum number of clubs or organizations to be actively involved in is three to four.
CULTIVATINGINNOVATIVETEEN-LEADERSHIPPROGRAMMING: BUILDING EVIDENCE OF IMPACT
Authors: Johnson Jeremy C. , Seibel Megan M. , Bush Sarah A. , Grove Benjamin B.
Published: May 2019

The Teen Excellence in Leadership Institute (TELI) was created to provide meaningful leadership and civic- engagementexperiencestoteens.WeintegratedChickering’sTheoryofIdentityDevelopmentandthe 4-H Citizenship Framework to develop program objectives and a model, consisting of four components: understanding of self, developing a network, community problem solving, and advocacy. This study aimed to determinetheoveralleffectivenessoftheprogram,highlightareasforprogramimprovement,andprovide a proof of concept for the model. Results on select 4-H Citizenship Common Measures indicated statistically significantgainsinthefourcomponentsofthemodelforcohortsoneandtwo.Focusgroupdatarevealed five themes: diversity, connection, skill development, practical application, and learning about self. Evaluative resultssubstantiateprogramimpactandareasforcontinuedprogramdevelopment.
MEASURING LEADER SELF-EFFICACY AMONG YOUTH
Authors: Christopher J , Selznick Benjamin S.
Published: May 2019

Leader self-efficacy (LSE) is a construct studied in adults and college students which is associated with leader emergence, individual performance, and group performance.However, to date, it has not been heavily examined in youth.Therefore, a five-item youth LSE scale was created which can aid in further research of this construct.This holds significant implications for future educational initiatives, research, and the development of the next generation of leaders.
Gastro-oesophageal reflux disease in adults
Authors: Perry Margaret
Published: May 2019

Gastro-oesophageal reflux disease is an unpleasant condition, reported to account for about 5% of GP consultations in western Europe ( United European Gastroenterology, 2018 ). Patients often describe a number of symptoms, which can make identifying the underlying cause challenging. The problem is reported to affect 25% of the population and is two to three times more common in men than in women, with 1% of the population suffering daily symptoms ( Ford and Moayyedi, 2009 ). This article will provide non-medical prescribers an overview of treatment and management and aims to give them more confidence in prescribing for their patients with this condition.
Achieving Royal Pharmaceutical Society competencies: a frailty nurse's perspective
Authors: Banks Joanna
Published: May 2019

Frailty is related to the ageing process and describes how a person's inbuilt reserve struggles to withstand major changes in health, such as infection, a change to medication or a new environment. The British Geriatric Society (2014) approximate that around 10% of people over the age of 65 years have frailty rising to between a quarter to a half of those aged over 85 years. Patients who are deemed frail are often at risk of adverse outcomes; therefore, it is important to seek out these individuals and care for them appropriately. This includes carrying out regular medication reviews and deprescribing where necessary.

This article will discuss prescribing for frail patients using the Royal Pharmaceutical Society's Competency Framework for all Prescribers.
Representing women, women representing: backbenchers’ questions during Prime Minister’s Questions, 1979–2010
Authors: Bates Stephen Holden , Sealey Alison
Published: May 2019

This article investigates linguistic traces of changing trends in the substantive representation of women, as well as broader representational claims related to constituencies, via an analysis of all backbench questions posed during Prime Minister’s Questions in the UK House of Commons during 1979–2010. We investigate the impact of sharp increases in female MPs, in particular, left-wing female MPs, and the presence of a left-wing government on MPs’ talk about women and about constituencies. We find no evidence of curvilinear trends in talk about women related to changes in government and female parliamentary presence. We also find that female MPs can be considered critical actors with regard to constituency talk.
Muslim Perkotaan di Tengah Pusaran Pilkada 2017 di Kota Yogyakarta
Authors: Isnanto Muh
Published: May 2019

In the 2017 elections in the city of Yogyakarta, which used to be the basis for the number 1 candidateâ€™s voice bag carrying Imam Priyono-Ahmad Fadli suffered defeat, this event if connected with the product 3 times the election in the reform era, this may not have much benefit to the lives of the people, the leaders or respected members of the council are still busy thinking about the bearer party rather than thinking about the interests and or needs of the real people, especially the welfare of the people in general. The problem is how high is the level of concern of urban Muslims in the city of Yogyakarta towards the candidate pair (Paslon) in the 2017 elections and why are urban Muslim communities like that, what are the factors? Research results show that, firstly, the level of concern of the urban Muslim community towards the Regional Head candidates in the 2017 elections. The community has started to use the basis of their rationality and religious awareness by always checking/recognizing their candidate pairs (47%), considering quality by never considering religious attributes 47%, always considering intelligence 53%, not considering gender 70% and ethnicity 69%, always considering 61% personality, 41% expertise, 45% participation. More than half (54%) warned that they knew that a candidate pair was using improper means and refused when a candidate in the election tripped over a case. More than half (52%) did not choose a candidate pair who tripped over the case. Report potential regional head pairs if someone cheats or violates the law. more than half (64%) report to the authorities. Secondly, factors that cause high concern because of the institutionalization of democracy, the election as a shortcut; and religious awareness
Игорь Кон: «Если бы в начале 1980-х меня куда-нибудь выпустили, я бы точно не вернулся»
Authors: Шалин Дмитрий Николаевич
Published: May 2019

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Феномен прекариата: комплексный исследовательский подход. Рец. на кн.: Тощенко Ж.Т. Прекариат: от протокласса к новому классу / Институт социологии ФНИСЦ РАН, РГГУ. М.: Наука. 2018.
Authors: Воловская Нина Михайловна , Плюснина Лидия Константиновна
Published: May 2019

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Kesulitan “Weaning” pada Kasus Flail Chest Akibat Fraktur Sternum yang Tidak Teridentifikasi
Authors: Edwar Pesta Parulian Maurid , Airlangga Prananda Surya , Salinding Agustina , Semedi Bambang Pujo , Sylvaranto Teguh , Rahardjo Eddy
Published: May 2019

Latar Belakang:Trauma toraks menyebabkan 20% dari semua kematian akibat trauma. Salah satu yang memiliki morbiditas dan mortalitas tinggi adalah flail chestdan fraktur sternum merupakan sebagian kecil dari penyebab flail chest. Mengingat kejadiannya yang sangat jarang maka fraktur sternum sering menjadi jebakan diagnostik yang terlupakan pada flail chest.Laporan Kasus:Terdapat 2 kasus yang dilaporkan dengan trauma toraks. Kasus pertama adalah multitrauma dengan Injury Severity Score(ISS) 50, trauma kepala, trauma abdomen dan trauma ekstremitas. Setelah dilakukan stabilisasi hemodinamik selama 3 hari, pasien sulit disapih dari ventilasi mekanik. Setelah tidak ditemukan lagi sumber perdarahan dan hemodinamik stabil pasien segera disiapkan operasi daruratdan ditemukan penyebabnya adalah fraktur sternum yang tidak teridentifikasi sebelumnya. Kasus kedua adalah trauma toraks dengan ISS 17, secara klinis tampak flail chestdan foto toraks antero-posterior yang normal. Setelah dilanjutkan CT scantoraks ditemukan fraktur sternum yang menyebabkan  pernafasan tidak adekuat. Segera dilakukan fiksasi eksternal dan hasilnya  memuaskan.Diskusi: Fraktur sternum seringkali disebabkan oleh mekanisme trauma toraks anterior yang berat dan dapat menimbulkan manifestasi flail chestsehingga dapat meningkatkan morbiditas dan mortalitas terlebih lagi bila disertai adanya trauma pada sistem organ lain serta penggunaan ventilator mekanik jangka panjang dan sepsis. Kejadian fraktur sternum sangat jarang dan foto toraks lateral pada kasus trauma juga jarang dilakukan sehingga seringkali fraktur sternum tidak teridentifikasi. Dengan mengetahui mekanisme trauma, gejala klinis yang tidak sesuai dengan gambaran foto toraks antero-posterior dan sulitnya penyapihan dari ventilasi mekanik  maka penggunaan ultrasonografi untuk skrining diharapkan dapat membantu menghindari jebakan terlambatnya identifikasi fraktur sternum.Kesimpulan:Pada trauma toraks dengan adanya fail chest, diagnostik dini diikuti fiksasi eksternal akan mengurangi morbiditas dan mortalitas pada pasien fraktur sternum.
Perbandingan Efektivitas Patient-Controlled Analgesia (PCA) Fentanil, PCA Morfin dan Tramadol Intravena Sebagai Analgetik Pasca Operasi Modified Radical Mastectomy (MRM)
Authors: Madjan Arie Faishal , Nurcahyo Widya Istanto
Published: May 2019

Latar Belakang: Operasi Modified Radical Mastectomy menimbulkan nyeri derajat sedang hingga berat pasca operasi. Sebagian pasien yang mendapat kombinasi anagetik tramadol dan ketorolak secara berkala, masih mengeluh nyeri. PCA merupakan metode baru pemberian analgetik. Penggunaan PCA fentanil dan PCA morfin diharapkan dapat lebih efektif dalam mengatasi nyeri pasca operasi MRM.Tujuan: Penelitian ini bertujuan untuk mengetahui perbandingan efektivitas, efek samping dan tingkat kepuasan pasien antara penggunaan PCA fentanil, PCA morfin dan tramadol intravena sebagai analgetik pasca operasi MRM.Metode:Dilakukan uji klinis tersamar ganda terhadap 36 pasien rencana operasi MRM yang memenuhi kriteria penelitian. Setelah dilakukan anestesi umum, pasien dibagi dalam 3 kelompok perlakuan pemberian analgetik pasca operasi: (1) kelompok PCA fentanil dengan fentanil loading dose 50 mcg, demand dose 20 mcg, lockout interval 10 menit, limitdose 70 mcg/jam, background infusion 30 mcg/jam; (2) kelompok PCA morfin dengan morfin loading dose 4 mg, demand dose 1 mg, lockout interval 10 menit, limit dose 6 mg/jam, tanpa background infusion; (3)kelompok tramadol yang mendapat tramadol intravena 100 mg/8jam. Dilakukan penilaian berkala skor NRS, RASS, tanda vital, efek samping dan tingkat kepuasan pasien selama 24 jam pasca operasi. Data dianalisa dengan Shapiro-Wilk dilanjutkan Kruskal-Wallis atau One way ANOVA, dianggap bermakna bila p< 0,05.Hasil:Efektivitas terbaik pada PCA fentanil, diikuti PCA morfin lalu tramadol. Skor RASS PCA fentanil dan PCA morfin lebih rendah dari tramadol (p=0,000). Terdapat efek samping mual, muntah dan dizziness yang secara statistik tidak berbeda bermakna. Tingkat kepuasan pasien tertinggi pada kelompok PCA fentanil, sedangkan antara kelompok PCA morfin dan tramadol tidak berbeda bermakna(p=0,009).Simpulan: PCA fentanil dan PCA morfin lebih efektif dibandingkan tramadol. PCA fentanil memberikan tingkat kepuasan pasien yang lebih tinggi dibanding PCA morfin dan tramadol. Terdapat efek samping mual, muntah dan dizziness namun secara statistik tidak berbeda bermakna.
Perbandingan Respon Hemodinamik 3 Menit dan 5 Menit Setelah Pemberian Fentanyl 2 mcg/kgbb iv saat Intubasi di RSUD DR Saiful Anwar Malang
Authors: Ainun Zakiyah , Basuki Djudjuk Rahmat , Isngadi Isngadi
Published: May 2019

Pendahuluan : upaya dalam mengurangi respon hemodinamik akibat laringoskopi intubasi dapat dengan non farmakologi maupun farmakologi salah satunya dengan fentanyl. Usaha tersebut dapat menurunkan morbiditas dan mortalitas sehingga memberikan output yang baik. Tujuan: untuk mengetahui apakah waktu 5 menit setelah injeksi fentanyl merupakan waktu yang tepat dalam melakukan tindakan laringoskopi intubasi dibandingkan dengan 3 menit setalah injeksi fentanyl.Metode : 43 pasien dengan status fisik ASA 1 dan II dilakukan pembiusan umum dengan pemasangan pipa endotrakea,di pilih secara tersamar acak tunggal. Sample penelitian dibagi menjadi dua kelompok yaitu kelompok I dengan 3 menit setelah pemberian fentanyl 2 mcg/kgbb dan kelompok II 5 menit setelah pemberian fentanyl 2 mcg/kgbb. Pasien diinduksi dengan propofol 2 mg/kgbb, difasilitasi dengan rocuronium 0.6 mg/kgbb. Kondisi respon hemodinamik dinilai sebelum induksi dan satu menit setelah laringoskopi intubasi, kemudian dibandingkan apakah waktu kelompok II lebih rendah daripada kelompok I. Data yang didapat akan diolah dengan SPSS 20.0. karakteristik akan diuji normalitas dengan Shapiro-wilk dan homogenitas dengan levene test. Perbandingan respon hemodinamik dua kelompok di uji dengan uji t sampel tidak berpasangan dengan tingkat kemaknaan p<0.05. Hasil : terdapat perbedaan bermakna pada kedua kelompok pada variabel sistolik (pada kelompok I rerata 9.95±20.72, kelompok II -4.04 ±19.08 dengan p 0.026), diastolik (reratakelompok 1 6.90±13.78 dan kelompok II -3.69n±11.76 dengan p 0.010), dan tekanan arteri rerata (rerata kelompok I 8.70 ±16.19 dan kelompok II rerata -4.91±14.04 dengan p 0.05). sedangkan untuk variabel denyut nadi tidak bermakna secara statistic p 0.082. Simpulan : tekanan darah akibat laringoskopi intubasi dilakukan setelah 5 menit injeksi fentanyl lebih rendah daripada 3 menit setelah injeksi fentanyl dan denyut nadi tidak didapatkan perbedaan antara kelompok 5 menit injeksi fentanyl dengan 3 menit setelah injeksi fentanyl pada pasien yang dilakukan anestesi umum.
Rasio Netrofil Limfosit dan Limfositopenia Sebagai Penanda Sepsis
Authors: Maqbul Puja Laksana , Leksana Ery , Harahap Mohamad Sofyan
Published: May 2019

Latar Belakang : Keadaan sepsis pada awalnya akan menyebabkan peningkatan jumlah netrofil diikuti oleh peningkatan limfosit, keadaan sepsis yang bertahan akan menyebabkan apoptosis dari limfosit, sehingga rasio netrofil limfosit akan meningkat, dan terjadi limfositopenia yang dapat dijadikan indikator sepsis.Tujuan : Mengetahui nilai RNL dan hitung limfosit pada pasien dicurigai sepsis di RSUP Dr. Kariadi Semarang.Metode : Penelitian ini merupakan penelitian diagnostik non eksperimental dengan desain cross sectional dengan jumlah sampel 30 pasien. Pasien ICU dengan dua atau lebih tanda SIRS dan dicurigai infeksi diambil sampel darah untuk dilakukan pemeriksaan hitung jenis leukosit dan pemeriksaan kultur darah, kemudian data dianalisis menggunakan kurva ROC.Hasil : Sumber infeksi terbanyak terjadi pada traktus digestivus (43,3%), obstetri ginekologi (23,3%), traktus respiratorius (16,7%), cerebrovaskular (10%) dan traktus urinarius (6,7%). Rasio Netrofil Limfosit memiliki AUC 0,425 (sensitivitas 60% dan spesifitas 20%), Limfositopenia absolut memiliki AUC 0,425 (sensitivitas 40% dan spesifitas 40%), sedangkan RNL dan Limfositopenia memiliki AUC 0,575 (sensitivitas 70% dan spesifitas 45%).Kesimpulan : Rasio Netrofil Limfosit dan Limfositopenia absolut tidak bisa dijadikan indikator sepsis pada pasien-pasien di ICU walaupun memiliki sensitivitas 70% dan spesisifitas 45%.
Zarządzanie wartością zdrowia w marketingu na przykładzie wybranych reklam koncernów farmaceutycznych
Authors: Barańska Marzena
Published: May 2019

Przedmiotem artykułu jest kwestia zarządzania wartością zdrowia w marketingu. Autorka podejmuje się analizy problemu w odniesieniu do wybranych reklam koncernów farmaceutycznych, korzystając m.in. z teorii potrzeb. Autorka zwraca uwagę, że ładunek perswazyjny przekazu audiowizualnego w odniesieniu do wyrobów farmaceutycznych wywiera większy wpływ na szczególnego adresata przekazu, jakim jest konsument, którego poziom analizy treści jest obniżony z uwagi na stan chorobowy. Autorka zauważyła we wnioskach końcowych, że skuteczność kampanii reklamowych zobowiązuje do poszukiwania nowych skutecznych narzędzi oddziaływania. Umiejętność zarządzania wymaga nieustannego analizowania otoczenia, zmieniających się preferencji konsumentów. W ostatnich latach coraz częściej obserwujemy instrumentalne wykorzystanie wartości. Poprzez połączenie z rekomendowanym towarem podnoszą jego atrakcyjność.