bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Religion and Spirituality Find a Place in Higher Education?
Authors: Laurence Peter
Published: October 2018

Do institutions of higher learning have a part to play in supporting students’ religion and spirituality? If so, how can campuses nourish these aspects of students’ lives without undermining such core values as diversity and religious freedom? The answer, explains the author, lies in embracing religious pluralism—a concept that can help educators see ways to honor the full spectrum of religion and spirituality without giving preference to any one tradition.
Educating for Character
Authors: Berkowitz Marvin W. , Fekula Michael J.
Published: October 2018

Increasingly, educators at colleges and universities are recognizing the importance of educating for that elusive thing called character. But their efforts are often piecemeal—a service learning program here, a residential contract there. Here's what a comprehensive approach to character education might look like.
Can the Youth Bulge Pose a Challenge for Turkey? A Comparative Analysis Based on MENA Region-Driven Factors
Authors: Ozerim Mehmet Gokay
Published: October 2018

One common characteristic of Middle East and North Africa (MENA) countries that have experienced internal conflicts in recent decades is their large youth cohorts, known as the youth bulge. As Turkey also has a youthful population, it raises the question of whether this will represent a threat rather than an opportunity for the society. This study investigates this question by identifying the major factors that can transform a youth bulge into a threat and analyses them comparatively for the specific case of Turkish youth. A novel set of factors is proposed that can be also used by further studies. The discussion related to these factors is organized under four major situations, namely (a) economic situation, (b) educational situation, (c) political situation and (d) cultural situation. The study concludes that while Turkey differs from most of the MENA region countries in terms of these structural factors, it tends to lag behind the average international standards, which leave young people in Turkey in a limbo between becoming an opportunity for the future of society or a challenge.
The efficacy of “IOL-Vip Revolution” telescopic intraocular lens in age-related macular degeneration cases with senile cataract
Authors: Dag Medine Yilmaz , Afrashi Filiz , Nalcaci Serhad , Mentes Jale , Akkin Cezmi
Published: October 2018

Purpose:

To evaluate the efficacy of the IOL-Vip Revolution telescopic intraocular lens in age-related macular degeneration patients.

Methods:

A total of 13 eyes of 12 age-related macular degeneration patients with senile cataract were enrolled. Selection of the patients was done by means of a low vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates residual visual function. After standard phacoemulsification surgery, the incision site was enlarged and the IOL-Vip Revolution system was implanted in the capsular bag. The outcome measures were best corrected visual acuity, contrast sensitivity, anterior chamber depth, endothelial cell density, central corneal thickness, and quality-of-life questionnaire.

Results:

The mean age of the subjects was 72.3 ± 8.5 years. The mean positive power of the intraocular lens was 59 ± 2 D and the negative intraocular lens power was standard (–46 D). Pre- and postoperative best corrected visual acuity were 1.08 ± 0.14 and 0.81 ± 0.16 logMAR in the operated eye and 1.13 ± 0.36 and 1.01 ± 0.40 logMAR in the unoperated eye, respectively. The best corrected visual acuity was increased significantly in both operated and unoperated eyes (p = 0.005 and 0.021, respectively). Quality of life and anterior chamber depth increased significantly (p = 0.018 and 0.008, respectively), while endothelial cell density decreased (p = 0.002). No significant differences were detected in central corneal thickness or contrast sensitivity (p = 0.133 and 0.684, respectively).

Conclusion:

The results showed that IOL-Vip Revolution telescopic intraocular lens is a promising treatment option in age-related macular degeneration patients. The rehabilitation program may have an important role in the restored clinical results, which also provided visual improvement in the unoperated eyes.
Bilateral noncalcified astrocytic hamartomas in retinitis pigmentosa: Multimodal imaging evaluation over 8 years of follow-up
Authors: Iovino Claudio , Casini Giamberto , Peiretti Enrico
Published: October 2018

Purpose:

To report the evolution of optic disk noncalcified astrocytic hamartomas in a patient with retinitis pigmentosa throughout 8 years of follow-up.

Methods:

Case report.

Results:

A 42-year-old white man with a diagnosis of retinitis pigmentosa was referred to our medical retinal center for the first time in 2010, for the development of a new optic nerve head lesion in the right eye. Fundus examination, fundus autofluorescence, fluorescein and green indocyanine angiography, spectral-domain optical coherence tomography were performed and confirmed the presence of a papillary noncalcified astrocytic hamartoma in the right eye. Four years later, multimodal imaging evaluation revealed in the left eye the presence of a first optic disk benign tumor, and in 2018, a second in the nasal retina, while in the right eye the sole papillary lesion increased slightly in size.

Conclusions:

Noncalcified astrocytic hamartomas can occur in patients with retinitis pigmentosa and can increase in size and number in time. A complete multimodal imaging evaluation is necessary to identify and classify any kind of new lesion that, as known, are associated with these group of hereditary retinal degenerations.
Exploring equal opportunities: Children’s experiences of the Swedish Community School of Music and Arts
Authors: Jeppsson Cecilia , Lindgren Monica
Published: October 2018

This article explores the social stratification of the Swedish Community School of Music and Arts, which offers voluntary extra-curricular arts education to children in Sweden, and children’s experiences of attending the school. A survey was executed where sixth-graders in Sweden were asked about their experiences of the school and about background factors such as their gender, country of birth, parents’ level of education and family involvement in the music and arts. The results show that the typical Swedish Community School of Music and Arts student is a Swedish-born girl with well-educated parents. Children of parents who play an instrument or sing are more likely to find their way to the school, and the level of support that parents provide contributes to the children’s persistence in their studies. In sum, the results largely conform to cultural reproduction theory.
Valuing forest park attributes by giving consideration to the tourist satisfaction
Authors: Kang Nannan , Wang Erda , Yu Yang
Published: October 2018

Despite the economic valuation of forest park resources has triggered a great deal of interest to the research community and park management, up to now no attention has been paid to the effect of psychological factors such as tourist satisfaction, which could potentially play a considerable role in contributing to the park resource valuation. This article attempts to fill this niche by carrying out a study on the economic valuation of the Xian-Ren-Tai National Forest Park in China, taking consideration of the tourist satisfaction. In the process, the choice experiment survey was used for data collection. Then, both conditional logit (CL) and random parameter logit models were used in parameter estimations to examine the factors that could potentially impact on the tourists’ willingness to pay. Results indicate that the tourists attach the greatest importance to the park’s natural environment and traffic conditions, and yet the level of tourists’ satisfaction on their tourism experience plays a big part in explaining the valuation results. Tourists who uphold a high level of satisfaction tend to pay more for the park attribute improvement than those with less satisfaction ones. The estimated compensating variation of the overall current park attributes has reached ¥184.95 per person per trip, of which 12.83% shall be attributable to the tourist satisfaction.
Physical education teacher resilience in high-poverty school environments
Authors: Ellison Douglas W. , Woods Amelia Mays
Published: October 2018

The purpose of this study was to investigate how the organizational context within high-poverty schools influences physical education (PE) teacher resilience. This study used an exploratory multiple case study design grounded in resilience theory. School administrators can create environments that either support or inhibit teachers’ attitudes about their jobs by the organizational structures and cultures they create in schools and through the relationships they foster. Because teacher attrition has a negative influence on the educational system, especially in high-poverty schools, providing resources to build resilience in teachers is critical to their professional success and development. Although literature exists related to PE teacher attrition, little work has focused on the reasons that they may remain in their role as a PE teacher. Understanding the facilitators and barriers to PE teacher resilience may aid in alleviating PE teacher attrition in high-poverty schools. The teacher participants ( n = 10) and school administrators ( n = 4) were chosen from six schools (five elementary schools and two middle schools) from two (one urban, one rural) high-poverty school districts (identified by having at least 90% of students eligible for free and reduced price lunch) in the Midwestern US. Two main themes surfaced regarding teachers’ resilience capacity: (a) school culture – the inconsistency in perceived leadership and support; and (b) elevated teacher turnover.
Living with the past at home: The afterlife of inherited domestic objects
Authors: Lipman Caron
Published: October 2018

This article examines people’s responses to the material objects they inherit or discover in their homes. Reflecting on interviews with inhabitants of a variety of English domestic interiors, the author explores the meanings, values and beliefs involved in choices to retrieve, retain, reposition or replace material residues from the home’s recent or distant past. Participants’ responses reveal how beliefs about the past and its objects become imbricated in homemaking practices, locating home as shared, both spatially and temporally, and enhancing or challenging senses of belonging. In particular, objects left by previous inhabitants are endowed with degrees of agency as part of the identity of home. Responses reflect a belief in the continuing presence of the past. Many objects require a form of negotiation – including rituals of appeasement or containment – expressing an entangled relationship between the heimlich and unheimlich in everyday homemaking practices.
Doing and undoing borders: The multiplication of citizenship, citizenship performances, and migration as social movement
Authors: Wonders Nancy A , Jones Lynn C
Published: October 2018

Despite the global and pervasive reality of human mobility, many western nations are framing migration as a security risk requiring a criminal justice response. Drawing on developments in the criminology of mobility, the social construction of difference, critical citizenship studies, and social movement theory, we develop an alternative theoretical framing of migration. We examine ways that the contemporary formation of citizenship and irregularity do bordering via the multiplication of citizenship categories that operate relationally and performatively to border subjectivities and construct differences. Drawing on illustrative examples from the United States and Spain, we then analyze the potential of local citizenship performances to undo borders and bridge the divide between irregularity and citizenship, with national and global implications for substantive and juridical rights. Reframing migration as a social movement and conceptualizing citizenship as a performance that reflects political struggle acknowledges the power of ordinary people to challenge borders from below.
The ‘war’/‘not-war’ divide: Domestic violence in the Preventing Sexual Violence Initiative
Authors: Gray Harriet
Published: October 2018

While recognising the importance of policy designed to tackle conflict-related sexual and gender-based violence, scholars have increasingly critiqued such policies for failing sufficiently to apprehend the multiple forms of this violence – from rape deployed as a weapon of war to domestic violence – as interrelated oppressions located along a continuum. In this article, I explore a connected but distinct line of critique, arguing that sexual and gender-based violence policies are also limited by a narrow understanding of how gender-based violences relate to war itself. Drawing on an analysis of the British Government’s Preventing Sexual Violence Initiative, I identify a key distinction which emerges between those types of sexual and gender-based violence which are considered to be part of war, and those which are not. This division, I suggest, closes down space for recognising how war is also enacted within private spaces.
Exploring research relationships and other ethical challenges of participatory visual research in remote environments
Authors: Nash Meredith , Moore Robyn
Published: October 2018

This critical reflection provides fellow researchers with insights into the ethical challenges of using visual methods in remote environments. We draw on Fine’s notion of ‘working the hyphens’ to explore the complexities of studying a leadership program for women in science, technology, engineering, mathematics and medicine (STEMM) on a ship in Antarctica. We reflect on how our researcher identities and relationships with participants shaped the research process and emergent ethical tensions. For instance, we discuss ethical issues that arose in relation to the contextual and relational aspects of the environment including psychological and physical demands of research participation in Antarctica, privacy and isolation in remote environments, and rapport. We also discuss issues related to participant-produced video diaries specifically including consent, confidentiality and participant safety. To conclude, we highlight implications for visual research in other remote settings.
Scheduled Emergency Trauma Operation: The Green Line Orthopedic Trauma Surgery Process Of Care
Authors: Ax M. , Reito A. , Koskimaa M. , Uutela A. , Paloneva J.
Published: October 2018

Background and Aims:

Traditionally, patients requiring an orthopedic emergency operation were admitted to an inpatient ward to await surgery. This often led to congestion of wards and operation rooms while, for less urgent traumas, the time spent waiting for the operation often became unacceptably long. The purpose of this study was to evaluate the flow of patients coded green in a traffic light–based coding process aimed at decreasing the burden on wards and enabling a scheduled emergency operation in Central Finland Hospital.

Materials and Methods:

Operation urgency was divided into three categories: green (>48 h), yellow (8–48 h), and red (<8 h). Patients, who had sustained an orthopedic trauma requiring surgery, but not inpatient care (green), were assigned an operation via green line process. They were discharged until the operation, which was scheduled to take place during office hours.

Results:

Between January 2010 and April 2015, 1830 green line process operations and 5838 inpatient emergency operations were performed. The most common green line process diagnoses were distal radial fracture (15.4% of green line process), (postoperative) complications (7.7%), and finger fractures (4.9%). The most common inpatient emergency operation diagnosis was hip fracture (24.3%). Green line process and inpatient emergency operation patients differed in age, physical status, diagnoses, and surgical procedures.

Conclusion:

The system was found to be a safe and effective method of implementing orthopedic trauma care. It has the potential to release operation room time for more urgent surgery, shorten the time spent in hospital, and reduce the need to operate outside normal office hours.
Understanding the contexts of leadership debates
Authors: Penn Helen
Published: October 2018

This colloquium argues that writings on leadership in the early years commonly assume a service ethos. The aim of nurseries and other early childhood settings is to provide a service for children and their parents, and the task of leadership is seen to be to find effective ways of defining and realizing this aim. But increasingly, and especially in English-speaking countries, early years childcare and education is viewed as an industry, as a specialized and speculative business. This has had major repercussions for the operation of services, especially in England where the various intermediary levels between individual nurseries and national or state policies, which have provided opportunities for discussion and exchange of practice, and a basis for negotiated standards for leadership, have been stripped out. Processes for accountability are badly eroded. Concepts of leadership are necessarily contextual.
Enchantments of stone: Confronting other-than-human agency in Irish pilgrimage practices
Authors: Lash Ryan
Published: October 2018

In contemporary Ireland, mountains, holy wells, and islands attract people from various geographic and religious backgrounds to participate in annual pilgrimages. Scholars and participants continue to debate the historical links of these events to 19th-century turas, “journey” traditions, early medieval penitential liturgies, and even prehistoric veneration of natural phenomena. Drawing from recent participant observation at Croagh Patrick mountain and excavations on Inishark Island, I analyze how modern and medieval pilgrimage practices generated “enchantments” through movements and embodied encounters with stones that materialize both past human action and other-than-human agency. Rather than products of timeless continuity of experience, such enchantments have varied widely across time. Viewing pilgrimage movements and materials in their taskscape settings highlights the articulation between the embodied affects and political and ideological effects of pilgrims’ engagement with stones in particular historic contexts. Questioning simple narratives of continuity, this study demonstrates how a relational approach can enhance analyses of pilgrimage as scenes of social reproduction, ideological controversy, and political contest.
Visiting the horned serpent’s home: A relational analysis of Paquimé as a pilgrimage site in the North American Southwest
Authors: VanPool Todd L , VanPool Christine S
Published: October 2018

Paquimé, Chihuahua, was the ceremonial center of the Medio period (AD 1200 to 1450) Casas Grandes world, and the focus of regional pilgrimages. We use a relational perspective to explore the connections that were created and expressed during the pilgrimage. We propose that Paquimé was considered a living city, and that pilgrims actively supported its vitality through offerings of marine shells and other symbolically important goods. A region-wide network of signal fires centered on Cerro de Moctezuma, a hill directly overlooking Paquimé, summoned pilgrims. Ritual negotiations also focused on the dead and may have included at least occasional human sacrifice. While the pilgrimages focused on water-related ritual, they also included community and elite competition as reflected in architectural features such as the ball courts. Central to the pilgrimage was negotiation with the horned serpent, a deity that controlled water and was associated with leadership throughout Mesoamerica and the Southwest. The horned serpent is the primary supernatural entity reflected at the site and in the pottery pilgrims took with them back to their communities. Thus, the pilgrimages were times when the Casas Grandes people created and transformed their relationships with each other, religious elites, the dead, the landscape, and the horned serpent. These relationships in turn are reflected across the region (e.g., the broad distribution of Ramos Polychrome). This case study consequently demonstrates the potential that the relational perspective presented throughout this issue has for providing insight into the archaeological record and the past social structures it reflects.
From enchantment to agencement: Archaeological engagements with pilgrimage
Authors: Van Dyke Ruth M
Published: October 2018

This commentary springs from insights gleaned from two sources. The first involves my archaeological research into the ancient pilgrimage center of Chaco Canyon, New Mexico; the second includes lessons learned by walking the medieval Camino de Santiago. The four papers in this volume describe enchanting destinations reached by archaeological pilgrims engaged in ambulatory knowing. I frame my discussion of these papers using DeLeuzean concepts of assemblage/ agencement, emphasizing the emergent properties of pilgrimage, and underscoring how archaeologists can study pilgrims in motion.
Value-informed pricing for virtual digital products: Evidence from Chinese MMORPG industry
Authors: Ren Qun , Rong Ke , Lu Chao , Liu Gordon , Ross Margaret
Published: October 2018

Value-informed pricing strategy, which focuses on determining the price level of products based on consumer value perception, is especially suitable to be applied in digital products rather than industrial ones. By carrying out 65 in-depth interviews with people involved in the Chinese Massively Multiplayer Online Role-Playing Game (MMORPG) industry, this article explores the process through which a value-informed pricing strategy is applied to determine the price level of virtual in-game accessories—exploring pricing preference through interacting with game players, swaying pricing alternatives through managing the competitive environment, and manipulating value perception through shaping the virtual marketplace. Furthermore, this article constructs a theoretical framework of value-informed pricing, including the above process, and deciphers the linkage mechanism between different segments. The findings not only enrich the theory of value-informed pricing under the application context of virtual digital products but also have implications for the practitioners in the MMORPG industry.
A brand’s eye view of correspondence analysis
Authors: Hoare Jake , Bock Tim
Published: October 2018

Correspondence analysis is widely used to create brand maps, which show the positioning of brands with respect to perceptual attributes. When the user of a map is principally concerned with only one brand, correspondence analysis should be rotated to better represent the data as it relates to that brand. An example is presented using brand personality.
Longitudinal study of medication use in caregivers of people with Alzheimer’s disease – Kuopio ALSOVA study
Authors: Välimäki Tarja , Gilmartin-Thomas Julia FM , Bell J Simon , Selander Tuomas , Koivisto Anne M
Published: October 2018

Background

The longitudinal pattern of medication use among family caregivers of people with dementia is not well understood, despite the potential for medication over- or under-use.

Objectives

To investigate caregiver medication use over a five-year follow-up using data obtained via self-report and from a national prescription register, and compare agreement between medication data obtained from the two sources.

Methods

Medication data for 222 family caregivers of people with Alzheimer’s disease were obtained via self-report and from the Finnish Social Insurance Institution. Generalised estimating equations, Kappa statistics and related samples Wilcoxon signed rank test were used to analyse medication use over time.

Results

The mean number of medications used by caregivers increased from 3.4 to 4.1 (self-reported current regular medications) and 2.4 to 2.8 (reimbursed prescription medications during the past 90 days) over five years (p < 0.001). Significantly, more medications were identified via self-report (mean 3.6, SD = 3.3) than the national prescription register (mean 2.6, SD = 2.4, Z= –12.300, p < 0.001). Agreement between the two data sources was good for cardiovascular medications and anti-hypertensives (Kappa = 0.883–0.967, p < 0.001) and medications for acid-related disorders (Kappa = 0.508–0.092, p < 0.001). Agreement was moderate for analgesics (Kappa = 0.281–0.477, p < 0.001) and psychotropics (Kappa = 0.281–0.562, p < 0.002). The proportion of caregivers using five or more medications increased from 27.5% to 44.6% (self-report), and 16.7% to 27.7% (register) (p < 0.001).

Conclusion

Caregivers use an increasing number of medications in the first five years of caring for persons with dementia, and self-report using a higher number of medications than data from the national prescription register suggest.
Talent Development for Faculty: The Case of Vietnam
Authors: Phuong Tam T. , Chai Dae Seok
Published: October 2018

The Problem

With the rise of a globalized knowledge-based economy, the Vietnamese government has demonstrated a determination to build world-class universities by making higher education development one of the top national priorities. The Vietnamese higher education system is an interesting case of a latecomer’s development in an emerging market economy regulated by a single-party socialist state espousing communism. Although they have invested in higher education for decades, the system is still in a trial phase. For example, only two national universities cracked the top 150 in the Asian region, not in the world. Although the faculty talent pool can significantly help achieve the goals of the Vietnamese higher education system, the quality of Vietnamese faculty members is a key limitation. Furthermore, literature on talent development (TD) for faculty in the Vietnamese context is rare.

The Solution

This study aims to explore faculty TD trends and issues in the Vietnamese higher education system. This comprehensive review of the literature (a) provides an overview of the Vietnamese higher education system; (b) presents findings on the scope, foci, activities, and outcomes of faculty TD activities, and (c) provides implications for policy, practice, and further research on TD for faculty in Vietnam. As few published reviews of faculty TD in Vietnamese universities are available, the current comprehensive literature review can set the foundation for more effective practices and further research on TD and human resources development (HRD) for faculty in Vietnam.

The Stakeholders

The recommendations provided from this study will help HRD practitioners, institutional and ministerial decision makers, and faculty members in Vietnam.
Challenges of Implementing Western Talent Development Models in a Collectivist Organizational Culture
Authors: Lucas Angela Christina , Ardichvili Alexandre , Casa Nova Silvia Pereira de Castro , Bittencourt João Paulo , Carpenedo Caroline
Published: October 2018

The Problem

In Brazilian business organizations, talent development (TD) programs are often based on models borrowed from Western countries. However, there are significant cultural barriers to successful implementation of such transplanted models. Research on TD in Brazil is scarce, especially, research on adoption of imported models and frameworks.

The Solution

This article is based on a case study of TD practices of a large Brazilian steel company that has a long history of human resource development (HRD) and a unique organizational culture. Our study suggests that this Brazilian company’s TD system is based on a combination of several well-known North American models. However, the implementation of the TD system that is based on meritocratic principles does not fully align with an organizational culture characterized by high power distance, paternalism, collectivism, and the emphasis on personal relationships over merit. We suggest ways of addressing the identified misalignments and point out the necessity of tropicalizing the implementation of TD models, which implies embracing Brazilian cultural traits and contexts.

The Stakeholders

The main audience for this article includes executives, managers, and HRD professionals executing TD strategies in organizations from emerging market economies and/or in firms doing business in emerging markets. In addition, the article will be of interest to scholars specializing in international HRD and talent development.
Altered Functional Connectivity of Alpha Rhythm in Obsessive-Compulsive Disorder During Rest
Authors: Tan Bo , Liu Qingxiao , Wan Chaoyang , Jin Zhenlan , Yang Yanchun , Li Ling
Published: October 2018

Obsessive-compulsive disorder (OCD) is a common inheritable psychiatric disorder characteristic of repetitive thinking, imagination (obsession), and stereotyped behaviors (compulsive). To explore whether there is an alteration of brain functional connectivity (BFC) in patients with OCD during rest, electroencephalogram (EEG) data of healthy controls (HCs) and patients with OCD were collected during rest in both eyes-closed and eyes-open states. Synchronization likelihood and graph theory were applied to construct and analyze brain functional networks of patients with OCD and HCs. Patients with OCD showed abnormal graph-theoretic parameters and impaired small world features in the alpha and beta bands. In addition, the topological analysis consistently showed that the long-range BFC of alpha rhythm was significantly reduced in the bilateral posterior areas in patients with OCD in comparison with HCs, while the BFC in the beta rhythm was significantly increased only in the eyes-open state. The findings suggest that the BFC of patients with OCD show abnormal small-world features and altered topological structure during rest, mainly in alpha and beta bands, which may provide a new insight for the diagnosis and treatment of OCD.
Stroke hospital admission rates in Brisbane and Queensland in 2015: Data from 11,072 cases
Authors: Anderlini Deanna , Wallis Guy , Marinovic Welber
Published: October 2018

Background and aims

Little data exist on the incidence of stroke in Australia. Our aim was to report age and sex disparities in hospital admission for stroke in Queensland, Australia's most populous northern state.

Methods

We identified all patients admitted to hospital in Queensland with a diagnosis of stroke from January to December 2015.

Results

Among 25,776 admissions with a diagnosis of stroke or TIA and related sequelae, stroke was the principal diagnosis in 11,072 cases of whom 5270 (47.60%) were first-ever stroke. Based on incidents per 100,000 population per year, the crude annual admission rate for first-ever strokes was 110 (95% CI, 107 to 113), 120 (95% CI, 115 to 124) for men and 101 (95% CI, 97 to 105) for women. The corresponding rates adjusted to the world population were 69 (95% CI, 52 to 85), and 88 (95% CI, 70 to 107) adjusted to the European population. Gender and age-adjusted incidence was greater for men than women in all age-groups, except those aged 30–34 years, where occurrence was 10 for men and 16 for women.

Conclusions

Based on the outcomes, hospital admission for stroke occurs less frequently in Queensland than in other regions of Australia. Men generally show a higher rate of hospitalization than women, with the notable exception of women aged 30–34, for whom the trend reverses.
UK clinical experience up to 52 weeks with linaclotide for irritable bowel syndrome with constipation
Authors: Yiannakou Yan , Agrawal Anu , Allen Patrick B. , Arebi Naila , Brown Steven R. , Eugenicos Maria P. , Farmer Adam D. , McLain-Smith Su , McLaughlin John , Sanders David S. , Lawrance Dominic , Emmanuel Anton
Published: October 2018

Background:

Linaclotide, a guanylate cyclase C agonist, has been shown in clinical trials to improve symptoms of irritable bowel syndrome with constipation (IBS-C). Here we report data from a real-world study of linaclotide in the UK.

Methods:

This 1-year, multicentre, prospective, observational study in the UK enrolled patients aged 18 years and over initiating linaclotide for IBS-C. The primary assessment was change from baseline in IBS Symptom Severity Scale (IBS-SSS) score at 12 weeks, assessed in patients with paired baseline and 12-week data. Change from baseline in IBS-SSS score at 52 weeks was a secondary assessment. Adverse events were recorded.

Results:

In total, 202 patients were enrolled: 185 (91.6%) were female, median age was 44.9 years (range 18.1–77.2) and 84 (41.6%) reported baseline laxative use. Mean (standard deviation) baseline IBS-SSS score was 339 (92), with most patients ( n = 129; 66.8%) classified as having severe disease (score ⩾300). In patients with paired data, there was a significant mean (95% confidence interval) decrease in IBS-SSS score from baseline to 12 weeks [−77.0 (−96.3, −57.7); p < 0.001; n = 124] and baseline to 52 weeks [−70.7 (−95.0, −46.5); p < 0.001; n = 76]. Overall, 174 adverse events were reported in 77 (38.1%) patients, most commonly diarrhoea ( n = 54; 26.7%), abdominal pain ( n = 21; 10.4%) and abdominal distension ( n = 13; 6.4%).

Conclusion:

Linaclotide significantly improved IBS-SSS score at 12 and 52 weeks. These results provide insights into outcomes with linaclotide treatment over 1 year in patients with IBS-C in real-world clinical practice.
Primary cilium and glioblastoma
Authors: Álvarez-Satta María , Matheu Ander
Published: October 2018

Glioblastoma (GBM) represents the most common, malignant and lethal primary brain tumour in adults. The primary cilium is a highly conserved and dynamic organelle that protrudes from the apical surface of virtually every type of mammalian cell. There is increasing evidence that abnormal cilia are involved in cancer progression, since primary cilia regulate cell cycle and signalling transduction. In this review, we summarize the role of primary cilium specifically with regard to GBM, where there is evidence postulating it as a critical mediator of GBM tumorigenesis and progression. This opens the way to the application of cilia-targeted therapies (‘ciliotherapy’) as a new approach in the fight against this devastating tumour.
Validation of electronic medical data: Identifying diabetes prevalence in general practice
Authors: Henderson Joan , Barnett Stephen , Ghosh Abhijeet , Pollack Allan J , Hodgkins Adam , Win Khin Than , Miller Graeme C , Bonney Andrew
Published: October 2018

Background:

Electronic medical records are increasingly used for research with limited external validation of their data.

Objective:

This study investigates the validity of electronic medical data (EMD) for estimating diabetes prevalence in general practitioner (GP) patients by comparing EMD with national Bettering the Evaluation and Care of Health (BEACH) data.

Method:

A “decision tree” was created using inclusion/exclusion of pre-agreed variables to determine the probability of diabetes in absence of diagnostic label, including diagnoses (coded/free-text diabetes, polycystic ovarian syndrome, impaired glucose tolerance, impaired fasting glucose), diabetic annual cycle of care (DACC), glycated haemoglobin (HbA1c) > 6.5%, and prescription (metformin, other diabetes medications). Via SQL query, cases were identified in EMD of five Illawarra and Southern Practice Network practices (30,007 active patients; from 2 years to January 2015). Patient-based Supplementary Analysis of Nominated Data (SAND) sub-studies from BEACH investigating diabetes prevalence (1172 GPs; 35,162 patients; November 2012 to February 2015) were comparison data. SAND results were adjusted for number of GP encounters per year, per patient, and then age–sex standardised to match age–sex distribution of EMD patients. Cluster-adjusted 95% confidence intervals (CIs) were calculated for both datasets.

Results:

EMD diabetes prevalence (T1 and/or T2) was 6.5% (95% CI: 4.1–8.9). Following age–sex standardisation, SAND prevalence, not significantly different, was 6.7% (95% CI: 6.3–7.1). Extracting only coded diagnosis missed 13.0% of probable cases, subsequently identified through the presence of metformin/other diabetes medications (*without other indicator variables) (6.1%), free-text diabetes label (3.8%), HbA1c result* (1.6%), DACC* (1.3%), and diabetes medications* (0.2%).

Discussion:

While complex, proxy variables can improve usefulness of EMD for research. Without their consideration, EMD results should be interpreted with caution.

Conclusion:

Enforceable, transparent data linkages in EMRs would resolve many problems with identification of diagnoses. Ongoing data quality improvement remains essential.
Assessing the Feasibility of Measuring Variation in Facility Design Among American Childbirth Facilities
Authors: Plough Avery , Polzin-Rosenberg Deb , Galvin Grace , Shao Amie , Sullivan Brendan , Henrich Natalie , Shah Neel T.
Published: October 2018

Objective:

To assess the feasibility of quantifying variation in childbirth facility design and explore the implications for childbirth service delivery across the United States.

Background:

Design has been shown to impact quality of care in childbirth. However, most prior studies use qualitative data to examine associations between the design of patient rooms and patient experience. There has been limited exploration of measures of unit design and its impact on care provision.

Method:

We recruited 12 childbirth facilities that were diverse with regard to facility type, location, delivery volume, cesarean delivery rate, and practice model. Each facility provided annotated floor plans and participated in a site visit or telephone interview to provide information on their design and clinical practices. These data were analyzed with self-reported primary cesarean delivery rates to assess associations between design and care delivery.

Results:

We observed wide variation in childbirth unit design. Deliveries per labor room per year ranged from 75 to 479. The ratio of operating rooms to labor rooms ranged from 1:1 to 1:9. The average distance between labor rooms and workstations ranged from 23 to 114 ft, and the maximum distance between labor rooms ranged from 9 to 242 ft. More deliveries per room, fewer labor rooms per operating room, and longer distances between spaces were all associated with higher primary cesarean delivery rates.

Conclusions:

Clinically relevant differences in design can be feasibly measured across diverse childbirth facilities. The design of these facilities may not be optimally matched to service delivery needs.
Target Stroke: Best Practice Strategies Cut Door to Thrombolysis Time to <30 Minutes in a Large Urban Academic Comprehensive Stroke Center
Authors: Bhatt Nirav , Marulanda-Londoño Erika T. , Atchaneeyasakul Kunakorn , Malik Amer M. , Asdaghi Negar , Akram Nida , D’Amour Daniel , Hesse Kathy , Zhang Tony , Sacco Ralph L. , Romano Jose G.
Published: October 2018

The therapeutic window for acute ischemic stroke with intravenous recombinant tissue plasminogen activator (IV rt-PA) is brief and crucial. The American Heart Association/American Stroke Association Target: Stroke Best Practice Strategies (TSBPS) aim to improve intravenous thrombolysis door-to-needle (DTN) time. We assessed the efficacy of implementation of selected TSBPS to reduce DTN time in a large tertiary care hospital. A multidisciplinary DTN committee assessed causes of delayed DTN time and implemented focused TSBPS in our urban academic medical center. We analyzed door-to-CT time, DTN time, and CT to IV rt-PA time in consecutive patients treated with IV rt-PA over 27 months preimplementation and 13 months postimplementation. One hundred forty-eight patients were included in the preimplementation and 126 in the postimplementation group. We found no significant difference between the groups in demographics, comorbidities, anticoagulation status, prethrombolysis hypertension treatment, arrival by EMS, after-hours arrival, or in stroke etiology. After implementation, median DTN time improved from 59 (interquartile range [IQR]: 52-80) to 29 (IQR: 20-41) minutes ( P < .001). Door-to-CT time decreased from 17 (14-21) to 16 (12-19) minutes ( P = .016), and CT-to-IV rt-PA time improved from 43 (IQR: 31-59) to 13 (IQR: 6-23) minutes ( P < .001). Rates of symptomatic intracranial hemorrhage (2.7% vs 3.2%, P = .82) and treatment of stroke mimics (9% vs 13%, P = .31) were similar in both the groups. Individualized hospital gap analysis identifies targeted interventions that lead to rapid and sustained improvement in treatment times.
Intentional and emergent strategies: Analyzing the motivational and structural dynamics in online communications of political interest organizations
Authors: Nitschke Paula , Donges Patrick
Published: October 2018

This article focuses on the motivational and structural dynamics of the online communication of political interest organizations. Instead of describing political interest organizations as fully rational players, we develop a theoretical framework that establishes an alternative view of political interest organizations by characterizing them as actors that are also dependent on their institutional environment. The basic assumption of this framework is that there is no unidirectional relationship between motives and structures and the online communication activities. Instead, there is a dynamic interplay of motives, structures, environmental conditions, and online communication. Against this theoretical framework, we discuss the findings from an interview study with communication executives of political interest organizations. The aim of this study was not to resolve the debate on whether political organizations communicate ‘strategically’ or not. Instead, we examined the motivational and structural dynamics that constitute the organizations’ online communications efforts.
Scapegoating in media coverage: Analysing blame-giving rituals in the public sphere
Authors: Viertmann Christine
Published: October 2018

This article explores scapegoating in media coverage by analysing news reports on three former CEOs of large German corporations (Deutsche Börse, Deutsche Bank, and Deutsche Bahn) during crisis situations. Scapegoating is defined as a social mechanism including its linguistic construction as an archetypal narrative. The scapegoat role for each CEO was analysed by using content analysis of business news reports (n = 864) from eight print newspapers and one online paper. A new methodology was developed based on a combination of the Linguistic Category System proposed by Semin and Fiedler and the rhetorical approach of Narrative Theme Analysis formulated by Boje. In addition, eight semi-structured expert interviews were conducted with Hartmut Mehdorn (former CEO of Deutsche Bahn), two communication directors, and five business journalists. The results revealed differences in attribution of the so-called ‘sacrificial marks’ or ‘stigmata’ related to a CEO’s group affiliation and personality. A scapegoat index value S is presented as the measurand to capture the scapegoat role of a person in media texts. The limitations of the study are linked to the small number (three) of case studies and the new methodology that needs further testing.
Assessing the feasibility of parent participation in a commercial weight loss program to improve child body mass index and weight-related health behaviors
Authors: Song MinKyoung , Lee Christopher S , Lyons Karen S , Stoyles Sydnee , Winters-Stone Kerri M
Published: October 2018

Objectives:

Little is known about how children’s health might be affected by parents’ participation in commercial weight loss programs. Given that more than 3.2 million people subscribe to just one commercial weight loss program, Weight Watchers, any secondary effects on children’s weight-related health behaviors (e.g. dietary behaviors, physical activity, and sedentary time) and body mass index from parent participation in commercial weight loss programs may have significant public health implications. This study examined the feasibility of conducting a study to assess such effects. Methods for recruitment and retention, and perceived acceptability and satisfaction among participants in small-scale preliminary study, were evaluated. Changes in body mass index and health behaviors among the parent–child dyads were also measured to test whether a larger-scale study would be warranted.

Methods:

This was an 8-week, pre–post observational feasibility study involving 20 parent–child dyads where both members had overweight or obesity. Physical and behavioral data were collected at baseline and 8 weeks from both members of the dyads. Parenting data were collected at the same time periods through parents’ self-report. Bivariate correlation was used to quantify the associations in changes for dyad members.

Results:

Feasibility goals for retention and perceived acceptability/satisfaction among participants were met. We reached approximately 80% of our enrollment goal. Parents showed a significant decrease in body mass index of 0.53 points (p < 0.05), while children showed a significant increase in raw body mass index (0.42, p < 0.05) and body mass index percentile (0.59, p < 0.05). However, correlation between changes in parent body mass index and changes in children body mass index percentile was positively correlated (r = 0.24, p = 0.31). A decrease in parent intake of total fat was associated with a decrease in the intake of fat in their children (r = 0.47, p < 0.05).

Conclusion:

Our findings support the viability of a larger-scale follow-up to assess the potential of using parent-only commercial weight loss program as a mechanism for improving health behaviors and body mass index in children with overweight or obesity.
Does Religion Buffer the Effects of Discrimination on Distress for Religious Minorities? The Case of Arab Americans
Authors: Shah Sarah
Published: October 2018

Religiosity is well documented as a coping resource that protects against the effects of discrimination on distress, but little is known about the utility of religious minorities’ religiosity. This study investigates if religious resources buffer the effect of discrimination on distress for Arab Americans and if that relationship differs based on religious minority status. Following the contours of the stress process model, I leverage data from the 2003 Detroit Arab American Survey (DAAS; N = 977) to test the relationship between distress, discrimination, and three measures of religiosity: frequency of religious service attendance, God salience, and salient religious practices. The results indicate that for the overall sample, only salient religious practices buffered discrimination. However, when religious affiliation was taken into account, the results indicate that both God salience and salient religious practices significantly buffer discrimination for Muslim respondents only. I conclude with theoretical contributions, study limitations, and future research avenues.
Dr Henry Shimizu: The Journey of a Canadian Plastic Surgeon, Advocate, and Artist
Authors: Sardiwalla Yaeesh , Morris Steven F.
Published: October 2018

Dr Henry Shimizu was a dedicated Canadian plastic surgeon with Japanese roots who spent his career practicing in Edmonton at the University of Alberta Hospital. He relished the opportunity to share his expertise by training residents and medical students. Dr Shimizu completed his plastic surgery training in the United States and was central to establishing the plastic surgery training program in Edmonton. Beyond clinical practice, Dr Shimizu was a prominent advocate in his community, serving as the Chairman of the Redress committee for Japanese internment. As a talented painter, he had produced magnificent oil paintings based on childhood recollections as an internee in the Slocan Valley. Dr Shimizu has made significant contributions to Canadian plastic surgery serving as president of the Canadian Society of Plastic Surgeons in 1978. His clinic work and dedication to the community at large were recognized with the Order of Canada in 2004 and more recently an honorary degree from the University of Victoria. Dr Shimizu continues to golf, paint, and travel in his retirement. He is happily married to his wife Joan and is the proud father of 4 children and 6 grandchildren.