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BACKGROUND: Hyperphosphatemia is associated with increased morbidity and mortality in patients with end-stage kidney disease (ESKD). Whereas clinical and observational studies have demonstrated the effectiveness of sucroferric oxyhydroxide (SO) in controlling serum phosphorus (sP) in ESKD, data on the real-world impact of switching to SO in patients on peritoneal dialysis (PD) are limited. In this retrospective database analysis, we examine the impact of SO on sP management over a 1-year period among PD patients prescribed SO as part of routine clinical care. METHODS: We analyzed de-identified data from adults on PD in Fresenius Kidney Care clinics who were prescribed SO monotherapy between May 2018 and December 2019 as part of routine clinical management. Changes from baseline in sP levels, phosphate binder (PB) pill burden, and laboratory parameters were evaluated during the four consecutive 91-day intervals of SO treatment. RESULTS: The mean age of the 402 patients who completed 1 year of SO was 55.2 years at baseline, and they had been on PD for an average of 19.9 months. SO was initiated with no baseline PB recorded in 36.1% of patients, whereas the remaining 257 patients were switched to SO from sevelamer (39.7%), calcium acetate (30.4%), lanthanum (1.2%), ferric citrate (14.0%), or more than one PB (14.8%). Mean sP at baseline was 6.26 mg/dL. After being prescribed SO, the percentage of patients achieving sP ≤ 5.5 mg/dL increased from 32.1% (baseline) to 46.5-54.0% during the 1-year follow-up, whereas the mean number of PB pills taken per day decreased from 7.7 at baseline (among patients on a baseline PB) to 4.6 to 5.4. Serum phosphorus and PB pill burden decreased regardless of changes in residual kidney function over the 12-month period. Similar results were observed for the full cohort (976 patients who either completed or discontinued SO during the 1-year follow-up). CONCLUSIONS: Patients on PD who were prescribed SO as part of routine care for phosphorus management experienced significant reductions in SP and PB pills per day and improvements in sP target achievement, suggesting the effectiveness of SO on SP management with a concurrent reduction in pill burden.

ObjectiveDespite the growing number of elderly hemodialysis patients, the influence of age on nutritional parameters, serum phosphorus (sP), and use of phosphate-binder (PB) medications has not been well characterized. We aimed to describe age-related differences in patient characteristics in a large, real-world cohort of maintenance hemodialysis patients, and to examine the impact of age on sP management with sucroferric oxyhydroxide (SO).MethodsWe retrospectively analyzed de-identified data from 2017 adult, in-center hemodialysis patients who switched from another PB to SO monotherapy as part of routine clinical care. Changes in baseline PB pill burden, sP levels, and nutritional and dialytic clearance parameters were assessed across varying age groups through 6 months.ResultsAt baseline, older patients had lower mean sP, serum albumin, and pre-dialysis weights compared with younger patients. Prescription of SO was associated with a 62% increase in the proportion of patients achieving sP ≤ 5.5 mg/dl and a 42% reduction in daily pill burden. The proportion of patients achieving sP ≤ 5.5 mg/dl after transitioning to SO increased by 113, 96, 68, 77, 61, 37 and 40% among those aged 19-29, 30-39, 40-49, 50-59, 60-69, 70-79, and ≥ 80 years, respectively.ConclusionsOlder patients had worse nutritional parameters, lower pill burden, and lower sP at baseline versus younger counterparts. Prescription of SO was associated with improved sP control and reduced pill burden across all ages.

Hypoalbuminemia results when compensatory mechanisms are unable to keep pace with derangements in catabolism/loss and/or decreased synthesis of albumin. Across many disease states, including chronic kidney disease (CKD), hypoalbuminemia is a well-established, independent risk factor for adverse outcomes, including mortality. In the setting of CKD, reduced serum albumin concentrations are often a manifestation of protein-energy wasting, a state of metabolic and nutritional alterations resulting in reduced protein and energy stores. The progression of CKD to kidney failure and the initiation of maintenance hemodialysis (HD) further predisposes an already at-risk population toward hypoalbuminemia such that approximately 60% of HD patients have albumin concentrations

Background: Data sharing is commonly seen as beneficial for science but is not yet common practice. Research funding agencies are known to play a key role in promoting data sharing, but German funders' data sharing policies appear to lag behind in international comparison. This study aims to answer the question of how German data sharing experts inside and outside funding agencies perceive and evaluate German funders' data sharing policies and overall efforts to promote data sharing. Methods: This study is based on sixteen guided expert interviews with representatives of German funders and German research data experts from stakeholder organisations, who shared their perceptions of German' funders efforts to promote data sharing. By applying the method of qualitative content analysis to our interview data, we categorise and describe noteworthy aspects of the German data sharing policy landscape and illustrate our findings with interview passages. Results: We present our findings in five sections to distinguish our interviewees' perceptions on a) the status quo of German funders' data sharing policies, b) the role of funders in promoting data sharing, c) current and potential measures by funders to promote data sharing, d) general barriers to those measures, and e) the implementation of more binding data sharing requirements. Discussion and conclusion: Although funders are perceived to be important promoters and facilitators of data sharing throughout our interviews, only few German funding agencies have data sharing policies in place. Several interviewees stated that funders could do more, for example by providing incentives for data sharing or by introducing more concrete policies. Our interviews suggest the academic freedom of grantees is widely perceived as an obstacle for German funders in introducing mandatory data sharing requirements. However, some interviewees stated that stricter data sharing requirements could be justified if data sharing is a part of good scientific practice. [ABSTRACT FROM AUTHOR]

Introduction: Sucroferric oxyhydroxide (SO), a non-calcium, chewable, iron-based phosphate binder (PB), effectively lowers serum phosphorus (sP) concentrations while reducing pill burden relative to other PBs. To date, SO studies have largely examined treatment-experienced, prevalent hemodialysis populations. We aimed to explore the role of first-line SO initiated during the first year of dialysis. Methods: We retrospectively analyzed deidentified data from adults receiving in-center hemodialysis who were prescribed SO monotherapy within the first year of hemodialysis as part of routine clinical care. All patients continuing SO monotherapy for 12 months were included. Changes from baseline in sP, achievement of sP ≤5.5 and ≤4.5 mg/dL, and other laboratory parameters were analyzed quarterly for 1 year. Results: The overall cohort included 596 patients, 286 of whom had a dialysis vintage ≤3 months. In the 3 months preceding SO initiation, sP rapidly increased (mean increases of 1.02 and 1.65 mg/dL in the overall cohort and incident cohort, respectively). SO treatment was associated with significant decreases in quarterly sP (mean decreases of 0.26–0.36; p < 0.0001 for each quarter and overall). While receiving SO, 55–60% of patients achieved sP ≤5.5 mg/dL and 21–24% achieved sP ≤4.5 mg/dL (p < 0.0001 for each quarter and overall vs. baseline). Daily PB pill burden was approximately 4 pills. Serum calcium concentrations increased and intact parathyroid hormone concentrations decreased during SO treatment (p < 0.0001 vs. baseline). Conclusions: Among patients on hemodialysis, initiating SO as a first-line PB resulted in significant reductions in sP while maintaining a relatively low PB pill burden. [ABSTRACT FROM AUTHOR]

Background: Data Sharing is widely recognised as crucial for accelerating scientific research and improving its quality. However, data sharing is still not a common practice. Funding agencies tend to facilitate the sharing of research data by both providing incentives and requiring data sharing as part of their policies and conditions for awarding grants. The goal of our article is to answer the following question: What challenges do international funding agencies see when it comes to their own efforts to foster and implement data sharing through their policies? Methods: We conducted a series of sixteen guideline-based expert interviews with representatives of leading international funding agencies. As contact persons for open science at their respective agencies, they offered their perspectives and experiences concerning their organisations' data sharing policies. We performed a qualitative content analysis of the interviews and categorised the challenges perceived by funding agencies. Results: We identify and illustrate six challenges surrounding data sharing policies as perceived by leading funding agencies: The design of clear policies, monitoring of compliance, sanctions for non-compliance, incentives, support, and limitations for funders' own capabilities. However, our interviews also show how funders approach potential solutions to overcome these challenges, for example by coordinating with other agencies or adjusting grant evaluation metrics to incentivise data sharing. Discussion and conclusion: Our interviews point to existing flaws in funders' data sharing policies, such as a lack of clarity, a lack of monitoring of funded researchers' data sharing behaviour, and a lack of incentives. A number of agencies could suggest potential solutions but often struggle with the overall complexity of data sharing and the implementation of these measures. Funders cannot solve each challenge by themselves, but they can play an active role and lead joint efforts towards a culture of data sharing. [ABSTRACT FROM AUTHOR]

Hemodiafiltration (HDF) achieves a more efficient reduction of the uremic toxic load compared to standard high‐flux hemodialysis (HF‐HD) by virtue of the combined diffusive and convective clearances of a broad spectrum of uremic retention solutes. Clinical trials and registry data suggest that HDF improves patient outcomes. Despite the acknowledged need to improve survival rates of dialysis patients and the survival benefit HDF offers, there is little to no utilization in some countries (such as the US) in prescribing HDF to their patients. In this analysis, we present the healthcare value‐based case for HDF (relative to HF‐HD) from the patient, provider, and payor perspectives. The improved survival and reduced morbidity observed in studies conducted outside the US, as well as the reduced hospitalization, are attractive for each stakeholder. We also consider the potential barriers to greater utilization of HDF therapies, including unfounded concerns regarding additional costs of HDF, e.g., for the preparation and microbial testing of quality of substitution fluids. Ultrapure fluids are easily attainable and prepared from dialysis fluids using established "online" (OL) technologies. OL‐HDF has matured to a level whereby little additional effort is required to safely implement it as all modern machine systems are today equipped with the OL‐HDF functionality. Countries already convinced of the advantages of HF‐HD are thus well positioned to make the transition to OL‐HDF to achieve further clinical and associated economic benefits. Healthcare systems struggling to cope with the increasing demand for HD therapies would therefore, like patients, be beneficiaries in the long term with increased usage of OL‐HDF for end stage kidney disease patients. [ABSTRACT FROM AUTHOR]

An interview is presented with dental technician Michael Anger of Michael Anger Dental Laboratory. Topics discussed include his most important characteristics for the job of a dental technician; his views on digital development in dental technology; and his idea of about switching from analog to digital processes.

Purpose: In prior analyses of real-world cohorts of hemodialysis patients switched from one phosphate binder (PB) to sucroferric oxyhydroxide (SO), SO therapy has been associated with improvements in serum phosphorus (sP) and reductions in daily PB pill burden. To characterize how SO initiation patterns have changed over time, we examined the long-term effectiveness of SO in a contemporary (2018– 2019) cohort. Patients and Methods: Adult Fresenius Kidney Care hemodialysis patients first prescribed SO monotherapy as part of routine care between May 2018 and May 2019 (N = 1792) were followed for 1 year. All patients received a non-SO PB during a 91-day baseline period before SO prescription. Mean PB pills/day and laboratory parameters were compared before and during SO treatment. Results were divided into consecutive 91-day intervals (Q1–Q4) and analyzed using linear mixed-effects regression and Cochran's Q test. These results were contrasted with findings from a historical (2014– 2015) cohort (N = 530). Results: The proportion of patients achieving sP ≤ 5.5 mg/dl increased after switching to SO (from 27.0% at baseline to 37.8%, 45.1%, 44.7%, and 44.0% at Q1, Q2, Q3, and Q4, respectively; P < 0.0001 for all). The mean daily PB pill burden decreased from a baseline of 7.7 to 4.4, 4.6, 4.8, and 4.9, respectively, across quarters (P < 0.0001 for all). Patients in the contemporary cohort had improved sP control (27.0% achieving sP ≤ 5.5 mg/dl vs 17.7%) and lower daily PB pill burden (mean 7.7 vs 8.5 pills/day) at baseline than those in the historical cohort. Overall use of active vitamin D was similar between cohorts, although higher use of oral active vitamin D (63.9% vs 15.7%) and lower use of IV active vitamin D lower (23.4% vs 74.2%) was observed in the contemporary cohort. Conclusion: Despite evolving treatment patterns, switching to SO resulted in improved sP control with fewer pills per day in this contemporary hemodialysis cohort. [ABSTRACT FROM AUTHOR]

Ethical Approval The purpose of this project was to a) implement a practice to improve the quality of patient care, and b) collect patient data regarding the implementation of clinical practice. Linda H Ficociello, SP 1 sp Joanna Willetts, SP 1 sp Claudy Mullon, SP 1 sp Curtis Johnson, SP 2 sp Michael S Anger, SP 1 sp Jeffrey L Hymes SP 1 sp SP 1 sp Global Medical Office, Fresenius Medical Care, Waltham, MS, USA; SP 2 sp Spectra Laboratories, Southaven, MS, USA Correspondence: Jeffrey L Hymes, Fresenius Medical Care, 1000 Corporate Centre Drive, Suite 400, Franklin, TN, 37067, USA, Email [email protected] Antibody response to the primary 2-dose regimen of mRNA-based coronavirus disease 2019 (COVID-19) vaccines is reduced in dialysis populations vs healthy controls.[1] Moreover, dialysis patients demonstrate a faster decline in antibody levels and diminished long-term antibody response than the general population.2-5 These findings support prioritizing this population for additional vaccine doses following primary vaccination. [Extracted from the article]

Informed decision-making is paramount to the improvement of dialysis therapies and patient outcomes. A cornerstone of delivery of optimal dialysis therapy is to delineate which substances (uraemic retention solutes or 'uraemic toxins') contribute to the condition of uraemia in terms of deleterious biochemical effects they may exert. Thereafter, decisions can be made as to which of the accumulated compounds need to be targeted for removal and by which strategies. For haemodialysis (HD), the non-selectivity of membranes is sometimes considered a limitation. Yet, considering that dozens of substances with potential toxicity need to be eliminated, and targeting removal of individual toxins explicitly is not recommended, current dialysis membranes enable elimination of several molecules of a broad size range within a single therapy session. However, because HD solute removal is based on size-exclusion principles, i.e. the size of the substances to be removed relative to the mean size of the 'pores' of the membrane, only a limited degree of selectivity of removal is possible. Removal of unwanted substances during HD needs to be weighed against the unavoidable loss of substances that are recognized to be necessary for bodily functions and physiology. In striving to improve the efficiency of HD by increasing the porosity of membranes, there is a greater potential for the loss of substances that are of benefit. Based on this elementary trade-off and availability of recent guidance on the relative toxicity of substances retained in uraemia, we propose a new evidence-linked uraemic toxin elimination (ELUTE) approach whereby only those clusters of substances for which there is a sufficient body of evidence linking them to deleterious biological effects need to be targeted for removal. Our approach involves correlating the physical properties of retention solutes (deemed to express toxicity) with key determinants of membranes and separation processes. Our analysis revealed that in attempting to remove the relatively small number of 'larger' substances graded as having only moderate toxicity, uncontrolled (and efficient) removal of several useful compounds would take place simultaneously and may compromise the well-being or outcomes of patients. The bulk of the uraemic toxin load comprises uraemic toxins below <30 000 Da and are adequately removed by standard membranes. Further, removal of a few difficult-to-remove-by-dialysis (protein-bound) compounds that express toxicity cannot be achieved by manipulation of pore size alone. The trade-off between the benefits of effective removal of the bulk of the uraemic toxin load and risks (increased loss of useful substances) associated with targeting the removal of a few larger substances in 'high-efficiency' HD treatment strategies needs to be recognized and better understood. The removability during HD of substances, be they toxic, inert or beneficial, needs be revised to establish the pros and cons of current dialytic elimination strategies. [ABSTRACT FROM AUTHOR]

Background: It has been proposed that substituting citrate-acidified dialysate (CAD) solutions for acetate-acidified dialysate (AAD) could improve hemodynamics and dialysis tolerance and reduce the requirement for systemic anticoagulation. Citrate chelates ionized calcium, but long-term effects of CAD use during maintenance hemodialysis have not been well studied. While many studies of the effects of CAD on serum calcium and intact parathyroid hormone (iPTH) have been short-term or have been limited by sample size, we aimed to determine if there are any long-term (i.e., 6-month) changes from pre-dialysis iPTH levels when patients are switched from AAD to CAD. Methods: This retrospective cohort study compared various clinical parameters, including pre-dialysis iPTH and serum calcium as well as single pool Kt/V, from eligible patients who received in-center hemodialysis thrice-weekly in geographically matched CAD (n=3) or AAD clinics (n=12). CAD clinics were defined as clinics converting from AAD to CAD if > 85% of the patients were prescribed CAD after implementation of CAD within the clinic. Results: Pre-dialysis iPTH was not significantly different from baseline to 6-month follow-up within either CAD or AAD clinics. Moreover, the mean change from baseline to month 6 in iPTH between patients (n=142) in CAD clinics (− 17 pg/mL) and patients (n=671) in AAD clinics (13 pg/mL) was similar (p = 0.24). Likewise, the differences in the mean change in serum calcium concentrations and dialysis adequacy (single pool Kt/V) were not significant between CAD and AAD clinics. For subgroups of patients who were never prescribed cinacalcet or calcium-based phosphate binders, there were no significantly different categorical shifts in iPTH between CAD and AAD clinics. Conclusion: Similar trends in single pool Kt/V, iPTH, and serum calcium levels were observed in clinics that switched from AAD to CAD versus the geographically matched AAD clinics. These results support CAD as a potential alternative to AAD in hemodialysis. [ABSTRACT FROM AUTHOR]

Background: Intermittent dosing of calcitriol for secondary hyperparathyroidism (SHPT) has been associated with greater parathyroid hormone (PTH) reduction with fewer calcemic and phosphatemic effects than daily (QD) dosing. Methods: Secondary analyses of three randomized, double-blind, placebo-controlled multicenter studies in stage 3 and 4 chronic kidney disease (CKD) patients with SHPT were performed to compare three times per week (TIW) with QD dosing of paricalcitol. The pharmacokinetics of TIW and QD dosing of paricalcitol capsules were assessed in a separate group of healthy subjects. Results: Pharmacokinetics revealed similar steady state paricalcitol exposure between dosing regimens. In CKD patients, baseline data were similar between the TIW studies (n = 72, paricalcitol; n = 73, placebo) and QD studies (n = 35, paricalcitol; n = 40, placebo). Both dosing regimens resulted in similar efficacy (91%) for the primary end point of two consecutive ≥30% decreases in intact PTH from baseline, but the QD regimen resulted in a greater percent reduction in intact PTH from baseline. The chances for developing increased serum calcium and phosphorus levels or Ca × P product were similar between paricalcitol and placebo groups for both treatment regimens. Furthermore, no difference in the risk for these elevations was detected between the TIW and QD regimens. Conclusions: QD dosing of paricalcitol capsules is as efficacious as TIW dosing in achieving the primary end point (2 consecutive ≥30% reductions in PTH) in stage 3 and 4 CKD patients with SHPT. Moreover, the QD regimen had no significant effect on hypercalcemia, hyperphosphatemia or Ca × P product as compared with placebo or intermittent dosing. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We conduct a comprehensive analysis of health determinants at the individual and workplace levels. Using a new individual-level German data set, we investigate the influence of these determinants on health, including collegiality, personality traits as measured by the Big Five, commitment to the company and job characteristics, while controlling for a set of standard sociodemographic and employment variables. We are interested in which determinants are important and which are less influential, whether interaction effects should be taken into account and whether the results depend on the modeling and estimation method used. Among the Big Five factors, conscientiousness, agreeableness and emotional stability are positively correlated with good overall health. The influence of job characteristics such as having substantial decision-making authority, not having physically demanding tasks, having pleasant environmental conditions, facing minimal time pressure and not being required to multitask are also positive. If employees frequently receive help when needed from their colleagues and do not feel unfairly criticized by others in the firm, they usually have fewer health problems. Each Big Five item influences mental health, whereas no statistical significance could be found for these items' relationships with the number of days workers were absent due to sickness, except for neuroticism. These results are, for the most part, robust to different modeling and estimation methods. [ABSTRACT FROM AUTHOR]

For the past 50 years, abortion opponents have fought for the power to ban abortion without little attention to how things might change when they won. The battle to make abortion illegal has been predicated on three nebulous assumptions about how abortion bans work. First, supporters believe banning abortion will deter it. Second, they hope bans will send a message about abortion—specifically, that abortion is immoral. And third, they expect bans to be competently implemented and enforced. Drawing on empirical work from within and outside of the U.S. this Article offers an evidence-based assessment of each of these assumptions. Part One examines the question of deterrence by exploring findings from countries with relatively high and relatively low abortion rates. After explaining why restrictive abortion laws alone do not reduce aggregate abortion rates, I consider the matter of individual deterrence. By identifying those most likely to be deterred by U.S. abortion bans, I illustrate how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children. Part Two tests the idea that abortion bans send a message. I consider the bans' meaning in context with U.S. laws and policies affecting families, exposing the difference between laws discouraging abortion, and those encouraging childbirth. Then, drawing from literature on the expressive function of the law, I assess the limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitment to children living in poverty. Part Three turns to the expectation that abortion bans will be competently enforced, noting the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans. This article concludes by considering why the consequences and limitations of abortion bans should matter to supporters and opponents, alike. [ABSTRACT FROM AUTHOR]

This article sets out a forward-looking account of moral responsibility on which the ground-level practice is directly sensitive to aims such as moral formation and reconciliation, and is not subject to a barrier between tiers. On the contrasting two-tier accounts defended by Daniel Dennett and Manuel Vargas, the ground-level practice features backward-looking, desert-invoking justifications that are in turn justified by forward-looking considerations at the higher tier. The concern raised for the two-tier view is that the ground-level practice will be insufficiently responsive to the forward-looking aims that are held to justify it. On the single-tier alternative, forward-looking considerations can more readily motivate substantial revisions, which the practice, due to serious and pervasive deficiencies, requires. [ABSTRACT FROM AUTHOR]

Using data from the German Socio-Economic Panel and exploiting the staggered implementation of a compulsory schooling reform in West Germany, this article finds that an additional year of schooling lowers the probability of being very concerned about immigration to Germany by around six percentage points (20 percent). Furthermore, our findings imply significant spillovers from maternal education to immigration attitudes of her offspring. While we find no evidence for returns to education within a range of labor market outcomes, higher social trust appears to be an important mechanism behind our findings. [ABSTRACT FROM AUTHOR]

Anger is a neglected area in the study of international relations. Set against the broader impact of emotions on international relations and the emotional turn in the human and social sciences, this exploratory article focuses on state and nonstate anger (as an emotion) in the contemporary era, here defined as the Age of Anger. The unique attributes of this era and states displaying anger are presented. The article concludes with a description and consequences of the behaviour of angry states and the inherent political utility of and dangers associated with anger. [ABSTRACT FROM AUTHOR]

This article presents an integrative approach to the special challenges of therapy with couples on the brink of dissolution or divorce—who often describe this therapy as their "last chance." In some, one partner is considering ending the relationship, and in others, both partners are considering ending it. Often, these couples have had prior dissatisfying experiences in couple therapy. Four types of last chance couples are described: high‐conflict couples; couples in which partners have differing goals for their lives or different timelines for reaching shared goals; couples in which one or both partners have acted in a manner that violates the values, expectations, emotional comfort, or safety of the other; and couples in which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspectival, theoretically eclectic integrative approach, is enlisted as a general framework for selecting and sequencing use of particular theories and their associated practices, based on the three "primary colors" of couple therapy: time frame/focus, level of directiveness, and change entry point. An additional complementary framework, the creative relational movement approach, is proposed to provide an integrative frame encompassing both language‐based and action‐based practices, suggesting that meaning is held and expressed as much through interaction or "relational motion" as it is through language. Principles of change are described. Due to the couple's level of crisis and desire for immediate evidence of possible improvement, priority is given to action‐based interventions in early stages of therapy, by engaging couples in "experiments in possibility." Typical action approaches are described. An extended vignette follows. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to offer a theoretical framework of whistleblowing that gives due recognition to the emotional and reflexive processes that underpin it. Modes of anger are integrated into the model based on a reading of Geddes and Callister (2007), and developed by Lindebaum and Geddes (2016) work on moral anger. Design/methodology/approach: The model is derived by interrogation of the extant literature on whistleblowing with due recognition accorded to emotional and reflexive dimensions that have been underrepresented in previous research. The model was tested by a qualitative study that uses memoir analysis to interrogate a board level whistle-blower's account of the complex, traumatic and like-changing nature of his experience. Findings: The paper identifies key stages in whistle-blower thinking before, during and subsequent to a decision to expose corporate wrongdoing. It demonstrates how emotional and reflexive processes influence a whistle-blower's mode of anger expression, and how different perspectives by the whistle-blower and the focal organisation may view this expression as moral or deviant anger. Research limitations/implications: The complexity of the whistleblowing process, together with possible alternative perspectives of it, makes identifying every influencing variable extremely challenging. Also, reliance on a whistle-blower's own account of his experience means that recall may be partial or self-serving. The model can be used to analyse other whistle-blower accounts of their experience, and further confirm its applicability. Originality/value: This is the first application of memoir analysis to a whistle-blower's account of his experience that relates modes of anger expression to stages in the whistleblowing episode. It addresses a significant imbalance in whistleblowing research that hitherto has emphasised rationality in whistle-blower decision making and downplayed the influence of reflexivity and emotion. [ABSTRACT FROM AUTHOR]

Judith Butler, Joan Tronto, and Stephen King all hinge human experience on shared ontological vulnerability, but whereas Butler and Tronto use vulnerability to build ethical commitments, King exploits aging, disability, and death to frighten us. King's horror genre is provocative for the imaginative landscape of feminist theory precisely because he uses vulnerability to magnify the anxieties of mass culture. In Christine, the characters' shared susceptibility to psychic and physical injury blurs the boundary between care and violence. Like Butler, King depicts our social worlds encrusted with normative violence: the mundane ways that norms police gender, race, class, and disability identities. And like Butler, King makes undecidability a key feature of human identity: the idea that needs and identities are uncertain. Normative violence and undecidability trouble the starting point of Tronto's care theory-attentiveness to needs-because both concepts invest interdependency with ambiguity and conflict. But like Tronto, King recognizes that care-actors must act, even amid ambiguity and even when their actions make care and aggression converge. Christine's supernatural plot details the psychic possession of an American teenager, but the novel's more terrifying story is about interdependency and how normative violence is not the antithesis of care, but its dark underbelly. [ABSTRACT FROM AUTHOR]

These lines, taken from the poem “Sweet Home,” were published by Eliza Cook (1818–89) in Once a Week in 1867. Accompanied by Joseph Swain's engraving (Figure 4), the poem presents an idealized portrait of a middle-class family in the nineteenth century. The home is a “blissful, holy place” where “Manhood, Infancy, and Age” can find their “love and peace” as well as “joy and grace.” Of particular interest is that Swain places the female figures – grandmother, mother with a child on her lap, and daughter – at the center of the engraving: their bodies and faces are clearly sketched, whereas father and son, the only two male figures in the engraving, merely show half their faces with their backs turned to the reader. Overall, the poem itself contains some of the striking echoes of the dominant ideology of home at the time. The scene of the family gathered around the hearth illuminates the all-embracing concept of domesticity – coziness, comfort, and intimacy. [ABSTRACT FROM PUBLISHER]

Research on general strain theory has demonstrated the impact of strain on decisions to engage in crime and delinquency. However, people differ in their responses to strain and onlysomeresort to crime or delinquency. There remain gaps in our knowledge of when, and under what conditions, individuals will react to strain with offending behavior. We rely on interviews with 40 incarcerated men to understand how they cope with specific prison strains, and why they make such coping choices. We find considerable variation in inmates’ coping responses. They use a variety of coping strategies—behavioral, cognitive, and emotional—and only some of these strategies involve offending. Our findings indicate that responses to prison strain are partly a function of past experience with strains, including prior experimentation with coping techniques. Results highlight the unfolding nature of the coping process and expose factors that deserve further attention in tests of GST. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to review the implementation of two strategies that are actually un-teachable yet highly effective in higher education: meditation and storytelling. Design/methodology/approach – Specifically focussing on workplace spirituality as a movement from corporate workers, and consequently, also a teaching topic in management education, the paper first indicates some problems faced in today's world, and relates these to the need for facilitating college courses in more compelling and comprehensive ways. Findings – Spirituality and spiritual concepts can involve emotional and other non-cognitive experiences which cannot be taught using traditional teaching approaches such as reading and lecture. Specific approaches, such as meditation and storytelling are useful for teaching spirituality and spiritual concepts in a business school classroom setting. These two strategies provide an opportunity for students to reflect on their experiences and to become more self-aware. Practical implications – Using the practical strategies discussed in this paper in management classes turns out to be a positive experience for both the course facilitators and the students. Originality/value – Reflecting on the overhaul attempts of management education in universities, even those with the prestige of Harvard and Stanford, the authors discuss some interesting strategies that can help management educators take their course experiences and the results attained to the next level. [ABSTRACT FROM AUTHOR]

Parental incarceration, poverty, urban violence, and drug use can be underlying factors of academic achievement gaps between Black urban males and their counterparts. These risk factors have the potential to position low-income urban students as struggling readers. Two qualitative case studies obtained from a larger mixed methods study illustrate exemplary after-school literacy engagements with Black urban adolescent males, each with an incarcerated parent. Two researchers, a counseling psychologist and a teacher educator, collaborated to create a strengths-based after-school program with culturally relevant literacy instruction as their primary objective. The 2 case study findings reveal the complexities of choosing culturally relevant texts, the need for motivation and engagement in order to build skills, and the fact that relationships are essential in the delivery of culturally responsive literacy instruction. The article concludes with recommendations for teachers working with at-risk Black adolescent males that focus on student empowerment, academic success, and building successful futures. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the XXIV Annual Conference of the European Society for Population Economics held at the Conference Center South in Essen, Germany from June 9 to 12, 2010. The event featured various papers, posters and lectures , along with updates on the European Society for Population Economics. A list of the papers presented at the event is also presented.

The essay discusses a passage in the book, "The Seventh Century in West-Syrian Chronicles," by Andrew Palmer. Palmer's translation of a reconstructed text of the lost secular history of Dionysius of Tell Mahre (d. 845) and an error in a key phrase in the part about the assassination of the second caliph 'Umar b. al-Khattāb are discussed.

Religion can reinforce tribal loyalties that lead to hatred and violence, but it also happens to be one of the oldest, deepest, most universal needs of the human soul. Religious leaders are continually ignored in the Israeli-Palestinian peace process even though they are essential to the implementation of any agreement. The Israeli settlements issue is an example of how a religiously-based ideology can distort political processes. The best kind of religious witness is being willing to break a cycle of retribution and to try to establish something different. This is an edited and abridged transcript of a presentation and panel discussion. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 23rd General Assembly of the European Society for Population Economics (ESPE) which was held in Seville, Spain on June 20, 2009. Organizers received several papers submitted for consideration, while delegates attended lectures by Bruno Frey from the University of Zurich and Barbara Petrongolo of the London School of Economics. The issue of converting ESPE to a registered non-profit organization is also considered in the assembly.

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The decisions of business leaders and government officials are currently guided by economic and social indicators. It is proposed that accounts of well-being be collected on an ongoing basis to complement the existing indicators. Accounts of subjective well-being would track the societal groups where happiness, life satisfaction, engagement, and positive feelings are high versus low, would indicate the activities that people find enjoyable versus unpleasant, and would monitor changing levels of well-being over time. The accounts would serve decision-makers by making important information on well-being and ill-being available to them. They would also greatly help applied psychology by drawing more attention and interest to important outcomes that are likely to result from psychological interventions. Les décisions des chefs d’entreprise et des responsables gouvernementaux se fondent actuellement sur des indicateurs sociaux et économiques. On propose de recueillir des données relatives au bien-être de façon continue en complément des indicateurs existants. Les mesures du bien-être subjectif détecteraient les groupes sociaux où le bonheur, la satisfaction de vivre, le sens des responsabilités et les sentiments positifs sont élevés ou bas, indiqueraient les activités que les gens trouvent agréables ou non et suivraient avec le temps les changements dans le niveau du bien-être. Ces mesures seraient utiles aux décisionnaires en mettant à leur disposition des informations importantes sur le bien-être et son contraire. Elles seraient aussi d’un grand secours pour la psychologie appliquée en accordant davantage d’attention et d’intérêt aux conséquences importantes susceptibles de résulter des interventions psychologiques. [ABSTRACT FROM AUTHOR]

This paper argues that therapy tends to reproduce a particular version of personhood, identified by Sampson's notion of the self-contained individual. The self-contained individual is a contemporary Western construction, which requires a denial of the interactive processes that permit its appearance and idealization. Focusing on constructionist therapies, it is argued that therapists use rhetorical strategies to more or less systematically argue for self-containment as a preferred way of being. These rhetorical manoeuvres render different aspects of self-containment plausible, practicable and 'real', while alternative versions of the self and behaviour are discursively minimized, becoming less plausible in the process. An analysis of two family therapy sessions is then used to illustrate these processes. It is suggested that therapy may reproduce Western ideals about being human. [ABSTRACT FROM AUTHOR]

AIMS OF THE PAPER: This paper explores psychoanalytic ideas of containment as described by Wilfred Bion and applies them understanding the concerns of a woman with serious illness and her husband. A case vignette shows psychoanalytic thinking in context. The paper explores verbatim exchanges that took place in a room just off a hospital ward and offers a psychoanalytically informed analysis. RATIONALE: This discussion suggests that the impact of physical illness is such that there is potential for the seriously ill to saturate health workers in anxiety and raw feelings. To protect themselves, nurses and other health workers could sometimes unconsciously overlook the emotional care of people in favour of routines, physical aspects of care and other demonstrable methods of treatment. CONCLUSIONS: Drawing on the work of Isabel Menzies Lyth, the discussion concludes by recommending that environments are needed in which a person with serious illness or family member can be helped to make sense of his or her experiences and so integrate them into a meaningful life continuum. Similar conditions are perhaps needed for nurses or other health workers. Appropriate methods of work discussions in clinical supervision might conceivably provide these important requirements. [ABSTRACT FROM AUTHOR]

This article presents a systems approach towards school/home issues related to grief and loss within the families of disabled students. Many times, the implications for the families of children having birth defects, traumatic illnesses, or accidents are not addressed fully in the process of planning the schools' interventions and accommodations for the disabled students. The article authors address the systemic needs of the families of these students in terms of their interactions with school personnel. Although the school psychologist may be a key person in the family counseling process, any team member who is versed in family systems counseling, such as the social worker or the school guidance counselor, can be the principal therapist. Because of the complex nature of disabling conditions and the effects they have on individual families, the authors encourage schools to develop resources that will be helpful to family counselors and other staff who work with families. A systemic approach can only help improve relationships between schools and families, fostering family growth and change as well as viable instructional plans for students.