bluuebunny/crossref_metadata_2025 huggingface dataset:
Knots in the Discourse of Innovation: Investigating Multiple Tensions in a Reacquired Spin-off
Authors: Sheep Mathew L. , Fairhurst Gail T. , Khazanchi Shalini
Published: May 2016

We examine the case of a corporate spin-off, in which its reacquisition by the parent firm radically changed its structure and culture. Employing a discourse lens, we study paradoxical tensions of innovation as key members “talk into being” the paradoxical circumstances of their environment. From our analysis, we develop the concept of tensional “knots,” discursive formulations in which members construct tensions, not only as co-occurring, but as Gordian (inseparable) entanglements of interdependence. Knotted tensions can be amplifying (exacerbating) or attenuating (improving) in their effects on one another, but with very different consequences to innovative action. Specifically, knotted tensions and the way in which members manage them set up counter-intuitive logics that serve to justify courses of innovative action or inaction. We propose a process model advancing understanding of interlinked tensions in more complex ways than current paradox theory allows. We conclude with a discussion of our contributions to paradox theory in innovative contexts, along with suggestions for future research.
Taking the bus in peri-urban Mexico City: Bodily perspectives on own and urban becoming
Authors: von Wissel Christian
Published: May 2016

This paper explores the movement of bodies in urbanising landscapes. In particular, it looks at the bodily practice that unfolds at a ‘bus stop made by stopping buses’ in peri-urban Mexico City. Doing so, I pursue three questions: What are the specificities of bodily practice in the peri-urban realm and out of what socio-material conditions do they emerge? How does this practice sit within notions of informality and cityness? And what urban imaginaries do peri-urban practitioners ‘grow’ out of their direct engagement with the material environment, that is, in this case, when taking buses? The bus stop in question is located in the municipality of Tecámac, State of Mexico, in the Metropolitan Area of Mexico City (ZMVM). It is a site of pure activity, social occurrence without being forged into built form; a site with ‘nothing there’ but the encounter of travellers and buses along the Mexico City-Pachuca highway. Carefully examining the seemingly banal activity of flagging down and boarding buses, however, allows us to take seriously the bodily and material dimensions of urban life and to acknowledge their influence on how city is made and thought. The paper draws on ethnographic research with a focus on visual and sensory methods.
Delivering on the Big Society? Tensions in hosting community organisers
Authors: Fisher Jenny , Lawthom Rebecca , Kagan Carolyn
Published: May 2016

The Big Society, including the community organising programme, was central to the UK Prime Minister, David Cameron’s vision for a redefined relationship between state and society. Promising the devolvement of power to neighbourhoods and citizens – Community organising was funded by the Cabinet Office in 2011. It was conceived of as a means of developing active engagement of communities and individuals to resolve the issues within deprived neighbourhoods. Manchester Metropolitan University hosted one of the first cohorts of community organisers working with a national organisation, Locality. This article provides a case study of a university-community partnership centred on community organising. Drawing on narratives, we consider the tensions inherent in university hosting of community organisers and the framing of the project as community organising as distinct from other forms of community practice.
Palliative lumboperitoneal shunt for leptomeningeal metastasis–related hydrocephalus: A case series
Authors: Yamashiro Shigeo , Hitoshi Yasuyuki , Tajiri Seiji , Uchikawa Hiroki , Ito Kiyotaka , Yoshida Akimasa , Kuratsu Jun-ichi
Published: May 2016

Background:

Leptomeningeal metastasis–related hydrocephalus causes distress to patients with end-stage cancer through headache and other symptoms by elevating intracranial pressure, thus reducing quality of life. Ventriculoperitoneal shunt has been used as a treatment option in palliative care. We review four cases of patients who underwent lumboperitoneal shunt for leptomeningeal metastasis–related hydrocephalus.

Cases:

All patients suffered from severe headache and nausea. The primary lesion was histologically diagnosed as lung adenocarcinoma in each case. The duration from diagnosis to onset of hydrocephalus symptoms ranged from 0 to 52 (mean 26) months. Cerebrospinal fluid pressure in every case was above the normal range due to high intracranial pressure.

Case management:

Conventional procedures for lumboperitoneal shunt were employed for all patients. Adjustable pressure valves were retrofitted into the shunt system.

Case outcome:

Three patients demonstrated significant improvement of clinical symptoms and quality of life after placement of lumboperitoneal shunts. In two cases, not only did performance status improve to independent daily activity but also comparatively long-term survival was achieved due to subsequent chemotherapies after surgery. No symptoms of peritoneal dissemination by floating cancer cells in cerebrospinal fluid were seen in any patients.

Conclusion:

Lumboperitoneal shunt appears to improve quality of life if the patient is suffering from symptoms of leptomeningeal metastasis–related hydrocephalus. Compared to ventriculoperitoneal shunt, lumboperitoneal shunt is less invasive and simpler, providing a suitable option for frail patients with end-stage cancer. Adjustable pressure shunt valves can cope with varying symptoms and ventricle sizes.
The Hidden Role of Teachers: Child and Classroom Predictors of Change in Interracial Friendships
Authors: Cappella Elise , Hughes Diane L. , McCormick Meghan P.
Published: May 2016

Children in late elementary and middle school tend to form friendships with same-race peers. Yet, given the potential benefits of cross-race friendships, it is important to understand the individual and contextual factors that increase the likelihood of cross-race friendship over time. Guided by contact hypothesis and systems theory, we examine the student and classroom predictors of change in same-race friendships over 1 school year using a sample of 553 African American and European American students in 53 classrooms. Results suggest that same-race friendships increase over time, with greater increases among European American and older children. Youth externalizing behavior predicted a greater increase in same-race friendships; classroom support predicted less of an increase in same-race friendships from fall to spring. Lastly, African American students in classrooms with greater differential teacher treatment were more likely to engage in cross-race friendships over time. Findings are discussed in light of psychological and educational theories and prior research.
Stakeholder Engagement and Public Information Through Social Media: A Study of Canadian and American Public Transportation Agencies
Authors: Manetti Giacomo , Bellucci Marco , Bagnoli Luca
Published: May 2016

This study uses theories on dialogic accounting to assess whether online interaction through social media is used as a mechanism of public information and stakeholder engagement by Canadian and American public transportation agencies. We embraced a quantitative methodology in which content analysis was performed on the Facebook and Twitter accounts of 35 transit operators in Canada and the United States. We categorized the contents of 1,222 Facebook posts and 2,615 tweets, assessed which level and what type of interaction was effectively reached for every category, tracked whether and how agencies reply to comments on their posts, and assessed the general tenor of the discussion. Our results show that public transportation agencies often take advantage of their presence on social media to provide the public with information on their services and to perform activities associated with stakeholder engagement. However, we have found some significant differences in the utilization of social media by public transportation agencies, all of which are discussed in the “Conclusion” section of this article. Twitter is most often used for public information messages, while Facebook appears to be used more to publish content in a dialogic perspective that creates two-way, collaborative conversations with users. In terms of practical implications, our study suggests that a broader and more continuous commitment to interaction between users and stakeholders on social media would create new opportunities for improving transparency and, indirectly, the services of public agencies.
On dimensionless numbers for the dynamic plastic response of quadrangular mild steel plates subjected to localized and uniform impulsive loading
Authors: Babaei Hashem , Mirzababaie Mostofi Tohid , Armoudli Ehsan
Published: May 2016

This paper studies the dynamic plastic response of thin quadrangular mild steel plates subjected to uniform and localized impulsive loading. For this, two new dimensionless numbers based on dimensionless governing equation of plates have been suggested. Four different effective parameters such as plate geometry, inertia of applied load, mechanical properties of material and strain rate sensitivity have been considered in suggested dimensionless numbers. The unknown coefficients of these numbers have been calculated by using singular value decomposition method. In order to illustrate the ability of empirical constitutive equations for predicting the maximum deflection, these equations are compared with different sets of experimental results that have been performed by various researchers. The comparison between the results of present empirical equations and the other theoretical and experimental ones shows that these models are more accurate than the other ones and are suitable to use for predicting the maximum deflection of all quadrangular mild steel plates subjected to uniform and localized loading.
Self-collected genital swabs compared with cervicovaginal lavage for measuring HIV-1 and HSV-2 and the effect of acyclovir on viral shedding
Authors: McNicholl Janet M , Leelawiwat Wanna , Whitehead Sara , Hanson Debra L , Evans-Strickfaden Tammy , Cheng Chen Y , Chonwattana Wannee , Mueanpai Famui , Kittinunvorakoon Chonticha , Markowitz Lauri , Dunne Eileen F
Published: May 2016

HIV-1 and HSV-2 are frequent genital co-infections in women. To determine how self-collected genital swabs compare to provider-collected cervicovaginal lavage, paired self-collected genital swabs and cervicovaginal lavage from women co-infected with HIV-1 and HSV-2 were evaluated. Women were in an acyclovir clinical trial and their samples were tested for HIV-1 RNA (361 samples) and HSV-2 DNA (378 samples). Virus shedding, quantity and acyclovir effect were compared. HIV-1 and HSV-2 were more frequently detected in self-collected genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage had detectable HIV-1 (p ≤ 0.001, Fisher’s exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage had detectable HSV-2 (p ≤ 0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs virus levels were correlated (Spearman’s rho, 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling, self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1, proportional odds ratios were 0.42 and 0.47 and for HSV-2, they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage, respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling.
Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care
Authors: Lindley Lisa C. , Cozad Melanie J.
Published: May 2016

Objective:

To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations.

Methods:

Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data.

Results:

Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = −.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = −.041, P < .05) and rural areas (β = −.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05).

Conclusion:

The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.
Transitions to End-of-Life Care for Patients With Chronic Critical Illness: A Meta-Synthesis
Authors: Leung Doris , Angus Jan E. , Sinuff Tasnim , Bavly Sherri , Rose Louise
Published: May 2016

Background:

Adults with chronic critical illness (CCI) frequently experience a terminal trajectory but receive varying degrees of palliation and end-of-life care (EOLC) in intensive care units (ICUs). Why palliation (over curative treatment) is not augmented earlier for patients with CCI in ICU is not well understood.

Purpose:

To identify the social structures that contribute to timely, context-dependent decisions for transition from acute care to EOLC for patients with CCI and their families.

Methods:

We conducted a meta-synthesis of qualitative and/or mixed-method studies that recruited adults with CCI, their families or close friends, and/or health-care providers (HCPs) in an ICU environment.

Results:

Five studies reported data from 83 patients, 109 family members, and 57 HCPs across 5 institutions in Canada and the United States. Overall, we found that morally ambiguous social expectations of treatment tended to lock in HCPs to focus on prescriptive work of preserving life, despite pathways that could “open” access to augmenting palliation and EOLC. This process limited space for families’ reflexivity and reappraisal of CCI as a phase liminal to active dying. Notably, EOLC mechanisms were informal and less visible.

Conclusion:

The management of dying is one of the central tenets of ICU care. Our findings suggest that patients and families need help in negotiating meanings of this situation and in using mechanisms that allow reappraisal and permit understanding of CCI as a phase liminal to dying. Moreover, these mechanisms may paradoxically reduce the ambiguity of patients’ future, allowing them to live more fully in the present.
Effects of functionally graded adhesive on failures of socket joint of laminated FRP composite tubes
Authors: Nimje SV , Panigrahi SK
Published: May 2016

The effects of functionally graded adhesive on failures in socket joint of laminated FRP composite tubes are analyzed in the present research. Various types of failures in the socket joint have been studied using strength of materials and fracture mechanics approach. The critical location in the socket joint has been identified using strength of material approach. Subsequently, the principle of fracture mechanics has been employed with a presumption that a circumferential failure front pre-exist at the critical location in the socket joint. The failure evolution in the functionally graded adhesively bonded socket joint of laminated FRP composite tubes and fracture behaviour of embedded failures have been discussed with respect to the variation of fracture parameters such as the individual modes of strain energy release rates (SERR) along the failure front. The novelty of functionally graded adhesive is introduced with linear function profile in order to improve the failure growth resistance of the socket joint structure. Based on the failure indices, it has been observed that free edges of the coupling region are more vulnerable zones for interfacial failure initiation as failure indices for all the critical surfaces of bond layer are found to be the highest at those locations. Further, the effects of functionally graded adhesive with varied modulus ratios on failure onset are observed for critical surface. It has been observed that the failure onset and its propagation shall be reduced/delayed due to the use of functionally graded adhesive in the joint. Based on the failure growth studies, it has been noticed that interfacial failure propagation is governed by in-plane shearing mode and, other modes are insignificant in propagation. Efforts have been made to enhance the crack/damage growth resistance properties of the bonding material. Series of FE simulations have been carried out for varied interfacial failure length in tubular socket joint with functionally graded adhesive in order to achieve the significant effect of material gradation on SERR. It has been noticed that the effect of material gradation of adhesive on SERR is more predominant for shorter interfacial failure length which leads to delay the failure growth.
Identification of Risk Factors for Bisphosphonate-Associated Atypical Femoral Fractures and Osteonecrosis of the Jaw in a Pharmacovigilance Database
Authors: Bejhed Rebecca S. , Kharazmi Mohammad , Hallberg Pär
Published: May 2016

BACKGROUND: Atypical femoral fractures (AFs) and osteonecrosis of the jaw (ONJ) are well-known adverse drug reactions (ADRs) associated with bisphosphonates. To prevent these ADRs and to aid in the search for pathogenic mechanisms, knowledge of risk factors can be helpful. Objective: To identify risk factors for bisphosphonate-related ONJ and AF. Methods: In this case-control study of reports of bisphosphonate-related ADRs from February 16, 1984, to October 16, 2013, in the Swedish national database of ADRs, we compared characteristics for cases of ONJ (n = 167) and AF (n = 55) with all other bisphosphonate-related ADRs (n = 565) with regard to demographic variables, clinical characteristics, and concomitant drug treatments. We adjusted for multiple comparisons with Bonferroni correction. Results: Time to onset of ADRs differed statistically significantly between cases of AF and controls (2156 vs 111 days). For ONJ versus controls, differences were statistically significant for time to onset (1240 vs 111 days), intravenous administration (40% vs 20%), dental procedures (49% vs 0.2%) and prostheses (5% vs 0%), cancer disease (44% vs 12%), multiple myeloma (21% vs 1%), rheumatoid arthritis (14% vs 5%), and treatment with antineoplastic agents and oxycodone. Conclusion: These results lend further evidence to previously identified risk factors for ONJ—that is, intravenous bisphosphonate administration; invasive dental procedures and dental prostheses; cancer disease, in particular multiple myeloma; and possibly, long-term bisphosphonate treatment. A putative further risk factor is rheumatoid arthritis. Only long-term bisphosphonate treatment was more common among AF cases. The lack of overlap of risk factors between ONJ and AF suggests different pathogenic mechanisms.
Comparative Effects and Analgesic Efficacy of the Agonist-Antagonist Opioids
Authors: Zola Elizabeth M. , McLeod Donald C.
Published: May 2016

Pentazocine, butorphanol, nalbuphine, and buprenorphine are mixed agonist-antagonist opioids that are effective analgesics, with less abuse potential than the agonists morphine, propoxyphene, and codeine. The dual properties of the agonist-antagonists are largely explained by their varying actions at the postulated three types ( μ, κ, and σ) of opioid receptors. The agonist-antagonists are classified as either morphine-like or nalorphine-like, based on their acute effects and withdrawal symptoms after chronic dosing. Buprenorphine is morphine-like, while the other drugs are nalorphine-like. These agents vary in the duration of analgesia, with pentazocine having a mean action of three hours and buprenorphine greater than six hours. The hemodynamic effects of nalbuphine and buprenorphine generally resemble those of morphine, while pentazocine and butorphanol increase cardiac workload, blood pressure, and pulmonary artery pressure. The agonist-antagonists have ceilings for respiratory depression, whereas the agonists produce dose-dependent depression. Agonist-antagonists generally produce less increase in biliary ductal pressure than does morphine. The major clinical limitations are that agonist-dependent patients may experience unpleasant subjective effects, when treated with the agonist-antagonists, and the nalorphine-like agents can produce psychotomimetic effects. More clinical experience is needed to rank the abuse potential within this group of opioids. The newer agents are being studied for oral use in acute and chronic pain.
Hexamethylmelamine and Pentamethylmelamine: An Update
Authors: Hahn Deborah A.
Published: May 2016

An updated review of the anticancer agents hexamethylmelamine (HMM) and its water-soluble analog pentamethylmelamine (PMM) is presented. Severe gastrointestinal and hematologic toxicity have limited the use of HMM drug combinations in ovarian cancer. Combinations involving HMM, cyclophosphamide, cisplatin, and doxorubicin in advanced ovarian cancer have resulted in only moderate response rates, with little to no change in median survival of previously treated patients. HMM now is being studied in previously untreated patients with advanced disease, in combination with these agents. In lung cancer, HMM continues to be a part of intensive and other regimens for the treatment of small-cell and non-small-cell carcinoma, although the value of the HMM is yet to be determined. Future trials have been recommended to determine whether HMM has a role in the treatment of endometrial and prostatic carcinomas. Five phase I studies of PMM have demonstrated severe, dose-limiting gastrointestinal and central nervous system toxicities. Thus, this agent may offer little advantage over HMM. Further phase I studies, with different PMM dosage schedules, are necessary before phase II studies can be recommended.
Effectiveness of Sublingual Clonidine in Patients Unable to Take Oral Medication
Authors: Gilkeson Gary S. , Delaney Robert L.
Published: May 2016

We report evidence that sublingual Clonidine may be effective in the treatment of hypertension in the patient unable to take oral medication. Four cases are presented illustrating the utility of this regimen; few side effects were observed. Sublingual Clonidine may be a useful addition to the treatment of the hypertensive patient because of its apparent effectiveness, simplicity, and safety.
Pharmacokinetic Comparison of Three Clindamycin Phosphate Dosing Schedules
Authors: Townsend Raymond J. , Baker Robert P
Published: May 2016

In a randomized, three-way crossover study, six male volunteers received clindamycin phosphate 600 mg iv q6h (treatment A), 600 mg iv q8h (treatment B), or 900 mg iv q8h (treatment C). Plasma clindamycin concentrations were determined periodically for eight hours after achieving steady state. The results indicate that treatment C yielded significantly higher peak plasma clindamycin concentrations than treatments A or B. There were no significant differences in minimum plasma clindamycin concentrations (Cmin) or area under the plasma concentration versus time curve (AUC24) between treatments A and C. However, both treatments A and C yielded significantly greater Cmjn and AUC24 values than treatment B. There were no significant differences among treatments for clindamycin clearance. It is concluded that clindamycin phosphate 900 mg q8h is a pharmacokinetically acceptable alternative to clindamycin phosphate 600 mg q6h.
Are Calcium-Channel Blockers Effective in the Treatment of Tardive Dyskinesia?
Authors: Cates Marshall , Lusk Kim , Wells Barbara G.
Published: May 2016

Objective

To review the data describing the use of calcium-channel blockers in the treatment of tardive dyskinesia (TD).

Data Sources

A MEDLINE search of the English-language literature and a bibliographic review of pertinent articles examining the use of calcium-channel blockers in the treatment of TD were performed. Medical Subject Headings (MESH) terms used were calcium-channel blockers, tardive dyskinesia, nifedipine, verapamil, and diltiazem.

STUDY SELECTION AND DATA EXTRACTION

Relevant case reports, open trials, and controlled studies reporting on the efficacy of calcium-channel blockers for treating TD are reviewed. Appropriate conclusions are drawn from the data and guidelines are suggested for the practitioner.

Data Synthesis

Studies addressing the efficacy of calcium-channel blockers in the palliative treatment of TD have yielded mixed results. Positive findings have been reported for nifedipine, verapamil, and diltiazem; nifedipine may be the most efficacious treatment and diltiazem the least. It appears that patients with TD who can tolerate higher doses of calcium-channel blockers may respond more favorably to treatment. Patient characteristics that may help determine a better response to treatment with calcium-channel blockers include advanced age and more-severe TD.

Conclusions

To determine the efficacy of calcium-channel blockers in the treatment of TD, additional data are needed from double-blind, placebo-controlled studies with larger sample sizes and longer durations of treatment. Until these data are available, calcium-channel blockers should be considered potentially useful therapy for the heretofore unresponsive TD.
Change in Prescribing Patterns of Intravenous Histamine2-Receptor Antagonists Results in Significant Cost Savings without Adversely Affecting Patient Care
Authors: Fudge Kathy A. , Moore Keith A. , Schneider Donald N. , Sherrin Thomas P. , Wellman Gregory S. , Mcghan William F. , Bootman J. Lyle , Townsend Raymond J.
Published: May 2016

Objective

The cooperative efforts and educational activities associated with a major histamine2-receptor antagonist (H2RA) formulary change and the clinical and financial results are described.

Evaluation Process

An extensive financial and clinical evaluation was conducted. Sources included primary literature, reference texts, institution-specific financial data, and reports of other hospitals’ experiences.

Interventions

Through cooperative efforts with key members of the medical staff, several interventions were adopted: maintain only one parenteral H2RA on the formulary; develop guidelines for H2RA use and stress ulcer prophylaxis; investigate a target drug-reminder system to promote oral H2RA use.

Results

Within a month after implementing the formulary change and educational process, prescribing of parenteral H2RAs changed from 80 percent ranitidine to 99 percent cimetidine. Monitoring of nonformulary ranitidine use revealed only three cases of possible or probable association of adverse central nervous system effects with cimetidine in an eight-month period. Elevations of theophylline, lidocaine, or phenytoin serum concentrations; or prothrombin time above the therapeutic range during warfarin therapy occurred in only 5 of 142 monitored patients who received concomitant therapy with an H2RA. No change in serum theophylline concentrations above the therapeutic range was noted in the hospital before and after the conversion. Savings have been estimated at $250 000 in the first year and $775 000 over four years, mostly from the conversion from intravenous ranitidine to intravenous cimetidine therapy.

Conclusions

Successful intervention can be accomplished by cooperation between the pharmacy and the medical staff to achieve cost savings without sacrificing the quality of care.
Using Caregiver Strain to Predict Participation in a Peer-Support Intervention for Parents of Children With Emotional or Behavioral Needs
Authors: Duppong Hurley Kristin L. , January Stacy-Ann A. , Lambert Matthew C.
Published: May 2016

Children receiving services for severe emotional and behavioral difficulties are less likely to have parents who are involved in their education and support services. Peer-to-peer family support programs are one approach to increasing the self-efficacy and empowerment of parents’ engagement in the treatment of a child’s mental health conditions. Furthermore, programs providing parental support may reduce the strain and negative consequences caregivers may experience due to the stress of caring for a child with emotional and behavioral needs. Although much is known about the relation between caregivers’ strain and children’s use of mental health services, less is known about caregiver strain and parents’ participation in family support programs. This study evaluated whether caregiver strain predicted parents’ ( N = 52) participation in a phone-based, peer-to-peer support intervention. Results of the regression analysis indicated that highly strained parents participated in four to seven more phone conversations over the course of intervention, which occurred across the academic year. Therefore, findings have implications for the school and mental health providers aiming to increase the involvement of parents of children with emotional and behavioral disorders.
Common Factors Between Couples Therapists and Imago Relationship Therapy
Authors: Holliman Ryan , Muro Lamar , Luquet Wade
Published: May 2016

In this study, 273 couples therapists were surveyed regarding their alignment with the beliefs, values, and intervention strategies of Imago Relationship Therapy (IRT). The Likert-type scale survey utilized 46 items reflecting 6 key domains important to the theory and practice. All domains reflected a minimum of 50% therapist agreement while 4 of the 6 domains reflected 75% or greater therapist agreement. Due to reported agreement with a majority of IRT domains, these findings suggest (1) potential common factors between IRT and couples therapists of diverse theoretical approaches and (2) a rationale for the consideration of IRT as an area of study for academics researchers and a model of training in marriage and family therapy programs.
Activation and Self-Efficacy in a Randomized Trial of a Depression Self-Care Intervention
Authors: McCusker Jane , Lambert Sylvie D. , Cole Martin G. , Ciampi Antonio , Strumpf Erin , Freeman Ellen E. , Belzile Eric
Published: May 2016

Objectives. In a sample of primary care participants with chronic physical conditions and comorbid depressive symptoms: to describe the cross-sectional and longitudinal associations of activation and self-efficacy with demographic, physical and mental health status, health behaviors, depression self-care, health care utilization, and use of self-care tools; and to examine the effects of a depression self-care coaching intervention on these two outcomes. Design/Study Setting. A secondary analysis of activation and self-efficacy data collected as part of a randomized trial to compare the effects of a telephone-based coached depression self-care intervention with a noncoached intervention. Activation (Patient Activation Measure) was measured at baseline and 6 months. Depression self-care self-efficacy was assessed at baseline, at 3 months, and at 6 months. Principal Findings. In multivariable cross-sectional analyses ( n = 215), activation and/or self-efficacy were associated with language, birthplace, better physical and mental health, individual exercise, specialist visits, and antidepressant nonuse. In longitudinal analyses ( n = 158), an increase in activation was associated with increased medication adherence; an increase in self-efficacy was associated with use of cognitive self-care strategies and increases in social and solitary activities. There were significant improvements from baseline to 6 months in activation and self-efficacy scores both among coached and noncoached groups. The self-care coaching intervention did not affect 6-month activation or self-efficacy but was associated with quicker improvement in self-efficacy. Conclusions. Overall, the results for activation and self-efficacy were similar, although self-efficacy correlated more consistently than activation with depression-specific behaviors and was responsive to a depression self-care coaching intervention.
Impact of Goal Setting and Goal Attainment Methods on Asthma Outcomes
Authors: Aaron Micah , Nelson Belinda W. , Kaltsas Elena , Brown Randall W. , Thomas Lara J. , Patel Minal R.
Published: May 2016

Optimal use of goal-setting strategies in self-management efforts with high-risk individuals with asthma is not well understood. This study aimed to describe factors associated with goal attainment in an asthma self-management intervention for African American women with asthma and determine whether goal attainment methods proved beneficial to goal achievement and improved asthma outcomes. Data came from 212 African American women in the intervention arm of a randomized clinical trial evaluating a telephone-based asthma self-management program. Telephone interview data were collected to assess goals and goal attainment methods identified, asthma symptoms, asthma control, and asthma-related quality of life at baseline and 2-year follow-up. Generalized estimating equations were used to assess the long-term impact of goal setting and goal attainment methods on outcomes. The average age of the sample was 42.1 years ( SD = 14.8). Factors associated with goal attainment included higher education ( p < .01) and fewer depressive symptoms ( p < .01). Using a goal attainment method also resulted in more goals being achieved over the course of the intervention (Estimate [ SE] = 1.25 [0.18]; p < .001) when adjusted for clinical and demographic factors. Use of and types of goal attainment methods and goals were not found to significantly affect asthma control, quality of life, or frequency of nighttime asthma symptoms at follow-up. Using a method to achieve goals led to greater goal attainment. Goal attainment alone did not translate into improved asthma outcomes in our study sample. Further studies are warranted to assess the challenges of self-management in chronic disease patients with complex health needs and how goal setting and goal attainment methods can be strategically integrated into self-management efforts to improve health endpoints.
Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial
Authors: Goodkind Jessica R. , Amer Suha , Christian Charlisa , Hess Julia Meredith , Bybee Deborah , Isakson Brian L. , Baca Brandon , Ndayisenga Martin , Greene R. Neil , Shantzek Cece
Published: May 2016

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants’ intervention experiences, and their feasibility and acceptability. In the current mixed-methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African, and Iraqi refugee adults and to engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013 and 2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, and postintervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community–academic partnerships engaged in RCTs.
What Does Having Your Pack in Your Pocket Say About You? Characteristics and Attitude Differences of Youth Carrying Tobacco at a Music Festival
Authors: Ilakkuvan Vinu , Reubenstein Rebecca , Xiao Haijun , Rath Jessica
Published: May 2016

The purpose of this study is to understand differences in demographics, frequency of tobacco use, and tobacco-related attitudes between youth/young adults who carry tobacco products and those who do not. Carrying tobacco is hypothesized to affect individuals’ smoker identity and thereby their tobacco-related attitudes. Carriers are an influential peer group, often serving as social sources of tobacco for others, setting tobacco-related social norms, and advertising tobacco via the packs they carry. Thus, understanding their characteristics and attitudes can aid in the targeting and tailoring of cessation messaging. In this study, 3,927 attendees ages 13 to 24 years at the Vans Warped Tour were surveyed using iPads and asked to photograph any tobacco products they were currently carrying. Current tobacco users were classified as proven carriers ( n = 363), unproven carriers ( n = 182), or noncarriers ( n = 1,426). Carriers ( N = 545) were older, were more often White, and used tobacco over twice as often as noncarriers. Results indicated carriers and noncarriers differed significantly on most antitobacco attitudes, with carriers feeling less strongly antitobacco.
Numerical investigation of multidirectional random wave interaction with a large cylinder
Authors: Ji Xinran , Liu Shuxue , Li Jinxuan , Jia Wei
Published: May 2016

To investigate the multidirectional wave run-up and forces on a large cylinder, a numerical model of multidirectional random wave loads on a large-scale cylinder is established based on the linear theory of wave interaction with a large-scale bottom-mounted vertical cylinder. The incident directional wave is specified using a discrete form of the Mitsuyasu-type spreading function. A wave basin experiment was carried out, and the numerical calculation results were verified by the results of the physical experiment. The results indicate that the wave directionality has significant effects on the distribution of the wave run-up around the cylinder. The transverse wave force occurs due to which the multidirectional waves at the two sides of the cylinder are totally different from each other at any time because of the wave directionality. Specially, for the multidirectional random wave with small directional spreading parameter ( s = 5), the transverse force Fy is about 57% of the normal force Fx and cannot be neglected any more. Results can provide reference for the real engineering design.
Evolving user needs and late-mover advantage
Authors: Querbes Adrien , Frenken Koen
Published: May 2016

We propose a generalized NK-model of late-mover advantage where late-mover firms leapfrog first-mover firms as user needs evolve over time. First movers face severe trade-offs between the provision of functionalities in which their products already excel and the additional functionalities requested by users later on. Late movers, by contrast, start searching when more functionalities are already known and typically come up with superior product designs. We also show that late-mover advantage is more probable for more complex technologies. Managerial implications follow.
A 15-Year Single-Center Experience of Endovascular Repair for Elective and Ruptured Abdominal Aortic Aneurysms
Authors: Broos Pieter P. H. L. , ‘t Mannetje Yannick W. , Stokmans Rutger A. , Houterman Saskia , Corte Giuseppe , Cuypers Philippe W. M. , Teijink Joep A. W. , van Sambeek Marc R. H. M.
Published: May 2016

Purpose: To evaluate the differences in technical outcomes and secondary interventions between elective endovascular aneurysm repair (el-EVAR) procedures and those for ruptured aneurysms (r-EVAR). Methods: Of the 906 patients treated with primary EVAR from September 1998 until July 2012, 43 cases were excluded owing to the use of first-generation stent-grafts. Among the remaining 863 patients, 773 (89.6%) patients (mean age 72 years; 697 men) with asymptomatic or symptomatic abdominal aortic aneurysms (AAAs) were assigned to the el-EVAR group; 90 (10.4%) patients (mean age 73 years; 73 men) were assigned to the r-EVAR group based on blood outside the aortic wall on preoperative imaging. The primary study outcome was technical success; secondary endpoints, including freedom from secondary interventions and late survival, were examined with Kaplan-Meier analyses. Results: At baseline, r-EVAR patients had larger aneurysms on average (p<0.001) compared to el-EVAR patients. Technical success was comparable (p=0.052), but there were more type Ia endoleaks at completion angiography in the r-EVAR group (p=0.038). As anticipated, more patients died in the first month in the r-EVAR group (18.9% vs 2.2% el-EVAR, p<0.001). At 5 years, there was an overall survival of 65.1% for the el-EVAR patients vs 48.1% in the r-EVAR group (p<0.001). The freedom from AAA-related mortality was 95.7% for el-EVAR and 71.0% for r-EVAR (p<0.001). Five-year freedom from type I/III endoleaks was significantly lower in the r-EVAR group (78.7% vs 90.0%, p=0.003). Five-year freedom from secondary intervention estimates were not significantly different (el-EVAR 84.2% vs r-EVAR 78.2%, p=0.064). Conclusion: Within our cohort of primary EVAR patients, r-EVAR cases showed comparable stent-graft–related technical outcome. Although there was a higher incidence of type Ia endoleaks on completion angiography in the r-EVAR group, the overall secondary intervention rate was comparable to el-EVAR.
The Mid-Term Clinical Follow-Up Using Drug-Eluting Balloons on Tibial Artery “De Novo” Lesions in Patients With Critical Limb Ischemia
Authors: Tolva Valerio , Casana Renato , Huibers Anne , Parati Gianfranco , Bianchi Paolo , Cireni Lea , Ferrero Emanuele , Halliday Allison
Published: May 2016

Rationale:

Restenosis due to intimal hyperplasia (IH) is a major clinical issue that affects the success of lower limb endovascular surgery. After 1 year, restenosis occurs in 40% to 60% of the treated vessels. The possibility to reduce IH using local antiproliferative drugs, such as taxols, has been the rationale for the clinical applications of drug-eluting stents and drug-eluting balloons (DEBs). The purpose of this study was to evaluate the clinical and instrumental efficacy of DEBs versus simple percutaneous transluminal angioplasty (PTA) in patients affected by chronic limb ischemia (CLI) with tibial artery “de novo” lesions.

Methods:

A retrospective analysis was performed and included all consecutive patients who underwent endovascular treatment for CLI in our centers between January 2011 and March 2013. Inclusion criteria were (1) “de novo” tibial artery stenosis and (2) Rutherford class >4. Lesions were further divided by TransAtlantic Inter-Societal Consensus (TASC) classification into groups A, B, C, and D.

Results:

Between January 2010 and March 2013, a total of 138 patients underwent simple PTA or DEB for CLI, and the groups were clinically and demographically homogenous. We decided to use DEBs in 70 cases. An improvement in the Rutherford Scale in cumulative and single TASC lesions classification was better in the DEB group (74% vs 51%; P = .024) at 24 months than in the PTA group. In the DEB group, the increase in ankle–brachial index was significantly higher than in the PTA group ( P = .039).

Conclusions:

Our experience in addition to the existing literature supports the use of DEB in patients with CLI Rutherford class >3.
A Cross-Domain Exploration of Performance Benefits and Costs of Idiosyncratic Deals
Authors: Lemmon Grace , Westring Alyssa , Michel Eric J. , Wilson Morgan S. , Glibkowski Brian C.
Published: May 2016

Drawing on justice theory and the side-bet theory of commitment, we explored the nuanced relationship between idiosyncratic deals and outcomes. We developed a model that posits affective commitment as a mediator between idiosyncratic deals and positive work outcomes, whereas continuance commitment mediates the relationship between idiosyncratic deals and negative nonwork domain outcomes. Furthermore, we hypothesized moderated mediation in that the employee’s assessment of organizational justice will moderate the relationship between idiosyncratic deals and continuance commitment, which in turn influences the nonwork domain outcomes. Data collected from 182 employee–manager dyads indicated support for our conceptual model. The implications of these findings are discussed in terms of how to manage both the benefits and the costs of idiosyncratic deals.
Intelligent collision avoidance based on two-dimensional risk model
Authors: Liang Yan-hua , Cai Chengtao
Published: May 2016

The collision avoidance and path planning technology is an important issue for submarine research field. It is essential and crucial for submarine to navigate underwater safely. There are lots of drawbacks for ensuring this important mission. For handling with the challenging and imperative issue, a novel and efficient collision risk model is proposed. A serial of motions of the submarine to be processed for fulfilling the collision avoidance based on this approach. The concepts of detection domain and fuzzy logic are adopted for modeling the degree of collision risk. The detection domain is used as the submarine safety scope when navigating underwater while the fuzzy logic is used as the mathematical implement for the analysis and synthesis of relations between obstacles or other submarines that are met in the navigation environment. The collision risk is regarded as one effective evaluation function that reflects which exact action should be done when the threshold of the risk degree is met. In order to verify the performance of proposed method, multisubmarines simulation experiments are concluded in different scenarios.