bluuebunny/crossref_metadata_2025 huggingface dataset:
In search of legitimacy: a semiotic analysis of business model disclosure practices
Authors: Di Tullio Patrizia , Valentinetti Diego , Nielsen Christian , Rea Michele Antonio
Published: December 2019

Purpose

This paper aims to investigate how firms disclose the presentation and content of business model (BM) information in corporate reports to manage their legitimacy in response to European Directive 2014/95.

Design/methodology/approach

Legitimacy theory is used to identify disclosure strategies pursued by firms in reaction to the new regulation. To understand how firms adopt these strategic responses, semiotic analysis is applied to a sample of European companies’ reports through Crowther’s (2012) framework, which is based on a mechanism of binary oppositions.

Findings

Half of the sample strategically choose to comply with the European Union (EU) Directive regarding BM information through the use of non-accounting language, figures, and diagrams. Other firms did not disclose any substantive information but managed the impression of compliance with the regulation, while the remainder of the sample dismissed the regulation altogether.

Research limitations/implications

This study demonstrates how organisations use the disclosure of BM information in their corporate reports to control their legitimacy. The results support the idea that firms can acquire legitimacy by complying with the law or giving the impression of compliance with the regulation. This study provides evidence on the first-time adoption of the EU Directive, and therefore, future research can enlarge the sample and conduct the analysis over a broader time frame.

Practical implications

A more precise indication of the EU Directive regarding “where” firms should report BM information, “how” the description of a BM should refer to the environmental, social, governance (ESG) factors, and a set of performance measures to track the evolution of a company’s BM overtime is needed.

Originality/value

While there has been a notable amount of research that has applied content analysis methodologies to investigate the thematic and syntactic aspects of BM disclosure in corporate reports, only a few studies have investigated BM disclosures in relation to the EU Directive. Furthermore, the application of semiotic analysis extends beyond traditional content analysis methodologies because it considers the structure of the story at many levels, thus developing a more complete textual picture of how BMs are described, allowing an analysis of the reasons behind the disclosure strategies pursued by firms.
Climate change adaptation actions by fish farmers: evidence from the Niger Delta Region of Nigeria
Authors: Onyeneke Robert Ugochukwu , Igberi Christiana Ogonna , Aligbe Jonathan Ogbeni , Iruo Felix Abinotam , Amadi Mark Umunna , Iheanacho Stanley Chidi , Osuji Emmanuel Emeka , Munonye Jane , Uwadoka Christian
Published: December 2019

This paper examined climate change adaptation strategies in fish farming and the effect of such methods on the profit of fish farmers in the Niger Delta region of Nigeria, Africa’s most populous country. Using cross‐sectional data obtained from 420 fish farmers from the region and applying multivariate probit and instrumental variable regressions, the study found that fish farmers have adopted a broad range of strategies to address climate risk and that these have significantly increased farmers’ profit. Our findings indicated important relationships between certain farm, socio‐economic and institutional characteristics and the adaptation actions. The study provides useful insight into factors that potentially encourage the adoption of livelihood‐enhancing climate risk adaptation strategies by fish farmers in the Niger Delta region and similar contexts.
‘Going institutional’ to overcome obstruction: Explaining the suppression of minority rights in Western European parliaments, 1945−2010
Authors: SIEBERER ULRICH , DUTKOWSKI JULIA F. , MEIßNER PETER , MÜLLER WOLFGANG C.
Published: December 2019

When and why do parliamentary majorities in Europe suppress parliamentary minority rights? This article argues that such reforms are driven by substantive policy conflict in interaction with existing minority rights. Government parties curb minority rights if they fear minority obstruction due to increased policy conflictanda minority‐friendly institutionalstatus quo. Empirical support is found for this claim using comparative data on all reforms in 13 Western European parliaments since 1945. A curbing of minority rights is significantly more likely under conditions of heightened policy conflict and these effects are stronger the more the institutionalstatus quofavours opposition parties. Contrary to frequent claims of consensual rule changes from single‐country studies in Europe, these findings demonstrate the importance of competitive strategies in explaining institutional reform in European parliaments. The conditional impact of thestatus quoprovides interesting theoretical links to historical institutionalist arguments on path dependence.
Accuracy of the Defining Characteristics of Fatigue in Patients with Heart Failure as Identified by the 6‐Minute Walking Test
Authors: Santos Vinicius Batista , Lopes Camila Takao , dos Anjos Lanay Dourado , Begot Isis , Cassiolatto Flavio , Guizilinni Solange , Moreira Rita Simone Lopes
Published: December 2019

PURPOSE

Identify the prevalence of the nursing diagnosis (ND) Fatigue in patients with heart failure (HF) and to analyze the accuracy of its defining characteristics (DCs).

METHODS

50 patients were assessed for Fatigue through a distance ambulated <300m during the Six‐Minute Walking Test (6MWT) and the report of insufficient energy. Sensitivity, specificity, positive and negative predictive values were calculated for the DCs associated with Fatigue.

FINDINGS

The prevalence of Fatigue was 48%. No DCs were sensitive and specific for determining Fatigue.

CONCLUSIONS

There were no DCs accurate enough to infer Fatigue.

IMPLICATIONS FOR PRACTICE

A distance ambulated <300m during the 6MWT should be included as a DC of Fatigue.
Phylogenetic analysis based on full genome sequencing of Italian tomato spotted wilt virus isolates identified in “Roggianese” sweet pepper and chilli pepper
Authors: Fontana Anna , Albanese Giuliana , Manglli Ariana , Tomassoli Laura , Tiberini Antonio
Published: December 2019

A study aimed at defining population structure of Italian tomato spotted wilt virus (TSWV) isolates was performed. Full genome sequencing of six TSWV isolates found in two Italian regions (two from Latium: Lazio 17 and Tarquinia; and four from Calabria: PepCal 10, 12, 22 and 24) were assembled. Identity percentages in nucleotide sequence among these TSWV isolates are here provided. The six full length genome sequences were compared with other two Italian isolates (p105 and p202/3WT) already fully sequenced, as well as full TSWV genomes that could be retrieved from GenBank. Phylogenetic analysis, performed in concatenated sequences and for each gene of each genome segment (L, M and S), confirmed the presence of two clades, namely A‐like and D‐like. In particular, the phylogenetic tree based on segment L grouped all the newly sequenced TSWV isolates in D‐like clade. In the M segment phylogenetic tree, all our TSWV isolates shifted in the A‐like clade. Isolates separation was not correlated to their geographical origin in phylogenetic study of distinct ORFs encoded by the RNA S segment. In fact, in nucleocapsid‐encoding phylogenetic tree, PepCal 10 and 22 grouped in an A‐like clade with p105, PepCal 12 and 24 in a D‐like clade with p202/3WT, whereas Lazio 17 and Tarquinia in a third well distinct group. NSs tree displayed only PepCal 10 with p105 in A‐like clade, whereas PepCal 12, 22, 24 with p202/3WT in D‐like subclade; and isolates from Latium grouped a separated clade adjacent to D‐like isolates. Additional analysis on putative reassortment events showed that TSWV Calabrian isolates likely originated from a reassortment event in M RNA and other in S RNA with p105 as major parent. Recombination events were detected in isolates from Latium in L and S RNAs with Chinese isolates as putative major parent.
The Resurgent Far Right and the Black Feminist Struggle for Social Democracy in Brazil
Authors: Perry Keisha‐Khan Y.
Published: December 2019

Black activists in Brazil have consistently reminded us that the violence of the military dictatorship (1964–1980) represented only one historical moment in the long history of white supremacist colonial violence and the legacy of slavery in the country. The resurgence of far‐right violence and politics in Brazil—specifically, the concerted attempt to repeal social gains for Blacks, women, and poor people—must be understood through this broad historical context of the ongoing enactment of white supremacy and must be read through an intersectional approach that reveals the vulnerabilities and exclusions that have further marginalized racialized and gendered populations, particularly Black women, from equal protection under laws and policies. [intersectionality, white supremacy, Black feminism, Brazil]
Vocal behavior of the Undulated Tinamou (Crypturellus undulatus) over an annual cycle in the Brazilian Pantanal: New ecological information
Authors: Pérez‐Granados Cristian , Schuchmann Karl‐L. , Marques Marinez I.
Published: December 2019

Tinamous (Tinamidae) are a group of Neotropical birds for which little information is available. The Undulated Tinamou (Crypturellus undulatus) is one of the most widespread species but also declining. Due to its secretive habits, ecological knowledge regarding the species relies on few anecdotal descriptions. We used automated recorders to monitor the vocal activity of the species over an annual cycle at four sites in the Brazilian Pantanal. We provide a description and analyze the diel and seasonal patterns of the calling activity in this species and provide new ecological information. The daily cycle showed two significant peaks in calling activity during the early morning and late afternoon, in agreement with the vocal behavior common among tinamous. The species was vocally active throughout the year, but it was significantly higher during September–October and March. This suggests that the breeding period of the Undulated Tinamou in the Brazilian Pantanal extends from September to April. After the months with highest calling activity, there was a strong decrease in activity, which might be related to the silent behavior of male tinamous during incubation. The seasonal pattern and breeding period identified for the Undulated Tinamou in the Brazilian Pantanal are in agreement with those observed in previous studies carried out with other Crypturellus species. The use of automated recorders was found to be a useful method for monitoring the calling activity of this secretive group of birds and might be useful in the assessment of future population trends in this and other declining tinamous.

Abstract in Portugese is available with online material.
Exploring vitamin D signalling within skin cancer
Authors: Vishlaghi Neda , Lisse Thomas S.
Published: December 2019

Sunlight exposure of the skin is associated with both risks and benefits. On one hand, sunlight ultraviolet (UV) radiation can cause skin cancer through signature DNA mutations. On the other hand, it can be absorbed in the skin by 7‐dehydrocholesterol to instigate endogenous synthesis of vitamin D to regulate anticancer effects. Thus, protecting one's skin from sunlight to avoid skin cancer may lead to impaired vitamin D levels arguing for sensible sun exposure practices. To limit cancer, vitamin D metabolites can promote uncharacterized and diverse sets of events such as repair responses to DNA damage, apoptosis of malignant cells, and suppression of immune surveillance, proliferation and angiogenesis. Recent findings also suggest that part of the anticancer effects of vitamin D within squamous cell carcinoma—a type of skin cancer most directly linked to sun exposure—involves the DDIT4‐mTOR catabolic signalling pathway to enhance cell autophagy. As mTOR activity and cellular metabolism are modulated as part of the DNA damage response, insights into the means by which mTOR can be controlled by vitamin D to suppress cancer is of molecular and clinical importance. Overall, the research so far suggests that presence of vitamin D through sunlight exposure and supplementation are beneficial for human health in the face of cancer.
Returning children home from care: What can be learned from local authority data?
Authors: Neil Elsbeth , Gitsels Lisanne , Thoburn June
Published: December 2019

International Human Rights and child rights conventions as well as U.K. wide legislation and guidance require that children in care should be returned home to one or both parents wherever possible. Reunification with parents is the most common route out of care, but rates of re‐entry are often higher than for other exit routes. This study used 8 years of administrative data (on 2,208 care entrants), collected by one large English local authority, to examine how many children were returned home and to explore factors associated with stable reunification (not re‐entering care for at least 2 years). One‐third of children (36%) had been reunified, with adolescent entrants being the most likely age group to return home. Three quarters (75%) of reunified children had a stable reunification. In a fully adjusted regression model, age at entry, being on a care order prior to return home, staying longer in care, being of minority ethnicity, and having fewer placements in care were all significant in predicting chances of stable reunification. The results underline the importance of properly resourcing reunification services. The methods demonstrate the value to local authorities of analysing their own data longitudinally to understand the care pathways for children they look after.
Museum Makers: Family Explorations of Data Science through Making and Exhibit design
Authors: Letourneau Susan M. , Liu ChangChia James , Donnelly Kaitlin , Meza Delia , Uzzo Stephen , Culp Katherine McMillan
Published: December 2019

Young children are capable of engaging in scientific and mathematical thinking, but often have few opportunities to use math as a tool for understanding the world. This article describes the development and implementation of a museum‐based after‐school workshop that introduced young children and their families to data science, an applied field that involves real‐world observations. Through three iterations of the workshop, the museum developed strategies for engaging families in interest‐driven cycles of data collection, organization, and interpretation. The workshop used design and making to motivate exploration of data and highlight the utility of mathematics for answering questions and guiding decisions. Children (ages 5–8) gathered data about museum exhibits (including size, features, visitors’ preferences, etc.) and applied what they learned to create models of their own exhibit ideas. We discuss the theoretical basis for the program, the process by which it was iteratively developed, and the final structure of the workshop activities and curriculum.
Selection of FCSRJ Best Papers, the Outstanding Paper, and the Emerging Scholar
Authors: DeVaney Sharon A.
Published: December 2019

Winners of the Best Papers published in FCSRJ during the previous year are honored at the annual conference of the American Association of Family and Consumer Sciences (AAFCS). Criteria for the Best Paper Award include originality of the topic, strength of the research methodology, and potential contribution to family and consumer sciences. There is a separate award that focuses on tenure‐track Assistant Professors; it is titled the Emerging Scholar Award. The presentation of awards for the Best Papers was established in 2009 by the previous Editor of the journal, and it has been continued each year.
How evolution shapes enzyme selectivity – lessons from aminoacyl‐tRNA synthetases and other amino acid utilizing enzymes
Authors: Tawfik Dan S. , Gruic‐Sovulj Ita
Published: December 2019

Aminoacyl‐tRNA synthetases (AARSs) charge tRNA with their cognate amino acids. Many other enzymes use amino acids as substrates, yet discrimination against noncognate amino acids that threaten the accuracy of protein translation is a hallmark of AARSs. Comparing AARSs to these other enzymes allowed us to recognize patterns in molecular recognition and strategies used by evolution for exercising selectivity. Overall, AARSs are 2–3 orders of magnitude more selective than most other amino acid utilizing enzymes. AARSs also reveal the physicochemical limits of molecular discrimination. For example, amino acids smaller by a single methyl moiety present a discrimination ceiling of ~200, while larger ones can be discriminated by up to 105‐fold. In contrast, substrates larger by a hydroxyl group challenge AARS selectivity, due to promiscuous H‐bonding with polar active site groups. This ‘hydroxyl paradox’ is resolved by editing. Indeed, when the physicochemical discrimination limits are reached, post‐transfer editing – hydrolysis of tRNAs charged with noncognate amino acids, evolved. The editing site often selectively recognizes the edited noncognate substrate using the very same feature that the synthetic site could not efficiently discriminate against. Finally, the comparison to other enzymes also reveals that the selectivity of AARSs is an explicitly evolved trait, showing some clear examples of how selection acted not only to optimize catalytic efficiency with the target substrate, but also to abolish activity with noncognate threat substrates (‘negative selection’).
Phylogeography of a salmonid fish, masu salmon Oncorhynchus masou subspecies‐complex, with disjunct distributions across the temperate northern Pacific
Authors: Yamamoto Shoichiro , Morita Kentaro , Kikko Takeshi , Kawamura Kouichi , Sato Shunpei , Gwo Jin‐Chywan
Published: December 2019

Climate oscillations during the Pleistocene had profound effects on the evolutionary history of freshwater fishes now distributed across northern temperate regions. The extent of continental glaciation on the western side of the North Pacific, including areas of East Asia, was more limited as compared with regions of North America, Europe and high‐latitude areas of the North Pacific. Therefore, the effects of climate oscillations might have influenced species in dissimilar ways depending on the species' distribution.

We used mitochondrial DNA (mtDNA) and microsatellite DNA (msDNA) markers to clarify the evolutionary history of masu salmon Oncorhynchus masou subspecies‐complex (family Salmonidae) distributed in historically non‐glaciated regions in the western North Pacific.

No marked regional or subspecies‐specific mtDNA haplotype associations were recognised, except for O. masou subsp., a lacustrine form endemic to Lake Biwa, an ancient lake in central Honshu. The landlocked subspecies O. masou formosanus, with a disjunct distribution on Taiwan Island, exhibited no diagnostic population features differing from the other subspecies, in either mtDNA or msDNA markers. Mismatch distribution and Bayesian skyline plot analyses indicated relatively recent range expansion and rapid population growth for masu salmon during the last glacial period (c. 0.1–0.15 Ma).

Contrary to the mtDNA genealogy, Bayesian clustering using msDNA showed two main genetic clusters, mainly northern populations of the subspecies O. m. masou and populations of the subspecies O. m. ishikawae in southern areas of the Japanese Archipelago. Notably, O. m. formosanus on Taiwan Island was included in the O. m. masou group, and O. masou subsp. was included in the O. m. ishikawae group.

Our results suggest that the masu salmon subspecies‐complex in historically non‐glaciated regions of the Temperate Northern Pacific is characterised by weak population structuring and shallow genetic differentiation among the subspecies, except for O. masou subsp. owing to its long isolation in Lake Biwa. Incomplete lineage sorting and historical inter‐subspecies hybridisation, possibly due to secondary contact, seem to be plausible explanations for discrepancies in the mitochondrial DNA genealogy and nuclear DNA genetic structure.
Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence‐Based Guideline
Authors: Evans Randolph W. , Burch Rebecca C. , Frishberg Benjamin M. , Marmura Michael J. , Mechtler Laszlo L. , Silberstein Stephen D. , Turner Dana P.
Published: December 2019

Objective

To provide updated evidence‐based recommendations about when to obtain neuroimaging in patients with migraine.

Methods

Articles were included in the systematic review if they studied adults 18 and over who were seeking outpatient treatment for any type of migraine and who underwent neuroimaging (MRI or CT). Medline, Web of Science, and Cochrane Clinical Trials were searched from 1973 to August 31, 2018. Reviewers identified studies, extracted data, and assessed the quality of the evidence in duplicate. We assessed study quality using the Newcastle‐Ottawa Scale.

Results

The initial search yielded 2269 publications. Twenty three articles met inclusion criteria and were included in the final review. The majority of studies were retrospective cohort or cross‐sectional studies. There were 4 prospective observational studies. Ten studies evaluated the utility of CT only, 9 MRI only, and 4 evaluated both. Common abnormalities included chronic ischemia or atrophy with CT and MRI scanning, and non‐specific white matter lesions with MRI. Clinically meaningful abnormalities requiring intervention were relatively rare. Clinically significant neuroimaging abnormalities in patients with headaches consistent with migraine without atypical features or red flags appeared no more common than in the general population.

Recommendations

There is no necessity to do neuroimaging in patients with headaches consistent with migraine who have a normal neurologic examination, and there are no atypical features or red flags present. Grade A Neuroimaging may be considered for presumed migraine for the following reasons: unusual, prolonged, or persistent aura; increasing frequency, severity, or change in clinical features, first or worst migraine, migraine with brainstem aura, migraine with confusion, migraine with motor manifestations (hemiplegic migraine), late‐life migraine accompaniments, aura without headache, side‐locked headache, and posttraumatic headache. Most of these are consensus based with little or no literature support. Grade C.
Immigration and Settler‐Colonies Post‐UNDRIP: Research and Policy Implications
Authors: Abu‐Laban Yasmeen
Published: December 2019

It is now common to identify a policy convergence around migration which is eroding the longstanding distinction made in the migration literature between “traditional” countries of immigration (like Canada, Australia, New Zealand and the United States) and other Western states. Taking the United Nations Declaration on the Rights of Indigenous Peoples as instructive, this article focusses on the case of Canada, arguing that its settler‐colonial foundation has impacted and continues to impact three areas relevant to the comparative study of migration: 1) national discourse; 2) land and forms of social power; and 3) politics and forms of solidarity. The implications of settler‐colonialism for the study of international migration are broader than the case of Canada and suggest the need to link considerations of Indigeneity systematically in migration studies, and to address the particularities of settler‐colonial states in relation to other Northern states by being attuned to “divergence within convergence.”
Nurses’ perceptions of and barriers to the optimal end‐of‐life care in hospitals: A cross‐sectional study
Authors: Chan Carmen W. H. , Chow Meyrick C. M. , Chan Sally , Sanson‐Fisher Robert , Waller Amy , Lai Theresa T. K. , Kwan Cecilia W. M.
Published: December 2019

Aims and objectives

To assess nurses’ perceptions of what constitutes optimal end‐of‐life (EOL) care in hospital and evaluate nurses’ perceived barriers to EOL care delivery.

Background

Care of dying patients is common in hospitals. However, little is known about the important elements of and barriers to optimal EOL care from key service providers’ perspective, which is crucial for quality EOL care in hospital settings.

Method

This is a cross‐sectional survey. Nurses practising in hospitals recruited by convenience sampling completed self‐report survey questionnaires. STROBE checklist was used in study reporting.

Results

One hundred and‐seventy‐five nurses participated in the survey. The majority (70%) had experience in caring for dying patients. The five most highly perceived factors constituting optimal EOL care included the following: “families know and follow patient's EOL wishes”; “patients emotional concerns identified and managed well”; “patients participating in decision‐making”; “EOL care documents stored well and easily accessed”; and “provide private rooms and unlimited visiting hours for families of dying patients”. Top five barriers were “doctors are too busy”; “nurses are too busy”; “insufficient private room/space”; “nurses have limited training in EOL care”; and “families have unrealistic expectations of patient's prognosis.” Multivariate regression analysis identified that nurses without experience in caring for dying patients reported a significantly higher number of perceived barriers towards EOL care (p = .012). Those with postgraduate degree training reported significantly fewer perceived barriers (p = .007).

Conclusion

Findings identified essential elements for optimal hospital EOL care not only involving patients and families in EOL decision and care, but also documentation and environmental issues in the healthcare system level and the needs for strengthening manpower and expertise at palliative care policy level.

Relevance to clinical practice

This study revealed quantitative data to inform health service managers and policy makers in terms of training and service development/ re‐design for EOL care in hospital settings.
Nursing home residents’ perspectives on their social relationships
Authors: Kang Bada , Scales Kezia , McConnell Eleanor S. , Song Yuting , Lepore Michael , Corazzini Kirsten
Published: December 2019

Aims and objectives

To explore nursing home residents’ perspectives on their relationships with other residents, family members and staff.

Background

The cultivation of social relationships is central to promoting well‐being in nursing homes, as these relationships allow residents, family members and staff to be valued as unique persons and empowered as partners in care. Few studies have examined how nursing home residents perceive the relationships in their social networks, both within and beyond the facility.

Design

Qualitative secondary analysis.

Methods

We analysed individual and group interviews obtained during “stakeholder engagement sessions” with cognitively intact residents (N = 11 sessions; N = 13 participants) from two nursing homes in North Carolina. The interviews were conducted as part of a larger study on person‐directed care planning. We integrated thematic and narrative analytic approaches to guide the analysis of interview data, using a three‐cycle coding approach. The COREQ checklist was followed.

Results

Four broad themes emerged from this analysis: (a) peer relationships foster a sense of belonging, purpose, achievement and significance; (b) residents’ relationships with family members support a sense of belonging, continuity and significance; (c) mutual respect and reciprocity between residents and nursing home staff promote a sense of belonging and significance; and (d) organisational factors pose barriers to forging meaningful relationships. Each type of relationship—peer, family and staff—made distinctive contributions residents’ psychosocial well‐being.

Conclusion

Recognising the diverse roles of different actors from residents’ social networks raises questions for future research to optimise the distinctive contributions of network members that promote residents’ psychosocial well‐being.

Relevance to clinical practice

This study highlights the need for nursing home staff to understand how residents’ social relationships influence residents’ psychosocial outcomes. Staff training programmes are needed to support residents’ rights and to dispel inaccurate interpretations of regulations that threaten sustained meaningful relationships.
Family INvolvement in inTensive care: A qualitative exploration of critically ill patients, their families and critical care nurses (INpuT study)
Authors: Kydonaki Kalliopi , Kean Susanne , Tocher Jennifer
Published: December 2019

Aims and objectives

To understand the different factors that impact on the involvement of adult family members in the care of critically ill patients from the perspective of patients, families and nurses, with the aim to inform the enactment of a patient‐ and family‐centred care intervention to support the patient–family–nurse partnership in care involvement.

Background

Existing evidence lacks theoretical underpinning and clarity to support enactment of patient‐ and family‐centred care and involvement of families in the care of the critically ill patient.

Design

Qualitative exploratory design using thematic analysis.

Methods

This study was conducted at two adult intensive care units in two tertiary university hospitals in the central belt of Scotland. Between 2013–2014, we conducted semi‐structured interviews with critically ill survivors (n = 19) and adult family members (n = 21), and five focus groups with nurses (n = 15) across both settings. Data were digitally recorded, transcribed verbatim, and uploaded in NVivo 10. Data were analysed thematically using a constructivist epistemology. Ethical approval was obtained prior to data collection. Data are reported according to the Consolidated Criteria for Reporting Qualitative Research checklist.

Results

Family's situational awareness; the perceived self in care partnership; rapport and trust; and personal and family attributes were the main factors that affected family involvement in care. Two key themes were identified as principles to enact patient‐ and family‐centred care in adult intensive care units: “Need for ‘Doing family’” and “Negotiations in care involvement.”

Conclusions

Negotiating involvement in care requires consideration of patients' and family members' values of doing family and the development of a constructive patient–family–nurses' partnership.

Relevance to clinical practice

Future policy and research should consider patients' and family's needs to demonstrate family bonds within a negotiated process in care participation, when developing tools and frameworks to promote patient‐ and family‐centred care in adult intensive care units.
To What Extent Are Multiword Sequences Associated With Oral Fluency?
Authors: Tavakoli Parvaneh , Uchihara Takumi
Published: December 2019

This study examined the relationship between oral fluency and use of multiword sequences (MWSs) across four proficiency levels (Low B1 to C1 of the Common European Framework of Reference). Data came from 56 learners taking the speaking test of the Test of English for Educational Purposes, and our analysis obtained different measures of fluency (speed, breakdown, repair) and MWSs (frequency, proportion, association). Results showed that (a) high‐frequency n‐grams correlated positively with articulation rate; (b) n‐gram proportion correlated negatively with frequency of mid‐clause pauses; and (c) n‐gram association strength correlated positively with frequency of end‐clause pauses and negatively with repair frequency. Qualitative analysis suggested that the test‐takers borrowed some task‐specific n‐grams from the task instructions and used them frequently in their performance. Whereas lower proficiency speakers used these n‐grams verbatim, C1 level speakers used them competently in a variety of forms. We discuss significant implications of the findings for phraseology and language testing research.
Negotiating the Multilingual Turn in SLA: Response to Stephen May
Authors: MENDOZA ANNA
Published: December 2019

In volume 103 of Modern Language Journal, Stephen May suggested that the multilingual turn has not fully delivered on its promises, pointing out second language acquisition (SLA) researchers’ continued focus on parallel monolingualisms rather than on dynamic bi/multilingualism, the lack of theorization of historicity in sociolinguistic research on the latter, the balkanization of academic knowledge preventing transdisciplinary scholarship, and West‐centered methodological nationalism. While I agree with his points, I believe the solution requires more than critical reflexivity, reading beyond our areas of interest, and relinquishing fast‐held methodological principles. Scholarly hegemony and disciplinary elitism exist because we are more than minds touting theories and epistemologies. We must acknowledge how we, as researchers, seek cultural prestige and economic well‐being by affiliating with the global North and its mechanisms for knowledge production. Given this, I discuss what scholars in both the global North and South can do to reform the discipline to address May's concerns, in terms of 1 action those in the global South must consistently attempt, and 4 responsibilities of those in the global North.
Current and emerging therapies for managing hyperphagia and obesity in Prader‐Willi syndrome: A narrative review
Authors: Tan Qiming , Orsso Camila E. , Deehan Edward C. , Triador Lucila , Field Catherine J. , Tun Hein Min , Han Joan C. , Müller Timo D. , Haqq Andrea M.
Published: December 2019

In early childhood, individuals with Prader‐Willi syndrome (PWS) experience excess weight gain and severe hyperphagia with food compulsivity, which often leads to early onset morbid obesity. Effective treatments for appetite suppression and weight control are currently unavailable for PWS. Our aim to further understand the pathogenesis of PWS led us to carry out a comprehensive search of the current and emerging therapies for managing hyperphagia and extreme weight gain in PWS. A literature search was performed using PubMed and the following keywords: “PWS” AND “therapy” OR “[drug name]”; reference lists, pharmaceutical websites, and the ClinicalTrials.gov registry were also reviewed. Articles presenting data from current standard treatments in PWS and also clinical trials of pharmacological agents in the pipeline were selected. Current standard treatments include dietary restriction/modifications, exercise, and growth hormone replacement, which appear to have limited efficacy for appetite and weight control in patients with PWS. The long‐term safety and effectiveness of bariatric surgery in PWS remains unknown. However, many promising pharmacotherapies are in development and, if approved, will bring much needed choices into the PWS pharmacological armamentarium. With the progress that is currently being made in our understanding of PWS, an effective treatment may not be far off.
Reducing postoperative pain in children undergoing strabismus surgery: From bundle implementation to clinical decision support tools
Authors: Ali Usman , Tsang Maisie , Campbell Fiona , Matava Clyde , Igbeyi Brenda , Balakrishnan Sindu , Shackell Kelly , Kotzer Gloria , Mc Donnell Conor
Published: December 2019

Background

Postoperative pain is a significant cause of morbidity in pediatric anesthesia, which can result in delayed discharge and unplanned hospital admission. Children undergoing strabismus surgery are known to be a particularly high‐risk group for postoperative pain.

Aim

The aim of this project was to reduce the incidence of moderate to severe postoperative pain by 25% over a period of 12 months in children undergoing strabismus surgery.

Methods

This was a multidisciplinary quality improvement project using the Institute for Healthcare Improvement model for improvement and iterative Plan‐Do‐Study‐Act cycles. Baseline data from one hundred patients were collected retrospectively from patient records. Subsequently, iterative interventions introduced comprised: a perioperative bundle (comprising preoperative acetaminophen, intraoperative dexamethasone and ketorolac, a long‐acting opioid, and two anti‐emetics), email reminders, dissemination of results at departmental rounds, and an intraoperative clinical decision aide. Postoperative pain data were collected as an outcome measure, and length of stay in PACU was monitored as a balancing measure. Statistical process control charts were constructed to monitor bundle compliance and incidence of postoperative pain in the postanesthesia care unit.

Results

Postoperative pain and bundle compliance data were collected for 1127 children in total. Baseline mean monthly incidence of moderate to severe postoperative pain was 47.3%. By the conclusion of this project, the incidence of postoperative pain decreased to 21%. Concurrently, mean bundle compliance increased to 78.7%. Mean length of PACU stay for baseline audit patients was 72.5 min compared with 70 min for patients after the introduction of the strabismus macro (November 2018‐April 2019, n 91) (mean difference, 2.5; 95% CI, −3.86 to 8.86; P = .439).

Conclusion

Through the implementation and adoption of an evidence‐based bundle of care, we successfully decreased the incidence of moderate to severe postoperative pain for children undergoing strabismus repair. We demonstrated that combining nudge theory with QI methodology can be an effective means of delivering positive results in quality improvement projects.
Pediatric waitlist and heart transplant outcomes in patients with syndromic anomalies
Authors: Wilkens Sarah J. , Priest James , Kaufman Beth D. , Barkoff Lynsey , Rosenthal David N. , Hollander Seth A.
Published: December 2019

Purpose

We sought to determine whether the presence of a systemic SA with potential complicating factors affects waitlist and post–HT outcomes in pediatric patients.

Methods

This is a single‐center retrospective review of pediatric patients listed for HT between January 1, 2009, and July 1, 2018. Patients were selected based on the presence of any underlying syndromes, which included chromosomal anomalies, skeletal myopathies, connective tissue disorders, mitochondrial disease,and other systemic disorders. Waitlist and post–HT outcomes were compared to those without SA.

Results

A total of 243 patients were listed for HT, of which 21 (9%) patients had associated SA. Of those, 16 (76%) survived to transplant, 3 (14%) died while on the waitlist, 1 (5%) improved and was removed from the waitlist, and 1 (5%) patient is currently listed. Waitlist survival was not different between those with/without an associated syndrome (P = 1.0). Among those who survived to HT, there was no difference in listing days (70 vs 90, P = .8), survival to hospital discharge [14 (93%) vs 150 (95%), P = .6], post‐HT intubation days (2 vs 2 days, P = .6), or post‐HT hospital length of stay (18 vs 18 days, P = .8). Overall survival during the study period post‐HT was not different between groups (P = .8).

Conclusion

A SA was present in 9% of pediatric patients wait‐listed for HT, but was not associated with an increased waitlist mortality or post‐HT hospital morbidity or long‐term survival. For several anomalies, HT is safe and feasible.
Understanding Motivations of Mega‐Gift Donors to Higher Education: A Qualitative Study
Authors: Worth Michael J. , Pandey Sheela , Pandey Sanjay K. , Qadummi Suhail
Published: December 2019

Patterns of giving to higher education by individual donors have changed in recent years, with large gifts accounting for an increasing percentage of the total. In light of this shift, understanding the motivations of donors who make very large gifts, commonly known as “mega‐gifts,” has become important. Efforts to explore these motivations run into access barriers. This article uses an innovative methodological approach to overcome this challenge. Drawing on the media coverage of mega‐gifts, the authors create donor biographies and carry out qualitative analysis of these donor biographies to examine donor motivations and evolution in motivations. The article draws on the existing literature to synthesize a typology of donor motivations and uses this typology to categorize the motivations of mega‐gift donors. The identification of additional subcategories under the broad category of impact is a significant contribution of this study and adds nuance to our understanding of mega‐gift donors to higher education institutions.
Successional dynamics of soil fungal diversity along a restoration chronosequence post‐coal mining
Authors: Ngugi Michael R. , Fechner Nigel , Neldner Victor J. , Dennis Paul G.
Published: December 2019

Soil disruption from open‐cut mining practices can adversely impact microbial communities and the ecosystem services that they mediate. Despite this, assessment of impacts of soil disruption, and the subsequent recovery of microbial communities is rarely studied. Monitoring of ecological restoration success on mine sites has traditionally focused on vegetation; however, most plants rely, at least in part, on associations with soil fungi for enhanced nutrient and water acquisition. Here, we used high‐throughput phylogenetic marker gene sequencing to characterize the diversity of soil fungal communities along a restoration chronosequence ranging from 3 to 23 years at a rehabilitated mine site. We used nonmined analogue sites as a baseline for comparative purposes and examined the associations of soil fungal communities with soil physicochemical and aboveground vegetation variables. Fungal richness on rehabilitated sites was significantly larger than on nonmined sites, suggesting that mixing of topsoil during stockpiling resulted in a composite microbial community. Fungal community composition was significantly influenced by edaphic variables and the length of rehabilitation, with mined sites becoming more similar to nonmined sites over time. Fungal populations associated with ectomycorrhizae were relatively more abundant than those associated with arbuscular mycorrhizae and declined in response to disturbance, but recovered over time on the woody dominated sites indicating a strong coupling of these fungi with aboveground vegetation. Our data indicate that soil fungal diversity is a useful bioindicator of soil restoration in mined sites and may complement more traditional vegetation‐based surveys.
Rerandomization and Regression Adjustment
Authors: Li Xinran , Ding Peng
Published: December 2019

Randomization is a basis for the statistical inference of treatment effects without strong assumptions on the outcome-generating process. Appropriately using covariates further yields more precise estimators in randomized experiments. R. A. Fisher suggested blocking on discrete covariates in the design stage or conducting analysis of covariance in the analysis stage. We can embed blocking in a wider class of experimental design called rerandomization, and extend the classical analysis of covariance to more general regression adjustment. Rerandomization trumps complete randomization in the design stage, and regression adjustment trumps the simple difference-in-means estimator in the analysis stage. It is then intuitive to use both rerandomization and regression adjustment. Under the randomization inference framework, we establish a unified theory allowing the designer and analyser to have access to different sets of covariates. We find that asymptotically, for any given estimator with or without regression adjustment, rerandomization never hurts either the sampling precision or the estimated precision, and, for any given design with or without rerandomization, our regression-adjusted estimator never hurts the estimated precision. Therefore, combining rerandomization and regression adjustment yields better coverage properties and thus improves statistical inference. To quantify these statements theoretically, we discuss optimal regression-adjusted estimators in terms of the sampling precision and the estimated precision, and then measure the additional gains of the designer and the analyser. We finally suggest the use of rerandomization in the design and regression adjustment in the analysis followed by the Huber–White robust standard error.
Technical Development of the Sutureless ELANA Clip Anastomosis Device
Authors: de Boer B. , van Doormaal T. P. C. , van Thoor S. , Gortzak K. , van der Zwan A.
Published: December 2019

A cranial bypass can be a last resort procedure for patients suffering from complex neurovascular pathology. Since the clinically proven excimer laser-assisted nonocclusive anastomosis (ELANA) technique has become available, it is no longer necessary to temporarily close the recipient artery to facilitate an anastomosis. Aiming to simplify and shorten the operation time of the ELANA technique, a sutureless ELANA, the so-called SELANA slide (SEsl) was developed, but it failed during clinical study. We developed an improved device, the SELANA clip (SEcl).We describe the SEcl design and the first in vitro test results. The SEsl design was optimized with a clip at the backside, creating the SEcl which facilitates smooth and friction-free insertion in the recipient artery. Subsequently, the laser catheter was optimized by adding a grid and conus to provide an improved vacuum and flat reaction surface during lasing. We aimed to compare the SEcl to the current ELANA regarding application time difference, anastomosis success (“flap retrieval”) and technical difficulties. Hereto 32 ELANA and 32 SEcl anastomoses were performed on pressurized rabbit arteries in the ELANA practice system. Mean application time difference was 14.0 min (95%CI 13.0–15.0). The flap retrieval rate of the ELANA anastomoses was 94% (30/32) and 100% (32/32) for the SEcl technique. During the experiments no technical difficulties were encountered. The SEcl is technical feasible with promising simplicity and application times. However, extensive in vivo short-term and long-term experiments are indispensable before clinical application.
A Method to Analyze Plantar Stiffness Variation in Diabetes Using Myotonometric Measurements
Authors: Banerjee Shib Sundar , Sreeramgiri Lakshmi Lasya , Hariram Seetharam , Ananthan Srivatsa , Swaminathan Ramakrishnan
Published: December 2019

Diabetes mellitus is a group of metabolic disease, which has become globally prevalent, and affects a large population in socio-economically backward countries in Asian continent. Chronic diabetes can lead to ulceration in the plantar region and may result in amputation. Assessment of mechanical properties of plantar tissues can aid in early diagnosis of ulceration. Myotonometry, a technique to measure dynamic stiffness, is preferred due to its noninvasiveness, easy employability, and rapid investigation. In this study, an attempt has been made to analyze the changes in biomechanical properties of plantar soft tissue in diabetes. MyotonPro, a handheld device, is used for this purpose. 43 diabetic subjects with varied duration of diabetes are recruited. Site-specific mechanical properties of the plantar region for both the feet are acquired and statistical analysis is performed. Results show that the MyotonPro is able to differentiate the stages of diabetes. It is seen that there is a spatial variability in the mechanical properties of the plantar. Additionally, it is observed that there is a significant increment in the plantar stiffness value in the group with higher diabetic age (p < 0.05). Further, significant changes in dynamic mechanical properties are also observed in submetatarsal region. Additionally, a right–left asymmetry has been observed in frequency and stiffness values for later stages of diabetes. This study demonstrated the feasibility of MyotonPro in discriminating the stages of diabetic period. Thus, the proposed approach could be useful in early diagnosis of foot ulceration for various clinical conditions.