bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating the New Era of Influencer Marketing: How to be Successful on Instagram, TikTok, & Co.
Authors: Haenlein Michael , Anadol Ertan , Farnsworth Tyler , Hugo Harry , Hunichen Jess , Welte Diana
Published: October 2020

Influencer marketing represents a $10 billion industry in 2020 and is becoming of increasing relevance for many firms, especially those operating in a business-to-consumer environment. Few firms in the fashion, beauty, travel, food, or beverage industries are running marketing campaigns these days that do not include, at least to some share, a collaboration with popular users on platforms such as Instagram and TikTok. However, many marketing managers still have a less than adequate understanding of those platforms compared with their knowledge of more traditional media channels and often find it hard to make the right decision in this fast-moving environment. To provide some guidance in this respect, this article aims to give an introduction to the most critical platforms for influencer marketing. It then presents advice to firms who want to engage in influencer marketing as well as specific questions on identifying the right influencers to collaborate with.
Changing the Work of Innovation: A Systems Approach
Authors: Day George S. , Shea Gregory
Published: October 2020

To achieve faster organic growth, firms need to change their prevailing narrative about innovation from growth denying to growth enabling. This requires changing the system through which the work of innovation gets done. This article describes the work systems model of organizational change and shows how a leadership team can select the most influential elements of the system to make a desired narrative a reality. Four elements of the work system are especially effective at encouraging a growth-affirming narrative: leadership commitment to innovation talent, prudent risk-taking, customer-centric innovation, and aligning metrics and incentives.
Research on design method of double-loop electric servo loading system with high-frequency band based on H∞ control strategy
Authors: Shui Yang , Wei Jianli , Yan Jie
Published: October 2020

In the hardware-in-the-loop simulation, the goal of electric loading is to realize the accurate tracking of the torque signal and test the performance of the aircraft actuator system. For some high dynamic aircraft, it is necessary to reduce the influence of the surplus torque to increase the system frequency band. This paper introduces a new electric loading system which adopts a double-loop servo motor as the torque loading mechanism. It applies two loops to track the position of the rudder and the aerodynamic load spectrum respectively. For the purpose of reducing the disturbance between two loops of the scheme, a two-DOF H∞ robust controller is designed, which improves the robustness of the system effectively. The simulation results show that the new system increases the upper limit of 25 Hz frequency band of the traditional single-loop system with PID control to the maximum of 40 Hz. The double-loop system thereby meets the technical requirements of the hardware-in-the-loop simulation experiment for high dynamic aircrafts.
Production behavior evaluation on multilayer commingled stress-sensitive carbonate gas reservoir
Authors: Guo Jianlin , Meng Fankun , Jia Ailin , Dong Shuo , Yan Haijun , Zhang Hao , Tong Gang
Published: October 2020

Influenced by the complex sedimentary environment, a well always penetrates multiple layers with different properties, which leads to the difficulty of analyzing the production behavior for each layer. Therefore, in this paper, a semi-analytical model to evaluate the production performance of each layer in a stress-sensitive multilayer carbonated gas reservoir is proposed. The flow of fluids in layers composed of matrix, fractures, and vugs can be described by triple-porosity/single permeability model, and the other layers could be characterized by single porosity media. The stress-sensitive exponents for different layers are determined by laboratory experiments and curve fitting, which are considered in pseudo-pressure and pseudo-time factor. Laplace transformation, Duhamel convolution, Stehfest inversion algorithm are used to solve the proposed model. Through the comparison with the classical solution, and the matching with real bottom-hole pressure data, the accuracy of the presented model is verified. A synthetic case which has two layers, where the first one is tight and the second one is full of fractures and vugs, is utilized to study the effects of stress-sensitive exponents, skin factors, formation radius and permeability for these two layers on production performance. The results demonstrate that the initial well production is mainly derived from high permeable layer, which causes that with the rise of formation permeability and radius, and the decrease of stress-sensitive exponents and skin factors, in the early stage, the bottom-hole pressure and the second layer production rate will increase. While the first layer contributes a lot to the total production in the later period, the well bottom-hole pressure is more influenced by the variation of formation and well condition parameters at the later stage. Compared with the second layer, the scales of formation permeability and skin factor for first layer have significant impacts on production behaviors.
Communication Intervention Implementation via Telepractice Parent Coaching: Child Outcomes and Correlations
Authors: Wattanawongwan Sanikan , Ganz J. B. , Pierson Lauren M. , Yllades Valeria , Liao Ching-Yi , Ura Sarah K.
Published: October 2020

Individuals with autism spectrum disorder (ASD) have deficits in social and communication skills that can cause problems such as difficulty interacting with others and challenging behaviors. Research has demonstrated the effectiveness of parents as intervention implementers to improve children’s communication skills. We evaluated the effects of a telepractice parent coaching communication intervention on communication skills of children with ASD utilizing a multiple probe design across participants. Parents applied strategies learned with their child, targeting communication skills, such as asking opinion-oriented questions or using augmentative and alternative communication to request items. Results indicated improvement in children’s communicative behaviors and a significant correlation between parent implementation of intervention elements and children behaviors. Effect size results for the participants indicated strong effects consistent with visually inspected data.
Clinical Predictors of Facial Nerve Outcomes After Surgical Resection of Vestibular Schwannoma
Authors: Ren Yin , MacDonald Bridget V. , Tawfik Kareem O. , Schwartz Marc S. , Friedman Rick A.
Published: October 2020

Objective

To identify clinical predictors of facial nerve (FN) outcomes after microsurgical resection of vestibular schwannoma (VS).

Study Design

Prospective cohort study.

Setting

Academic medical center.

Methods

Consecutive patients undergoing VS resection from November 2017 to October 2019 were included. FN function was evaluated with the House‐Brackmann (HB) scale and stratified into good (HB I‐II) and poor (HB III‐VI) function. Analyses included descriptive statistics, correlation, and logistic regression.

Results

Of 256 patients who met criteria (mean age, 47.7 years; 62.5% female), 227 (88.7%) achieved good FN function postoperatively and 238 (93.0%) at latest follow‐up (mean, 154.8 days). Operative approaches consisted of translabyrinthine (50.8%), retrosigmoid (25.0%), and middle fossa craniotomies (24.2%). Extent of resection was decided intraoperatively, and gross or near total resection was accomplished in 237 (92.6%) cases. Postoperative HB grade correlated with latest HB grade (0.615, P <. 001). Factors associated with good postoperative FN function included small tumor size (≤15 mm; odds ratio [OR], 2.425; P =. 042), gross or near total resection (OR, 3.170; P =. 041), and ≥100‐µV intraoperative FN electromyographic response to a 0.05‐mA stimulus (OR, 22.242; P <. 001). Factors associated with good FN function at latest follow‐up included gross total resection (OR, 7.764; P =. 003) and ≥100‐µV FN electromyographic response (OR, 8.518; P <. 001), accounting for surgical approach and tumor size.

Conclusion

Microsurgical resection of VS can be accomplished with excellent FN outcomes. Gross total resection and ≥100‐µV intraoperative FN electromyographic response predicted excellent FN outcomes. Immediate postoperative FN function is a prognosticator of long‐term FN function.
In‐Practice Endocrine Surgery Fellowship: A Novel Training Model
Authors: Tierney Hien T. , Eldeiry Leslie S. , Garber Jeffrey R. , Haddad Chia A. , Varvares Mark A. , Iannuzzi Ralph A. , Randolph Gregory W.
Published: October 2020

Objective

Endocrine surgery is an expanding field within otolaryngology. We hypothesized that a novel endocrine surgery fellowship model for in‐practice otolaryngologists could result in expert‐level training.

Study Design

Qualitative clinical study with chart review.

Setting

Urban community practice and academic medical center.

Methods

Two board‐certified general otolaryngologists collaborated with a senior endocrine surgeon to increase their endocrine surgery expertise between March 2015 and December 2017. The senior surgeon provided intensive surgical training to both surgeons for all of their endocrine surgeries. Both parties collaborated with endocrinology to coordinate medical care and receive referrals. All patients undergoing endocrine surgery during this time frame were reviewed retrospectively.

Results

A total of 235 endocrine surgeries were performed. Of these, 198 thyroid surgeries were performed, including 98 total thyroidectomies (48%), 90 lobectomies (45%), and 10 completion thyroidectomies (5%). Sixty cases demonstrated papillary thyroid carcinoma, 11 follicular thyroid carcinoma, and 4 medullary thyroid carcinoma. Neck dissections were performed in 14 of the cases. Thirty‐seven parathyroid explorations were performed. There were no reports of permanent hypoparathyroidism. Thirteen patients (5.5%) developed temporary hypoparathyroidism. Six patients (2.5%) developed postoperative seroma. Three patients (1.3%) developed postoperative hematomas requiring reoperation. One patient (0.4%) developed permanent vocal fold paralysis, and 3 patients (1.3%) had temporary dysphonia. Thirty‐five of 37 (94.5%) parathyroid explorations resulted in biochemical resolution of the patient’s primary hyperparathyroidism.

Conclusion

This is the first description of a new fellowship paradigm where a senior surgeon provides fellowship training to attending surgeons already in practice.
Myringoplasty With an Ultrathin Cartilage‐Perichondrium Complex Graft Versus Temporalis Fascia Graft: A Propensity Score–Matched Analysis
Authors: Huang Yi‐Bo , Hu Lu‐lu , Ren Dong‐Dong , Han Zhao
Published: October 2020

Objective

To compare endoscopic myringoplasty using the cartilage‐perichondrium complex as a graft (test group) with temporalis fascia microscopic myringoplasty (control group).

Study Design

A retrospective cohort study.

Setting

Department of Otorhinolaryngology in a tertiary Chinese hospital.

Methods

Data were collected on patients between 2017 and 2019. To balance the baseline characteristics between groups, we performed a propensity score–matched analysis, and 44 patients were included in each group. Hearing improvement and eardrum closure rates were compared, and risk factors affecting them were analyzed.

Results

In the control and test groups, 90.90% and 86.36% of patients had a mean air‐bone gap ≤20 dB after the surgery, respectively (P =. 843). The air conduction (AC) threshold gain at each frequency was similar in the 2 groups (P >. 05). The closure rates were 95.45% and 93.18%, respectively (P =. 645). The air‐bone gap improved significantly after surgery, F(1, 61) = 6.729, P =. 012. Age, group, middle ear mucosal status, and location of the perforation did not affect the change in air‐bone gap or the drum closure rate (P >. 05). However, there was an interaction between the change in air‐bone gap and the size of the perforation, F(1, 61) = 11.067, P = 0001.

Conclusion

Endoscopic myringoplasty using a cartilage‐perichondrium complex graft is comparable with traditional surgery. Age, location of the perforation, and middle ear mucosal status did not significantly affect the change in air‐bone gap or the drum closure rate. A perforation size ≥50% was always associated with a better air‐bone gap improvement.
The Limitations of Online Surveys
Authors: Andrade Chittaranjan
Published: October 2020

Online surveys are growing in popularity, perhaps because they are an easy, convenient, and inexpensive means of data collection. Online surveys commonly suffer from two serious methodological limitations: the population to which they are distributed cannot be described, and respondents with biases may select themselves into the sample. Research is of value only when the findings from a sample can be generalized to a meaningful population. When the population addressed by the survey cannot be described, and when the sample is contaminated by respondents with biases, findings from online surveys cannot be generalized and may therefore mislead.
Selection of suitable pedicle screw for degenerated cortical and cancellous bone of human lumbar spine: A finite element study
Authors: Jain Pushpdant , Khan Mohammed Rajik
Published: October 2020

Pedicular arthrodesis is the traditional procedure in terms of increase in the biomechanical stability with higher fixation rate. The current work aims to identify the effect of three spinal pedicle screws considering cortical and cancellous degeneracy condition. Lumbar section L2-L3 is utilized and various load and moment conditions were applied to depict the various biomechanical parameters for selection of suitable screw. Three dimensional model is considered in finite element analysis to identify the various responses of pedicle screw at bone screw juncture. Computed tomography (CT) images of a healthy male were considered to generate the finite element vertebral model. Generated intact model was further utilized to develop the other implanted models of degenerated cortical and cancellous bone models. The three fused instrumented models with different cortical and cancellous degeneracy conditions were analyzed in finite element analysis. The results were obtained as stress pattern at bone screw boundary and intervertebral disc stress. FE simulated results represents significant changes in the von Mises stress due to various load and moment conditions on degenerated bones during different body movement conditions. Results have shown that among all pedicle screws, the 6.0 mm diameter screw reflects very less stress values at the juncture. Multiple results on biomechanical aspects obtained during the FE study can be considered to design a new stabilization device and may be helpful to plan surgery of critical sections.
Ingredient Branding: A Differentiation Strategy for the Commoditized World
Authors: Panwar Tapish , Khan Kalim
Published: October 2020

Ingredient branding, as one of the potent branding strategies, relies upon the added equity based on a strategic alliance of two brands. This article aims to discuss the fundamentals of ingredient branding and consolidate the extant knowledge with the help of an extensive literature review. A set of implementation guidelines for ingredient branding strategy, as well as the risks associated with the strategy, have been discussed. Finally, it has been argued that ingredient branding, due to its nuances and advantages can be useful for a firm to differentiate against its competitors in a highly commoditized market. This article will help managers and marketers decide about adopting an ingredient branding strategy, and choosing the right ingredient for the host brand to achieve a sustainable differentiation against competition.
Lion Conservation and the Lion Bone Trade in South Africa: On CITES, Shifting Paradigms, “Sustainable Use” and Rehabilitation
Authors: Turner Jason , Wels Harry
Published: October 2020

In lion conservation, the International Union for Conservation of Nature (IUCN), the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), and Trade Records Analyses of Flora and Fauna in Commerce (TRAFFIC) are considered key United Nations (UN) institutions for “science-based decisions” on global policy formulation for conservation and combating wildlife crime.

CITES, but probably also TRAFFIC and IUCN, still adheres to and operates in the paradigm of the “sustainable use” of animals, based on the long leading philosophical Cartesian paradigm in academia that premises that humans and animals differ in kind, and that animals do not “feel” and have the neurological capacities to think like us. But this Cartesian worldview can no longer withstand the latest scientific evidence, developments, and new insights that show how people and animals only differ in degree and not in kind. The concept of “sustainable use” of wildlife, including lions, therefore needs to be rethought in the light of this new paradigm.

In South Africa, the “sustainable use” of lions includes the trade in lion’s bones from captive lions, which was legalized in 2016. The Wildlife Animal Protection Forum of South Africa (WAPFSA) appealed against this legalized trade, based on rational arguments that fit CITES and its Cartesian approach to animals but also on the paradigm shift where humans and animals are no longer considered different in kind but only in degree. This paradigm shift has led to initiatives to try and suggest possible ways forward for a political order that matches this “new normal.” Probably the most developed in this context is the concept of “zoopolis,” which is explored in this article. The four “vulnerabilities” on which the concept is based were all found to be relevant to lion conservation and fighting wildlife crime in South Africa.
Musa’s Predicament and the MBA Capstone Project Team
Authors: Ahmad Ghufran , Hussain Nehan
Published: October 2020

The case is focused on the difficult challenges faced by a second-year MBA Capstone Project Team at the Suleman Dawood School of Business, Lahore University of Management Sciences in Pakistan. The project deadline is closing in; however, the team is facing serious work-related and interpersonal issues with detrimental consequences for the team dynamics and ultimate success of the project. As one of the founding members of the team, Musa is perplexed and confused about how to resolve the conflicts in the team, which has divided into two factions due to the mishandling of the situation by another team member, Elias. The faculty advisor to the team has called an emergency meeting, and Musa wants to find a way out of the current crisis to complete the project successfully. The case also illustrates gender-based biases that may surface in specific cultural contexts.
The Ontological Crisis of Schooling: Situating Migrant Childhoods and Educational Exclusion
Authors: Rajan Vijitha
Published: October 2020

This article emphasises the discord between ‘mobile childhoods’ and ‘immobile schools’ as the fundamental problematic of educational inclusion of migrant children in India. Formal schooling system predicated upon static ideals of age, grade, learning, curriculum and language, fails to accommodate the lived realities of migrant children. By drawing upon field work narratives with migrant children in Bangalore, I show that migrant children’s educational exclusion cannot be understood in terms of their mobility alone, instead it needs to be problematised in the context of dominant spatio-temporal ideals of childhood and schooling.
MGNREGA in Kashmir: An Analysis of Labour Market Outcomes and Livelihood Security
Authors: Malla Mushtaq Ahmad
Published: October 2020

This article attempts to examine the coverage and labour market outcomes of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) in Kashmir. It is based on a cross-sectional mixed-method study of 200 households, 40 bureaucrats and local political representatives conducted in Kupwara, one of the poorest districts of Jammu & Kashmir. The article argues that MGNREGA is poorly implemented and is not functioning as a guaranteed safety net for the poor households that suffer from job scarcity. Considerable benefits are directed towards the non-poor, while several poor and deserving households are excluded. This bias is a result of rationing in local distribution by middlemen in collusion with bureaucrats to further their political and economic interests. In addition, the administration’s orientation towards MGNREGA as a development policy instead of a social protection, supply shortage in the provision of MGNREGA work and administrative delays in project operationalisation are some of the key bottlenecks. The article contends that the policy has enormous scope and potential to achieve its anticipated objective of acting as livelihood protection for job scarce workers in rural Kashmir, if it is implemented as a social protection policy following its provisions in its true spirit.
School Nurse Job Descriptions in Urban Districts: Alignment With the Framework for 21st-Century School Nursing Practice
Authors: Reising Virginia , Cygan Heide
Published: October 2020

It is recommended that every student has daily access to a school nurse and that school nurses work in alignment with the Framework for 21st-Century School Nursing Practice (Framework). Little is known about Framework alignment with school nursing practice. The purpose of this study is to describe the alignment between the Framework and school nurse job descriptions in large, urban school districts across the United States. Using content analysis, with a directed approach, researchers used the Framework to analyze school nurse job descriptions for 16 school districts, analyzing 375 individual job responsibilities. The majority of job responsibilities reviewed (86%) were related to principles within the care coordination and community/public health nursing component, while job responsibilities within the key principles of leadership and quality improvement components were limited (14%). The Framework can be a useful tool to guide school nurse practice and however needs to be intentionally brought into job descriptions.
An Intervention to Promote Adherence to Glasses Wearing Among Urban Public Elementary School Students: Associations With Classroom Behavior
Authors: Haag Tania M. , Velazquez Gabriela Calderon , Wiggins Tresa , Spin Paul , Johnson Sara B. , Connor Katherine A.
Published: October 2020

Glasses wearing at school remains low even when glasses are provided. This study investigated whether a classroom intervention to promote glasses wearing was associated with increased glasses wearing and improved classroom behavior. A pretest, posttest design was implemented with 44 students in Grades 1–4 at an urban public elementary school. Over 5 weeks, teachers encouraged eyeglass wearing through a classroom tracker, verbal reminders, and incentives. Glasses wearing and student behavior were monitored using the Direct Behavior Rating Scale of academic engagement and behavior for 13 weeks, including 4 weeks before and after the intervention. Glasses wearing increased from 56% to 73% (95% confidence interval [CI] = [0.08, 0.26]) in the first 2 weeks of the intervention, but not after a spring recess. The intervention was associated with significantly improved academic engagement (4.31%, 95% CI [2.17, 6.45]), respect (3.55%, 95% CI [1.77, 5.34]), and disruption (−4.28%, 95% CI [−6.51, −2.06]) compared to baseline. Higher academic engagement and disruption persisted 4 weeks after the intervention ended. A classroom-based glasses tracking and incentive system is associated with improved eyeglass wearing and classroom behavior among elementary students. A longer term randomized trial is needed to confirm these promising results.
School Concussion Policy in Colorado: Lack of Knowledge and Access Are Barriers to Education
Authors: Wicklund Alissa , Andrews Barb , Coatsworth J. Douglas
Published: October 2020

All states have youth sports concussion laws that have helped shape school concussion policy. However, state laws do not specify how schools distribute policy. The present study examined parent, youth, and school personnel’s knowledge of school concussion policy in Colorado and ease of access to policy via school website. Youth ( n = 1,987), parents ( n = 520), and school personnel ( n = 130) completed an online survey about knowledge of their schools’ concussion policy. Less than half of parents (48.9%) and students (43.0%) knew their school had a policy. School personnel were aware of the policy (96%). Among youth, rates of knowledge differed across gender, school level, and sport participation. Forty-nine percent of school district websites contained information on concussion. There are gaps in knowledge of concussion policy for youth and their parents. Teachers, administrators, coaches, and school nurses, who are educated on policy, could help facilitate communication. School websites are not being fully utilized to disseminate concussion policy.
Conventional and Postqualitative Research: An Invitation to Dialogue
Authors: Monforte Javier , Smith Brett
Published: October 2020

This article explores a question that was left mostly unanswered in a recent special issue of Qualitative Inquiry surveying the field of postqualitative research: How can conventional and post qualitative research coexist within the qualitative community? The importance of addressing this key question is first highlighted. Then, a possible answer is offered, which is: By promoting a new paradigm dialogue grounded in the principles of agonistic pluralism. Challenging the idea of consensus and harmonious coexistence, agonistic pluralism allows casting researchers with competing paradigmatic positions as adversaries or “friendly enemies,” which exist together in the same space without each sacrificing its beliefs about knowledge production. We invite members of the global qualitative community to explore this possibility.
Acceptability of HIV Oral Self-Test Among Men Having Sex With Men and Transgender Population: A Qualitative Investigation From Pune, India
Authors: Rao Amrita , Patil Sandip , Aheibam Sharmila , Kshirsagar Prajkta , Hemade Pranoti , Panda Samiran
Published: October 2020

Globally HIV-self-test is considered as an important tool to end AIDS. However, several countries, including India, are yet to adopt such a strategy. Against this background, we conducted a qualitative inquiry exploring acceptability of an HIV-oral-self-test (HIVOST) among MSM and TG communities in the district of Pune, India. Discussions were facilitated around an HIVOST kit developed in-country. Most of the participants expressed familiarity with the concept of self-test. They realised that confirmatory diagnostic test would be required following a positive HIVOST screening result. Discrimination from health care workers, crowded environment, lack of privacy and delay in getting reports were hurdles faced during HIV testing at public healthcare facilities. Contrastingly, quick results, painless technique and no-blood-draw were perceived advantages of HIVOST. Innovative suggestions were obtained on how-to-do instruction modalities, kit distribution venues and redressing of apprehensions. Such qualitative responses indicated interest and encouraging level of acceptance around HIVOST among study participants.
Doege–Potter Syndrome and Hypoglycemia associated with Solitary Fibrous Tumor of the Pleura: Two Case Reports
Authors: Fernández-Trujillo Liliana , Bolaños Jhon E , Álvarez Carolina , Giraldo Julián , Velásquez Mauricio , Zúñiga-Restrepo Valeria , Pérez Bladimir , Sua Luz F
Published: October 2020

Solitary fibrous tumors of the pleura (SFTP) are rare mesenchymal neoplasms that originate from mesenchymal growth in the pleura, tend to be single tumors, usually have an indolent course and show nonspecific symptoms. SFTP can be often diagnosed from an incidental finding of a single mass in the thorax and should be confirmed by biopsy and immunohistochemistry. A minority of cases may present Doege–Potter syndrome (DPS, episodes of refractory hypoglycemia) associated with production of insulin-like growth factor 2 (IGF-2). Both SFTP and DPS are rare occurrences with less than 2000 cases reported worldwide. The curative treatment is tumor resection. Two cases of patients with DPS caused by SFTP are presented below.
Sociality and temporality in local experiences of distress and healing: Ethnographic research in northern Rwanda
Authors: Otake Yuko , Tamming Teisi
Published: October 2020

Prior studies have traced sociality and temporality as significant features of African healing. However, association between the two has not been explicitly investigated. This paper explores how sociality and temporality are associated in local experiences of distress and healing among northern Rwandans. The ethnographic research, including in-depth interviews, focus-group discussions and participant observation, was conducted in 2015–2016, with 43 participants from the Musanze district who have suffered from not only the genocide but also post-genocide massacres. Findings identified common local idioms of distress: ibikomere (wounded feelings), ihungabana (mental disturbances), ihahamuka (trauma), and kurwara mu mutwe (illness of the head, severe mental illness). One stage of distress was perceived to develop into another, slightly more serious than the previous. Social isolation played a significant role in the development as it activated ‘remembering’ and ‘thinking too much’ about the past and worsened symptoms. Subsequently, healing was experienced through social reconnection and a shift of time orientation from the past to the future; the healing experience traced a process of leaving the past behind, moving forwards and creating a future through community involvement. The experiences of distress and healing in this population were explained by two axes, i.e. sociality (isolation – reconnection) and temporality (past – future), which are associated with each other. Given the sociality–temporality association in African post-war healing, the study highlights that assistant programmes that facilitate social practice and future creation can be therapeutic and be an alternative for people who cannot benefit from talking-based and trauma-focused approaches.
The Setswana speech rhythm of 6–7 year-old Setswana–English bilingual children
Authors: Sebina Boikanyego , Setter Jane , Daller Michael
Published: October 2020

Aims and objectives:

This study investigates the acquisition of Setswana speech rhythm, considered to be typically syllable-timed, by early sequential Setswana–English bilingual children aged 6–7 years old growing up in Botswana, a country with a diglossic setting, where English is the dominant high-status language in educational and public contexts. For this group of children, taught full-time in English from the age of 3 years, the L2 becomes their dominant language through exposure to English-medium education. The aim was to ascertain if the prosodic patterns of Setswana spoken by the bilingual children are similar to those of the monolingual children or if English, considered to be stress-timed, has an effect on these prosodic features.

Data and analysis:

The speech rhythm patterns of 10 Setswana–English bilingual children were compared with those of 10 age-matched Setswana monolingual children educated in public schools for whom English is a learner language. The study primarily examines spontaneous speech from the telling of a wordless picture storybook, and utilises rhythm metrics nPVI-V and Varco V to examine the speech rhythm of the children.

Findings:

The results showed that the prosodic pattern of Setswana in the bilingual group diverged from that of the non-bilingual group.

Originality:

This is the first such study on speech rhythm in bilingual children in Setswana.

Significance:

The research provides evidence in this population of effects from English bilingualism on L1 Setswana speech prosody, and challenges the assumption that speech rhythm prosody is established early in life, especially when the language is a less marked, syllable-timed language like Setswana.
Non-traumatic Dorsalis Pedis Artery Aneurysm
Authors: Wicander Janet
Published: October 2020

A true dorsalis pedis artery aneurysm is a very rare find. This is a case presentation of a patient with an asymptomatic non-traumatic dorsalis pedis artery aneurysm. A 49-year-old man was referred to the vascular lab for evaluation of an asymptomatic non-traumatic pulsatile lump on the dorsal aspect of his left foot. The patient reported that the lump had been present for at least 4 years. Color flow duplex ultrasound was used to evaluate the lump. Color flow duplex ultrasound examination of the lump demonstrated a dilatation of the dorsalis pedis artery, measuring approximately 1.05 cm by 1.35 cm. Mural thrombus is noted in gray scale image. Normal Doppler flow was noted in the dorsalis pedis artery, proximal, and distal to the aneurysm. The patient was referred to a vascular surgeon. Subsequently, he underwent a lower extremity arteriogram confirming the diagnosis of a dorsalis pedis artery aneurysm, with good distal blood flow to the toes. The patient underwent resection of the dorsalis pedis artery aneurysm. Reverse great saphenous vein was used as an interposition graft. Follow-up graft scans demonstrated good flow in the graft and in the native artery, distal to the graft. True dorsalis pedis artery aneurysms are very rare finding. When left untreated, the patient is at risk for embolization to the digits. Color flow Doppler is a very useful tool in diagnosing and assessing these aneurysms.
A Call for Intersectional Healthcare Design Research
Authors: Crocker Sophie
Published: October 2020

The majority of patient experience research has been conducted in culturally Western contexts without controlling for cultural and demographic variation. Designers are left with little choice but to apply contextually specific and demographically neutral research to a wide range of healthcare systems, cultural contexts, and demographic conditions. It is possible that some research will transfer and generate the intended outcomes. However, it is likely much will not, and there is currently little way of knowing what does and does not work in environments outside of those where the study was conducted. Healthcare design research conducted in a variety of sociocultural conditions could help to ensure healthcare facilities are designed to best suit the sociodemographic needs of their users and support the wider public health ambitions of the health system. Health inequalities that exist within and between nations are well-known, and while the systems and structures that inform these inequalities are complex, it is likely design can play a role in ensuring these inequalities are not exacerbated by the environments in which care is provided. In other words, while healthcare designers may not be able to affect the geographies of inequality outside health facilities, they should endeavor to impact those within. It is critical that studies be repeated in a wide variety of conditions and that design decisions be openly published, shared, and discussed to create a discourse around methods, ethics, and comparative studies in the field of Intersectional Healthcare Design Research.
The role of hypoxia‐induced modulation of alveolar epithelial Na+‐ transport in hypoxemia at high altitude
Authors: Baloglu Emel , Nonnenmacher Gabriel , Seleninova Anna , Berg Lena , Velineni Kalpana , Ermis‐Kaya Ezgi , Mairbäurl Heimo
Published: October 2020

Reabsorption of excess alveolar fluid is driven by vectorial Na+‐transport across alveolar epithelium, which protects from alveolar flooding and facilitates gas exchange. Hypoxia inhibits Na+‐reabsorption in cultured cells and in‐vivo by decreasing activity of epithelial Na+‐channels (ENaC), which impairs alveolar fluid clearance. Inhibition also occurs during in‐vivo hypoxia in humans and laboratory animals. Signaling mechanisms that inhibit alveolar reabsorption are poorly understood. Because cellular adaptation to hypoxia is regulated by hypoxia‐inducible transcription factors (HIF), we tested whether HIFs are involved in decreasing Na+‐transport in hypoxic alveolar epithelium. Expression of HIFs was suppressed in cultured rat primary alveolar epithelial cells (AEC) with shRNAs. Hypoxia (1.5% O2, 24 h) decreased amiloride‐sensitive transepithelial Na+‐transport, decreased the mRNA expression of α‐, β‐, and γ‐ENaC subunits, and reduced the amount of αβγ‐ENaC subunits in the apical plasma membrane. Silencing HIF‐2α partially prevented impaired fluid reabsorption in hypoxic rats and prevented the hypoxia‐induced decrease in α‐ but not the βγ‐subunits of ENaC protein expression resulting in a less active form of ENaC in hypoxic AEC. Inhibition of alveolar reabsorption also caused pulmonary vasoconstriction in ventilated rats. These results indicate that a HIF‐2α‐dependent decrease in Na+‐transport in hypoxic alveolar epithelium decreases alveolar reabsorption. Because susceptibles to high‐altitude pulmonary edema (HAPE) have decreased Na+‐transport even in normoxia, inhibition of alveolar reabsorption by hypoxia at high altitude might further impair alveolar gas exchange. Thus, aggravated hypoxemia might further enhance hypoxic pulmonary vasoconstriction and might subsequently cause HAPE.
Stim‐activated TRPC‐ORAI channels in pulmonary hypertension induced by chronic intermittent hypoxia
Authors: Castillo‐Galán Sebastian , Arenas German A. , Reyes Roberto V. , Krause Bernardo J. , Iturriaga Rodrigo
Published: October 2020

Obstructive sleep apnea (OSA), a breathing disorder featured by chronic intermittent hypoxia (CIH) is associated with pulmonary hypertension (PH). Rodents exposed to CIH develop pulmonary vascular remodeling and PH, but the pathogenic mechanisms are not well known. Overexpression of Stim‐activated Transient Receptor Potential Channels (TRPC) and Calcium Release‐Activated Calcium Channel Protein (ORAI) TRPC‐ORAI Ca2+ channels (STOC) has been involved in pulmonary vascular remodeling and PH in sustained hypoxia. However, it is not known if CIH may change STOC levels. Accordingly, we studied the effects of CIH on the expression of STOC subunits in the lung and if these changes paralleled the progression of the vascular pulmonary remodeling and PH in a preclinical model of OSA. Male Sprague‐Dawley rats (∼200 g) were exposed to CIH (5%O2, 12 times/h for 8 h) for 14, 21, and 28 days. We measured right ventricular systolic pressure (RVSP), cardiac morphometry with MRI, pulmonary vascular remodeling, and wire‐myographic arterial responses to KCl and endothelin‐1 (ET‐1). Pulmonary RNA and protein STOC levels of TRPC1, TRPC4, TRPC6, ORAI 1, ORAI 2, and STIM1 subunits were measured by qPCR and western blot, and results were compared with age‐matched controls. CIH elicited a progressive increase of RVSP and vascular contractile responses to KCl and ET‐1, leading to vascular remodeling and augmented right ventricular ejection fraction, which was significant at 28 days of CIH. The levels of TRPC1, TRPC4, TRPC 6, ORAI 1, and STIM 1 channels increased following CIH, and some of them paralleled morphologic and functional changes. Our findings show that CIH increased pulmonary STOC expression, paralleling vascular remodeling and PH.
Residence at moderately high altitude and its relationship with WHO Group 1 pulmonary arterial hypertension symptom severity and clinical characteristics: the Pulmonary Hypertension Association Registry
Authors: Fakhri Shoaib , Hannon Kelly , Moulden Kelly , Peterson Ryan , Hountras Peter , Bull Todd , Maloney James , De Marco Teresa , Ivy Dunbar , Thenappan Thenappan , Sager Jeffrey S. , Ryan John J. , Mazimba Sula , Hirsch Russel , Chakinala Murali , Shlobin Oksana , Lammi Matthew , Zwicke Dianne , Robinson Jeffrey , Benza Raymond L. , Klinger James , Grinnan Daniel , Mathai Stephen , Badesch David
Published: October 2020

Background

WHO Group 1 pulmonary arterial hypertension is a progressive and potentially fatal disease. Individuals living at higher altitude are exposed to lower barometric pressure and hypobaric hypoxemia. This may result in pulmonary vasoconstriction and contribute to disease progression. We sought to examine the relationship between living at moderately high altitude and pulmonary arterial hypertension characteristics.

Methods

Forty‐two US centers participating in the Pulmonary Hypertension Association Registry enrolled patients who met the definition of WHO Group 1 pulmonary arterial hypertension. We utilized baseline data and patient questionnaire responses. Patients were divided into two groups: moderately high altitude residence (home ≥4000 ft) and low altitude residence (home <4000 ft) based on zip‐code. Clinical characteristics, hemodynamic data, patient demographics, and patient reported quality of life metrics were compared.

Results

Controlling for potential confounders (age, sex at birth, body mass index, supplemental oxygen use, race, 100‐day cigarette use, alcohol use, and pulmonary arterial hypertension medication use), subjects residing at moderately high altitude had a 6‐min walk distance 32 m greater than those at low altitude, despite having a pulmonary vascular resistance that was 2.2 Wood units higher. Additionally, those residing at moderately high altitude had 3.7 times greater odds of using supplemental oxygen.

Conclusion

Patients with pulmonary arterial hypertension who live at moderately high altitude have a higher pulmonary vascular resistance and are more likely to need supplemental oxygen. Despite these findings, moderately high altitude Pulmonary Hypertension Association Registry patients have better functional tolerance as measured by 6‐min walk distance. It is possible that a “high‐altitude phenotype” of pulmonary arterial hypertension may exist. These findings warrant further study.
In New Territory: Consent and the Extended Duties Dental Nurse
Authors: Elsden Jacqui
Published: October 2020

With the introduction of direct access to treatment from dental care professionals (DCPs) in 2013, dental nurses are being trained to support the wider dental team in a number of additional skills. The name for this expanded team role is Extended Duties Dental Nurse (EDDN). These new duties take the EDDN into new territories, one of which includes the issue of consent. This article explains the background to direct access and the extra responsibilities for EDDNs in terms of consent and indemnity. It explores the new knowledge required to gain valid consent and presents a scenario for consideration. The article concludes that it is important for EDDNs to develop their professional approach, taking early advice from the referring dentist and/or professional indemnity adviser if faced with an unfamiliar scenario.
Communication Skills for Extended Duties Dental Nurses: The Childsmile Perspective
Authors: O'Keefe Emma
Published: October 2020

Good communication and influencing skills are key competency areas for dental nurses and are highly relevant when working with children and their families/carers in Childsmile, a national oral health improvement programme for children in Scotland. The General Dental Council (GDC) identifies communication skills as one of the nine principles for registrants; a large number of complaints seen by the GDC relate to allegations around communication and patient expectations not being fully met. Much time and investment has been spent in researching the role of the Extended Duties Dental Nurse (EDDN) and ensuring appropriate training is provided. While there is specific training for EDDNs delivering the Childsmile programme, the programme appreciates that good communication skills are a core component of all training programmes for dental nurses.

This paper sets out to explore the role of EDDNs in Childsmile and specifically looks at the importance of good communication skills and how it facilitates and impacts on the delivery of the Childsmile programme in a variety of settings.
Learning from a Special Care Dentistry Needs Assessment
Authors: Johnson Ilona
Published: October 2020

The General Dental Council recognised special care dentistry (SCD) as a speciality in 2008 and local service reviews have been carried out in order to develop SCD services. A needs assessment was completed to inform the implementation of recommendations from a 2010 review of SCD in Wales.

Aim

The aim of this paper is to outline the process, findings and learning from the needs assessment and the implications for SCD.

Method

A focused needs assessment approach was used. Stakeholder consultations were used to develop a working definition for the needs assessment. Data were collected from existing health and social care sources and analysed using descriptives and geographic information system (GIS) mapping.

Results

Data sources for needs assessment were limited. Analysis showed that health conditions were common in the population and increased with age. The majority of people who reported seeing a dentist were seen in general dental practice. Older people with health conditions were less likely to report seeing a dentist. Patients often needed to travel for specialist care services.

Conclusion

General dental practice teams have a significant role in caring for SCD patients. Careful planning of specialist care, joint working and enhancing skills across the general practice team will reduce the burden of care and enhance patient safety. Improvements in data for assessment of SCD needs are required to help this process.
Introduction to Pain
Authors: Renton Tara
Published: October 2020

This edition of PDJ is intended to provide a wide overview on orofacial pain for dental and medical teams. Both acute and chronic orofacial conditions relevant to dentistry and medicine will be covered, and emphasising a holistic and pragmatic approach. Orofacial pain is the most common presenting symptom for patients presenting to their dentist and increasingly commonly presenting to doctors in general practice and A&E departments.

Pain in the trigeminal system causes much higher psychological and neurophysiological distress compared with other body regions, as the trigeminal nerve is the great sensory protector to the eyes, ears, nose, mouth and meninges, the senses that underpin our very existence. It is an anathema that surgery in and around the face and mouth is predominantly undertaken by dentists on conscious patients, unlike other surgical specialties. This explains the expectation of pain by patients when seeing their dentists, sadly an expectation which is frequently fulfilled, fuelling high levels of anxiety and fear, which in turn increases the pain experience.
An Overview of Dental Anxiety and the Non-Pharmacological Management of Dental Anxiety
Authors: Hare Jennifer , Bruj-Milasan Geanina , Newton Tim
Published: October 2020

In this article we will seek to provide an overview of dental anxiety and fear, including its most extreme manifestation, dental phobia. We will explore the prevalence of different levels of dental anxiety and outline some broad principles for the management of dental anxiety based on an approach which suggests that management should be proportionate to the level of anxiety.