bluuebunny/crossref_metadata_2025 huggingface dataset:
Educational System Building in a Changing Educational Sector: Environment, Organization, and the Technical Core
Authors: Spillane James P. , Seelig Jennifer L. , Blaushild Naomi L. , Cohen David K. , Peurach Donald J.
Published: August 2019

The institutional environment of U.S. school systems has changed considerably over a quarter century as standards and test-based accountability became central ideas in policy texts and discourses about improving education. We explore how U.S. school systems are managing in this changed environment by focusing on system leaders’ sense-making about their environments as they attempt to build educational systems to improve instruction, the core technology of schooling. We identify the policy texts and discourses system leaders notice and their framings, interpretations, and uses of these cues as they build educational infrastructures to support more coherent instructional visions. We argue that school systems’ educational infrastructure building efforts were intended at coupling their systems’ formal organization with particular environmental cues in an effort to influence classroom instruction. In turn, we argue that these educational infrastructure building efforts can simultaneously be motivated by, and in pursuit of, institutional ritual and technical rationality.
Driving Cessation and Social Isolation in Older Adults
Authors: Qin Weidi , Xiang Xiaoling , Taylor Harry
Published: August 2019

Objective: This study investigated the impact of driving cessation on social isolation in older adults. Method: Data were obtained from Rounds 1 through 6 of the National Health and Aging Trends Study. The study sample consisted of 6,916 Medicare beneficiaries aged 65 or above who were eligible drivers at baseline. Mixed-effects ordered logistic regression and piecewise regression were used to examine the impact of driving cessation on social isolation. Results: In multivariable mixed-effects ordered logistic regression, past-year nondrivers had a twofold increase in the odds of being in a higher social isolation category (odds ratio [OR] = 2.1, p < .001). Piecewise regression analysis showed that social isolation scores increased by 0.08 points ( p = .024) following an incident of driving cessation. Discussion: Driving cessation is associated with a higher risk of social isolation in older adults. Interventions to reduce social isolation among older adults may improve public health by targeting older adults who have recently stopped driving.
Rainbow Lanyards: Bisexuality, Queering and the Corporatisation of LGBT Inclusion
Authors: Calvard Thomas , O’Toole Michelle , Hardwick Hannah
Published: August 2019

This article presents the powerful account of Hannah, a woman working in a UK university who identifies as bisexual and queer. Hannah’s voice reflects a younger generation of workers who have come of age with the emergence of queer theory and activism supporting greater LGBT rights. Her narrative illustrates the tensions around developing an inclusive stance towards diverse sexual identities at work. Hannah’s account resonates with critical views of diversity management and inclusion practices, where non-normative minority identities are reduced to corporate categories and initiatives for management by majorities. More specifically, the account presented also covers the complexities and challenges of discussing and disclosing gendered sexualities at work, namely bisexuality, which serves as an illustration of ‘queering’ – a resistance towards understanding identities as fixed, manageable and binary. The article provides insight into how and why sexual identity matters for issues of power and conflict at work.
A novel approach to determine splitter vane length for an extremely high hub/tip ratio mixed-flow compressor impeller
Authors: Xiang Hang , Chen Jiang , Cheng Jinxin , Song Xiancheng , Niu Han
Published: August 2019

This paper presents an approach to determine splitter vane length in radial compressor impellers based on a modified 1D performance prediction model, which considers the effects of splitter vane length and blade number on impeller internal losses. The splitter vane length corresponding to optimum blade number is investigated to achieve the maximum efficiency of a mixed-flow compressor impeller with an extremely high hub/tip ratio. An empirical formula for calculating splitter vane length is proposed. CFD results show that blade number and splitter vane length have a complex coupling interaction which makes it inappropriate to be described by equivalent solidity or effective blade number. 1D results and CFD verification indicate that optimum full-length blade number is 42 and corresponding splitter vane length is 20% of full-length blade length at design flow rate. The impeller peak efficiency mainly depends on minimum loss superposition of blade loading, skin friction and tip clearance. With the increase of splitter vane length and blade number, blade loading loss and clearance loss decline while skin friction loss increases.
Workplace Spirituality and Person–Organization Fit Theory: Development of a Theoretical Model
Authors: Palframan Jason T. , Lancaster Brian L.
Published: August 2019

This article advances the theoretical and practical value of workplace spirituality by drawing on person–organization (PO) fit theory and transpersonal psychology to investigate three questions: (a) What antecedents lead individuals and organizations to seek and foster workplace spirituality? (b) What are the perceived spiritual needs of individuals, and how are those needs fulfilled in the workplace? and (c) What are the consequences of meeting spiritual needs as individuals perceive them? Using constructivist grounded theory, analysis of interview data from thirty-four participants located in organizations across the Netherlands, Ireland, the United Kingdom, and Portugal led to development of a workplace spirituality, PO fit model in which we propose reconciling self as a core factor of workplace spirituality. We note how through the process of reconciling self, workplace spirituality is related to meaning making and how an individual perceives their work environment as conducive to self-expression and inner purpose. Practical and theoretical implications are discussed, as are limitations of the study and ideas for future research.
Assessing driving fitness in dementia: a challenge for old age psychiatrists
Authors: Neilson Duncan , Chacko Emme , Cheung Gary
Published: August 2019

Objective:

To investigate how old age psychiatrists consider the fitness of dementia patients to drive safely and the challenges they face.

Method:

Participants were interviewed using a semi-structured approach that explored topics including their approach to driving fitness and cessation, challenges experienced and previous training. Thematic analysis was used to generate main themes.

Results:

Thirteen participants were recruited. Most felt they were not experts in driving fitness. Many found these assessments challenging for both themselves and their patients, with a negative impact on therapeutic alliance. There was a lack of formal training and variability both in the approach when considering fitness to drive as well as raising the issue of driving with patients.

Conclusions:

These results highlight the need to increase the availability of training for driving fitness, and to develop a standardised approach to help improve consistency amongst clinicians.
An Adapted Model of Cost-Related Nonadherence to Medications Among People With Disabilities
Authors: Gupta Shikha , McColl Mary Ann , Guilcher Sara J. T. , Smith Karen
Published: August 2019

Despite emerging evidence on cost-related nonadherence (CRNA) to prescription medications, there is little conceptualization and exploration of this phenomenon with respect to disability. Specifically, there is a gap in the literature that explores factors influencing medication cost–adherence relationship among individuals living with a disability. To advance research on and policy for CRNA to medications among people with disabilities, we need a framework that can contribute towards guiding solutions to this problem. We examined the applicability of Piette and colleagues’ existing model for CRNA to the context of people with disabilities and suggested an adapted model (CRNA to medications for persons with disability [CRNA-d]) that can provide a more specific conceptualization of CRNA with respect to disability. The adapted CRNA-d model depicts that CRNA to prescription medications with respect to disability is a dynamic and multifaceted phenomenon, determined by various socioeconomic, disability-related, medication-related, prescriber-related, and system-related factors. We discuss how higher susceptibility to health complications, barriers to income and employment, additional health care costs, the complexity of medical regimens, limited access to physician services, and other policy-related factors increase the risk of persons with disabilities to face cost-related barriers to fulfill their necessary medications.
Implementation Issues in Functional Family Therapy: A Narrative Analysis of the Evidence
Authors: Weisman Clio , Montgomery Paul
Published: August 2019

This analysis of functional family therapy (FFT) studies examines whether their variable outcomes are attributable to implementation issues. Studies were identified firstly, by way of a recent overview, supplemented by an update of a highly sensitive search including 15 databases, 10 websites, all existing relevant reviews, gray literature as well as contacting experts in the field. Updated searches were conducted in August 2018 and were analyzed according to the Oxford Implementation Index and an assessment of supervision quality. In total, the search yielded 150 records; 48 full texts were retrieved of which 32 were excluded leaving 16 studies containing 5,320 unique participants included for analysis. There was no evidence of reported harm. Improved training and supervision were associated with better core outcomes. Although there was no apparent dose relationship, it appears that implementation issues are important and also that class and ethnicity were identified for areas of further study.
Talk to Me, Not at Me: An Ethnographic Study on Health-Related Help-Seeking Behavior Among Socially Marginalized Danish Men
Authors: Pedersen Annette , Haslund-Thomsen Helle , Curtis Tine , Grønkjær Mette
Published: August 2019

Research shows that men tend to have delayed health-related help-seeking behavior. In this ethnographic study, we explored influential factors related to health-related help-seeking behavior among socially marginalized men who seem not to benefit from existing municipal health care services in a large Danish municipality. The study included 200 hours of participant observations and 25 ethnographic interviews with men between 45 and 65 years of age in their own homes and in public parks among their peers. In this study, we found that the men had several complex and interacting social- and health-related conditions, which seemed to affect their health-related help-seeking behavior. We conclude that collaborative initiatives between the outreach team who occasionally visits bench sites in the public parks and the municipal health care services in the local areas could lay the groundwork for encouraging men’s health-related help-seeking behavior and aid men in supporting each other.
Promoting Psychosocial Adjustment in Individuals Born With Cleft Lip and/or Palate and Their Families: Current Clinical Practice in the United Kingdom
Authors: Stock Nicola Marie , Zucchelli Fabio , Hudson Nichola , Kiff James D. , Hammond Vanessa
Published: August 2019

Objectives:

The importance of psychosocial aspects of care has received growing recognition in recent years. However, the evidence base for psychosocial intervention remains limited. Specialist clinicians working in cleft lip and/or palate (CL/P) services hold a wealth of knowledge and experience yet to be elicited. The aims of this study were to identify common psychosocial challenges and potential risk and/or protective factors for psychosocial distress from the perspective of specialist clinicians and to establish the types of interventions currently being delivered in practice.

Design:

Individual interviews with 17 clinical nurse specialists and 19 specialist clinical psychologists, representing all 16 UK CL/P surgical sites. Data were analyzed using inductive content analysis.

Results:

Numerous psychosocial challenges affecting individuals with CL/P and their families were identified across the life span. Risk factors were predominantly contextual in nature, while protective factors appeared amenable to intervention. Participants drew upon a range of therapeutic models and approaches to guide formulation and intervention, while acknowledging the lack of evidence to support these approaches in CL/P populations specifically.

Conclusions:

Findings have important implications for the way in which psychosocial support for CL/P and related conditions is delivered and evaluated. A framework for the standardized assessment of holistic individual and familial well-being is proposed. Suggestions for increasing the evidence base for specific psychosocial interventions are made, including enhanced family functioning; social, emotional, and appearance concerns; treatment decision-making; and screening for psychosocial and developmental issues.
Floating Frame of Reference formulation for modeling flexible multi-body systems in premise operational conditions
Authors: Nada Ayman , Bishiri Abdullatif
Published: August 2019

The Floating Frame of Reference (FFR) formulation is a well-established and reliable method for modeling flexible multi-body systems. The FFR formulation has been adopted for dynamic systems that are characterized by large rotations with relatively small deformations. Many scientific papers have pointed out these characteristics with the scrutiny of the simulation results and comparisons with other modeling techniques. However, the FFR is still enclosed in the theoretical aspects and simulation work and faces difficulties when being applied to practical systems. The crucial point in these difficulties centers on coordinate reduction and the associated mapping between nodal and modal coordinates. The process of selecting the necessary modes may be theoretically simple, but the situation is different when applied in a real operational environment. The strategy developed in this work combines the Operational Modal Analysis, specifically the Frequency Domain Decomposition (FDD) approach, and the FFR formulation to build a suitable model of practical multi-body systems. The output model has been validated experimentally. The results show that the proposed FFR-FDD method can be efficiently used to construct multi-body models for those systems that work in premise operational conditions.
Periprocedural Anticoagulation Management For Nonoperating Room Anesthesia Procedures: A Clinical Guide
Authors: Tao Jing , Oprea Adriana D.
Published: August 2019

Non-operating room anesthesia presents unique challenges for anesthesiologists. Limited preprocedural optimization and unfamiliarity with the location and procedure itself add to the difficulties in delivering safe care for these patients. Management of chronic oral anticoagulation can prove especially problematic since risks of bleeding for non-operating room procedures vary widely and differ from traditional surgeries. In addition, many physicians may not be familiar with the growing number of newly approved oral anticoagulants and their periprocedural management. This review will examine common non-operating procedures, their risks of bleeding, as well as pharmacokinetics of oral anticoagulants available on the market and periprocedural management options.
An Automated Text Message Navigation Program Improves the Show Rate for Outpatient Colonoscopy
Authors: Mahmud Nadim , Doshi Sahil D. , Coniglio Mary S. , Clermont Michelle , Bernard Donna , Reitz Catherine , Khungar Vandana , Asch David A. , Mehta Shivan J.
Published: August 2019

Background. Numerous barriers to outpatient colonoscopy completion exist, causing undue procedure cancellations and poor bowel preparation. We piloted a text message navigation program to improve colonoscopy adherence. Method. We conducted a prospective study of patients aged 18 to 75 years scheduled for outpatient colonoscopy at an urban endoscopy center in April 2018. An intervention arm consisting of bidirectional, automated text messages prior to the procedure was compared with a usual care arm. We enrolled 21 intervention patients by phone and randomly selected 50 controls. Outcomes included colonoscopy appointment adherence, bowel preparation quality, and colonoscopy completion. Results. The arms had similar demographics and comorbidities. Intervention patients had higher colonoscopy appointment adherence (90% vs. 62%, p = 0.049). There were no significant differences in preparation quality or procedure completeness. Poststudy surveys indicated high patient satisfaction and perceived usefulness of the program. Conclusion. A bidirectional, automated texting navigation program improved colonoscopy adherence rates as compared with usual care.
Populism/people/popular: Reflections from a Latin American perspective
Authors: Misoczky Maria Ceci
Published: August 2019

The motives for writing this essay are twofold. First, there is a risk that the stigma currently associated with populism may contaminate the notions of people and popular struggles that are so relevant in the Latin American political and organizational context. Thus, this essay contributes towards overcoming the predominant discussion on populism from the perspective of the Global North West. The second motive arises from the understanding that the organizational processes within popular movements and struggles cannot be comprehensively studied without fully appreciating the knowledge theoretically elaborated in, and that emerges from below, which most often remains restricted to the practices and spaces of struggle. Dussel’s philosophy and ethics of liberation can contribute to a renewal of the way we study and theorize organization to include the radical potentiality of developing anti-management studies in the engagement with popular struggles, such as those organized against the destructive impacts of business and management in the production and reproduction of people’s lives and livelihoods. Therefore, this contribution is directed specifically to the study and theorization of these processes, providing inspiration for our practices of co-constructing knowledge that can be relevant and meaningful for activists and their organizational processes. Besides that, Dussel’s philosophy and ethics of liberation also provide contributions for the negative critique of populism as the political expression of fetishized vertical power that, in concrete historical situations, subordinates the original foundational popular power.
Beyond coups: terrorism and military involvement in politics
Authors: Bove Vincenzo , Rivera Mauricio , Ruffa Chiara
Published: August 2019

A wealth of research in comparative politics and international relations examines how the military intervenes in politics via coups. We shift attention to broader forms of military involvement in politics beyond coups and claim that terrorist violence and the threat of terror attacks provide a window of opportunity for military intervention, without taking full control of state institutions. We highlight two mechanisms through which terrorism influences military involvement in politics: (1) government authorities demand military expertise to fight terrorism and strengthen national security and “pull” the armed forces into politics, and (2) state armed actors exploit their informational advantage over civilian authorities to “push” their way into politics and policy-making. A panel data analysis shows that domestic terror attacks and perceived threats from domestic and transnational terrorist organizations increase military involvement in politics. We illustrate the theoretical mechanisms with the cases of France (1995–1998 and 2015–2016) and Algeria (1989–1992).
Beyond de jure and de facto boundaries: tracing the imperial geographies of US law
Authors: Irani Freya
Published: August 2019

Since 1945, US judges have extended numerous “domestic” US laws (including securities and antitrust laws) to govern economic transactions taking place “abroad”. However, they have generally failed to extend US labor and employment laws to govern employer–employee relationships outside “US territory”. Through a close reading of federal court decisions and drawing on recent work in the field of critical legal studies, this article makes an argument for centering the study of jurisdiction in International Relations scholarship and for approaching states as instantiated in their jurisdictional assertions. I suggest that such an approach enables us to capture the geographies—including the imperial geographies—of US law in the “normal,” everyday course of affairs. In particular, such an approach allows us to see that, since the mid-20th century, the legal authority and legal relations of the US government have come to be organized around the notion of the national economy (rather than simply around, for example, notions of territory or citizenship). What this means is that it is increasingly a posited relationship to this national economy that determines whether people and corporations, wherever in the world they are located, are subjected to or protected by US law.
Voice therapy for Parkinson’s disease via smartphone videoconference in Malaysia: A preliminary study
Authors: Chan Min Yen , Chu Shin Ying , Ahmad Kartini , Ibrahim Norlinah Mohamed
Published: August 2019

Introduction

Intensive voice therapy is one of the best evidence-based treatments to improve speech and voice difficulties to individuals with Parkinson’s disease (PD). However, accessibility to intensive voice therapy is highly challenging in Malaysia due to the lack of voice specialised speech-language therapists. This study examined the feasibility of using smartphone videoconference to deliver intensive voice therapy to individuals with PD in Malaysia.

Methods

Intensive voice therapy was delivered to 11 adults with PD using a smartphone videoconference method via WhatsApp Messenger freeware. The therapy consisted of 12 sessions over four weeks and focused on increasing vocal loudness. Outcomes were assessed using objective, perceptual and quality-of-life measures pre and post treatment. Participant satisfaction with the telerehabilitation method was obtained via the Smartphone-Based Therapy Satisfaction Questionnaire.

Results

Significant gains were reported for sound pressure level in sustained vowels and monologue. Perceptual ratings showed significant improvements in overall mean severity and loudness after treatment. Mean scores of speech intelligibility and Voice Handicap Index-10 were significantly better post treatment. Overall, participants were highly satisfied with the smartphone videoconference method.

Discussion

Present results suggest that the smartphone videoconference method is feasible to deliver intensive voice therapy to individuals with PD to gain better speech and voice functions. Future studies need to address the standardisation of the system protocol to optimise this novel service delivery method in Malaysia.
Effectiveness of the Stepping Stones Triple P group parenting program in reducing comorbid behavioral problems in children with autism
Authors: Kasperzack Daria , Schrott Bastian , Mingebach Tanja , Becker Katja , Burghardt Roland , Kamp-Becker Inge
Published: August 2019

Children with autism spectrum disorders often exhibit comorbid behavioral problems. These problems have an impact on the severity of the core symptoms, the progression of the disorder as well as on the families’ quality of life. We evaluated the effectiveness of the Stepping Stones Triple P group parent training program as a supplementary intervention in the treatment of children with autism spectrum disorder. Therefore, we employed a single group repeated measures design and assessed child variables via parents’ and teachers’ judgments at four successive time points. The participants were parents of 24 children with autism spectrum disorder aged between 3.6 and 12 years. We found a significant reduction of comorbid behavioral problems in the children, primarily in the parents’ judgment at follow-up. Furthermore, a reduction of the autism spectrum disorder core symptoms emerged. The teachers’ judgment particularly revealed an improvement in children’s social relationships. Effect sizes were large ( ƞ2ranging from 0.14 to 0.23). The findings demonstrate the effectiveness of the Stepping Stones Triple P as a supplementary intervention for reducing comorbid behavioral problems in the treatment of children with autism spectrum disorder. Higher parental self-efficacy and parental attributions, including parents’ ability to influence child problem behaviors, are discussed as important factors for the effectiveness of Stepping Stones Triple P.
Virtual hype meets reality: Users’ perception of immersive journalism
Authors: Nielsen Søren Lund , Sheets Penelope
Published: August 2019

This study responds to recent calls to investigate how media users perceive virtual reality technology in journalism. Within a uses and gratifications framework, focus group participants were asked to experience recent immersive journalistic productions and discuss their reactions. Six distinct gratifications were identified, which cluster into gratifications related to experience, affect, and action. Despite clear reservations about the technology, users see great potential for journalistic use. If employed responsibly, users think virtual reality can add considerable value to mainstream journalistic productions, potentially boosting engagement and trust. Researchers and practitioners can benefit from this initial study of users’ impressions of and reactions to immersive journalism.
Challenges in the management of late developing malocclusions in adulthood: A case report of acromegaly
Authors: Sharma Geetanjali , Amin Dipali , Shorafa Mohammad
Published: August 2019

The development of a malocclusion in adulthood can present as a diagnostic and management challenge to an orthodontist. It is prudent to identify the aetiology of changes to the occlusion which will influence the management plan. Uncommon causes include acromegaly.

Orthodontists are in a good position to identify certain underlying disorders based on a patient’s presenting malocclusion that may otherwise go unnoticed and undiagnosed until other systemic signs and symptoms present themselves at the latter stages of the condition. This case report highlights possible aetiological factors of a developing malocclusion in adulthood and presents the clinical manifestations and joint orthodontic–surgical management of a patient with a developing skeletal III base attributed to acromegaly.
Portable technology and multi-domain energy practices
Authors: Robinson Thomas Derek , Arnould Eric
Published: August 2019

This article complements the concept of embedded security by proposing disembedded security to capture consumers’ energy practices when travelling across multiple domains of energy accessibility. Consumer mobility outside the home produces misalignments between infrastructure and portable technology experienced as ‘hysteresis of the battery’. Hysteresis captures how respondents are subject to ‘unpleasant unpredictability’ about battery-based technology and infrastructure, which spurs hermeneutic reflection about energy, location and sociality. Multi-domain energy practices therefore bring energy consumers to ‘reembed’ or create a sense of psychological comfort on the move. Charge levels on battery icons not only structure daily patterns of consumer life through planning efforts but become interpretively entangled in issues of duration, distance and sociality as energy demands in portable technology push consumers to avoid disruption.
Habermas on rationality: Means, ends and communication
Authors: Blau Adrian
Published: August 2019

This is a constructive critique of Habermas’s account of rationality, which is central to his political theory and has sparked theoretical and empirical research across academia. Habermas and many critical theorists caricature means-ends rationality (the ability to pick good means to ends), e.g. by wrongly depicting it as egocentric. This weakens Habermas’s attempt to distinguish means-ends rationality from his hugely important and influential idea of communicative rationality (roughly, the rationality of genuine discussion). I suggest that sincerity and autonomy, rather than non-egocentrism, are the key distinguishing features of communicative rationality. This shows that communicative rationality actually overlaps with means-ends rationality. Indeed, means-ends rationality is needed by critical theorists, as I exemplify by showing its use in deliberative democracy. Moreover, means-ends rationality will be present in discourse ethics, as I show with the example of moral discourse about gay marriage. My article thus challenges decades of what Habermas and critical theorists have written on means-ends and communicative rationality, but I stay broadly true to – and hopefully improve – Habermas’s account of rationality.
Improved Patient Recovery With Minimally Invasive Aortic Valve Surgery: A Propensity-Matched Study
Authors: Bruno Piergiorgio , Cammertoni Federico , Rosenhek Raphael , Mazza Andrea , Pavone Natalia , Iafrancesco Mauro , Nesta Marialisa , Chiariello Giovanni Alfonso , Spalletta Claudio , Graziano Giovanni , Sanesi Valerio , D’Errico Denise , Massetti Massimo
Published: August 2019

Objective

Despite conflicting evidence available, minimally invasive aortic valve replacement (MIAVR) is increasingly used as an alternative to full sternotomy. We sought to compare early outcomes of aortic valve replacement through a full sternotomy (conventional aortic valve replacement [CAVR]) and upper ministernotomy (MIAVR).

Methods

We analyzed 297 patients having undergone primary, elective, isolated MIAVR or CAVR between January 2014 and June 2018. Following propensity score matching, 120 patients remained in each group.

Results

MIAVR required longer bypass (93 ± 26 vs 81 ± 24 minutes, P < 0.01) and operative times (214 ± 39 vs 182 ± 37 minutes, P < 0.01). However, aortic cross-clamp times were comparable (57 ± 17 vs 54 ± 14 minutes for MIAVR and CAVR, respectively, P = 0.14). MIAVR had less 24-hour blood loss (253 ± 204 vs 323 ± 296 mL, P = 0.03), less red blood cells transfusions [1.4 packs (1.1 o 1.9) vs 2.1 packs (1.8 to 2.7), P = 0.01], and shorter assisted ventilation time (7.1 ± 3.3 vs 9.7 ± 3.8 hours, P < 0.01) when compared to CAVR. These results led to significantly shorter intensive care unit and hospital stays for MIAVR patients (2.5 ± 1.3 vs 3.4 ± 1.1 days, P < 0.01 and 6.9 ± 4.1 vs 8.2 ± 4.8 days, P = 0.03, respectively). Thirty-day mortality and clinical outcomes did not differ significantly among groups.

Conclusions

MIAVR through upper ministernotomy was shown to be as safe and reliable as CAVR. Patient recovery time was improved by shortening mechanical ventilation and reducing blood loss and transfusions. These results may be significant for high-risk patients undergoing aortic valve surgery.
Reappraising Reappraisal
Authors: Uusberg Andero , Taxer Jamie L. , Yih Jennifer , Uusberg Helen , Gross James J.
Published: August 2019

What psychological mechanisms enable people to reappraise a situation to change its emotional impact? We propose that reappraisal works by shifting appraisal outcomes—abstract representations of how a situational construal compares to goals—either by changing the construal ( reconstrual) or by changing the goal set ( repurposing). Instances of reappraisal can therefore be characterized as change vectors in appraisal dimensional space. Affordances for reappraisal arise from the range of mental models that could explain a situation ( construal malleability) and the range of goals that the situation could serve ( goal set malleability). This framework helps to expand our conception of reappraisal, assess and classify different instances of reappraisal, predict their relative effectiveness, understand their brain mechanisms, and relate them to individual differences.
What forecasting the prevalence of inflammatory bowel disease may tell us about its evolution on a national scale
Authors: Santiago Mafalda , Magro Fernando , Correia Luís , Portela Francisco , Ministro Paula , Lago Paula , Dias Cláudia Camila
Published: August 2019

Inflammatory bowel disease (IBD) is increasingly prevalent within western societies. Its complex and chronic facets in addition to its increasing prevalence place a great economic burden on our healthcare systems. Our aim was to estimate the national prevalence of IBD through predictive models. We used prevalence data which spans the years 2003–2007 to estimate prevalence until 2030 by means of four forecasting methods. Prevalence rates are estimated to be 4–6-times higher in 2030 when compared with 2003 with an average annual percent change of 5%. IBD is poised to have a substantial impact on healthcare systems in the near future, given its rapidly increasing prevalence. Forecasting methods will allow for a proactive stance on the development of health policies that will be needed to provide high quality and cost-effective care to these patients, while ensuring the economic viability of healthcare systems.
Role of Omega-3 Polyunsaturated Fatty Acids in Treatment of Nasal Polyposis
Authors: Attia Tamer M.
Published: August 2019

Background

Nasal polyposis is a common disease with steroids either systemic or topical being the key element in its medical treatment. With known side effects of systemic steroids, other anti-inflammatory agents should be evaluated, preferably the natural ones.

Objective

To evaluate the role of omega-3 polyunsaturated fatty acids in the treatment of nasal polyposis.

Methods

This is a single-blinded randomized-controlled trial including 164 patients with grade II nasal polyposis receiving a short course of systemic steroids until subsidence of polyposis. Patients were distributed equally after into 2 groups according to maintenance therapy with group I receiving omega-3 fatty acids in a dose of 3 g per day with local budesonide nasal spray and group II receiving only local budesonide nasal spray. Both groups were compared regarding incidence and grade of recurrence of polyposis and duration from onset of maintenance therapy to onset of recurrence.

Results

A nonsignificant effect for omega-3 was found on the incidence of recurrence of nasal polyposis ( P = .1) and the grade of recurrent polyposis ( P = .66). However, omega-3 intake had a highly significant effect on delaying the incidence of recurrence of polyposis ( P < .0001).

Conclusion

Omega-3 fatty acid has a beneficial effect on delaying the incidence of recurrence of nasal polyposis through its proven anti-inflammatory mechanism of action. This minimizes the need for systemic steroid administration with its known side effects. Omega-3 fatty acids supplementation should be considered while tailoring the maintenance regimen for medical treatment of chronic rhinosinusitis with nasal polyposis.
Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals
Authors: Roc Lourdes , de Mendoza Carmen , Fernández-Alonso Miriam , Reina Gabriel , Soriano Vicente ,   on behalf of the Spanish HTLV Network, Rodríguez C. , Vera M. , del Romero J. , Marcaida G. , Ocete M.D. , Caballero E. , Molina I. , Aguilera A. , Rodríguez-Calviño J.J. , Navarro D. , Rivero C. , Vilariño M.D. , Benito R. , Algarate S. , Gil J. , Ortiz de Lejarazu R. , Rojo S. , Eirós J.M. , San Miguel A. , Manzardo C. , Miró J.M. , García J. , Paz I. , Poveda E. , Calderón E. , Escudero D. , Trigo M. , Diz J. , García-Campello M. , Rodríguez-Iglesias M. , Hernández-Betancor A. , Martín A.M. , Ramos J.M. , Gimeno A. , Gutiérrez F. , Rodríguez J.C. , Sánchez V. , Gómez-Hernando C. , Cilla G. , Pérez-Trallero E. , López-Aldeguer J. , Fernández-Pereira L. , Niubó J. , Hernández M. , López-Lirola A.M. , Gómez-Sirvent J.L. , Force L. , Cifuentes C. , Pérez S. , Morano L. , Raya C. , González-Praetorius A. , Pérez J.L. , Peñaranda M. , Hernáez-Crespo S. , Montejo J.M. , Roc L. , Martínez-Sapiña A. , Viciana I. , Cabezas T. , Lozano A. , Fernández J.M. , García-Bermejo I. , Gaspar G. , García R. , Górgolas M. , Vegas C. , Blas J. , Miralles P. , Valeiro M. , Aldamiz T. , Margall N. , Guardia C. , do Pico E. , Polo I. , Aguinaga A. , Ezpeleta C. , Sauleda S. , Pirón M. , González R. , Barea L. , Jiménez A. , Blanco L. , Suárez A. , Rodríguez-Avial I. , Pérez-Rivilla A. , Parra P. , Fernández M. , Fernández-Alonso M. , Reina G. , Treviño A. , Requena S. , Benítez-Gutiérrez L. , Cuervas-Mons V. , de Mendoza C. , Barreiro P. , Soriano V. , Corral O. , Gómez-Gallego F.
Published: August 2019

Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor–recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain.
Low provider and staff self-care in a large safety-net HIV clinic in the Southern United States: Implications for the adoption of trauma-informed care
Authors: Sales Jessica M , Piper Kaitlin , Riddick Clara , Getachew Betelihem , Colasanti Jonathan , Kalokhe Ameeta
Published: August 2019

Objective:

This mixed-methods needs assessment study examined self-care practices among providers, staff, and administrators at an HIV clinic and identified barriers and facilitators to strengthening self-care services in this setting.

Methods:

Surveys (n = 31) and qualitative interviews (n = 23) were conducted with staff, providers, and administrators at a large, safety-net HIV clinic.

Results:

Surveys indicated an overall absence of formal self-care services including resources to manage stress, opportunities to debrief, and formal mechanisms to voice concerns. Based on interviews with staff and providers, deficiencies in self-care services included support for dealing with complex patients, formal mechanisms for feedback, and time for self-care. Administrators recognized the need for more support, acknowledged that opportunities for employees to voice concerns were lacking, and felt that implementing multi-disciplinary team meetings could improve morale and reduce stress and burnout.

Conclusion:

This assessment revealed a need to enhance self-care in safety-net HIV services. Adoption of trauma-informed care, which includes activities to strengthen self-care, could reduce workplace burnout.
Gene expression analysis in scars treated with silicone cream: a case series
Authors: Kikuchi Robin , Khalil Abdullah J , Zoumalan Christopher I
Published: August 2019

Background:

In contrast to fetal scar tissue, adult scar tissue presents with visible scarring. Topical silicone creams have been shown to improve the appearance of scars. This case series compares the genetic expression of post-surgical scar tissues that received topical scar treatment with silicone cream, SKN2017B, or no treatment. SKN2017B is a recently formulated silicone-based scar cream that contains selective synthetic recombinant human growth factors, hyaluronic acid, and vitamin C. We hypothesise that scars treated with silicone-based scar creams have a more favourable genetic expression resembling a well-healing scar.

Methods:

Women who had undergone an abdominoplasty were included in this investigation and randomly assigned to treat part of the scar with topical silicone, another part with SKN2017B, and to leave a third part untreated. After four weeks, punch biopsies were taken and the RNA sequenced. Healthy abdominal skin was biopsied as baseline data. Genes of interest were identified and median values were calculated for the samples.

Results:

SKN2107B-treated scars demonstrated the lowest collagen type I to collagen type III ratio. Other key genes of interest in wound healing showed the lowest (favourable) expression of fibroblast activation protein alpha, lysyl oxidase and cartilage oligomeric matrix protein; the highest (favourable) expression of fibronectin type III domain containing 1 and matrix metallopeptidase 9 were found in scars treated with SKN2017B.

Conclusion:

The results of this small case series demonstrate a trend that those scars treated with topical silicone cream, notably SKN2017B, display the most favourable gene expression for wound healing.
Multi-bidder First Price Auction with Beliefs
Authors: Park Hyeon
Published: August 2019

This paper characterizes the set of equilibria in the first price auction with multiple bidders—specifically three bidders, each of whose type space is multi-dimensional, incorporating a bidder’s beliefs about others’ valuations. In this auction, each bidder independently and privately learns the other two opponents’ valuations with some probability. This paper derives closed form solutions for equilibrium bidding behaviours parameterized by the degree of information when the bidder has homogeneous beliefs regarding each opponent. This paper demonstrates how much the level of information affects the bidding behaviours of the informed bidders. In addition, this paper extends the model into [Formula: see text] bidders when a high value bidder has fixed beliefs that all other bidders are identical types, and show how the value of information changes as the number of participants increases. Finally, this paper speculates on the possible changes in the efficiency of the model from increasing the valuation space to an arbitrary number.

JEL Classification: D44, D82, D83
An Analysis of Community-Based Health Workforce Training Efficacy: Evidence From the Affordable Care Act Insurance Navigators in Illinois
Authors: Thornton Michele , Leininger Lindsey , Calhoun Elizabeth
Published: August 2019

Objectives. A community-based training with core competencies in health insurance, health care resources, and outreach for over 1,700 Affordable Care Act navigators in Illinois from 2013 to 2014 was designed, delivered, and evaluated by an academic–community partnership with expertise in health care, social services, health policy, and community outreach. Methods. Pre- and posttraining scores on a knowledge-based certification exam were linked to navigators’ baseline sociodemographic characteristic. Additionally, self-reported training evaluation and posttraining support were summarized from an online follow-up survey of the workforce. Results. Although the material was initially unfamiliar and the population heterogeneous, the training program brought all identified subgroups from a below passing mean score (71%) on the pretest up to above proficiency (80%) in a posttest assessment—suggesting a highly accessible training program across navigator sociodemographic groups. Navigators reported additional training on Medicaid and marketplace structure and eligibility to be very important. Conclusions. Supplementing or replacing diminishing federal funding for consumer outreach workforce training and support at the state or community level was found to be an important priority that can increase competencies in a diverse population. Findings also indicated that the inclusion of ongoing wrap-around resources remain in high demand among navigators in the complex, ever-changing health care landscape in the United States.
Caregivers’ Experiences Regarding Training and Support in the Post-Acute Home Health-Care Setting
Authors: Chase Jo-Ana D , Russell David , Rice Meridith , Abbott Carmen , Bowles Kathryn H , Mehr David R
Published: August 2019

Background:

Post-acute home health-care (HHC) services provide a unique opportunity to train and support family caregivers of older adults returning home after a hospitalization. To enhance family-focused training and support strategies, we must first understand caregivers’ experiences.

Objective:

To explore caregivers’ experiences regarding training and support for managing older adults’ physical functioning (PF) needs in the post-acute HHC setting.

Method:

We conducted a qualitative descriptive study using semi-structured telephone interviews of 20 family caregivers. Interviews were recorded, transcribed, and analyzed using conventional content analysis.

Results:

We identified the following primary categories: facilitators to learning (eg, past experience, learning methods), barriers to learning (eg, learning on their own, communication, timing/logistics, preferred information and timing of information delivery), and interactions with HHC providers (eg, positive/negative interactions, provider training and knowledge).

Conclusion:

Caregivers were responsive to learning strategies to manage older adults’ PF needs and, importantly, voiced ideas to improve family-focused training and support. HHC providers can use these findings to tailor training and support of family caregivers in the post-acute HHC setting.
Models to Examine the Validity of Cluster-Level Factor Structure Using Individual-Level Data
Authors: Stapleton Laura M. , Johnson Tessa L.
Published: August 2019

When researchers model multilevel data, often a shared construct of interest is measured by individual-level observations, for example, students’ responses regarding how engaging their instructor’s teaching style is. In such cases, the construct of interest, “engaging teaching,” is shared at the cluster level across individuals, yet rarely are these shared constructs modeled as such. To address this gap, we discuss multilevel confirmatory factor analysis models that have been applied to item-level data obtained from multiple raters within given clusters, focusing particularly on measuring a characteristic at the cluster level. After discussing the parameters in each potential model, we make recommendations as to the appropriate modeling approach and the steps to be taken for model assessment given a set of data and hypothesized construct of interest. In particular, we encourage applied researchers not to use a model without constraints across the within-cluster level and the between-cluster level because such models assume that the average amount of the individual-level construct in a cluster does not differ across clusters. To illustrate this issue, we present simulation results and evaluate a series of models using empirical data from the Trends in International Mathematics and Science Study.
Gravity gradient tensor of a vertical pyramid model of flat top and bottom with depth-wise parabolic density variation
Authors: Gokula Anand Prakash , Sastry Rambhatla G.
Published: August 2019

As an alternative to the popular rectangular parallelepiped model, we have developed a novel 3D analytical forward-problem solution for the gravity gradient tensor of a vertical pyramid model with parabolic density contrast variation. Its flexibility and effectiveness are demonstrated with the help of synthetic simulations and a case study involving Chintalapudi subbasin, India. We have addressed the singularities and numerical stability in numerical implementation of our algorithm for modeling and practical implementation.