bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychedelics as potential catalysts of scientific creativity and insight
Authors: Gandy Sam , Bonnelle Valérie , Jacobs Edward , Luke David
Published: May 2022

Creativity, that is the creation of ideas or objects considered both novel and valuable, is among the most important and highly valued of human traits, and a fundamental aspect of the sciences. Dreams and hypnagogic states have been highly influential in promoting scientific creativity and insight, contributing to some important scientific breakthroughs. Phenomenologically, the latter states of consciousness share a great deal of overlap with the psychedelic state, which has also been associated with facilitating scientific creativity on occasion. The current article proposes that the dream, hypnagogic and psychedelic states share common features that make them conducive to supporting some aspects of scientific creativity and examines the putative underlying neurophenomenological and cognitive processes involved. In addition, some notable occurrences of scientific insights that have emerged from these types of altered states are reviewed and shared common features are presented, providing a ground for future research. The psychedelic state may have its own characteristic features making it amenable to creativity enhancement, such as brain hyperconnectivity, meta-cognitive awareness, access to a more dependable and sustained altered state experience, and potential for eliciting sustained shifts in trait openness. The contextual factors which may contribute to enhancement of scientific creativity and insight will be evaluated. While research in this area is limited, further work to elucidate how psychedelics may best contribute to scientific creativity enhancement is warranted.
Are neutrophil–lymphocyte and platelet–lymphocyte ratios useful for determining active phase of Peyronie’s disease?
Authors: Greenberg Jacob W , Kim Joseph , Pincus Joshua , Sandberg Maxwell L , Dick Brian , Greenberg Rachel M , Raheem Omer , Hellstrom Wayne JG
Published: May 2022

Background:

Management options for Peyronie’s disease (PD) are determined by the phase of the condition. Experts counsel against surgical intervention during the active phase of PD. Patients with chronic phase of PD are offered either collagenase injections or surgical intervention. Accurately characterising a patient’s phase of PD is crucial in determining the appropriate treatment option.

Objective:

To investigate neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as possible predictors for the determination of acute or chronic phase of PD.

Methods:

This study retrospectively queried all patients who presented for initial diagnosis of PD from 2016 to 2020 and had complete blood count (CBC) laboratory values before initial therapy. PD phase was defined per the American Urological Association guidelines. The active phase of PD was defined as a changing penile curvature and/or growing palpable plaque. The chronic phase of PD was defined as a stabilised penile curvature. All statistical analyses were two-tailed, using a significance level of 0.05.

Results:

One hundred nine patients met inclusion: 27 (25%) active phase and 82 (75%) chronic phase patients. Demographic and erectile characteristics were not statistically different between the two groups. NLR and PLR values between active and chronic phase patients were comparable ( p > 0.05). A linear regression evaluated correlations between the duration of PD and either NLR or PLR. Neither NLR nor PLR was correlated with PD duration on Spearman, Pearson, or Kandall tests. In addition, NLR and PLR were not noted to be predictors of PD phase on multiple logistic regression. Finally, a receiver operator characteristic curve was generated. NLR and PLR yielded an area under curve of 58% and 57.8%, respectively.

Conclusions:

Two recent studies suggested NLR and PLR could be used to predict the phases of PD. However, after evaluating a cohort of 109 men from our institution, our data do not support the use of peripheral blood PLR or NLR to determine the phase of PD.
Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study
Authors: Cotton Erin , Geraghty Robert , Umranikar Sameer , Saeed Kordo , Somani Bhaskar
Published: May 2022

Objective:

Asymptomatic bacteriuria (ASB) during pregnancy is a risk factor for development of urinary tract infections and pyelonephritis, which can lead to maternal and foetal consequences. This study aimed to determine the prevalence of ASB during pregnancy, the most common causative pathogens and their resistance patterns.

Methods:

A retrospective analysis was performed using microbiology laboratory data from urine sample cultures from pregnant women collected at our University hospital over a 6-year period (2014–2019). Identification and susceptibility testing were performed using standard microbiology procedures based on British Society of Antimicrobial Chemotherapy and European Committee on Antimicrobial Susceptibility Testing.

Results:

From a total of 18,938 urine samples, 1522 (8.04%) were positive for bacteriuria, the most common isolates were Escherichia coli and Coliform (lactose fermenters) ( n = 1171, 76.9%), followed by Enterococcus faecalis and other enterococci ( n = 191, 12.5%). In 2019, the resistance of E. coli was 56.8%, 25.3% and 4.7% to amoxicillin, trimethoprim and gentamicin, respectively, with an increasing pattern of resistance to trimethoprim and gentamicin from 2014 to 2019. The resistance rates to nitrofurantoin were 1% and 5.5% for E. coli and Group B Streptococcus, respectively.

Conclusion:

Our study shows the trends of antimicrobial resistance in this vulnerable group and will help confirm treatment effectiveness and direct guideline recommendations locally and internationally.

Level of Evidence:

2b
Energy transitions in the shadow of a dictator: Decarbonizing neoliberalism and lithium extraction in Chile
Authors: Kingsbury Donald V
Published: May 2022

The global economy’s neoliberal era began in 1973 with a military coup in Chile lead by General Augusto Pinochet. Though the country returned to civilian rule in 1990, the dictatorship continues to determine much of Chile’s political economy, especially in extractive sectors, a legacy that also carries consequences for decarbonization in the 21st century. As the latest stage of globalization, contemporary energy transitions offer an opportunity to examine the kind of global and local extractivisms established in the context of the dictatorship in Chile – an order that also accelerated the environmental impacts of the Anthropocene. Just as the Anthropocene is less a geological age defined by human activity as much as the compounding consequences of a relatively small segment of humanity, so too is neoliberalism traceable to specific people, histories, and institutions. This article traces these elements as Chile rewrites Pinochet’s constitution to highlight hopes and challenges of energy transitions as political, social, and ecological processes.
Deprescribing Opportunities for Hospitalized Patients With End-Stage Kidney Disease on Hemodialysis: A Secondary Analysis of the MedSafer Cluster Randomized Controlled Trial
Authors: Moryousef Joseph , Bortolussi-Courval Émilie , Podymow Tiina , Lee Todd C. , Trinh Emilie , McDonald Emily G.
Published: May 2022

Background:

End-stage kidney disease patients on dialysis have a substantial risk of polypharmacy due their propensity for comorbidity and contact with the health care system. MedSafer is an electronic decision support tool that integrates patient comorbidity and medication lists to generate personalized deprescribing reports focused on identifying potentially inappropriate medications (PIMs).

Objective:

To conduct a secondary analysis of patients on regular hemodialysis included in the MedSafer randomized controlled trial to investigate the patterns of polypharmacy and evaluate the efficacy of the MedSafer deprescribing algorithms.

Design:

Secondary analysis of a cluster randomized clinical trial.

Setting:

Medical units in 11 acute care hospitals in Canada.

Patients:

The MedSafer trial enrolled 5698 participants with an expected prognosis of >3 months, age 65 years and older, and on 5 or more daily home medications; 140 participants were receiving chronic hemodialysis.

Measurements:

The primary outcome of the trial was 30-day adverse drug events (ADEs) post-hospital discharge, and a key secondary outcome was deprescribing.

Methods:

Control patients received usual care (medication reconciliation), whereas clinicians caring for intervention patients received a MedSafer report that highlighted individualized opportunities for deprescribing.

Results:

There were 70 patients in each of the control and intervention arms. The median number of home medications was 14 (compared with a median of 10 medications in the general trial population). The most frequent medications observed that were potentially inappropriate were proton pump inhibitors (potentially inappropriate in 55/76 users; 72.4%), diabetes medications in patients with a HBA1C <7.5% (36/65 users; 55.4%), docusate (27/27 users; 100%), gabapentinoids (27/36 users; 75%), and combination antiplatelet/anticoagulants (22/97 users; 22.7%). The proportion of PIMs deprescribed was higher during the intervention phase (28.8% vs 19.3%; absolute increase 9.4% [95% confidence interval 1.3%-17.6%]) compared with the control phase. There was no observed difference in ADEs at 30-day post-discharge between the control and the intervention groups. The most common ADE (n = 3) was gastrointestinal bleeding attributed to antiplatelet agents.

Limitations:

This was a post hoc exploratory analysis, the original trial did not stratify by hemodialysis status, and the small sample size precludes drawing any definitive conclusions.

Conclusion:

MedSafer facilitates deprescribing in hospitalized patients on hemodialysis. Larger-scale implementation of decision support software for deprescribing in dialysis and long-term follow-up are likely required to demonstrate an impact on ADEs.
Early development of a novel scale to measure adaptation in people diagnosed with inflammatory bowel disease - the A-inflammatory bowel disease
Authors: Matini Lawrence , Ogden Jane
Published: May 2022

Objective

To undergo the preliminary development of a new measure of patient adaptation to Inflammatory Bowel Disease (IBD): A-IBD.

Design

Based on a prior conceptualisation of adaptation, a 40-item scale was generated and completed by 304 people diagnosed with IBD.

Main outcome measures

Psychometric analysis of the measure. Association with the Brief Illness Perception Questionnaire (Brief IPQ) and the Inflammatory Bowel Disease Questionnaire (IBDQ).

Results

The 18-item scale consisted of four subscales (patient identity, person identity, acceptance, expectations). Weak to moderate correlations were found between subscales of the A-IBD and the Brief IPQ and IBDQ.

Conclusion

The A-IBD shows potential for assessing adaptation. Further analysis could confirm its usefulness.
Association between online health information-seeking and medication adherence: A systematic review and meta-analysis
Authors: Lim Hooi Min , Dunn Adam G , Lim Jing Ran , Abdullah Adina , Ng Chirk Jenn
Published: May 2022

Background

The evidence of the impact of online health information-seeking (OHIS) on health outcomes has been conflicting. OHIS is increasingly recognised as a factor influencing health behaviour but the impact of OHIS on medication adherence remains unclear.

Objectives

We conducted a systematic review and meta-analysis to examine the associations between OHIS and medication adherence.

Methods

We searched Medline, Embase, Web of Science, Scopus, CINAHL and Psychology and Behavioural Science Collection for studies published up to December 2020. The inclusion criteria were studies that reported the associations of OHIS and medication adherence, quantitative design, reported primary data only, related to any health condition where medications are used and conducted on patients either in clinical or community settings. A meta-analysis was used to examine the association between OHIS and medication adherence.

Results

A total of 17 studies involving 24,890 patients were included in this review. The study designs and results were mixed. In the meta-analysis, there was no significant association (n = 7, OR 1.356, 95% CI 0.793-2.322, p = 0.265), or correlation (n = 4, r = -0.085, 95% CI −0.572-0.446, p = 0.768) between OHIS and medication adherence. In the sub-group analysis of people living with HIV/AIDS, OHIS was associated with better medication adherence (OR 1.612, 95% CI 1.266-2.054, p < 0.001).

Conclusions

The current evidence of an association between OHIS and medication adherence is inconclusive. This review highlights methodological issues on how to measure OHIS objectively and calls for in-depth exploration of how OHIS affects health decisions and behaviour.
Teaching ascesis: Recovering the neglected center of early Christian pedagogy
Authors: Hughes Kyle R
Published: May 2022

This article aims to recover the foundational importance of training in ascesis for Christian education. For early Christian pedagogues such as Basil of Caesarea and John Chrysostom, education was seen not so much as the transmission of information as it was an invitation to a life of virtue and faith; to this end they especially encouraged teaching that would promote an ascetical lifestyle and therefore greater communion with God. By examining two key patristic texts connecting pedagogy and asceticism, this article outlines an approach that can enable modern Christian teachers to engage their students with ascetical practices that will contribute to their spiritual formation and counter-cultural witness.
Improving Consumer Experiences in Permanent Supportive Housing Co-Located With Health Centers: A Case Study From the Department of Veterans Affairs
Authors: Jacobs Zachary M. , Reddy Anjani T. , Weinreich Heidi M. , Nazinyan Mariam , Pila Jose M. , Gabrielian Sonya
Published: May 2022

Background:

Permanent Supportive Housing (PSH), which provides subsidies for independent housing and supportive services, is an evidence-based practice that improves health and housing for homeless experienced persons. Though most PSH is scattered-site, that is, housing dispersed throughout the mainstream rental market, project-based PSH offers housing and supportive services in dedicated facilities with on-site services. In 2013, the Veterans Health Administration (VA) at Greater Los Angeles opened a novel project-based PSH program located on a VA campus. To inform plans to expand project-based PSH at this VA, we examined participants’ experiences in this program. We aimed to identify participant characteristics that suggested they were well suited for the planned PSH expansion; to characterize services that participants found valuable in this setting; and to highlight gaps between participants’ needs and PSH services provided.

Methods:

We performed semi-structured interviews with a convenience sample (n = 24) of participants who had engaged in this project-based PSH program. Interviews asked why participants selected housing on a VA campus and explored valued program characteristics, designs, and services. Using rapid analysis methods, we generated templated summaries of each participant’s responses across the domains of our interview guide, then used matrix analyses to identify salient themes across the interviews.

Key Findings:

Participants appreciated the ease of access to medical and mental health services; however, as services were assumed to be optimized by virtue of co-location with VA healthcare, their PSH providers often did not link them with non-VA social services as assertively as desired. Many participants raised concerns about building safety and on-site substance use. A lack of participant engagement in program oversight, often leading to conflicts with staff and building management, was also highlighted in our interviews.

Discussion:

Given the value placed on ease of access to healthcare, these data suggest the value of this PSH model for persons with healthcare vulnerabilities. Specific recommendations for the planned PSH expansion include: (1) continuation of proximate, open-access healthcare; (2) clear tenant policies; (3) tenant councils for each development; (4) staff knowledgeable of non-VA resources and social services; (5) Veteran-preferred hiring practices by Property/Service management; (6) gender-specific accommodations; and (7) robust 24/7 security on-site.
The Racialized Consequences of Jail Incarceration on Local Labor Markets
Authors: Thomas Christopher
Published: May 2022

As a racialized labor market institution, the criminal justice system shapes racial patterns in local labor markets through processes of exclusion and marginalization. How do local county jails contribute to these dynamics? To examine that question, the relationship between county-level jail and employment rates is examined across the U.S. between 2007 and 2017. The study uses a System Generalized Method of Moments (GMM) dynamic panel model approach that structurally controls for simultaneous determination and other sources of endogeneity. A racial stratification analysis identifies a negative relationship between jail and employment in the urban counties with the highest percentage of Black residents aged 15 to 64, whereas areas with the lowest percentage of Black residents have a positive relationship between jail and employment. These racially differential spillover effects suggest that the impact of jail incarceration on employment is significantly racialized at this level of analysis.
Performing Anti-racism: Universities Respond to Anti-Black Violence
Authors: Casellas Connors Ishara , McCoy Henrika
Published: May 2022

Higher education institutions (HEI) are communities nestled within and a part of the local, regional, and national contexts. Increasingly, college and university presidents have begun to comment on local and national events, particularly as these events make their way onto campuses. This study examines 99 presidential statements from both public and private institutions, disseminated in the week following the 2020 murder of George Floyd. Using critical race discourse analysis (CRDA), the findings consider how institutional discourse constructs a history of advancing racial equity, leverages institutional mission and values, includes institutional and personal calls to action, and the intersecting use and exclusion of explicitly racialized discourse. Despite institutions discussing race and racism, they frequently construct these topics and their attendant needs as external to the institutions. These findings expand the exploration into institutional discourse in response to racialized incidents on campus and beyond. How institutions use these opportunities to move beyond performative rhetoric towards action and institutional change represents a significant opportunity to transform colleges and universities in ways that support racially minoritized communities both on and off-campus.
Research on the Influence of Mixed-Ownership Reform on Exploratory Innovation of SOEs: The Mediation Effect of Agency Conflict and Financing Constraint
Authors: Yuan Runsen , Li Chunling , Cao Xinjie , Li Nian , Khaliq Nosherwan
Published: May 2022

State-owned enterprises (SOEs) are the leading force in the national economy. The main goal of mixed-ownership reform is to enhance the SOEs’ independent innovation capability, thereby bringing high-quality development of the national economy. Based on the baseline regression and mediation effect model, this study explores the impact of mixed-ownership reform on exploratory innovation of SOEs from ownership structure adjustment and control rights allocation. The results show that the diversity of mixed shareholders, the depth of mixed equity, and the control of mixed equity significantly increase the SOEs’ exploratory innovation investment. And the shareholding ratio of heterogeneous shareholders has a differentiated influence on exploratory innovation. The mediation effect test indicates that the promotion effect of mixed-ownership reform of SOEs in the ownership structure dimension is achieved by reducing the second-type agency conflict and easing the financing constraints. In contrast, the promotion effect in the control rights allocation dimension is achieved by lowering the first-type agency conflict. The findings demonstrate that the mixed-ownership reform have positive effect on the SOEs’ exploratory innovation investment, and the different dimensions of mixed-ownership reform have disparate function routes to exploratory innovation. This study provides guidance for SOEs on how drive national innovation development through mixed-ownership reform. SOEs should guarantee the rights of non-state-owned capital to hold shares and appoint directors, improve internal governance mechanisms, so as to accelerate the development of exploratory innovation activities.
A Study on How Psychological Capital, Social Capital, Workplace Wellbeing, and Employee Engagement Relate to Task Performance
Authors: Al Kahtani Nasser Saad , M. M. Sulphey
Published: May 2022

The current study was conducted to examine the relationship between Psychological capital (PsyCap), Social capital, Workplace wellbeing, and Employee engagement in Saudi Arabia. Only limited evidence exists about the relationship between the constructs in Saudi Arabia. Data was collected from 395 gainfully employed Saudi samples, using five standardized and validated questionnaires. The data was analyzed using Exploratory and Confirmatory Factor Analysis and Structural Equation Modeling (SEM). SEM was conducted using the R Program. The results indicate a significant positive relationship between PsyCap, workplace wellbeing, and employee engagement with task performance. No significant relationship was found between social capital and workplace wellbeing. By addressing a previously unexplored area, the present study has provided substantial contribution to the literature
Novel 3D Contextual Interactive Games on a Gamified Virtual Environment Support Cultural Learning Through Collaboration Among Intercultural Students
Authors: Zhang Bo , Goodman Lizbeth , Gu Xiaoqing
Published: May 2022

This study aims to help international students learn the language and cultural knowledge of their future study destination by collaborating with local students through coplaying games in online virtual rooms. Therefore, this study explores whether the 3D interactive game with specific contexts on a virtual platform can support intercultural collaboration and improve the students’ language and cultural learning. This study created novel 3D contextual interactive games (3DCIGs) in a gamified virtual environment (GVE), established on a unique virtual platform named Terf®. Terf® enables the observing and recording of data related to the conversations and behaviors of users. To investigate the effects of 3DCIGs on students, a focus group consisting of newly arrived Chinese students and Irish students from an Irish university participated in this study. The study adopted mixed methods of qualitative and quantitative analysis to examine whether 3DCIGs effectively motivate the collaborative learning of intercultural students compared with text-based assignments set in the Game Play Rooms. The findings reveal that the novel 3DCIGs developed in this study have a positive potential to motivate intercultural students to engage in team collaboration and help their cultural and language knowledge exchange.
The Experience of Applying a Narrative Research Approach With Female Entrepreneurs in Sri Lanka
Authors: Surangi H. A. K. N. S. S.
Published: May 2022

The area of female entrepreneurship has recently received considerable attention, which is dominated by quantitative studies. However, the narrative methodology approach offers the opportunity to gain in-depth, rich information beyond the boundaries of a question-response type of interview. Therefore, the article puts forward researching female entrepreneurship through the application of the narrative design. Fourteen women were purposively approached and interviewed. Findings revealed that researcher characteristics including understanding and respecting others, insider, outsider perspectives, and multiple identities as critical attributes of success in conducting narrative interviews. In addition, interview skills such as building trust and language were crucial to sustaining such characteristics when bringing together the stories of the respondent. Therefore, narrative design can be identified as an essential method that produces new knowledge, permitting, in this case, to better understand the complexity of women’s experiences.
War and Intimate Partner Violence in Africa
Authors: Le Kien , Nguyen My
Published: May 2022

This paper evaluates the impacts of armed conflict on intimate partner violence against women in Africa. Exploiting both spatial and temporal variations in the number of battles proxying for armed conflict intensity, we find that women residing in conflict-affected areas are prone to suffering intimate partner violence. In particular, a 1SD increase in the number of battles (equivalent to the increase by 4.8 battles) raises the composite indices of less severe violence, more severe violence, emotional abuse, and sexual abuse against women by 8.74%, 10.34%, 10.64%, and 7.14% relative to the sample averages, respectively. Given the long-term consequences of intimate partner violence, our findings call for expanding efforts in the prevention and mitigation of armed conflict.
Using Photovoice With Male Problematic Gamblers to Understand Their Lived Story on the Path to Recovery in South Korea
Authors: Kim Min Ah , Chun JongSerl , Shim HaiSun
Published: May 2022

Illegal gambling has significantly affected individuals’ lives in South Korea, and it is difficult for problematic gamblers to recover despite the decreasing rate of problematic gambling. This study used photovoice to explore the life experiences and desires of seven male problematic gamblers in a rehabilitation center during their path to recovery in South Korea. Photovoice consisted of six sessions involving orientation, photo-taking and group discussions of photographs, and sharing of outcomes. Twelve subthemes emerged within four main themes predetermined by the participants: (a) my life after gambling, (b) what I have lost from gambling, (c) what would help my recovery, and (d) picturing myself recovered in the near future. Participants’ lives had completely changed after they started gambling; particularly, their personality had been negatively affected and their life became filled with mental suffering. Their financial well-being was compromised, their health worsened, and they lost the trust of other people and a sense of purpose in their lives. Despite these challenges, they made tremendous efforts to recover from gambling and pictured a recovered future. The lived narratives provide evidence that recovery from gambling problems is a long journey including recognition of the problem and development of personal strategies that are perceived as beneficial for their recovery and strengthening their motivation for change.
Trade Openness, Government Consumption, and Economic Growth Nexus in Saudi Arabia: ARDL Cointegration Approach
Authors: Islam Md. Saiful , Alsaif Saleh Saud , Alsaif Talal
Published: May 2022

This study intends to examine the influence of trade openness on economic growth in the Kingdom of Saudi Arabia including government consumption and labor force as control variables. Using time-series yearly data from 1985 to 2019, the study applies the Auto-Regressive Distributed Lag (ARDL) cointegration regression and the Toda-Yamamoto (T-Y) Granger causality check to achieve the objective of the study. The ARDL model estimation discloses the positive contribution of trade openness and labor force to economic growth in the short and long run as well; government consumption causes economic growth positively in the short-run, while in the long its impact is insignificant run. The T-Y Granger causality test outcomes have demonstrated several bidirectional and unidirectional causalities. There are three feedback relations; “trade openness-economic growth,” “economic growth-government consumption,” and “government consumption-labor forces.” Three are an equal number of unidirectional causalities; “labor forces to economic growth,” “labor forces to trade openness,” and “trade openness to government consumption.” The outcomes have implications for the policymaker to boost the Kingdom’s trade openness to benefit further from trade, rationalize its government’s size to promote private sector growth to raise the latter’s effective contribution to GDP, and accelerate income growth.
Unwrapping Software Projects Success in Asia: Assessing the Role Of Authentic Leadership, Psychological Empowerment, and Job Engagement in Project Success Using a Serial-Mediation Approach
Authors: Khattak Shoukat Iqbal , Rizvi Tahir Hussain , Khan Muhammad Anwar
Published: May 2022

This research examines the impact of authentic leadership style on project success through mediation effects of psychological empowerment and job engagement in the software industry of Pakistan. Data were collected from 343 self-reports of employees working on different software projects in Pakistan. As per results, authentic leadership enhanced project success directly and indirectly through the serial-mediation effects of psychological empowerment and job engagement. The current findings contribute to prior literature in many ways: (i) social exchange theory—by identifying new antecedents and outcomes of job engagement; (ii) leadership literature—by offering an integrated framework with psychological empowerment and job engagement as two explanatory mechanisms (mediators) linking the under researched authentic leadership to project success; (iii) project management literature—by unwrapping new antecedents (i.e., authentic leadership, psychological empowerment, and job engagement) to project success; offers an empirical case for the potential applications of the undermined leadership style, authentic leadership, in the software sector.
A Randomized Preference Trial Comparing Cognitive-Behavioral Therapy and Yoga for the Treatment of Late-Life Worry: Examination of Impact on Depression, Generalized Anxiety, Fatigue, Pain, Social Participation, and Physical Function
Authors: Danhauer Suzanne C. , Miller Michael E. , Divers Jasmin , Anderson Andrea , Hargis Gena , Brenes Gretchen A.
Published: May 2022

Background

Depression, generalized anxiety, fatigue, diminished physical function, reduced social participation, and pain are common for many older adults and negatively impact quality of life. The purpose of the overall trial was to compare the effects of cognitive-behavioral therapy (CBT) and yoga on late-life worry, anxiety, and sleep; and examine preference and selection effects on these outcomes.

Objective

The present analyses compared effects of the 2 interventions on additional outcomes (depressive symptoms, generalized anxiety symptoms, fatigue, pain interference/intensity, physical function, social participation); and examined whether there are preference and selection effects for these treatments.

Methods

A randomized preference trial of CBT and yoga was conducted in adults ≥60 years who scored ≥26 on the Penn State Worry Questionnaire-Abbreviated (PSWQ-A), recruited from outpatient medical clinics, mailings, and advertisements. Cognitive-behavioral therapy consisted of 10 weekly telephone sessions. Yoga consisted of 20 bi-weekly group yoga classes. Participants were randomized to(1): a randomized controlled trial (RCT) of CBT or yoga (n = 250); or (2) a preference trial in which they selected their treatment (CBT or yoga; n = 250). Outcomes were measured at baseline and post-intervention.

Results

Within the RCT, there were significant between-group differences for both pain interference and intensity. The pain interference score improved more for the CBT group compared with the yoga group [intervention effect of (mean (95% CI) = 2.5 (.5, 4.6), P = .02]. For the pain intensity score, the intervention effect also favored CBT over yoga [.7 (.2, 1.3), P < .01]. Depressive symptoms, generalized anxiety, and fatigue showed clinically meaningful within-group changes in both groups. There were no changes in or difference between physical function or social participation for either group. No preference or selection effects were found.

Conclusion

Both CBT and yoga may be useful for older adults for improving psychological symptoms and fatigue. Cognitive-behavioral therapy may offer even greater benefit than yoga for decreasing pain.
A Directed Content Analysis of Interagency Collaboration Literature Within the Framework of the Working Alliance
Authors: Park Jinhee , Hill Julie C. , Montgomery Tammy W. , Barker Katherine E. , White Kevin L.
Published: May 2022

This study examined previous literature that described approaches to interagency collaboration and identified the most appropriate practices to implement while working with transition-age youth with disabilities and their families. Within this qualitative content analysis review of literature on interagency collaboration, we used the theory of working alliance and its three categories (i.e., goals, bonds, tasks) to support best practices in interagency collaboration for youth with disabilities. Twelve themes were developed to support the three categories and define how stakeholders could create successful interagency collaboration. These themes can be used to provide guidance for best practices to inform successful interagency collaboration among those involved in the transition planning process. Limitations and implications for future research and practice are discussed.
“Dedicado a Mi Familia”: The Role of Familismo on Academic Outcomes Among Latinx College Students
Authors: Azpeitia Jovani , Bacio Guadalupe A.
Published: May 2022

Addressing the retention and support of Latinx college students is imperative given their low graduation rates despite increasing enrollment. We sought to extend our understanding of the effects of familismo (i.e., the sense of providing support, acting in reference, and feeling an obligation to the family) on academic outcomes among Latinx college students by examining the roles of immigrant generation and gender. Latinx college students ( N = 176) from highly selective and predominantly White institutions completed self-report measures on familismo, academic motivation, and ganas. Familismo positively predicted academic motivation for first-generation Latinos and second-generation Latinas, suggesting that this association differs by immigrant generation and gender. Findings revealed that familism support most closely predicted academic motivation. Understanding the factors that promote academic motivation among Latinx college students, rather than those that hinder it, is crucial to addressing the disparities in attaining a higher education faced by this growing and diverse community.
A retrospective cohort study of anterior half peroneus longus tendon vs hamstring tendon for anterior cruciate ligament reconstruction: A minimum 3-years follow-up
Authors: Gunadham Ukris , Woratanarat Patarawan
Published: May 2022

Background: The anterior half of the peroneus longus tendon (AHPLT) has recently gained popularity to become the alternate graft choice for anterior cruciate ligament reconstruction due to its acceptable biomechanical properties, easy and safe to harvest. Methods: A retrospective study was conducted to compare the results of anterior cruciate ligament (ACL) reconstruction with AHPLT and hamstring graft at the minimum of 3 years follow-up. Knee stability, International Knee Documentation Committee (IKDC) subjective score and Tegner activity level were collected. Results: There was no clinical significance regarding physical examination. Postoperative IKDC score was higher in the hamstring group compared with AHPLT group. Multiple regression analysis was done. The parsimonious model revealed graft types and gender were the most optimal variables explained postoperative IKDC score. Conclusion: AHPLT graft can be an alternative choice to conventional graft for single anatomic ACL reconstruction with less donor site morbidity, however there must be concern for smaller graft in short and thin female patients.
Efficacy of unloader knee orthosis and lateral wedge insole on static balance in medial knee osteoarthritis
Authors: Dwarakanathan Raagavi , Mohanty Rajesh Kumar , Sahoo Swapna , Prasad Sakti
Published: May 2022

Background

Medial knee osteoarthritis can contribute to pain and stiffness, interfere with balance and limit functional activities of daily living. Unloader knee orthosis or lateral wedged insoles are current conservative approaches used to treat these conditions. The aim of this study was to identify and compare the effects of them on the balance parameters.

Methods

66 subjects with mild to moderate medial knee osteoarthritis were randomly assigned to wear unloader knee brace or full-length 6° lateral wedge insole. Primary outcome balance parameters were stability %, path length and average velocity of center of pressure and mobility score which were investigated by HUMAC® Balance and Tilt system. Secondary outcome measures were knee function score using Knee Injury and Osteoarthritis Outcome Score scale. Assessment was performed at baseline and six months post orthotic intervention period.

Findings

Both orthoses improved all parameters compared to the baseline condition (p < 0.05). Unloader knee orthosis showed a significant improvement in all balance parameters compared to lateral wedged insoles (p < 0.001) except mobility scores (p = 0.527). Except activities of daily living (p = 0.752) and sports and recreational activities (p = 0.437), unloader knee orthosis had a greater effect on the pain (p = 0.002) and symptoms (p < 0.001) sub scales than lateral wedged insoles. However, quality of life sub-scale scores for insoles were more effective than the knee orthosis.

Interpretation

Unloader knee orthosis improved balance and knee function scores more than lateral wedged insole, though both orthoses produced significantly improved results compared to baseline assessment.
Climate Mitigation Investments: An Economic and Policy Outlook
Authors: Tewary Tavishi , Jain Vranda , Gopalakrishnan Badri Narayanan , Anand Arpan
Published: May 2022

The recent trade tensions have posed unprecedented challenges on economic activities, geographical distribution and future human existence. These trade tensions have accentuated the issues of investment and climate change. The article applies CGE modelling to assess the impact of trade policy shocks on sectors contributing to high carbon emissions. The study recognizes the role of trade as a facilitator for promoting investment in renewable sectors. Additionally, the study proposes a framework for boosting investment in climate change mitigation. This research advocates the need for synchronization between trade and investment policies and calls for pre-emptive actions for integrated comprehensive and holistic actions from institutions and governments.
HHV-8-Associated Multicentric Castleman Disease, a Diagnostic Challenge in a Patient With Acquired Immunodeficiency Syndrome and Fever
Authors: Dunn Robert , Jariwal Roopam , Venter Frederick , Mishra Shikha , Bhandohal Janpreet , Cobos Everado , Heidari Arash
Published: May 2022

Patients with acquired immunodeficiency syndrome (AIDS) are at an increased susceptibility to pathogens and associated malignancies which can present with a unique constellation of symptoms. In this article, we describe a case of Castleman disease in a patient with AIDS, nonadherent with antiretroviral therapy (ART), who presented with fevers, constant abdominal pain, nausea, and vomiting. After an extensive work up, a lymph node biopsy confirmed a diagnosis of human herpesvirus-8 (HHV-8)-associated multicentric Castleman disease. Patients presenting with AIDS and fever have broad differential diagnoses; therefore, reaching a diagnosis as rare as Castleman disease can be challenging. HHV-8 has a propensity to CD20 positive B cells, which allows rituximab to be an effect treatment.
Situating HIV Stigma in Health Facility Settings: A Qualitative Study of Experiences and Perceptions of Stigma in ‘Clinics’ among Healthcare Workers and Service Users in Zambia
Authors: Mulubale Sanny , Clay Sue , Squire Corinne , Bond Virginia , Kasoka Kasoka , Stackpool-Moore Lucy , Oraro-Lawrence Tessa , Chonta Mutale , Chiiya Chipo
Published: May 2022

The study focused on the representations, processes and effects of HIV stigma for healthcare workers living with HIV within health facilities in Zambia. A descriptive study design was deployed. A total of 56 health workers and four service user participants responded to a structured questionnaire (n = 50) or took part in key informant interviews (n = 10) in five high HIV-prevalence provinces. Most participants did not disclose if they were living with HIV, except for four participants who responded to the questionnaire and were selected for being open about living with HIV. Semi-structured interviews were carried out with health workers in key government health facility positions. The questions were standardized and used a Likert scale. Descriptive statistical and thematic analyses were applied to the data. Results show that antiretroviral treatment (ART) has an impact on stigma reduction. Almost half the participants agreed that treatment is reducing levels of HIV stigma. However, fears of exposure of HIV status and labelling and judgemental attitudes persist. No comprehensive stigma reduction policies and guidelines in healthcare facilities were mentioned. Informal flexible systems to deliver HIV services were in place for health workers living with HIV, illustrating how stigma can be quietly navigated. Lack of confidentiality in healthcare facilities plays a role in fuelling disclosure issues and hampering access to testing and treatment. Stigma reduction training needs standardization. Further, codes of conduct for ‘stigma-free healthcare settings’ should be developed.
Outcomes of Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years and Younger Than 30 Years
Authors: Weng Chun-Jui , Yang Cheng-Pang , Yeh Wen-Ling , Hsu Kuo-Yao , Chang Shih-Sheng , Chiu Chih-hao , Chen Alvin Chao-yu , Chan Yi-Sheng
Published: May 2022

Background:

Few studies have compared the outcomes of anterior cruciate ligament (ACL) reconstruction between older patients and younger patients.

Purpose:

To evaluate the clinical and functional outcomes of ACL reconstruction with autologous hamstring tendon in patients >50 years and <30 years. It was hypothesized that the outcomes would be comparable between these age groups.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients >50 years (older group) or <30 years (younger group) who underwent ACL reconstruction surgery with autologous hamstring tendon between 2012 and 2015 at the authors’ hospital were retrospectively enrolled in this study. All patients had a minimum of 2 years of follow-up. Intraoperative findings, including cartilage and meniscal injury, were recorded, and clinical and functional outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm, and Tegner activity scores. We used the paired-samples t test for statistical analysis between the 2 age groups.

Results:

A total of 67 patients and 459 patients were included in the older and younger groups, respectively. Both groups achieved significant preoperative to postoperative improvement in IKDC (older group, from 41.4 to 88.9; younger group, from 49 to 91.2), Lysholm (older group, from 49.8 to 86.1; younger group, from 50.2 to 91.8), and Tegner (older group, from 2.7 to 4.4; younger group, from 4.6 to 6.9) ( P < .05 for all) scores. The change in Tegner score from preinjury to postoperatively was not statistically significant in the older group (from 4.5 to 4.4; P = .471), although it was significant in the younger group (from 7.5 to 6.9; P < .05). No between-group differences were noted in preoperative or postoperative IKDC or Lysholm scores. Both age groups reached a high rate of return to sports activity, and no major complications or ACL retears were noted in either group.

Conclusion:

Comparable results after ACL reconstruction were achieved in patients >50 years compared with patients <30 years, with a high rate of return to sports activity and a low rate of complications at the 2-year follow-up. The younger group returned to a higher Tegner score, while the older group did not.
Cryoneurolysis for Digital Neuralgia in Professional Baseball Players: A Case Series
Authors: Shaffer Johnathon P. , Williams Vernon B. , Shin Steven S.
Published: May 2022

Background:

Thumb injuries are common in baseball players and can sometimes be challenging to effectively manage. A subset of patients experience failed nonoperative management yet do not have a clear indication for surgery. Cryoneurolysis or cryoanalgesia is a form of neuromodulation for pain that has been approved by the US Food and Drug Administration; it has been used safely and effectively on a variety of peripheral nerves. The mechanism of action involves percutaneous introduction of a small probe under local anesthetic to nerve tissue using ultrasound guidance. The probe is then cooled to –88°C using nitrous oxide, which results in secondary Wallerian degeneration. Axonal and myelin regeneration occurs completely in 3 to 6 months.

Purpose:

To describe a nonsurgical approach to refractory digital neuralgia using cryoneurolysis in a series of professional baseball players.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included were 3 professional baseball players, each presenting with thumb pain in his top batting hand refractory to nonoperative modalities. Visualization of the superficial radial sensory and ulnar digital nerves was obtained using ultrasound. The skin was prepared in sterile fashion. A 22-gauge, 1.5-inch (3.8-cm) needle was then advanced using ultrasound guidance, and local anesthetic was applied. Both treatment sites were marked using a skin marker. Cryoneurolysis was performed using a 5-mm tip, and 60-second treatment cycles were performed at each site. Each of the cycles resulted in a roughly 5 × 7–mm lesion visible as hypoechoic signal.

Results:

All 3 players endorsed significant and prolonged relief and were able to return to an elite level of play.

Conclusion:

Study findings indicated marked efficacy and safety of using cryoneurolysis of the ulnar digital nerve and the superficial radial sensory nerve in a small group of elite baseball players with refractory digital neuralgia.