bluuebunny/crossref_metadata_2025 huggingface dataset:
Career Goal Importance as a Moderator in the Relationship Between Career Feedback and Career-Related Stress
Authors: Hu Shi , Hood Michelle , Creed Peter A.
Published: September 2016

Based on goal-setting theory, this study examined the relationship between negative career goal feedback and career-related stress, tested whether career goal–performance discrepancy operated as a mediator in this relationship, and assessed whether career goal importance strengthened the indirect effect of negative feedback on stress via discrepancy. Using a sample of 317 health profession university students (mean age = 19.5 years), we found that negative feedback was associated positively with stress and that discrepancy mediated this relationship. Consistent with goal-setting theory, we also found that discrepancy was higher at higher levels of negative feedback for those with higher goal importance, and the indirect effect of negative feedback on stress through discrepancy increased with increasing goal importance. These findings highlight important roles for career goal feedback and career goal importance in young peoples’ career goal pursuit.
Acculturation, Enculturation, Gender, and College Environment on Perceived Career Barriers Among Latino/a College Students
Authors: Holloway-Friesen Holly
Published: September 2016

This study examined the role culture and college environment had on the perception of ethnic and gender career barriers of 138 Latino/a college students. Specifically, background characteristics (i.e., parent education, immigration status, and sex), acculturation, enculturation, and college environment on perceived ethnic/gender barriers were examined. Results showed 18% of the variance in perceived ethnic and gender career barriers were predicted by sex, acculturation, and college environment. As expected, sex, acculturation, and college environment negatively predicted perceived ethnic and gender career barriers. Latinas anticipated discrimination in future worksites more than Latino males. Acculturation and a welcoming college environment that supported diverse students predicted lower perceived ethnic and gender career barriers. Enculturation did not significantly predict perceived career barriers. Supporting the hypothesis, an interaction effect between sex and college environment predicted perceived career barriers. Implications for practice and future research are discussed.
Synthesis and characterization of new aromatic polyesters with a (4-phenoxyphenyl)phenylmethene linkage
Authors: Zhu Lu , Wang Chao-Li , Mao Xue-Chun , Huang Zhen-Zhong , Sheng Shou-Ri
Published: September 2016

A series of new aromatic polyesters containing a (4-phenoxyphenyl)phenylmethene linkage were prepared by phase transfer-catalyzed interfacial polycondensation of 1,1-bis(4-hydroxyphenyl)-1-(4-phenoxyphenyl)-1-phenylmethane with terephthaloyl chloride, isophthaloyl chloride, and so on. The inherent viscosities of the polyesters ranged from 0.62 to 0.90 dL/g, while number-average molecular weights were in the range of 30,500–35,500 g/mol. All the polyarylates were readily soluble in organic solvents such as dichloromethane, chloroform (CDCl3), tetrahydrofuran, meta-cresol, pyridine, N, N-dimethylformamide, N, N-dimethylacetamide, and 1-methyl-2-pyrrolidinone at room temperature, and could be cast into tough, transparent, and flexible films from their CDCl3 solutions. Wide-angle X-ray diffraction measurements revealed the amorphous nature of the polyarylates. These polymers showed glass transition temperatures ( Tgs) between 178°C and 240°C and decomposition temperatures at 10% weight loss ranging from 446°C to 483°C, while the initial degradation temperatures in the range of 410–435°C under nitrogen atmosphere. These new polyarylates exhibited higher Tgs and better solubility than bisphenol A-based analogues.
An unusual initial manifestation of acute myeloid leukemia
Authors: Gawai Sonali R , Binesh VG , Betsy Ambooken , Jisha KT
Published: September 2016

Leukemia cutis is seen in around 20% of acute monocytic leukemia. They usually present as papules or nodules or infiltrated plaques but ulceration is uncommon. A 28-year-old female presented with multiple painless indurated genital ulcers of three weeks’ duration with low-grade fever, gum hyperplasia, and generalized lymphadenopathy. Tissue smear from the edge of the ulcer showed atypical monocytes suggestive of leukemic infiltrate which was further confirmed by peripheral smear and bone marrow aspirate. Herein, we report a case of acute monocytic leukemia (AML) with leukemia cutis presenting initially with genital ulcers simulating chancre.
Inferring marginal association with paired and unpaired clustered data
Authors: Lorenz Douglas J , Levy Steven , Datta Somnath
Published: September 2016

In the marginal analysis of clustered data, where the marginal distribution of interest is that of a typical observation within a typical cluster, analysis by reweighting has been introduced as a useful tool for estimating parameters of these marginal distributions. Such reweighting methods have foundation in within-cluster resampling schemes that marginalize potential informativeness due to cluster size or within-cluster covariate distribution, to which reweighting methods are asymptotically equivalent. In this paper, we introduce a reweighting scheme for the marginal analysis of clustered data that generalizes prior reweighting methods, with a particular application to measuring bivariate correlation in unpaired clustered data, in which observations of two random variables are not naturally paired at the within-cluster level. We develop unpaired clustered data analogs of well-known product moment correlation coefficients (Pearson, Spearman, phi), as well as the polyserial coefficient for measuring correlation between one discrete and one continuous variable. We evaluate the performance of these coefficients via a simulation study and demonstrate their use by finding no statistically significant association between dental caries at an early age and dental fluorosis at age 13 using a large dental dataset.
The Political De-determination of Legal Rules and the Contested Meaning of the ‘No Bailout’ Clause
Authors: Castillo Ortiz Pablo José
Published: September 2016

Traditional debates on legal theory have devoted a great deal of attention to the question of the determinacy of legal rules. With the aid of social sciences and linguistics, this article suggests a way out of the ‘determinate–indeterminate’ dichotomy that has dominated the academic debate on the topic so far. Instead, a dynamic approach is proposed, in which rules are deemed to undergo processes of political ‘de-determination’ and ‘redetermination’. To illustrate this, the article uses the example of Article 125 of the Treaty on the Functioning of the European Union, the ‘no bailout’ provision, which played a major role in the management of the Euro-crisis. As will be shown, with the start of the crisis, this provision, whose meaning was once scarcely controversial, became the object of intense interpretative disagreement. As it became politically relevant, the rule also became the site of interpretative competitions, until the intervention of the European Court of Justice disambiguated and redefined its meaning.
Ethics of rationing of nursing care
Authors: Rooddehghan Zahra , Yekta Zohreh Parsa , Nasrabadi Alireza N
Published: September 2016

Background:

Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values.

Objectives:

The present research sought to explore aspects of rationing nursing care in Iran.

Research design:

This study applied qualitative content analysis, a method to explore people’s perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions.

Participants and research context:

The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran.

Ethical considerations:

The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants.

Findings:

According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses’ feeling of guilt.

Conclusion:

Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people’s lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon are warranted.
Fostering trusting relationships with older immigrants hospitalised for end-of-life care
Authors: Johnstone Megan-Jane , Rawson Helen , Hutchinson Alison Margaret , Redley Bernice
Published: September 2016

Background:

Trust has been identified as a vital value in the nurse–patient relationship. Although increasingly the subject of empirical inquiries, the specific processes used by nurses to foster trust in nurse–patient relationships with older immigrants of non-English speaking backgrounds hospitalised for end-of-life care have not been investigated.

Aims:

To explore and describe the specific processes that nurses use to foster trust and overcome possible cultural mistrust when caring for older immigrants of non-English speaking backgrounds hospitalised for end-of-life care.

Research design:

A qualitative descriptive approach was used. Twenty-two registered nurses were recruited from four metropolitan health services in Melbourne, Australia.

Ethical considerations:

Research approval was granted by the Human Research Ethics Committees of the host institution and four participating health services.

Findings:

Thematic analysis revealed that fostering trust encompassed the following three commensurate stages: establishing trust, strengthening trust and sustaining trust. Underpinning the successful achievement of these stages was the nurses’ moral commitment (reflected in their intentional, conscious and conscientious approach) to fostering trust as an essential ingredient of quality end-of-life care.

Discussion:

This study has shown that while professional competencies are important to providing quality end-of-life care to older immigrant patients of non-English speaking backgrounds, it is a nurse’s moral commitment to fostering trust that may ultimately lay the foundations for a trusting quality care relationship to be established and sustained.

Conclusion:

This study has captured the processes used by nurses to foster trust as an essential element of quality end-of-life care in older immigrants. The characteristics of trust and the different factors influencing its expression in diverse cultural contexts are, however, under-researched. Accordingly, gaps remain in the knowledge and understanding of the specific cultural nuances and manifestations of trust across and within different cultures. This is an area that is germane to further cross-cultural and international collaborative scholarly inquiry and research.
Compatibility of Common Instructional Models With the DACUM Process
Authors: Wyrostek Warren , Downey Steven
Published: September 2016

Practitioners use an expansive array of instructional design models. Although many of these models acknowledge the need for analyzing occupational roles, they do not define steps for conducting these analyses. This article reviews prominent models and provides prescriptive guidance for selecting appropriate models given a project’s (a) Product Requirements, (b) Resource Availability, and (c) Philosophical Compatibility with DACUM (Developing a CurriculUM) procedures.
Video Inspired the Radio Star
Authors: Giebelhausen Robin
Published: September 2016

Interdisciplinary arts education in music has often included connective lines toward drama, dance, and visual arts. This article will suggest five different projects that could be used to link music to video in order to develop media arts and music interdisciplinary connections.
Building a Mentorship-Based Research Program Focused on Individual Interests, Curiosity, and Professional Skills at the North Carolina School of Science and Mathematics
Authors: Shoemaker Sarah E. , Thomas Christopher , Roberts Todd , Boltz Robin
Published: September 2016

The North Carolina School of Science and Mathematics (NCSSM) offers students a wide variety of real-world opportunities to develop skills and talent critical for students to gain the essential professional and personal skills that lead to success in science, technology, engineering, and mathematics (STEM) careers. One of the key avenues available to gain research experience is the Mentorship Program. This program uses a unique pre- and co-curriculum that guides approximately 80 students each year to take a leading role in setting up and executing a research experience with professionals and scholars at local universities/corporations. The Mentorship Program is based entirely on students seeking out mentors of interest at partner institutions. Successful partnerships rely on a strong interest and goodwill among researchers and professionals to mentor as well as the appropriate structure and student preparation by the partner school. The program emphasizes that experiential learning is still a “classroom” academic program and not just an enrichment program, internship, or shadowing experience.
Experiential Learning at the Gatton Academy of Mathematics and Science in Kentucky
Authors: Roberts Julia Link , Breedlove Lynette , Strode Derick B.
Published: September 2016

This article describes the model for The Gatton Academy of Mathematics and Science in Kentucky where Kentucky’s young people can extend their learning through university classes, global experiences, and research.
A Conversation With Randy Asher, Principal of New York City’s Brooklyn Technical High School
Authors: Asher Randy J.
Published: September 2016

This is a conversation with Randy Asher, principal of New York City’s Brooklyn Technical High School. Brooklyn Tech is a selective science high school in New York City, founded in 1922 as a school for boys with potential for careers in engineering and applied science. Today, it provides full-time education for both male and female students from the New York metropolitan area. With enrollment of over 5,500, it is the largest STEM school in the United States.
Approaches of high school instrumental music educators in response to student challenges
Authors: Edgar Scott N.
Published: September 2016

The purpose of this multiple instrumental case study was to explore approaches of four high school instrumental music educators assuming the role of facilitative teacher in responding to challenges affecting the social and emotional well-being of their students. This study utilized the framework of social emotional learning as a lens to view the educators’ interactions. The four participants represented diverse demographic settings and had at least 10 years of instrumental music teaching experience. Findings and implications include strategies for providing support, unique elements of the instrumental music classroom, and perceived outcomes from providing support.
Performance assessment and prioritization of mitigation approaches for pre-seismic code structures
Authors: Mwafy Aman , Elkholy Said
Published: September 2016

The selection of an efficient mitigation technique from a number of alternatives to reduce the seismic risk of pre-seismic code school buildings is the main focus of this study. An on-ground survey of the school building stock in a large study area that extends for 6000 km2 enabled the selection of four different benchmark structures. Detailed simulation models are developed for the selected benchmark buildings and 14 retrofit alternatives to define their performance criteria and assess their seismic vulnerability. The earthquake hazard of the study region is accounted for using a wide range of ground motions, representing two seismic scenarios pertinent to several medium seismicity regions. The relative seismic performance of pre-code buildings and different mitigation alternatives from a large number of dynamic response simulations up to collapse is described in terms of fragility curves as well as a proposed measure of response termed the overall performance factor. This measure of response along with the systematic seismic assessment approach adopted in this study enable prioritizing different retrofit alternatives based on their performance-to-cost ratios, which help to arrive at an efficient and cost-effective mitigation strategy for the implementation at the regional scale.
Subjective health literacy: Development of a brief instrument for school-aged children
Authors: Paakkari Olli , Torppa Minna , Kannas Lasse , Paakkari Leena
Published: September 2016

Aims: The present paper focuses on the measurement of health literacy (HL), which is an important determinant of health and health behaviours. HL starts to develop in childhood and adolescence; hence, there is a need for instruments to monitor HL among younger age groups. These instruments are still rare. The aim of the project reported here was, therefore, to develop a brief, multidimensional, theory-based instrument to measure subjective HL among school-aged children. Methods: The development of the instrument covered four phases: item generation based on a conceptual framework; a pilot study ( n = 405); test–retest ( n = 117); and construction of the instrument ( n = 3853). All the samples were taken from Finnish 7th and 9th graders. Results: Initially, 65 items were generated, of which 32 items were selected for the pilot study. After item reduction, the instrument contained 16 items. The test–retest phase produced estimates of stability. In the final phase a 10-item instrument was constructed, referred to as Health Literacy for School-Aged Children (HLSAC). The instrument exhibited a high Cronbach alpha (0.93), and included two items from each of the five predetermined theoretical components (theoretical knowledge, practical knowledge, critical thinking, self-awareness, citizenship). Conclusions: The iterative and validity-driven development process made it possible to construct a brief multidimensional HLSAC instrument. Such instruments are suitable for large-scale studies, and for use with children and adolescents. Validation will require further testing for use in other countries.
A rapid technique for monitoring volatile organic compound emissions from wood–plastic composites
Authors: Väisänen Taneli , Laitinen Kimmo , Tomppo Laura , Joutsensaari Jorma , Raatikainen Olavi , Lappalainen Reijo , Yli-Pirilä Pasi
Published: September 2016

Wood–plastic composites (WPCs) have numerous indoor applications, including framing, decoration and flooring. However, the impact of WPCs on indoor air quality has not been widely studied. Proton-transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) was utilized to monitor the release of volatile organic compounds (VOCs) from a commercial WPC for 41 days since its day of manufacture. Additionally, the emission rates of VOCs from seven different WPC samples were compared and converted into air concentrations to evaluate whether the odour thresholds would be exceeded. The VOCs studied were formaldehyde, acetaldehyde, acetic acid, cyclohexene, furan, furfural, guaiacol and monoterpenes. The results from the 41-day test revealed that the emission rates of monoterpenes, guaiacol, furfural and acetaldehyde declined by 75%–93%, whereas an opposite phenomenon was observed for cyclohexene (nearly a threefold increase). The comparison of VOC emission rates from seven WPC samples indicated that none of the samples had the lowest or highest emission rate for every VOC studied. The present results are significant in at least two aspects; this study shows that the VOC emission rates from WPCs can be determined by using PTR-TOF-MS. Furthermore, it seems that guaiacol and acetaldehyde exceed their odour thresholds and therefore humans will be able to detect these compounds from the WPCs studied.
Study on the indoor environmental performance of complex insulation material: Carbonized rice hull and glass wool
Authors: Yin Cheng-Ri , Yeom Dongwoo , Lee Kyu-In
Published: September 2016

The purpose of this study is to make a complex insulation material with carbonized rice hull and glass wool and to verify the environmental control performance. Full-scale experimental mock-ups were constructed, and the control performance in an indoor environment was compared and verified through monitoring experiments. The complex insulation mock-up showed a relatively high temperature during spring, summer and autumn. The difference in the heat storage capacity of the materials was the cause for this difference. Also, the complex insulation material was proven as more effective at maintaining the stability of the indoor environment and temperature during spring, summer and autumn. In addition, the complex insulation was able to control the indoor humidity at a comfortable level during every season. Our results have therefore verified that the carbonized rice hull was effective at controlling the indoor humidity. When compared with the pure carbonized rice hull insulation, the complex insulation wall was relatively thin; therefore, more net indoor area could be achieved by using the complex insulation material. In addition, if self-produced, the complex insulation could be economically more feasible. Therefore, this complex material was synthetically proven to have merits for insulation of lightweight timber houses for thermal comfort of occupants.
Questioning the president: Examining gender in the White House press corps
Authors: Meeks Lindsey
Published: September 2016

In 2014, President Barack Obama made history by only calling upon women journalists during a domestic news conference with the White House press corps. To capitalize on and examine this critical first in journalism, this study analyzed the potential influence of a journalist’s gender in White House press corps news conferences with President Obama a year before and a year after the all-female conference. The content analysis examined what political issues journalists emphasized in presidential news conferences and whether these issue emphases varied (a) by journalists’ gender and (b) before and after the all-female conference. Results revealed that, to some extent, men and women emphasized different issues. Furthermore, there were marked shifts after the all-female conference. First, women were called upon more often. Second, women emphasized several issues more than men. In particular, women became predominant on questions dealing with so-called ‘masculine’ or ‘hard news’ issues, for example, macroeconomics and foreign trade. This work suggests that gender, in all of its permutations – be it the journalist’s gender, the gendering of issues, or the gendering of occupational spaces – matters and may affect journalists’ lines of questioning.
A co-operative inquiry about love using narrative, performative and visual methods
Authors: Godden Naomi Joy
Published: September 2016

Participatory researchers advocate using presentational arts-based methods to collectively inquire into a social phenomenon. In a co-operative inquiry in an Australian rural community, ten community workers inquired into the ‘love ethic’ in their community work practice using narrative, performative and visual methods to gather, analyse and interpret data within cycles of reflection and action. Group members collectively and democratically chose to use presentational inquiry tools such as storytelling, dialogical performance, gift-giving, drawing and other non-traditional approaches to explore the topic and generate collaborative knowledge. These methods were engaging and empowering, and supported group members to develop a love-based framework of community practice. The group’s final collective drawing depicts the roots, trunk, fruit and saplings of a tree representing the values, process, outcomes and cyclical nature of the love ethic in community work.
When bad things happen to good people
Authors: Thaysen Jens Damgaard , Albertsen Andreas
Published: September 2016

According to luck egalitarianism, it is not unfair when people are disadvantaged by choices they are responsible for. This implies that those who are disadvantaged by choices that prevent disadvantage to others are not eligible for compensation. This is counterintuitive. We argue that the problem such cases pose for luck egalitarianism reveals an important distinction between responsibility for creating disadvantage and responsibility for distributing disadvantage which has hitherto been overlooked. We develop and defend a version of luck egalitarianism which only holds people responsible for creating disadvantage. This revision enables luck egalitarianism to offer compensation to those who are disadvantaged by preventing disadvantage to others, like dependent caretakers, without compromising the responsibility–sensitivity at the heart of luck egalitarianism.
The relationship between planning and the market from the perspective of property rights theory: A transaction cost analysis
Authors: Slaev Aleksandar D
Published: September 2016

Current social and economic theory has yet to explain why, despite the many advantages of the market mechanism, planning is employed at all levels of market economy. Like other studies, this research proposes an explanation based on the form of property rights; however, it uses specific definitions of market, private planning and collective planning that establish unambiguous links between them and the structure of ownership. Thus, the article supports the position that the employment of planning or market mechanisms in economic and social activities depends solely on the structure of property rights. The contribution of this article is the formulation of two criteria for the allocation of property rights derived from Coase’s seminal works, termed in this text as Coase’s criterion of institutional optimisation and Coase’s market cost criterion. An important aspect of this proposal is the suggestion that Coase’s theory can be a powerful tool with which to study shared/common entitlements. It illuminates the nature and the mechanisms of private and collective planning and their relationship to the market. The article concludes that private planning may exist only if it is good enough to improve the efficiency of the market. Collective planning is indispensable when markets employ shared/collectively owned resources.
Axial–bending coupling vibration of mass eccentric double-beam system with discrete elastic connections
Authors: Su Jinpeng , Lei Zhiyang , Hua Hongxing
Published: September 2016

The existence of mass eccentricity will lead to the energy transfer between axial and flexural vibrations of a beam. To study the coupling properties of a double-Timoshenko beam system, a non-uniform coupled double-beam system is modeled in which the upper beam is typical and the lower beam is mass eccentric simulated by a non-uniform two-layer Timoshenko beam. By incorporating Hamilton’s principle and spectral element method, the axial–bending coupled governing equations of the system are derived and the approach can also be easily used to analyze the influences of the parameters and other coupled beam systems. Both the free and forced vibration results of a double-beam system by this method are consistent with the corresponding finite element model’s and thus this method is validated. The coupled properties and their mechanism are revealed. The influences of axial and transverse flexible connection on the coupling properties including free and forced vibration are investigated. A systematic matching principle of reducing the vibration of the coupled system is proposed.
Getting College Students Back on Track
Authors: Kodama Corinne M. , Han Cheon-Woo , Moss Tom , Myers Brittany , Farruggia Susan P.
Published: September 2016

The present study examines the outcomes of a 5-week summer bridge writing program at a Midwestern, urban, public university designed to provide remedial instruction for incoming first-year college students, approximately 500 students annually for 7 years. Regression results showed that program participation was a positive, significant predictor on the outcomes of 6- and 4-year graduation, first-year earned credits, and first-year college grade point average, even after controlling for demographic and academic preparation variables. The combination of academic preparation and an introduction to the college experience helped to prepare students for college success. This institutionally funded program shows promise in addressing the remediation needs of students and preparing them for success in credit-bearing courses as well as college life in general, getting them on track for timely college graduation.
Applying Critical Discourse Analysis in Health Policy Research
Authors: Evans-Agnew Robin A. , Johnson Susan , Liu Fuqin , Boutain Doris M.
Published: September 2016

Critical discourse analysis (CDA) is a promising methodology for policy research in nursing. As a critical theoretical methodology, researchers use CDA to analyze social practices and language use in policies to examine whether such policies may promote or impede social transformation. Despite the widespread use of CDA in other disciplines such as education and sociology, nursing policy research employing CDA methodology is sparse. To advance CDA use in nursing science, it is important to outline the overall research strategies and describe the steps of CDA in policy research. This article describes, using exemplar case studies, how nursing and health policy researchers can employ CDA as a methodology. Three case studies are provided to discuss the application of CDA research methodologies in nursing policy research: (a) implementation of preconception care policies in the Zhejiang province of China, (b) formation and enactment of statewide asthma policy in Washington state of the United States, and (c) organizational implementation of employee antibullying policies in hospital systems in the Pacific Northwest of the United States. Each exemplar details how CDA guided the examination of policy within specific contexts and social practices. The variations of the CDA approaches in the three exemplars demonstrated the flexibilities and potentials for conducting policy research grounded in CDA. CDA provides novel insights for nurse researchers examining health policy formation, enactment, and implementation.
Resisting the Neoliberalization of Higher Education: A Challenge to Commonsensical Understandings of Commodities and Consumption
Authors: Saunders Daniel B. , Blanco Ramirez Gerardo
Published: September 2016

In this article, we explore commodities and consumption, two concepts that are central to critiques of the neoliberal university. By engaging with these concepts, we explore the limits of neoliberal logic. We ground this conceptual entanglement in Marxist and post-Marxist traditions given our understanding of neoliberalism both as an extension of and as a meaningfully different form of capitalism. As colleges and universities enact neoliberal economic assumptions by focusing on revenue generation, understanding students as customers, and construing their faculty as temporary service providers, the terms commodity and consumption have become commonplace in critical higher education literature. When critiques concerning the commodification and consumption of higher education are connected with these theoretical and conceptual foundations, they not only become more effective but also provide a more meaningful guide upon which current and future scholars can build.
Culturally Adapted Behavioral Activation
Authors: Benson-Flórez Gregory , Santiago-Rivera Azara , Nagy Gabriela
Published: September 2016

The scarcity of accessible culturally competent service providers and a general sense of mistrust in Eurocentric-based mental health settings exacerbate the lack of help seeking and effective therapeutic engagement for Latinos. Thus, clinical interventions that account for diverse values and worldviews may be an important step in the helpful treatment of U.S. Latino populations. Behavioral activation (BA), an evidence-based intervention for the treatment of depression, was recently evaluated through a preliminary clinical trial study in a community clinic primarily serving Spanish-speaking Latinos, and the results were promising. A culturally adapted version of BA was developed for Latinos, which took into consideration the cultural value of familismo (a collectivist worldview and preference for maintaining close connections to family); however, BA has not been previously applied to Latino families. The current case study presents the clinical treatment of a Mexican American family living in the southwest of the United States experiencing numerous stressors resulting in depressive symptoms. Specifically, this family sought therapy having experienced many negative life events, including stressors associated with institutionalized racism, their financial situation, and acculturation process. This led to a disruption of the family hierarchy, anger, unhappiness, fear, and isolation among family members. Outcomes of the intervention include a decrease in depressive symptoms and improved family communication and relationships by their involvement in activities such as attending cultural events in their community, family outings, and the children’s participation in extracurricular activities.
Urban Preservation and Renewal
Authors: Born George Walter
Published: September 2016

This article takes up the creation of Boston’s Beacon Hill historic district during the 1950s as a significant chapter of preservation planning history. Inspired by similar efforts in the South, this campaign succeeded in a decade commonly associated with conformity and consensus, suburbia and urban renewal, obsolescence and progress. Activists on Beacon Hill persuaded their neighbors and city and state officials that the heretofore little-used technique of historic district designation should be employed in a big, northern industrial city. In so doing, they led the way for the more widespread historic preservation movement that followed during the 1960s and 1970s.
Developing the delirium care pathways
Authors: Traynor Victoria , Britten Nicole , Burns Pippa
Published: September 2016

The aim of this study was to develop delirium care pathways (DCPs) useable and relevant for registered practitioners in all care settings: community; acute; and nursing homes. A qualitative approach was adopted to develop the pathways inductively. Focus groups and one-to-one interviews with registered practitioners ( n = 45) working as managers, practitioners and clinical nurse consultants were undertaken to develop draft versions of the pathways, which was pilot trialled across 19 clinical settings. The publication of the DCPs was a concise and easily readable document for registered practitioners who required immediate guidance on how to implement evidence-based delirium care for older people and their family carers, including three patient journeys explaining best-practice delirium care in community, acute and nursing home care settings, a webpage resource and printable posters of the pathways' patient journeys to promote the use of the pathways in clinical settings. The work undertaken to develop the pathways was further developed through new policy documents, state-wide initiatives to improve delirium care in hospitals, development of educational resources on delirium care and other knowledge translation projects on this topic.
Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study
Authors: Peters S. E. , Johnston V. , Ross M. , Coppieters M. W.
Published: September 2016

This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes.

Level of evidence: V
Leiomyoma of the Foot and Ankle: A Case Series
Authors: Szolomayer Lauren K. , Talusan Paul G. , Chan Wayne F. , Lindskog Dieter M.
Published: September 2016

Leiomyoma is a benign soft-tissue tumor that can arise in any soft tissue; however, in the extremities, it is usually a subcutaneous mass. Masses in the foot and ankle in general are rare, and few reports in the literature describe leiomyoma in this region of the body. We present a series of 8 cases of leiomyoma of the foot and ankle, 4 of which are subclassified as angioleiomyomas. The characteristic patient presentation, imaging, and histological findings are presented here to increase awareness of this soft-tissue mass in the foot and ankle.

Levels of Evidence: Level V
Getting to grips with the obesity epidemic in Europe
Authors: Cuschieri Sarah , Mamo Julian
Published: September 2016

Obesity is a global epidemic. It is responsible for increased patient morbidity and mortality. Significant related pathologies including diabetes mellitus compound the overall risks. Obesity is a significant financial burden. This includes direct and indirect medical costs, amounting to millions of euros each year. Multiple European studies have outlined a steady incline in obesity prevalence rates. Tackling obesity is no easy task. Policy makers aiming to reduce obesity rates should adopt an evidence-based approach. This entails adopting both micro- and macro-interventions tweaked to each country’s individual requirements. The ideal way forward would be to tackle obesity from the individual, population-wide and food industry angles. The key towards a successful intervention is for each country to carry out well-planned health examination studies, in an attempt to pin point local risk factors. Having a correct individualized picture, each country can move forward and draw policies and interventional procedures. The aim should be to primarily improve the quality of life. Second, the country’s capital expenditure is also reduced.
Therapeutic drug monitoring of mexiletine at a large academic medical center
Authors: Nei Scott D , Danelich Ilya M , Lose Jennifer M , Leung Lydia Yuk Ting , Asirvatham Samuel J , McLeod Christopher J
Published: September 2016

Introduction:

The therapeutic trough range for mexiletine (0.8–2 mcg/mL) was largely established in the setting of arrhythmia prophylaxis following myocardial infarction.

Objective:

Describe the usage patterns of serum mexiletine concentrations and the impact of these concentrations on mexiletine dosing in modern practice for ventricular arrhythmia treatment.

Methods:

A single-center, retrospective analysis was conducted using the electronic medical record to identify serum mexiletine concentrations drawn between December 2004 and December 2014. The primary endpoint was the incidence of mexiletine concentrations drawn as troughs. Secondary outcomes included the incidence of mexiletine concentrations that prompted a dose change, association between adverse events and elevated concentrations, and association between baseline characteristics and mexiletine concentrations.

Results:

A total of 237 individual concentrations were included for analysis with 109 (46.0%) drawn appropriately as trough concentrations. Only 31 (13.1%) of the 237 concentrations drawn prompted a dose change. Mexiletine was primarily used for the treatment of ventricular arrhythmias (96.2%), and 108 (45.6%) concentrations were drawn in an effort to assess efficacy. The median concentration was statistically different between patients with and without an adverse event (0.8 vs 0.7 mcg/mL, respectively; p = 0.017), but may not represent a clinical significance. Patients with hepatic dysfunction had higher median concentrations compared to those without hepatic dysfunction (1.30 vs 1.07 mcg/mL; p = 0.01).

Conclusion:

Mexiletine concentrations are often drawn at inappropriate times and seldom influence a dose change. This study suggests that routine monitoring of mexiletine concentrations may not be necessary; however, therapeutic drug monitoring may be considered in patients with hepatic dysfunction or to confirm mexiletine absorption in patients where this represents a concern.
A case study of stakeholder perceptions of patient held records: the Patients Know Best (PKB) solution
Authors: Bidmead Elaine , Marshall Alison
Published: September 2016

Introduction

Patients Know Best (PKB) provides a patient portal with integrated, patient-controlled digital care records. Patient-controlled personal health records facilitate coordinated management of chronic disease through improved communications among, and about, patients across professional and organisational boundaries. An NHS foundation trust hospital has used PKB to support self-management in patients with inflammatory bowel disease; this paper presents a case study of usage.

Methods

The stakeholder empowered adoption model provided a framework for consulting variously placed stakeholders. Qualitative interviews with clinical stakeholders and a patient survey.

Results

Clinicians reported PKB to have enabled a new way of managing stable patients, this facilitated clinical and cost effective use of specialist nurses; improved two-way communications, and more optimal use of outpatient appointments and consultant time. The portal also facilitated a single, rationalised pathway for stable patients, enabling access to information and pro-active support. For patients, the system was a source of support when unwell and facilitated improved communication with specialists. Three main barriers to adoption were identified; these related to concerns over security, risk averse attitudes of users and problems with data integration.

Conclusions

Patient-controlled personal health records offer significant potential in supporting self-management. Digital connection to healthcare can help patients to understand their condition better and access appropriate, timely clinical advice.
Social media and contentious politics in South Africa
Authors: Baragwanath Robyn
Published: September 2016

This article is an explication of the student protests that erupted throughout South African universities in the latter part of 2015. These protests are symptomatic of greater governmental failings and are evidence that protest action has become one of the only means of effective civic participation in contemporary South African politics.
Effects of a continuum of care intervention on frail elders’ self-rated health, experiences of security/safety and symptoms: A randomised controlled trial
Authors: Ebrahimi Zahra , Eklund Kajsa , Dahlin-Ivanoff Synneve , Jakobsson Annika , Wilhelmson Katarina
Published: September 2016

We aimed to evaluate effects of the intervention on self-rated health, experiences of security/safety and symptoms. A non-blinded controlled trial was performed with participants randomised to either the intervention group or a control group, with follow-ups at 3, 6 and 12 months. The intervention involved collaboration between a nurse with geriatric competence at the emergency department, the hospital wards and a multi-professional team for care and rehabilitation of older adults, with a case manager from the municipality as the hub. Older people who sought care at the emergency department at Sahlgrenska University Hospital/Mölndal and who were discharged to their own homes in the Mölndal municipality were asked to participate. Inclusion criteria were age 80 years and older, or 65 to 79 years with at least one chronic disease and dependency in at least one activity of daily living. Analyses were conducted on the basis of the intention-to-treat principle. Outcome measures were self-rated health, experiences of security/safety and symptoms. These were analysed using Svensson’s method. Of 161 participants, 76 were allocated to the control group and 85 to the intervention group. Positive effects of the intervention were observed for frail older adult’s symptoms and self-rated health.
solveME: fast and reliable solution of nonlinear ME models
Authors: Yang Laurence , Ma Ding , Ebrahim Ali , Lloyd Colton J. , Saunders Michael A. , Palsson Bernhard O.
Published: September 2016

Background

Genome-scale models of metabolism and macromolecular expression (ME) significantly expand the scope and predictive capabilities of constraint-based modeling. ME models present considerable computational challenges: they are much (>30 times) larger than corresponding metabolic reconstructions (M models), are multiscale, and growth maximization is a nonlinear programming (NLP) problem, mainly due to macromolecule dilution constraints.

Results

Here, we address these computational challenges. We develop a fast and numerically reliable solution method for growth maximization in ME models using a quad-precision NLP solver (Quad MINOS). Our method was up to 45 % faster than binary search for six significant digits in growth rate. We also develop a fast, quad-precision flux variability analysis that is accelerated (up to 60× speedup) via solver warm-starts. Finally, we employ the tools developed to investigate growth-coupled succinate overproduction, accounting for proteome constraints.

Conclusions

Just as genome-scale metabolic reconstructions have become an invaluable tool for computational and systems biologists, we anticipate that these fast and numerically reliable ME solution methods will accelerate the wide-spread adoption of ME models for researchers in these fields.