bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowing poverty: Social workers’ perceptions of poverty knowledge
Authors: Strier Roni , Nouman Hani , Kantarovich Nurit
Published: September 2021

Given the global and local social inequalities and the complex life circumstances of people living in poverty, social workers are called upon to broaden their knowledge with the purpose of developing social services that respond to the needs of this growing population. However, very little research has been done on the kind of knowledge that social workers require in order to care for this population. The present article focuses on the epistemological aspects of service development for people living in poverty and reviews three main issues: What is “poverty knowledge,” where does it come from, and what are the barriers to and opportunities for its development? These questions are investigated through a qualitative paradigm among social workers employed in Israel’s public social services.

Findings

Findings reveal a profound epistemological controversy about what poverty knowledge means: Is it objective, consistent, readily available, and transferrable knowledge, or is it a dynamic and reflexive process affected by a great number of fluctuating contexts? Findings stress the dominance of positivist views of poverty knowledge, mostly derived from practice while other sources of knowledge development, such as service users’ local knowledge, theory, and research knowledge were seen as less relevant to their needs.

Applications

Practical recommendations are offered relating to the need for poverty knowledge development processes in social services as well as in social-work education through collaborative, contextual, and reflective learning with and from service users and other stakeholders.
Parole as resentencing: Exploring the punitive accounts of parole decision-making through the comparative case study of Israel
Authors: Dagan Netanel
Published: September 2021

Parole boards have traditionally assessed prisoners’ future risk and rehabilitation prospects in deciding on early release from prison. However, parole boards may do more. In some systems, they may deny parole applications for punitive reasons, thus acting as a resentencing authority. This study conducted a qualitative analysis of the punitive discourses of parole decision-making, with Israel as a comparative case study. Through interviews with 20 chairpersons of Israeli Parole Boards, we found three themes of punitive parole decision-making: (a) preserving public confidence in the criminal justice system; (b) preserving penal proportionality; and (c) re-censuring an especially depraved moral character. The findings suggested that parole boards’ punitive discretion is multidimensional and complex. Such punitive discretion may be openly implemented, it may be cloaked as risk assessment, or decided without formal recognition. The findings further indicated that resentencing through discretionary parole may not only conflict with rehabilitation and risk aims, but may also raise challenges for retributive and deterrent penal policy. Implications for comparative parole policy are discussed.
A review for using swarm intelligence in architectural engineering
Authors: Khalil Randa , El-Kordy Ahmed , Sobh Hesham
Published: September 2021

Swarm intelligence algorithms are natural-inspired computational methods that mimic the social interaction between creatures to solve certain problems. Swarmative computational architecture (SCA) is a novel nomenclature proposed by the authors to present the use of various swarm algorithms in solving architectural problems. It includes three main aspects: form generation/adaptation, performance evaluation, and optimization. This study provides a systematic review and comparative analysis for the major publications within the review scope. The correspondence between dynamic subjects and the objective functions for the optimization process is presented. Particularly, dynamic subjects such as building formation parameters and objective functions such as occupant comfort and energy consumption. The main results and criteria are categorized into the design approach, case study, form generation/adaptation, and performance evaluation/optimization. Finally, this review presents the current trends and highlights the gaps in the use of swarm algorithms to solve architectural engineering problems.
Barriers and Facilitators to Community Health Worker Outreach and Engagement in Detroit, Michigan: A Qualitative Study
Authors: Lapidos Adrienne , Kieffer Edith C. , Guzmán Rebeca , Hess Kristen , Flanders Tessana , Heisler Michele
Published: September 2021

An effective approach to engaging populations who face health care access barriers is support from community health workers (CHWs). There is little research, however, on specific barriers and facilitators related to two key areas of CHW practice: outreach, defined as the ability to make any initial contact with the priority population, and engagement, defined as the ability to continue to work with the priority population after initial contact is made. The current qualitative study is ancillary to a randomized evaluation of a CHW-led program for Medicaid Health Plan enrollees. Implementation experiences with outreach and engagement led the evaluators to develop the current study in which health plan and nonhealth plan CHWs (n = 12) serving low-income, predominantly Black populations in Detroit participated in qualitative semistructured interviews to elucidate barriers and facilitators to outreach and engagement. All audio recordings were transcribed verbatim. The study team used inductive qualitative data analysis techniques. Barriers to outreach included inaccurate contact information and mistrust. Barriers to engagement included lack of ability to provide needed resources, leading to hopelessness and diminished trust, and discontinuity of services due to eligibility changes and terminated programs. Facilitators included adapting outreach schedules and strategies to community needs, availability of resources, and relational strategies that leveraged CHW social proximity. Further research should systematically investigate the relative success of different CHW-led outreach and engagement strategies for specific populations so as to better design and implement CHW programs.
Collective Healing: A Framework for Building Transformative Collaborations in Public Health
Authors: Cowan Emily S. , Dill LeConté J. , Sutton Shavaun
Published: September 2021

The capacity of cross-sector collaboration to create meaningful change across social–ecological levels has long been understood in public health. But the ability of cross-sector collaboration to achieve systemic change around the structural determinants of health remains complicated. In 2021, now more than ever, we understand the imperative of strengthening the capacity of collaborative efforts to address the myriad structural health crises facing our communities, from police violence and mass incarceration to Jim Crow laws and redlining, to urban renewal and environmental injustice. Our proposed collective healing framework brings together the collective impact model and radical healing framework to offer a blueprint for cross-sector collaboration that understands the practices of healing to be at the center of public health collaborations and public health practice at large. In this framework, public health practitioners and our collaborators are asked to prioritize relationship building, engage in critical self-reflection, to move beyond compromise, to address differences, to interrogate traditional metrics and approaches, to remake the collective table, and to build shared understanding through action.
Advancing the Health of Migrant and Seasonal Farmworkers in the United States: Identifying Gaps in the Existing Literature, 2021
Authors: Bloss Jamie E. , LePrevost Catherine E. , Zahra Abdul G. , Firnhaber Gina C. , Cofie Leslie E. , Zepeda Ramón , Lee Joseph G. L.
Published: September 2021

There are profound health inequities for agricultural workers. We sought to assess the literature on migrant and seasonal farmworker health with an eye toward health promotion interventions, special populations, use of community health workers (CHWs), and technology. We conducted a systematic mapping review by searching five databases in March 2021. Using quantitative content analysis after establishing interrater reliability, we coded titles and abstracts to assess 13 topics and six characteristics of the research such as its focus on health promotion, use of technology, and inclusion of CHWs. We identified 1,083 records. Just 8.2% of records described or evaluated a health promotion effort to intervene in farmworker well-being and even fewer (4.2%) examined unique populations of farmworkers such as indigenous farmworkers ( n = 11) or sexual minority farmworkers ( n = 1). A small body of literature focused on the role of CHWs or promotores most frequently described their role in implementing health interventions. The literature on farmworker health has gaps regarding health promotion interventions, special populations, and integration of CHWs into research projects. We offer suggestions to fill in identified gaps in the literature.
Implementation of CDC Guidelines for Recess: A Formative Research Study
Authors: Suleman Shazeen , Calderon Velazquez Gabriela , Haag Tania , Connor Ryan , Marshall Beth
Published: September 2021

The American Academy of Pediatrics recognizes recess as an essential part of overall child development in schools, impacting children’s cognitive, socioemotional and physical health and development. However, recess is often removed from the school curriculum in exchange for more classroom activities. The Centers for Disease Control and Prevention (CDC) and SHAPE America developed Strategies for Recess in Schools to promote high-quality recess through specific actions, yet is not known how these are successfully implemented, particularly, in underserved settings. This formative research study examined the implementation of the CDC strategy in an urban, inner-city charter elementary school to identify barriers and facilitators to successful recess implementation from the perspective of various stakeholders. Thirteen in-depth interviews and focus group discussions were conducted with parents, teachers, recess monitors, and school administrators. Interviews were recorded, transcribed, and coded for thematic analysis, supported by group discussion and analytic memos. Results suggested that although stakeholders recognized the importance of recess, the implementation of the CDC strategy was neither uniformly understood nor implemented, suggesting that additional frameworks may be helpful in implementing the CDC strategy in schools in underserved communities.
Evaluation of a Narrative Video to Promote Prevention and Early Detection of Cervical Cancer Among Latinas
Authors: Calderón-Mora Jessica , Alomari Adam , Byrd Theresa L. , Shokar Navkiran K.
Published: September 2021

Objective

To evaluate the impact of an online-delivered, theory-based narrative video on cervical cancer screening knowledge, attitudes, and beliefs in a predominantly Latino community.

Methods

The study design was a nonrandomized pretest–posttest evaluation. The eligibility criteria included men and women 18 years or older not previously enrolled in our community cervical cancer screening program who had internet access. Participants were recruited via in-person county-wide flyer distribution and social media dissemination. The intervention involved a narrative video designed for Latinas delivered via the internet. The 17-minute video is novella style, with a culturally tailored storyline and setting that covers cervical cancer risk factors and statistics, importance of screening, and addresses testing barriers. The measures were knowledge about cervical cancer and screening, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, subjective norms, and self-efficacy. Analysis was performed using change scores for knowledge and psychosocial variables and descriptive statistics for satisfaction and acceptability of the video.

Results

Data from 227 surveys were analyzed; respondent mean age: 37.6 years; 98.8% female, 88.8% Hispanic; 42.0% had an annual income of $20,000 or less; and 85.2% had at least a high school education. Knowledge and all psychosocial variables improved significantly. More than 90% of the participants rated all of the satisfaction items as good or excellent.

Conclusions and Implications for Practice

A culturally appropriate narrative video about cervical cancer and screening disseminated online effectively improved knowledge and psychosocial variables among Latinas. Our findings indicate that health promotion interventions online could be effective for improving desired health behavior through a new means of educational dissemination by way of websites and social media outlets.
Acquired Carotid-Jugular Fistula Secondary to a Pseudoaneurysm Following Carotid Endarterectomy
Authors: Narroway Harry G. , Bourke Bernard , Tchen Adrian S.
Published: September 2021

Acquired arteriovenous fistulas involving the carotid artery are most frequently the result of trauma and iatrogenic causes such as central venous catheterisation. Occasionally, they may develop spontaneously due to erosion of an aneurysm into an adjacent vein. We report a rare case of an acquired carotid-jugular fistula secondary to a pseudoaneurysm that occurred four months following carotid endarterectomy
Outcomes After Selective Fasciotomy for Revascularization of Nontraumatic Acute Lower Limb Ischemia
Authors: Lin Jonathan H. , Humphries Misty D. , Hasegawa Jason , Saroya Jasmeet , Mell Matthew W.
Published: September 2021

Objectives: Limited data support the use of fasciotomies in acute limb ischemia (ALI) in patients with isolated arterial occlusion. This study describes an experience in which fasciotomies are not regularly performed post-revascularization. Methods: Using International Classification of Diseases, Ninth and Tenth Edition codes, patients presenting to the University of California Davis Medical Center between January 2003 and July 2018 with ALI, excluding those with traumatic injuries were identified. The primary outcome was major amputation, and the secondary outcome was foot drop. Additionally, the characteristics of those patients in each category of ischemic severity excluding those with grade 3 ischemia were summarized. Results: Of the 253 patients identified, revascularization was successful in 230 patients with 11 total fasciotomies performed. One hundred thirty-five patients were Rutherford Class 1/2A and 95 were 2B. In those with 1/2A ischemia, 134 (102 had >6 hours of symptoms) did not undergo fasciotomy with only one amputation occurring in this group. In those with 2B ischemia, 65 had >6 hours of symptoms; 58 did not undergo fasciotomy with 4 major amputations. In the 30 patients with ≤6 hours of ischemic symptoms, 27 did not undergo fasciotomy with 1 major amputation occurring in this group. There were no amputations in those patients who underwent fasciotomies. Additionally, there were 14 patients with a foot drop, of which 11 were in patients with 2B ischemia without fasciotomy. Conclusions: The data suggest that regardless of ischemic duration, 1/2A patients may not need fasciotomies, while those patients with 2B ischemia may benefit.
Efficacy and Safety of Ultrasound-Guided Repeat Access and Repeat Closure With an ExoSeal Vascular Closure System in Patients With Peripheral Arterial Disease
Authors: Kobayashi Taira , Hamamoto Masaki , Okazaki Takanobu , Tomota Mayu , Fujiwara Takashi , Yoshitomi Yuki , Takahashi Shinya
Published: September 2021

Objective

The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided repeat access and repeat closure with an ExoSeal vascular closure system.

Methods

A total of 123 endovascular therapy (EVT) procedures were performed in 59 patients (65 limbs) with ultrasound-guided repeat access and repeat implantation of an ExoSeal vascular closure system between January 2019 and March 2021. The procedural details and postprocedural outcomes of EVT with repeat access and use of ExoSeal (RE group) were compared with those of EVT with initial use of ExoSeal (IE group) in the same patients. In a subgroup analysis, these outcomes were also compared in early repeat (within 3 months) and late repeat (over 3 months) cases.

Results

The technical success rate of ultrasound-guided access in the RE group was 100%. The procedural success rate of EVT and deployment success rate of ExoSeal in the RE group were 93% and 94%, respectively, which were not significantly different to those in the IE group. Access site complications in the RE group occurred in 2 cases (2%), again with no significant difference with the IE group. The median puncture, procedural, and hemostasis times in the RE group were 3 [2-5], 36.5 [29-54], and 7 [5-10] min, respectively, which were not significantly longer than those in the IE group. In the RE group, early and late repeat closure was performed in 66 (54%) and 57 (46%) cases, respectively, and there were no significant differences in the technical success of ultrasound-guided access, procedural success of EVT, deployment success of ExoSeal, and access site complication rates in these cases.

Conclusions

Ultrasound-guided access facilitated higher technical success of repeat access and fewer access site complications in EVT with repeat use of ExoSeal, regardless of the interval between procedures.
Comparison of the Postoperative Complications Between Robotic Total and Distal Gastrectomies for Gastric Cancer Using Clavien–Dindo Classification: A Propensity Score-matched Retrospective Cohort Study of 726 Patients
Authors: Li Zheng-yan , Zhao Yong-liang , Qian Feng , Tang Bo , Luo Zi-yan , Wen Yan , Shi Yan , Yu Pei-wu
Published: September 2021

Background

This study was designed to compare the postoperative complications after Robotic total gastrectomy (RTG) and robotic distal gastrectomy (RDG) and to systematically evaluate the safety and feasibility of RTG for the treatment of gastric cancer (GC).

Methods

Patients with GC who underwent RTG or RDG for curative intent between March 2010 and August 2019 were analyzed. We used propensity score matching (PSM) to reduce selection bias. The morbidity and mortality within 30 days after surgery between the RTG and the RDG groups were compared.

Results

According to Clavien–Dindo (C–D) classification, the morbidity and mortality of the RTG group were comparable to those of the RDG group. Subgroup analyses showed no significant difference between the RTG and RDG groups in all stratified parameters (all P > .05). Multivariate analysis revealed that age ≥70 years ( P = .002) and surgeons’ experience ≤25 cases ( P = .013) were independent risk factors for overall complication. Surgeons’ experience ≤25 cases ( P = .010) was identified as an independent risk factor for severe complication.

Conclusion

RTG is a safe and feasible surgical procedure for the treatment of GC with acceptable morbidity and mortality. More complications were observed for RTG, indicating that RTG is more invasive than RDG.
Is degree of chronic illness management in heart transplant centers associated with better patient survival? Findings from the intercontinental BRIGHT study
Authors: Cajita Maan Isabella , Denhaerynck Kris , Berben Lut , Dobbels Fabienne , Van Cleemput Johan , Crespo-Leiro Maria , Van Keer Jan , Poncelet Alain Jean , Russell Cynthia , De Geest Sabina
Published: September 2021

Purpose

To explore the association between the degree of Chronic illness management and survival rates at 1-, 3-, 5-years post heart transplantation.

Methods

Exploratory secondary analysis of a cross-sectional, international study (Building Research Initiative Group study). Latent profile analysis was performed to classify 36 heart transplant centers according to the degree of chronic illness management.

Results

The analysis resulted in 2 classes with 29 centers classified as “low-degree chronic illness management” and 7 centers as “high-degree chronic illness management”. After 1-year posttransplantation, the high-degree chronic illness management class had a significantly greater mean survival rate compared to the low-degree chronic illness management class (88.4% vs 84.2%, p = 0.045) and the difference had a medium effect size (η2 = .06). No difference in survival for the other time points was observed. Patients in high-degree chronic illness management centers had 52% lower odds of moderate to severe drinking (95% confidence interval .30–.78, p = 0.003). No significant associations between degree of chronic illness management and the other recommended health behaviors were observed.

Conclusions

The findings from this exploratory study offer preliminary insight into a system-level pathway (chronic illness management) for improving outcomes for heart transplant recipients. The signals observed in our data support further investigation into the effectiveness of chronic illness management-based interventions in heart transplant follow-up care.
‘Grey areas’: ethical challenges posed by social media-enabled recruitment and online data collection in cross-border, social science research
Authors: Bamdad Sara , Finaughty Devin A , Johns Sarah E
Published: September 2021

Are social science, cross-border research projects, where recruitment and data collection are carried out remotely (e.g. through social media and online platforms), required to follow similar ethical and data-sharing procedures as ‘on-the-ground’ studies that use traditional means of recruitment and participant engagement? This article reflects on our experience of dealing with this question when we (multi-national but UK based researchers) had to switch to online data collection due to the restrictions posed by the COVID-19 pandemic, such as the inability to travel or work in person with local communities and collaborators. Using social media platforms and online data collection when conducting research brings many advantages, such as being able to communicate remotely but directly with gatekeepers and collaborators, and in reaching potential participants on a global scale. However, neither the guidelines and advice for conducting ethically sound internet-based research, nor the academic literature focussed on building equitable research partnerships between the Global North and the Global South, offer much information regarding the ethical concerns, or address the grey areas, posed by this type of digital and distanced transnational research. In our experience, conducting research remotely made negotiations of access very challenging due to the politics of positionality between Global North and South researchers, lack of clarity on ethical processes and (mis)perceptions of gatekeepers who we could not meet in person. We hope the reflections on, and discussion of, our experience encourage deliberation on the present ethical challenges posed by online and social-media-disseminated data collection, particularly in cross-border circumstances.
“Down-to-Earth TV dramas”: The reception of authenticity, reality, and modality in Danish TV dramas
Authors: Kaptan Yeşim
Published: September 2021

This article investigates how Turkish audiences conceptualize authenticity in their engagement with foreign television (TV) productions in the case of Danish TV dramas. The theoretical notion of authenticity is juxtaposed with empirical material from fieldwork interactions, focus group interviews, and one-on-one interviews conducted with Turkish audiences between 2016 and 2018. By employing a semiotic analysis of fieldwork data, I argue that Turkish audiences attribute authenticity to the Danish TV drama series according to a socially created modality (truth value of a sign). This article draws on accounts about modality markers in TV drama series such as authentic portrayals of Danish TV characters and plausible-realistic depictions as a verisimilitudinous representation of everyday life. In the context of cross-cultural television viewing practices, the way Turkish audiences attribute meaning to Danish TV series in terms of authenticity, realism, and modality reveals a distinct differentiation between Danish TV dramas and other nationally and globally circulating media products.
Slogans With Negations’ Effect on Sustainable Luxury Brand
Authors: Septianto Felix , Kemper Joya , Northey Gavin
Published: September 2021

The integration of sustainability within luxury brands is of increasing concern to practitioners and academics alike. Thus, it is important to consider how brands can develop effective communication strategies to promote sustainable luxury brands, particularly among an increasingly skeptical consumer base. This research thus investigates the impact of advertising slogans with negations (vs. affirmations) in this regard. Three experimental studies show that advertising slogans with negations (vs. affirmations) increase brand trustworthiness (Studies 1 and 3) and favorable brand attitudes (Studies 1 and 2) among consumers with high levels of skepticism. Notably, this effect is driven by an increased cognitive flexibility (Study 3). The findings of this research can assist sustainable luxury brand managers in developing effective communication strategies to increase favorable consumer responses to sustainable luxury brands.
Capitalist crisis and uneven development applied in Southern Africa
Authors: Bond Patrick
Published: September 2021

Some of the most decisive moments in the neoliberal era were implanted first as major changes to the United States and world financial system during the early 1980s. As an inside observer at the Federal Reserve briefly during the time, learning a bourgeois mode of economic theory and description—especially applied to the global recession, financial failures, and worsening inequality of that era—was unsatisfying. The ideological and applied power configuration was shifting from Keynesianism to Monetarism and with it came irresponsible banking deregulation. Seeing this from the Fed, and beginning to grasp the formidable implications for low-income people of the Global South—from redlined West Philadelphia to debt-riddled Southern Africa—meant that instead of social-democratic nostalgia, I sought an antidote in Marxist theory and anti-apartheid solidarity activism. With the help of Johns Hopkins University geographers, the financial frothiness that was washing over sites I was learning about in detail, suddenly became explicable in terms of underlying capitalist crisis tendencies. As I saw how they applied to uneven development, race, gender, ecological, and other super-exploitative relations in Zimbabwe and South Africa, especially using Rosa Luxemburg’s capitalist/non-capitalist framing in her theory of imperialism, not only analysis but praxis became all the more urgent. Those overaccumulation tendencies, their spatial and temporal displacement, and accumulation by dispossession have been central categories for analysis and strategy ever since.
Complications Associated With Nasopharyngeal COVID-19 Testing: An Analysis of the MAUDE Database and Literature Review
Authors: Hakimi Amir A. , Goshtasbi Khodayar , Kuan Edward C.
Published: September 2021

Background

Nasopharyngeal swab testing, which has greatly increased in utilization due to the COVID-19 pandemic, is generally safe and well-tolerated, although it may be rarely associated with adverse events.

Methods

Publicly reported adverse events associated with nasopharyngeal COVID-19 testing within the Manufacturer and User Facility Device Experience (MAUDE) database and the published literature were queried.

Results

A total of 129 adverse events were reported, including 66 from the MAUDE database and 63 from literature review. The most common complications were swab fracture resulting in retained foreign body (47%), followed by epistaxis (17%), and headache (11%). Seven (12%) of the reported retained foreign body cases required removal under general anesthesia, while 1 (5%) of the epistaxis cases required surgical intervention. The most serious adverse event was meningitis following cerebrospinal fluid leak.

Conclusions

Patients and healthcare providers should be aware of the potential risks associated with testing, with attention to ensuring proper technique, and be prepared to recognize and manage adverse events.
Remdesivir use and outcomes during the FDA COVID-19 emergency use authorization period
Authors: Elshaboury Ramy H. , Monk Miranda M. , Bebell Lisa M. , Bidell Monique R. , Adamsick Meagan L. , Gandhi Ronak G. , Paras Molly L. , Hohmann Elizabeth L. , Letourneau Alyssa R.
Published: September 2021

Background:

Remdesivir (RDV) was approved for treatment of coronavirus disease 2019 (COVID-19), in May 2020 under US Food and Drug Administration emergency use authorization (EUA). Clinical outcomes related to RDV use in hospitalized patients during the EUA period are not well described.

Methods:

We conducted a retrospective study of patients who received RDV under EUA. The primary outcome was clinical recovery by day 14 as determined by an eight-category ordinal scale. Secondary outcomes included recovery and survival to day 28, and adverse events. Recovery and survival were calculated using a stratified log-rank Kaplan–Meier estimator and a Cox proportional hazards model.

Results:

Overall, 164 patients received RDV between May and October 2020, and 153 (93.3%) had evaluable data. Most (77.1%) were hospitalized within 10 days of symptom onset, and 79.7% started RDV within 48 hours. By days 14 and 28, 96 (62.7%) and 117 patients (76.5%) met the definition of clinical recovery, respectively. Median time to recovery was 6 days [interquartile range (IQR) 4–12]. Mortality rates were 6.5% and 11.8% by days 14 and 28, respectively. Age and time to start of RDV after hospital admission were predictive of recovery and 28-day mortality.

Conclusions:

In this real-world experience, outcomes after 5 days of RDV therapy were comparable to those of clinical trials. Disease severity, age, and dexamethasone use influenced clinical outcomes. Time to RDV initiation appeared to affect recovery and 28-day mortality, a finding that should be explored further. Mortality rate decreased over the analysis period, which could be related to dexamethasone use and improved management of COVID-19.
Breaking the Sound of Silence: Explication in the Use of Strategic Silence in Crisis Communication
Authors: Pang Augustine , Jin Yan , Seo Youngji , Choi Sung In , Teo Hui-Xun , Le Phuong D. , Reber Bryan
Published: September 2021

Crises present organizations with the “rhetorical exigency” to enact control. Silence is not an option. This study, as the first empirical examination of Le et al’s (2019) seminal study on silence in crisis communication, examines, first, if silence can be strategically used as a bona fide strategy; second, under what circumstances should silence be broken; and third, when silence is broken, how it affects (a) organizational reputation, (b) societal risk perception, and (c) the publics’ crisis information sharing intention. An online experiment was conducted using a nationally representative sample in the United States. Participants were recruited in 2019 via a Qualtrics panel. The stimuli used in this study consisted of two components: (1) an explanation about a fictitious company; and (2) two types of silence breaking (forced vs. planned) embedded in each stimulus accordingly after the same crisis incident. Four hypothesis were conceptualized. They were all supported. Collectively, they showed that the effect of silence-breaking type on crisis information sharing intention was mediated by societal risk perception, which is conditioned by participants’ level of perceived organizational reputation. Silence, or failure to fill the information vacuum, has not been an option to consider thus far as it suggests the organization is “not in control.” However, this study suggests the types of silence organizations can adopt and the modes the organizational silence can be broken. It provides a new lens for organizations to engage in business communication.
Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study
Authors: Hijryana M. , MacDougall M. , Ariani N. , Kusdhany L.S. , Walls A.W.G.
Published: September 2021

Introduction:

The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people.

Objectives:

To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences.

Methods:

Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes.

Results:

Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process.

Conclusions:

Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences.

Knowledge Transfer Statement:

This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.
Sonographic Estimated Fetal Weight Within an Indian Cohort: Is the Hadlock Four Regression Model Appropriate or Does It Merit Adjustments?
Authors: Joish Upendra Kumar , Rathod Tukaram , Anitha Prabhu S.
Published: September 2021

Objective:

Sonographic estimated fetal weight (EFW) has an influence on the management of a pregnancy. The Hadlock 4 regression model (Hadlock-4), based on fetal biometry, is widely used. There are significant discrepancies noted between EFW, using Hadlock-4, compared to the actual infant birth weights (ABW) in the author’s clinical practice. The research objective was to compare the EFW, using Hadlock-4, with ABW and determine minor arithmetic modifications needed for this population.

Materials and Methods:

A prospective observational study was done enrolling women in the third trimester, who underwent sonography and delivered within a week of the examination. The sonographic cases were divided into class intervals by gestational age. The EFW were compared with the ABW, using a Pearson coefficient and mean percentage errors (MPE). The EFW values were increased or decreased, by a certain percentage, to keep the mean percentage error in an acceptable range.

Results:

The strength of association between the EFW and ABW was 0.69 ( p = .014). The EFW and the MPEs for women delivering at 36-40 weeks and beyond was significantly more (13.2 and 18.2%). The EFWs at 36-40 weeks and beyond 40 weeks were reduced by 3 and 8% respectively, which reduced the MPEs. After this modification 97.6% of ABWs fell within +/-2 standard deviations of the EFWs.

Conclusion:

A simple 3 and 8% reduction of EFWs, using the Hadlock-4, with those sonographic examinations at 36-40 weeks and beyond 40 weeks gestation respectively, is proposed to increase reliable in this Indian patient practice.
CAR T-cell therapy for secondary CNS DLBCL
Authors: Ahmed Gulrayz , Hamadani Mehdi , Shah Nirav N.
Published: September 2021

Management of secondary central nervous system (SCNS) involvement in relapsed or refractory aggressive B-cell lymphomas remains an area of unmet medical need. We report a single-center retrospective analysis of 7 adult patients with SCNS lymphoma (SCNSL) who underwent chimeric antigen receptor (CAR) T-cell therapy for their refractory disease, and we describe the safety of whole brain radiation therapy (WBRT) as a bridging therapy. Six patients (85.7%) achieved a complete response at day 28, and 1 patient had progressive disease. The median progression-free survival was 83 days (range, 28-219 days), and median overall survival was 129 days (range, 32-219 days). Three patients died as a result of disease progression. Of the 5 patients who received WBRT as bridging therapy, 3 had no immune effector cell–associated neurotoxicity syndrome (ICANS), but 2 patients had grade 1 or grade 3 ICANS. No grade 4 ICANS was reported in this subset of patients. We conclude that SCNSL should not preclude patients from receiving CAR T-cell therapy as a treatment option because of concerns regarding ICANS, and bridging with WBRT is not associated with increased ICANS.
Blood transfusion trends in the United States: national inpatient sample, 2015 to 2018
Authors: Goel Ruchika , Zhu Xianming , Patel Eshan U. , Crowe Elizabeth P. , Ness Paul M. , Katz Louis M. , Bloch Evan M. , Tobian Aaron A.R.
Published: September 2021

Blood transfusions are among the most common therapeutic procedures performed in hospitalized patients. This study evaluates contemporary national trends in red blood cell (RBC), plasma, platelet, and cryoprecipitate transfusions. National Inpatient Sample, the largest all-payer inpatient database representing 94% to 97% of the US population, was evaluated from the fourth quarter (Q4) of 2015 through 2018. Quarterly trends for the percentage of hospitalizations with a transfusion procedure were separately examined for each blood product using log binomial regression and reported as quarterly percent change (QPC). The percentage of hospitalizations with an RBC transfusion decreased from 4.22% (2015Q4) to 3.79% (2018Q4) (QPC = −0.72; 95% confidence interval [CI], −1.26 to −0.19; Ptrend = .008). Although plasma transfusions also decreased, QPC = −1.33 (95% CI, −2.00 to −0.65; Ptrend < .001), platelet transfusions remained stable QPC = −0.13 (95% CI, −0.99 to 0.73; Ptrend = .766). In contrast, hospitalizations with cryoprecipitate utilization significantly increased QPC = 2.01 (95% CI, 0.57 to 3.44; Ptrend = .006). Significant quarterly reductions in RBC transfusions were also seen among many, but not all, strata of sex, race/ethnicity, patient risk severity, and admission type (elective vs nonelective). Despite significant declines in RBC transfusions among older adults, there were no significant changes among pediatric age-group (<18 years) and those 18 to 49 years. The decline in RBC and plasma transfusions suggests steady incorporation of robust evidence base showing safety of restrictive transfusions. Increased cryoprecipitate use may be reflective of wider adoption of hypofibrinogenemia management and hemostasis testing for coagulopathic patients.
A rare case of persistent air leak: beware of all the tubes
Authors: Havaldar Amarja Ashok , Fazal Abdul Rahim , Chennabasappa Abhilash
Published: September 2021

Background

Patients with acute respiratory failure, impaired consciousness, and impaired airway reflexes will require invasive mechanical ventilation. Monitoring of such patients is important. The use of ventilator scalars and loops help in monitoring, diagnosing the abnormality, and treating the patients effectively. We report a rare cause one should suspect in a case of persistent and fixed air leak in a patient requiring mechanical ventilation.

Case presentation

We describe a 28-year-old young patient requiring ventilator support due to neuromuscular weakness. His neuromuscular weakness was rapidly progressing involving the respiratory muscles. The patient was intubated and put on mechanical ventilator support. He was transferred from another health care center to our hospital. On evaluation, the patient was intubated with ETT no 8. The patient had persistent air leak as observed on the ventilator graphics. We checked for ETT cuff malfunction, ventilator circuit, catheter mount, and HME for any disconnection causing the leak. The air leak which we observed in our patient was due to the malpositioned Ryle’s tube.

Conclusions

Vigilant monitoring of patients requiring mechanical ventilation is necessary. For the evaluation of the cause of air leak, algorithmic approach will help in correctly identifying the abnormality.
Variation in the vitamin D receptor gene, plasma 25-hydroxyvitamin D, and risk of premenstrual symptoms
Authors: Jarosz Alicia C. , Noori Daniel , Zeitoun Tara , Garcia-Bailo Bibiana , El-Sohemy Ahmed
Published: September 2021

Background

Vitamin D status has been associated with the presence and severity of several premenstrual symptoms (PMSx) in some, but not all studies. Inconsistencies among findings may be explained by unaccounted genetic variation in the vitamin D receptor (VDR).

Objective

To determine whether associations between vitamin D status and individual PMSx are influenced byVDRgenotype.

Methods

Seven hundred sixteen women aged 20-29 years old from the Toronto Nutrigenomics and Health study provided plasma samples and completed a questionnaire on the presence and severity of 15 common PMSx. Plasma 25-hydroxyvitamin D (25(OH)D) concentration was measured and participants were categorized into sufficient (≥ 50 nmol/L) and insufficient (< 50 nmol/L) vitamin D status groups. DNA was obtained from blood samples to genotype for a commonVDRsingle nucleotide variant, rs796858. Using logistic regression, odds of experiencing PMSx were compared between vitamin D-sufficient and insufficient women, stratified by genotype.

Results

Among CC homozygotes, insufficient vitamin D status was associated with higher odds of experiencing premenstrual fatigue (OR, 2.53; 95% CI, 1.40, 4.56) and nausea (OR, 2.44; 95% CI, 1.00, 5.95). Among TT homozygotes, insufficient vitamin D status was associated with lower odds of experiencing fatigue (OR, 0.44; 95% CI, 0.20, 0.97) and increased appetite (OR, 0.48; 95% CI, 0.22, 1.04). Insufficient vitamin D status was associated with higher odds of increased appetite in women with the CT genotype (OR, 1.78; 95% CI, 1.03, 3.07).VDRgenotype modified the association between vitamin D status and the following PMSx: increased appetite (interactionp= 0.027), fatigue (interactionp= 0.016), and nausea (interactionp= 0.039).

Conclusion

We found evidence thatVDRgenotype may modify the association between 25(OH)D and some PMSx. Insufficient 25(OH)D was associated with a higher risk of premenstrual fatigue in those with the CC genotype, but lower risk in those with the TT genotype.
Relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in patients with obstructed defecation
Authors: Elsawy Mervat Sheta , Saba Emmanuel Kamal Aziz
Published: September 2021

Background

Obstructed defecation is a common pelvic floor medical problem among adult population. Pelvic floor disorders were reported to be associated with sexual dysfunction including erectile dysfunction among male patients. The aim was to determine the relation between pelvic floor neurophysiological abnormalities and erectile dysfunction in male patients with obstructed defecation.

Methods

This cross-sectional study included 65 married male patients with obstructed defecation and a control group consisted of 15 apparently healthy married males. Assessment of obstructed defecation severity was done by using modified obstructed defecation score, time of toileting and Patient Assessment of Constipation-Quality of Life questionnaire. Assessment of erectile functions was done using erectile function domain of International Index of Erectile Function questionnaire and Erectile Dysfunction-Effect on Quality of Life Questionnaire. Anal manometry and dynamic pelvis magnetic resonance imaging were done. Electrophysiological studies included pudendal nerve motor conduction study and needle electromyography of external anal sphincter, puborectalis and bulbocavernosus muscles.

Results

There were 32 patients (49.2%) who had erectile dysfunction. The maximum straining anal pressure was significantly higher among patients with erectile dysfunction. Pudendal nerve terminal motor latency was significantly delayed and the percentage of bilateral pudendal neuropathy was significantly higher among patients with erectile dysfunction. The percentage of electromyography evidence of denervation with chronic reinnervation in the external anal sphincter and bulbocavernosus muscles were significantly higher among patients with erectile dysfunction. Regression analysis detected three co-variables to be associated with significantly increasing the likelihood of development of erectile dysfunction. These were maximum straining anal pressure (odd ratio = 1.122), right pudendal nerve terminal motor latency (odd ratio = 3.755) and left pudendal nerve terminal motor latency (odd ratio = 3.770).

Conclusions

Erectile dysfunction is prevalent among patients with obstructed defecation. It is associated with characteristic pelvic floor electrophysiological abnormalities. Pelvic floor neurophysiological changes vary from minimal to severe neuromuscular abnormalities that usually accompanying erectile dysfunction. Pudendal neuropathy and increased maximum straining anal pressure are essential risk factors for increasing the likelihood of development of erectile dysfunction in patients with obstructed defecation.