bluuebunny/crossref_metadata_2025 huggingface dataset:
Providing Ethical and Humane Care to Hospitalized, Incarcerated Patients With COVID-19
Authors: Rorvig Leah , Williams Brie
Published: February 2021

The COVID-19 pandemic is devastating the health of hundreds of thousands of people who live and work in U.S. jails and prisons. Due to dozens of large outbreaks in correctional facilities, tens of thousands of seriously ill incarcerated people are receiving medical care in the community hospital setting. Yet community clinicians often have little knowledge of the basic rights and ethical principles governing care of seriously ill incarcerated patients. Such patients are legally entitled to make their own medical decisions just like non-incarcerated patients, and retain rights to appoint surrogate decision makers and make advance care plans. Wardens, correctional officers, and prison health care professionals should not make medical decisions for incarcerated patients and should not be asked to do so. Dying incarcerated patients should be offered goodbye visits with their loved ones, and patients from federal prisons are legally entitled to them. Community health care professionals may need to advocate for this medically vulnerable hospitalized patient population to receive ethically appropriate, humane care when under their care in community hospitals. If ethical care is being obstructed, community health care professionals should contact the prison’s warden and medical director to explain their concerns and ask questions. If necessary, community clinicians should involve a hospital’s ethics committee, leadership, and legal counsel. Correctional medicine experts and legal advocates for incarcerated people can also help community clinicians safeguard the rights of incarcerated patients.
I’m Every Woman: Advancing the Intersectional Leadership of Black Women School Leaders as Anti-Racist Praxis
Authors: Peters April L. , Miles Nash Angel
Published: February 2021

The rallying, clarion call to #SayHerName has prompted the United States to intentionally include the lives, voices, struggles, and contributions of Black women and countless others of her ilk who have suffered and strived in the midst of anti-Black racism. To advance a leadership framework that is rooted in the historicity of brilliance embodied in Black women’s educational leadership, and their proclivity for resisting oppression, we expand on intersectional leadership. We develop this expansion along three dimensions of research centering Black women’s leadership: the historical foundation of Black women’s leadership in schools and communities, the epistemological basis of Black women’s racialized and gendered experiences, and the ontological characterization of Black women’s expertise in resisting anti-Black racism in educational settings. We conclude with a four tenet articulation detailing how intersectional leadership: (a) is explicitly anti-racist; (b) is explicitly anti-sexist; (c) explicitly acknowledges the multiplicative influences of marginalization centering race and gender, and across planes of identity; and (d) explicitly leverages authority to serve and protect historically underserved communities.
Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study
Authors: Seifert Miriam , Davies Amy , Harding Sam , McLeod Sharynne , Wren Yvonne
Published: February 2021

Objective:

To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type.

Design:

Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children’s cleft type and syndromic status.

Participants:

A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old.

Main Outcome Measure(s):

Mothers’ rating of their children’s intelligibility using the ICS.

Results:

The average ICS score for the total sample was 3.75 ( sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 ( always intelligible). Children’s speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence ( P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81).

Conclusions:

These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.
The Personality Inventory for DSM-5–Brief Form: An Examination of Internal Consistency, Factor Structure, and Relationship to Aggression in an Incarcerated Offender Sample
Authors: Dunne Ashley L. , Trounson Justin S. , Skues Jason , Pfeifer Jeff E. , Ogloff James R. P. , Daffern Michael
Published: February 2021

This study evaluated the internal consistency and factor structure of the Personality Inventory for DSM-5–Brief Form (PID-5-BF), and its relationship to aggression in 438 incarcerated Australian male offenders. Results provide support for the internal consistency and five-factor and bifactor structure of the PID-5-BF. The PID-5-BF total score, as well as the domains of Antagonism, Disinhibition, and Negative Affect (low), demonstrated significant relationships with aggression. These results provide preliminary support for the psychometric properties of the PID-5-BF within prison settings, and suggest that a PID-5-BF assessment may be useful within forensic settings to screen for broad maladaptive personality characteristics that are indicative of a greater propensity for aggressive behavior.
The Two Faces of Exosomes in Parkinson’s Disease: From Pathology to Therapy
Authors: Izco Maria , Carlos Estefania , Alvarez-Erviti Lydia
Published: February 2021

Accumulating evidence suggests that exosomes play a key role in Parkinson’s disease (PD). Exosomes may contribute to the PD progression facilitating the spread of pathological alpha-synuclein or activating immune cells. Glial cells also release exosomes, and transmission of exosomes derived from activated glial cells containing inflammatory mediators may contribute to the propagation of the neuroinflammatory response. Glia-to-neuron transmission of exosomes containing alpha-synuclein may contribute to alpha-synuclein propagation and neurodegeneration. Additionally, miRNAs can be transmitted among cells via exosomes inducing changes in the genetic program of the target cell contributing to PD progression. Exosomes also represent a promising drug delivery system. The brain is a difficult target for drugs of all classes because the blood-brain barrier excludes most macromolecular drugs. One of the major challenges is the development of vehicles for robust delivery to the brain. Targeted exosomes may have the potential for delivering therapeutic agents, including proteins and gene therapy molecules, into the brain. This review summarizes recent advances in the role of exosomes in PD pathology progression and their potential use as drug delivery system for PD treatment, the two faces of the exosomes in PD.
Nucleolin Improves Heart Function During Recovery From Myocardial Infarction by Modulating Macrophage Polarization
Authors: Tang Yuting , Lin Xiaofang , Chen Cheng , Tong Zhongyi , Sun Hui , Li Yuanbin , Liang Pengfei , Jiang Bimei
Published: February 2021

Background:

Nucleolin has multiple functions within cell survival and proliferation pathways. Our previous studies have revealed that nucleolin can significantly reduce myocardial ischemia-reperfusion injury by promoting myocardial angiogenesis and reducing myocardial apoptosis. In this study, we attempted to determine the role of nucleolin in myocardial infarction (MI) injury recovery and the underlying mechanism.

Methods:

Male BALB/c mice aged 6–8 weeks were used to set up MI models by ligating the left anterior descending coronary artery. Nucleolin expression in the heart was downregulated by intramyocardial injection of a lentiviral vector expressing nucleolin-specific small interfering RNA. Macrophage infiltration and polarization were measured by real-time polymerase chain reaction, flow cytometry, and immunofluorescence. Cytokines were detected by enzyme-linked immunosorbent assay.

Results:

Nucleolin expression in myocardium after MI induction decreased a lot at early phase and elevated at late phase. Nucleolin knockdown impaired heart systolic and diastolic functions and decreased the survival rate after MI. Macrophage infiltration increased in the myocardium after MI. Most macrophages belonged to the M1 phenotype at early phase (2 days) and the M2 phenotype increased greatly at late phase after MI. Nucleolin knockdown in the myocardium led to a decrease in M2 macrophage polarization with no effect on macrophage infiltration after MI. Furthermore, Notch3 and STAT6, key regulators of M2 macrophage polarization, were upregulated by nucleolin in RAW 264.7 macrophages.

Conclusions:

Lack of nucleolin impaired heart function during recovery after MI by reducing M2 macrophage polarization. This finding probably points to a new therapeutic option for ischemic heart disease.
School Choice as Community Disempowerment: Racial Rhetoric about Voucher Policy in Urban America
Authors: Johnson Richard
Published: February 2021

Depictions of school choice offering greater individual and local autonomy are widespread, yet they sit uneasily with portrayals of such policies within African-American political discourse. This article analyses the ways in which opposition to publicly funded private school vouchers has been used as a cue to signal solidaristic ties to the African-American electorate. School choice is highly racialized. Black politicians have been known to campaign against school choice policies by presenting them as tools of White outsiders to break up and divide the Black community. Although opinion polls have indicated that a majority of African-American voters support education vouchers, in a campaign context school choice policies can be framed through the prisms of racial authenticity and community control. Using data drawn from interviews with political operatives and archival research in Newark, New Jersey, this article demonstrates that school choice can paradoxically be rendered as a policy of community disempowerment.
Women and Local Politics: Determinants of Women’s Emergence and Success in Elections to Czech Town Councils, 1998–2018
Authors: Maškarinec Pavel
Published: February 2021

The main objective of this paper is to analyse where women run for and win seats in local councils of Czech towns between 1998 and 2018. Our results are to some extent contradictory to those from Western Europe. More importantly, this study demonstrates that strategic context impacts on women’s emergence and success in local elections in a different way. First, we do not confirm that larger towns are more promising for women’s representation. While more fragmented party systems in larger cities contribute to making women’s candidacy more common, a large pool of female candidates does not result in their higher presence in local councils. Second, we identify openness of local environment to women, in terms of women’s previous representation, as a strong determinant of female representation in Czech towns, both in terms of candidacy and success.
Dose-escalation strategy in refractory metastatic colorectal cancer: A change in terms of cost-effectiveness
Authors: Giuliani Jacopo , Fiorica Francesco , Ponturo Giovanni , Azzurro Maurizio , Ruzzenente Andrea , Bonetti Andrea
Published: February 2021

The analysis was conducted to assess the pharmacological costs of regorafenib and trifluridine/tipiracil in the treatment of refractory metastatic colorectal cancer (mCRC). Pivotal phase III randomized controlled trials (RCTs) of regorafenib and trifluridine/tipiracil in the treatment of refractory mCRC were considered. We have also considered the ReDOS trial, in order to verify if the dose-escalation strategy (practice changing for regorafenib) could influences the results. Differences in OS (expressed in months) between the different arms were calculated and compared with the pharmacological costs (at the Pharmacy of our Hospital and expressed in euros (€)) needed to get one month of OS. Trifluridine/tipiracil resulted the less expensive, with 1167.50 €per month OS-gained. The ReDOS trial further reduce costs with 510.41 €per month OS-gained in favour of regorafenib with the escalation-dose strategy. Both regorafenib and trifluridine/tipiracil can be considered economically sustainable treatments for refractory mCRC, apparently with a lower cost of trifluridine/tipiracil. The adoption of a dose-escalation strategy (ReDOS trial) could reverse the situation making regorafenib more cost-effective than trifluridine/tipiracil.
Retrospective interview-based long-term follow-up study of cats diagnosed with idiopathic cystitis in 2003–2009
Authors: Eggertsdóttir Anna V , Blankvandsbråten Stine , Gretarsson Páll , Olofsson Anna E , Lund Heidi S
Published: February 2021

Objectives

The aim of this study was to register long-term recurrence rates and mortality rates in cats diagnosed with feline idiopathic cystitis (FIC), with an observation period until death or a minimum of 10 years.

Methods

Data regarding recurrence of signs of feline lower urinary tract disease (FLUTD) and FLUTD-related mortality in cats diagnosed with FIC between 2003 and 2009 were obtained through structured telephone interviews with the cat owners from December 2018 until February 2019. The interviews were based on a standardised questionnaire covering whether the cat was still alive or not, whether death/euthanasia were due to FLUTD and whether the cat had experienced recurrent episodes of clinical signs of FLUTD. If recurrences had occurred, exact numbers or estimates of 1–3, 4–6 or >6 recurrences were recorded.

Results

The owners of 50/105 FIC cats included in a previous study (48%) were available for inclusion in the present study. At the time of the interview, only 6/50 cats (12%) were still alive. The FLUTD-related mortality rate was 20% (n = 10/50). Twenty-three cats (46%) had no recurrences, three cats (6%) were euthanased shortly after diagnosis, nine cats (18%) had 1–3 recurrences, three cats (6%) had 4–6 recurrences and six cats (12%) had >6 recurrences. For the remaining six cats, the number of recurrences was uncertain.

Conclusions and relevance

The long-term prognosis for cats diagnosed with FIC may, based on the results from the present study, be regarded as fairly good, as approximately 70% of the cats either recovered without additional episodes, experienced only a few recurrences, are still alive after a minimum of 10 years since inclusion in the study, or were euthanased for reasons unrelated to FLUTD.
Use of tissue plasminogen activator to alleviate postoperative subcutaneous ureteral bypass obstruction secondary to blood clot in seven cats
Authors: Dropkin Casey A , Burdick Stacy K , Berent Allyson C , Weisse Chick W
Published: February 2021

Case series summary

Seven cats were found to have postoperative subcutaneous ureteral bypass (SUB) occlusion secondary to blood clot formation. An increase in serum creatinine led to imaging and clot detection in all but one case. Alteplase, a tissue plasminogen activator, was infused into the SUB via the port in four cats, intravesicularly via a transurethral urinary catheter in one cat, and by both routes in two cats. Patency of the SUB was re-established in all cats within 2 days. No short- or long-term complications directly attributed to alteplase administration were observed.

Relevance and novel information

The results of this case series suggest that alteplase infusion via either the SUB port and/or a transurethral catheter should be considered prior to surgical intervention for the treatment of postoperative SUB occlusion secondary to a blood clot.
Prevalence and causes of clinically detectable uveitic serous retinal detachment
Authors: Kinast Robert M , Solomon Sharon D , Cubillan Leo DP , Hovakimyan Anna , Acharya Nisha , Cunningham Emmett T
Published: February 2021

Purpose:

To describe the prevalence and causes of clinically detectable uveitic serous retinal detachment (SRD).

Methods:

Retrospective chart review of a large clinic-based series.

Results:

Serous retinal detachment was present in 78 of the 2761 (2.8%) patients. Vogt-Koyanagi-Harada (VKH) disease was the most commonly identified cause (38/78, 48.7%). Less common associated etiologies included toxoplasmic retinochoroiditis (8/78, 10.3%), sarcoidosis (5/78, 6.4%), intraocular lymphoma (4/78, 5.1%), presumed tuberculosis (3/78, 3.8%), and posterior scleritis (2/78, 2.6%). Fifteen patients (19.2%) with uveitic SRD at presentation had no identifiable etiology and were labeled idiopathic or indeterminant. Thirty of the 38 patients with VKH disease (78.9%) had positive neurological and/or integumentary findings, and therefore constituted either complete or incomplete subtypes of the disease. The remaining eight (21.1%) had presumed/ocular VKH disease limited to the eye.

Conclusion:

While VKH disease by far is the most common cause of clinically detectable uveitic SRD, a number of other non-infectious and infectious inflammatory disorders were also associated with this distinctive clinical finding.
Exploring the embodied subtleties of collaborative creativity: What organisations can learn from dance
Authors: Satama Suvi , Blomberg Annika , Warren Samantha
Published: February 2021

This study illustrates the value of embodied subtleties in the process of collaborative creativity. Drawing on a sensory ethnography of two dance productions, we illustrate the fine-grained ways in which professional dancers negotiate creative processes behind the scenes. We identify three aspects through which collaborative creativity emerges from bodily subtleties: (1) moving beyond individual bodies towards collective ambitions, (2) relating to colleagues’ micro-gestures and bodily nuances, and (3) the role of ‘serious play’ between bodies in setting the scene for the first two aspects to occur. The findings will contribute to our understanding of the practice of collaborative creativity, which we treat as not only a mental but also a highly intimate bodily practice. We conclude that appreciating sensory micro-dynamics between oneself and one’s colleagues is crucial for creative collaboration, which is increasingly necessary for management learning in contemporary organisations.
Using telemedicine to facilitate social distancing in otolaryngology: A systematic review
Authors: Moentmann Michael R , Miller Ryan J , Chung Michael T , Yoo George H
Published: February 2021

Objectives

As the coronavirus 2019 pandemic puts strains on current models of otolaryngology practice, telemedicine is an attractive way for otolaryngologists to reduce in-person appointments while still addressing the health of their patients. This systematic review of the literature aims to identify the evidence basis for using telemedicine in otolaryngology practice to limit person-to-person interactions while achieving comparable quality to in-person services.

Methods

The authors gathered articles from three databases (Embase, PubMed and Web of Science), performed a comprehensive literature review of articles published on telemedicine since 2002, and selected articles for inclusion based on their relevance to otolaryngology and the potential of the intervention to improve patient social distancing.

Results

A total of 7153 articles were identified from the initial query. After review, 35 met the inclusion criteria. Of the included articles, 32 (91%), found their specific telemedicine intervention to be effective when compared to in-person services. Twenty articles (57%) were related to remote otoscopy. Other telemedical interventions included videoconferencing for peri-operative visits, diagnosis of peritonsillar abscess, telephone-based voice evaluations and evaluation of nasal fractures.

Conclusions

Video-otoscopy is the most well-supported telemedical intervention which limits physical contact between otolaryngologists and their patients. Other interventions have also demonstrated efficacy but have yet to be as widely validated as video-otoscopy. Telehealth facilitators play a key role in providing high-quality telehealth services. More invasive procedures, such as laryngoscopy, require further evidence to demonstrate definite benefits in a telemedicine setting.
Assessing anthropometric and laboratory outcomes of a paediatric telehealth weight management program
Authors: Lukenbill Timothy , San Giovanni Christine B , Simpson Annie , Chew Marshall , Basco William , Roberts James
Published: February 2021

Introduction

Telehealth can expand quality care to patients unable to access specialty health services. The purpose of this study was to compare changes in body mass index (BMI) and laboratory values in patients visiting a weight management clinic for in-person versus telehealth counselling.

Methods

A retrospective cohort study of active program participants from two to 22 years old was conducted. Change in BMI, BMI z-score, low-density lipoprotein (LDL), alanine aminotransferase (ALT), and glycated haemoglobin (HbA1c) levels were measured at each patient’s initial and final visit for the study period, and the difference was analysed for significance. Change in BMI z-score was analysed for non-inferiority of the telehealth group using a delta of 0.15.

Results

We evaluated 1019 of 1126 (90.5%) in-person patients and 58 of 75 (77.3%) of telehealth clinic patients. The mean initial BMI was 32.2 and 32.6 for the in-person and telehealth groups, respectively. There were mean decreases in BMI z-scores of 0.044 and 0.032 in the in-person and telehealth groups, respectively, P < 0.001 with a margin of 0.15. The changes in mean HbA1c ( p = 0.59), mean LDL ( p = 0.93), and a mean ALT ( p = 0.09) were not significant, although only a minority of patients followed-up for lab draws, limiting interpretation of these results.

Discussion

Attending a weight management clinic via telehealth was non-inferior to in-person visits for enacting a clinically significant change in BMI z-score, mitigating the effect of sample size on BMI z-score results. These findings give credibility to telehealth as a means of increasing access to paediatric weight management care.
Task type completion in lower level EFL classes: A conversation analytic study
Authors: Park Yujong
Published: February 2021

This study assesses a range of task-based interaction (i.e. structured vs. unstructured tasks) between lower-English-proficiency middle school English as a foreign language (EFL) learners in a task-based learning (TBL) class employing conversation analytic methodology. From the video data, which allowed for an emic analysis of the students’ vocal and non-vocal actions when engaging in the different task types, it was found that in both the structured and unstructured task interactions, because the students were mainly focused on task completion, there were frequent minimal turns and sequences. A deviant case analysis revealed that the participants prioritized task completion as the focus of activities even when engaging in social talk by evoking various types of roles (e.g. students, friends). The study proposes several pedagogical suggestions for employing tasks in lower-level EFL contexts.
Finite element analysis of single-storey unreinforced alternative masonry walls
Authors: De Villiers Wibke I , Van Zijl Gideon PAG , Boshoff William P
Published: February 2021

The most commonly cited obstacles to the uptake of alternative masonry units on a meaningful scale, despite significant research investment, are a lack of standards and understanding of their structural behaviour. This paper contributes to the body of knowledge on finite element analysis of alternative masonry structures, towards improved understanding of their structural behaviour. Two critical masonry wall configurations, in the context of South African low-income, government-subsidised housing, are analysed using the simplified micro-modelling approach, under ultimate limit state wind and seismic actions. Three alternative masonry materials are characterised and employed in the numerical analyses, geopolymer, compressed-stabilised earth and adobe blocks, as well as conventional concrete blocks as benchmark. Despite the wide spectrum in masonry materials analysed, the chosen modelling approach captured the major failure mechanisms well. The four materials performed as expected relative to one another, but most wall/material configurations failed to resist the required design load, including the conventional concrete masonry material.
Investigation of corona discharge ionization of barbituric acid using ion mobility spectrometry along with quantum chemical calculations
Authors: Ghahremani Masoumeh , Salehabadi Hafezeh , Bahrami Hamed , Amanlou Massoud
Published: February 2021

This study aimed at examining atmospheric-pressure chemical ionization of barbituric acid through the corona discharge ion mobility spectrometry (CD-IMS) and the quantum chemical calculations. The results indicated two product ion peaks in the IMS spectrum of barbituric acid. The thermal decomposition of the barbituric acid sample was investigated by scanning the temperature of the injection port and analyzing the temporal evolution of the IMS peaks over elapsed time. It was found that the barbituric acid sample was not thermally decomposed in the injection port of the instrument. Experimental evidences were collected by changing the reactant ions, concentration of barbituric acid sample, and IMS cell temperature. The two observed peaks were then assigned to cationic form and oxygen protonated isomers of barbituric acid. The positions of the product ion peaks were explicated considering the dipole moments of the product ions.
A chronotopic approach to identity performance in musical numbers: a choreo-musical case study of ‘Rewrite the Stars’ and ‘This Is Me’
Authors: Elyamany Nashwa
Published: February 2021

Musical numbers, as viral modes of entertainment, influential forms of visual culture and catalysts of popular discourse are dense with multivariate aesthetic performers, and are interlaced to punctuate the melodramatic narrative texture in advancement of the plot and characterization in musical films. Performing identity through dancing bodies has been the subject of several film, music, culture, performance and communication research endeavours yet has rarely been explored from multimodal discourse analysis perspectives. To examine the ‘resilient identities’ underlying performances, the article adopts an eclectic approach informed by the Bakhtinian chronotope with regard to two numbers drawn from a recent American musical film in order to pinpoint: (a) the full repertoire of multimodal resources of narrative agency and identity performance; (b) the emotional experiences evoked by the musical numbers; and (c) the social practices that constitute, maintain and resist social realities and identities. The unconventional approach to the analysis of the musical numbers is what makes the current research project stand out among interdisciplinary studies of musical discourse.
Children helping to co-construct a digital tool that is designed to increase children’s participation in child welfare investigations in Sweden
Authors: Blomberg Helena , Östlund Gunnel , Lindstedt Philip Rautell , Cürüklü Baran
Published: February 2021

How do children (aged 6–12 years) understand and make use of a digital tool that is under development? This article builds on an ongoing interdisciplinary research project in which children, social workers (the inventers of this social innovation) and researchers together develop an interactive digital tool (application) to strengthen children’s participation during the planning and process of welfare assessments. Departing from social constructionism, and using a discursive narrative approach with visual ethnography, the aim of the article is to display how the children co-construct the application and contribute with “stories of life situations” by drawing themselves as characters and the places they frequent. The findings show that the children improved the application by suggesting more affordances so that they could better create themselves/others, by discovering bugs, and by showing how it could appeal to children of various ages. The application helped the children to start communicating and bonding when creating themselves in detail, drawing places/characters and describing events associated with them, and sharing small life stories. The application can help children and social workers to connect and facilitate children’s participation by allowing them to focus on their own perspectives when drawing and sharing stories.
Moral Injury and Biblical Studies: An Early Sampling of Research and Emerging Trends
Authors: Kelle Brad E.
Published: February 2021

Moral injury emerged within clinical psychology and related fields to refer to a non-physical wound (psychological and emotional pain and its effects) that results from the violation (by oneself or others) of a person’s deepest moral beliefs (about oneself, others, or the world). Originally conceived in the context of warfare, the notion has now expanded to include the morally damaging impact of various non-war-related experiences and circumstances. Since its inception, moral injury has been an intersectional and cross-disciplinary term and significant work has appeared in psychology, philosophy, medicine, spiritual/pastoral care, chaplaincy, and theology. Since 2015, biblical scholarship has engaged moral injury along two primary trajectories: 1) creative re-readings of biblical stories and characters informed by insights from moral injury; and 2) explorations of the postwar rituals and symbolic practices found in biblical texts and how they might connect to the felt needs of morally injured persons. These trajectories suggest that the engagement between the Bible and moral injury generates a two-way conversation in which moral injury can serve as a heuristic that brings new meanings out of biblical texts, and the critical study of biblical texts can contribute to the attempts to understand, identify, and heal moral injury.
Reinventing Middle School Using Design Thinking: Managing Reform at an Independent School
Authors: Gray Elizabeth , Lowenhaupt Rebecca
Published: February 2021

This case presents how the leadership team and faculty of a small, independent school used design thinking to respond to a competitive marketplace and desire for enrollment growth in the middle grades. The new middle school head came in with a mandate for substantial change and sought to engage all stakeholders in a process of redesign and program renewal. The case describes how leaders involved the school community in the Design Thinking protocol to solve intangible design problems. It explores leadership challenges presented by this approach, including strategies to address these challenges.
A Vignette-Based Transformative Multiphase Mixed Methods Interventional Study Featuring Venn Diagram Joint Displays: Financial Education With Hong Kong Early Adolescent Ethnic Minority Students
Authors: Ling Hua Loon , Pang Ming Fai
Published: February 2021

Despite great interest in the transformative mixed methods, an example of using vignettes in a multiphase mixed methods interventional study has been lacking. This study investigates the social justice problem of poverty in the context of financial education with Hong Kong early adolescent ethnic minority students. The discussion contributes to the field of mixed methods research by demonstrating the use of a vignette-based methodology as a tool for integration, representation, and utilization of participant voices in a multiphase design. The use of joint displays in the form of Venn diagrams illustrates how interdisciplinary research findings that may reveal multiple aspects of noncohering phenomena can be interpreted through simultaneous visualization of integration and diffraction.
Internal valvuloplasty combined with sleeve wrapping in the treatment of severe deep venous incompetence: A case report
Authors: Wu Yingfeng , Wei Libing , Gao Xixiang , Qi Yixia , Tong Zhu , Gu Yongquan , Hua Yang , Wang Lili , Wang Wei , Guo Lianrui
Published: February 2021

Background

The main cause of severe chronic venous insufficiency is deep venous incompetence. Deep venous reconstructive surgeries are reserved for cases that do not show a good response to conservative therapies.

Method

We present the case of a 68-year-old man presenting with swelling, pain, and pigmentation in his left lower limb for 14 years and ulcers for 10 years. Descending venography identified a Kistner’s grade IV reflux in the deep vein of the left lower limb. Internal valvuloplasty was performed following Kistner’s method. Meanwhile, external wrapping with a 1-cm-wide polyester-urethane vascular patch was performed to strengthen the vein wall in the venospasm condition.

Results

Symptoms were immediately relieved postoperatively. Refractory ulcers healed five months after the procedure. At the six-month follow-up, color duplex ultrasound of the deep vein of the left lower limb showed no reflux in the proximal segment of the femoral vein.

Conclusion

Internal valvuloplasty combined with sleeve wrapping is feasible in the treatment of severe deep venous incompetence with good short-term results.
An ethics framework for consolidating and prioritizing COVID-19 clinical trials
Authors: Meyer Michelle N , Gelinas Luke , Bierer Barbara E , Hull Sara Chandros , Joffe Steven , Magnus David , Mohapatra Seema , Sharp Richard R , Spector-Bagdady Kayte , Sugarman Jeremy , Wilfond Benjamin S , Lynch Holly Fernandez
Published: February 2021

Given the dearth of established safe and effective interventions to respond to COVID-19, there is an urgent ethical imperative to conduct meaningful clinical research. The good news is that interventions to be tested are not in short supply. Unfortunately, the human and material resources needed to conduct these trials are finite. It is essential that trials be robust and meet enrollment targets and that lower-quality studies not be permitted to displace higher-quality studies, delaying answers to critical questions. Yet, with few exceptions, existing research review bodies and processes are not designed to ensure these conditions are satisfied. To meet this challenge, we offer guidance for research institutions about how to ethically consolidate and prioritize COVID-19 clinical trials, while recognizing that consolidation and prioritization should also take place upstream (among manufacturers and funders) and at a higher level (e.g. nationally). In our proposed three-stage process, trials must first meet threshold criteria. Those that do are evaluated in a second stage to determine whether the institution has sufficient capacity to support all proposed trials. If it does not, the third stage entails evaluating studies against two additional sets of comparative prioritization criteria: those specific to the study and those that aim to advance diversification of an institution’s research portfolio. To implement these criteria fairly, we propose that research institutions form COVID-19 research prioritization committees. We briefly discuss some important attributes of these committees, drawing on the authors’ experiences at our respective institutions. Although we focus on clinical trials of COVID-19 therapeutics, our guidance should prove useful for other kinds of COVID-19 research, as well as non-pandemic research, which can raise similar challenges due to the scarcity of research resources.
Towards and away from the body: The relevance of the direction of use in the coding of object-related actions
Authors: Scotto di Tella Gianluca , Ruotolo Francesco , Ruggiero Gennaro , Iachini Tina , Bartolo Angela
Published: February 2021

This study examines whether the perception of an object automatically activates the representation of the direction of use of that object. To this aim, we carried out two experiments. In Experiment 1, participants were asked to explicitly categorise objects as used either away from the body (AB, for example, a hammer) or towards the body (TB, for example, a toothbrush). In Experiment 2, participants were asked to judge whether the same objects were natural or manmade. In both experiments, they were asked to respond by moving a joystick backwards (i.e., TB) or frontwards (i.e., AB). Therefore, their response could either be congruent (i.e., backward response with TB objects, frontward response with AB objects) or incongruent (i.e., backward response with AB objects, frontward response with TB objects) with the direction of object use. Results from Experiment 1 showed that in the congruent condition, participants were faster in judging the direction of object use than those in the incongruent condition (congruency effect). Crucially, results from Experiment 2 showed the presence of a congruency effect even when the direction of object use was task-irrelevant. However, this effect was found only for TB objects. These results suggest that the perception of TB objects automatically activates the direction of object use with respect to the body, thus showing evidence of direct connection between perception and action. A specific role of the body might account for different action representation processes involved in TB and AB object-related actions.
Coaches’ impact on youth athletes’ intentions to continue sport participation: The mediational influence of the coach–athlete relationship
Authors: Wekesser Meredith M , Harris Brandonn S , Langdon Jody , Wilson Charles H
Published: February 2021

About 70% of youth athletes drop out of sport by age 13. Self-determination theory has been utilised to investigate athletes’ motivations for behaviours including sport persistence (i.e. continuation) and suggests that the coach can be an influence on such motivations. Basic need fulfillment via interpersonal coaching behaviours, the coach-athlete relationship (CAR), and intentions to continue sport participation have been examined independently and in various combinations and directions, but these variables have not been examined collectively in this manner. The purpose of this study was to determine if CAR quality mediates the relationship between interpersonal coaching behaviours and intentions to continue sport participation. Surveys were administered to 148 athletes ages 11 to 16 from organised sports teams. No significant indirect effects of mediation could be established. However, there was a significant and direct effect of competence-supportive behaviours on intentions ( β = .341, p < .001). Overall, the total effects model was significant ( F(1,146) = 18.762, p < .001, adjusted R2 = .114). Significant positive relationships were shown among supportive coach behaviours and CAR quality in addition to CAR quality and intentions. Negative relationships were demonstrated among thwarting coach behaviours and CAR quality. Results support that coaches’ competence-supportive behaviours can positively impact CAR quality and intentions to continue sport participation in youth athletes.
A single center observational study of the incidence, frequency and timing of critical care physiotherapy intervention during the COVID-19 pandemic
Authors: Rich Jessica , Coman Mark , Sharkey Alison , Church Daniel , Pawson Jessica , Thomas Amanda
Published: February 2021

Introduction

The recent COVID-19 pandemic saw many patients admitted to an intensive care setting and requiring mechanical ventilation. The NHS increased their critical care beds which included expanding the amount of staff. Physiotherapists were a key part of this and were required to complete numerous interventions within the COVID critical care setting throughout the pandemic. Our aim was to collect the incidence and frequency of physiotherapy interventions performed during the COVID-19 pandemic in a critical care setting.

Method

Data was collected across all critical care beds at the Royal London Hospital for an eight-week period between March- April 2020. We retrospectively collected physiotherapy interventions for example, endotracheal suctioning and functional rehabilitation for every patient in the critical care setting. The Chelsea Critical Care Physical Assessment Tool (CPAx) scores were also obtained for patients on ACCU admission and discharge.

Results

A total of 213 patients were included in the sample, 163 COVID-19 positive and 50 COVID-19 negative. Recorded sessions included secretion management (821), weaning (271), rescue therapy (82) and functional rehab (534) across the eight-week period. The mean CPAx score on admission to ACCU for the entire sample was 9/45 points. On discharge that score had improved to 25/45 points.

Conclusion

This unique project has enabled us to report on the critical care physiotherapy interventions provided during the COVID 19 pandemic. This interesting data on frequency and timing of interventions may be useful to plan future relocation staffing plans and optimal allocation of care.
Critical illness in the returning traveller
Authors: Howells Phillip , Laird Steven , Johnston Andrew McD , Billyard Thomas
Published: February 2021

A 70 year old man, who had recently travelled in rural Iraq, presented with fevers, rigors, and developed multiorgan failure. An extensive range of diagnostic tests was undertaken in an attempt to identify the cause. He was treated with multi-organ support and a number of antibiotics. Critical illness in the returning traveller presents a number of challenges on the ICU: obtaining adequate history, the potentially broad differential diagnosis, the requirement for numerous and sometimes specialised investigations and risks of infection transmission to staff and other patients. Travellers are more often elderly, more likely to have comorbidities and immunosuppression whilst global disease patterns are changing. Particular consideration should be given to unusual infections and venous thromboembolic disease from prolonged immobility whilst in transit, alongside more commonly encountered diseases. Antimicrobial resistance may be encountered and appropriate infection control is essential for the protection of patients, staff and others. Specialist support is available in the UK via the Imported Fever Service, especially for High Consequence Infectious Diseases. Consideration of non-infectious causes of fever and critical illness in returning travellers is also warranted. Crucially, a multidisciplinary team approach with thorough information gathering, repeated clinical review and judicious use of investigations are essential for optimal patient care.
Keeping you post-ed: Space-time regimes, metaphors, and post-apartheid
Authors: Houssay-Holzschuch Myriam
Published: February 2021

Societies that have undergone systemic change are characterized as ‘post’—post-socialist, post-colonial, etc.—to encapsulate the impact the past still has on their structure and functioning. Research on these societies has therefore tended to adopt a mostly temporal approach, investigating the tension between continuity and change. Using the example of post-apartheid South Africa, I make a case for a more balanced approach to post situations by including space as equally valuable. I draw my theoretical inspiration from Hartog’s notion of regimes of historicity and Massey’s space-time to argue that we should investigate space-time regimes. I show that a space-time regime of entanglement, often passéist, with blurred temporal boundaries and messy, place-bound experiences of time, characterizes post situations. Finally, using South Africa as my empirical grounding, I offer a set of metaphors to describe and analyze the concrete places that this entangled, post space-time produces.
Combining ecological momentary assessment, wrist-based eating detection, and dietary assessment to characterize dietary lapse: A multi-method study protocol
Authors: Goldstein Stephanie P , Hoover Adam , Evans E Whitney , Thomas J Graham
Published: February 2021

Objectives

Behavioral obesity treatment (BOT) produces clinically significant weight loss and health benefits for many individuals with overweight/obesity. Yet, many individuals in BOT do not achieve clinically significant weight loss and/or experience weight regain. Lapses (i.e., eating that deviates from the BOT prescribed diet) could explain poor outcomes, but the behavior is understudied because it can be difficult to assess. We propose to study lapses using a multi-method approach, which allows us to identify objectively-measured characteristics of lapse behavior (e.g., eating rate, duration), examine the association between lapse and weight change, and estimate nutrition composition of lapse.

Method

We are recruiting participants (n = 40) with overweight/obesity to enroll in a 24-week BOT. Participants complete biweekly 7-day ecological momentary assessment (EMA) to self-report on eating behavior, including dietary lapses. Participants continuously wear the wrist-worn ActiGraph Link to characterize eating behavior. Participants complete 24-hour dietary recalls via structured interview at 6-week intervals to measure the composition of all food and beverages consumed.

Results

While data collection for this trial is still ongoing, we present data from three pilot participants who completed EMA and wore the ActiGraph to illustrate the feasibility, benefits, and challenges of this work.

Conclusion

This protocol will be the first multi-method study of dietary lapses in BOT. Upon completion, this will be one of the largest published studies of passive eating detection and EMA-reported lapse. The integration of EMA and passive sensing to characterize eating provides contextually rich data that will ultimately inform a nuanced understanding of lapse behavior and enable novel interventions. Trial registration: Registered clinical trial NCT03739151; URL: https://clinicaltrials.gov/ct2/show/NCT03739151
Social Return on Investment (SROI) to Assess the Impacts of Tourism: A Case Study
Authors: Ariza-Montes Antonio , Sianes Antonio , Fernández-Rodríguez Vicente , López-Martín Carmen , Ruíz-Lozano Mercedes , Tirado-Valencia Pilar
Published: February 2021

This article contributes to the debate on the social and economic impacts generated by tourism activities using a methodology that is still insufficiently explored in the field of tourism and the impacts that this causes: social return on investment (SROI). Using the analysis of a case as a guiding thread, this article shows how the application of this methodology allows one to know in depth the social value that an emblematic palace (one of the main tourist attractions of a city in the south of Spain that was designated as a United Nations Educational, Scientific, and Cultural Organization [UNESCO] World Heritage Site) brings, the changes experienced by the interest groups that interact with it, and the theory of change that promotes the very existence of the palace. Its results and conclusions can also inform policies and strategies of these other actors related to the intervention.