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When classroom facilities are out of date, students complain (Habaci et al., in Procedia Soc Behav Sci 64:58-64 2012, https://doi.org/10.1016/j.sbspro.2012.11.008). But, before students arrive on campus, what do they know about their classrooms? Media has changed how people acquire information; websites are second only to college tours in influencing prospective students (Langmead in How college websites influence students' web experience. eCampusNews. Today's Innovation in Education (2013). https://www.ecampusnews.com/2013/03/21/how-college-websites-influence-students-web-experience/?all); furthermore, photographs impact website design (Kolowich in 14 of the best college websites (And why they're so awesome) (2019), Hubspot. https://blog.hubspot.com/marketing/best-college-websites). Can photographed classrooms influence judgments of the institution itself? In this 2 × 2 between-subjects experiment, participants read a scenario about a college too far away to visit and viewed a website picture of a seminar room (unrenovated or renovated) before responding to measures of classroom satisfaction and college academic life more broadly (e.g., student retention). Institutional rank (mentioned or not), was the 2nd variable. Participants were 300 AmazonMTurk workers, 237 of whom passed manipulation checks and were retained in analyses. The classroom furnishings comprised a scale (10 items, Cronbach's alpha = 0.879), as did questions dealing with perceptions of the institution (9 items, Cronbach's alpha = 0.897). Analyses revealed a significant main effect for renovation status, for both the furnishings scale (p < 0.001) and perceptions of the institution (p < 0.001), but not for rank (p = 0.052), with an institution being ranked in the top 50 being viewed more positively. For renovation status, the newer classroom was viewed more positively for both scales. Classroom status also significantly influenced estimates of first-year student retention (renovation status, p < 0.001; rank, p = 0.027), with higher estimates of retention for the renovated classroom and when rank was mentioned.

This paper reads the sale of citizenship via citizenship‐by‐investment (CBI) programmes through an offshore lens. Scholarship on offshore industries has long positioned citizenship sales as part of offshore capitalism—without exploring the phenomenon in any depth. Research on CBI, in turn, has with some notable exceptions neglected the phenomenon's offshore nature. This paper argues that CBI is an outgrowth and increasingly integral part of offshore capitalism, offering a new form of what Susan Roberts calls “regulatory arbitrage”, aiding elite wealth accumulation and power. The paper establishes this relationship by examining the countries and firms selling citizenship, their marketing strategies and customers and, crucially, the nature of the product which rests on the three “offshore pillars”, as described by Ronen Palan—virtual residency, easy incorporation, and secrecy. Conceptualising CBI as an offshore provision can transform how the phenomenon is understood and opens new avenues of thinking about its socio‐structural role and impact in an unequal world. [ABSTRACT FROM AUTHOR]

Although antibodies remain the most widely used tool for biomedical research, antibody technology is not flawless. Innovative alternatives, such as Nanobody® molecules, were developed to address the shortcomings of conventional antibodies. Nanobody® molecules are antigen-binding variable-domain fragments derived from the heavy-chain-only antibodies of camelids (VHH) and combine the advantageous properties of small molecules and monoclonal antibodies. Nanobody® molecules present a small size (~15 kDa, 4 nm long and 2.5 nm wide), high solubility, stability, specificity, and affinity, ease of cloning, and thermal and chemical resistance. Recombinant production in microorganisms is cost-effective, and VHH are also building blocks for multidomain constructs. These unique features led to numerous applications in fundamental research, diagnostics, and therapy. Nanobody® molecules are employed as biomarker probes and, when fused to radioisotopes or fluorophores, represent ideal non-invasive in vivo imaging agents. They can be used as neutralizing agents, receptor-ligand antagonists, or in targeted vehicle-based drug therapy. As early as 2018, the first Nanobody®, Cablivi (caplacizumab), a single-domain antibody (sdAb) drug developed by French pharmaceutical giant Sanofi for the treatment of adult patients with acquired thrombocytopenic purpura (aTTP), was launched. Nanobody® compounds are ideal tools for further development in clinics for diagnostic and therapeutic purposes. [ABSTRACT FROM AUTHOR]

Background: Neonatal patients who no longer require level IV neonatal intensive care unit care are transferred to less acute levels of care. Standardized assessment tools have been shown to be beneficial in the transfer of patient care. However, no standardized tools were available to assist neonatal providers in the assessment and communication of the infants needs at transfer.Purpose: The purpose was to develop a Transfer Assessment and Communication Tool (TACT) that guides provider decision making in the transfer of infants from a level IV neonatal intensive care unit to a less acute level of care within a regionalized healthcare system.Methods: Phase 1 included developing the first draft of the TACT using retrospective data, known variables from published literature, and study team expertise. In phase 2, the final draft of the TACT was created through feedback from expert neonatal providers in the regionalized care system using e-Delphi methodology.Results: The first draft of the TACT, developed in phase 1, included 36 characteristics. In phase 2, nurses, nurse practitioners, and physician experts representing all levels of newborn care participated in 4 e-Delphi surveys to develop the final draft of the TACT, which included 74 weighted characteristics.Implications For Practice and Research: Potential benefits of the TACT include improved communication across healthcare teams, reduced risk for readmission, and increased caregiver visitation. The next steps are to validate the TACT for use either retrospectively or in real time, including characteristic weights, before implementation of this tool in the clinical setting. [ABSTRACT FROM AUTHOR]

Immigrant integration is a key concern in migration research. Yet, recent critiques argue that "immigrant integration" amounts to a neo-colonial form of governance and that scholarship needs to study the discourse of integration, rather than operationalize integration as analytical tool. Drawing on ethnographic research in Nairobi, this article engages and develops these critiques in two ways. It discusses how the notion "integration" is used as a "category of practice" in relation to privileged migrants, so-called expats, in ways that reflect personal anxieties and aspirations, uneven power relations and structural inequalities. Further, the article suggests "provincializing" integration as a way forward: (re)visiting "integration discourse" from its constitutive objects, others, and silences. This requires placing more centrally the voices of those assumedly in need of integration and examining how integration is formulated, practized and contested also in relation to privileged migration and in the Global South. [ABSTRACT FROM AUTHOR]

The final panel considered whether it was productive to approach migration from the perspective of a global middle class, a concept first advanced by economists in the early 2000s (Milanovic & Yitzhaki, 2002). While they defined it in quantitative terms, does such a class carry distinctive qualitative traits or a shared identity or set of values that apply across borders? Do we see evidence for the theory that 'postmaterial' values are becoming global as middle-class lifestyle spread (Inglehart, 2018), and how does this relate to migration? Can it be linked to particular temporal (present-oriented) and spatial (downscaling) aspirations? How does migration both reflect and constitute social stratification? Does the migrant middle class develop new class sensitivities that could be critical of sending-country class structures or are class identities transplanted seamlessly? If there is a global middle class, does it reconfigure global racial hierarchies?. [ABSTRACT FROM AUTHOR]

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Rosita Armytage. 2020. Big capital in an unequal world: The micropolitics of wealth in Pakistan. London: Berghahn Books. Ashley Mears. 2020. Very important people: Status and beauty in the global party circuit. New York: Princeton University Press. [ABSTRACT FROM AUTHOR]

Objectives: To address a gap in the literature by investigating the subjective experience of participants to the form and content of medical information displayed in a healthcare setting. Background: Artwork can enhance the experience of patients, but much less is known about how individuals react to displays of medical information in the form of posters or pamphlets, especially those about unsettling conditions (e.g., skin cancer). Methods: In a 2 × 2 × 2 between-subjects design, researchers investigated the content of medical information (skin cancer vs. skin care) that was on display in a simulated exam room, whether the form was a pamphlet or a poster, and reason for the visit (routine annual skin check or evaluating a mole) on measures of subjective experience, including anxiety. Results: Viewing material about skin cancer produced greater anxiety and greater arousal than did viewing material about sunscreen, and given the choice of four images (pamphlet and poster for sunscreen, pamphlet and poster for skin cancer), the sunscreen poster was recommended to improve the patient's experience and lower stress. In terms of display format, posters are judged to provide more visual engagement than are pamphlets. Conclusions: Exam rooms should offer multiple opportunities for visual engagement without images that produce anxiety. More research is needed to understand the subjective experience of the patient's interaction with the content and format of medical information. [ABSTRACT FROM AUTHOR]

'Expatriate' is an unstable and contested term, as emphatically embraced by some, as rejected by others. The category 'migrant', on the other hand, can have all the veneer of a self-evident and technical category. Yet, their tense relationship suggests the usefulness of an examination of their co-production and combined effects. This article explores the everyday socio-cultural production of the category 'migrant' in its tense relationship with the category 'expatriate'. More specifically, it draws on 8 months of ethnographic research in Nairobi and The Hague to examine how participants deploy the category 'migrant' in the context of conversations about 'expatriates' or 'expatriate' lives. The article argues that the category 'migrant' emerges as polysemic and malleable as it is constructed with and against the 'expatriate'; both categories are joined by a constitutive but not straightforward relationship that is deeply politicised and specifically works to reproduce racialised power relations. The polysemy of these overlapping terms is thus reflective of and operative in racialised power relations in ways that demand more analytical attention. As such, the categories' relationship reflects the 'polyvalent mobility' of race as it works through ostensibly neutral migration categories and 'takes on the form of other things'. [ABSTRACT FROM AUTHOR]

Objective: The study fills a gap in the literature by examining the size of the art displayed and waiting time in an exam office on patients' judgments of the quality of care they are likely to receive. Background: A body of research shows that the content of art in healthcare settings has an impact on patients' well-being, yet no work has empirically systematically examined the size of the art displayed on perceived healthcare outcomes. Method: A fully crossed 4 ×2 between-subjects experimental design examined the impact of exposure to images in an outpatient exam room that varied in the size of what was displayed (a landscape scene: small, medium, large, and control—blank wall) crossed by the time waiting for the physician (10 vs. 45 min). The Dependent Variables were the reported anxiety and various measures of satisfaction with the healthcare visit. Results: The size of the art had a significant effect on the majority of the dependent variables; specifically, the large image had a more positive impact than the other sizes; longer waits were also negatively evaluated by patients and affected anxiety and judgments of room spaciousness. Conclusions: Identifying the recommended content of art displayed is necessary but not sufficient; the size of the art in its context has the potential to impact a range of important perceptions related to healthcare. When the size does not match the available wall space (i.e., the canonical size was not utilized), a variety of ratings of the healthcare environment (including the practitioner) were negatively affected. [ABSTRACT FROM AUTHOR]

This paper traces the category "expatriate" in the Royal Dutch Shell Group of Companies, focusing on two key moments of corporate structural change in the 1950s and 1990s. The paper examines how the "expatriate" was materially and narratively produced by the corporation, by employees labelled expatriate and by spouses. It interrogates continuities and transformations, and their power effects, inquiring who became an expatriate, for what purposes, what meaning the category was inscribed with, and how it was lived. The central argument of the paper is that the Shell "expatriate" has a postcolonial genealogy: its constitution, functions, and lived experience cannot be understood without accounting for histories of European imperialism. The category initially reified imperial power relations – indeed, was instrumental to their racialised production. The mid‐century "racial break" prompted changes, yet did not result in the wholesale decolonisation of corporate mobilities and managerial hierarchies as imperial differentiations and logics continued to work in the postcolonial corporation, if in adapted and ambiguous ways. Similarly, the Shell "expatriate" was a gendered construct that not only denoted husbands' corporate control but increasingly depended on women's organisational, emotional, and social labour, until its gendered destabilisation in the 1990s. The shifting and fragmented category "expatriate" thus reflects how racialised and gendered logics were (re)worked, by and for corporate management, in contested and ambiguous ways. More generally, the paper historicises contemporary managerial arrangements of multinational firms, which depend squarely on migration, and shows them to be central to the postcolonial production of racial capitalism. It thereby contributes to furthering the dialogue between postcolonial and economic approaches in geography. This paper traces the genealogy of the category "expatriate" in the Royal Dutch Shell Group of Companies, focusing on two key moments of structural change in the 1950s and 1990s. The central argument is that the Shell "expatriate" has a postcolonial genealogy: its constitution, functions, and lived experience cannot be understood without accounting for histories of European imperialism. The shifting and fragmented migratory category "expatriate" reflects how racialised and gendered logics were (re)worked, by and for corporate management, in contested and ambiguous ways. [ABSTRACT FROM AUTHOR]

This paper theorizes the border as imbricated in everyday life, especially in a small territory such as Gibraltar. We document the results of a 2018 survey of Gibraltarians' attitudes toward the frontier between the 2016 Brexit referendum and the planned departure of the UK from the EU in 2019. We argue that virtually all respondents felt that a change in the border regime would affect community cohesion and identity. Second, we argue that generational differences within Gibraltar are productive of variegated attitudes towards Brexit and the frontier. Generational differences are complicated by the dynamism of Gibraltar's population composition. [ABSTRACT FROM AUTHOR]

Migrants who are privileged by citizenship, class or 'race' are largely still absent from mainstream migration research and theory; until recently, they were generally assumed to be adaptable and acceptable cosmopolites, positive drivers of cross-border transfers of knowledge and skills. This has been addressed by an emerging scholarship on 'expatriates'. This article offers a review and critical reading of that literature; it considers the instabilities and ambiguities of the term 'expatriate' and situates expatriate migrants within the global economy, before examining the gendered nature of expatriation and attending to migrants' incorporation in host contexts and expatriate negotiations of identity. The literature suggests that at the heart of these processes lie complex configurations of racialisation, gender, class and nationality, often involving problematic reproductions of the colonial past. This article argues that these issues are inherently related to the category's inconsistencies, rendering it difficult as a 'category of analysis'. Instead, rather than using the term as a pre-given conceptual frame, it needs to be treated as a 'category of practice' to be investigated in its own right. Especially as the subject becomes more established in migration studies, scholars need to reckon with the ongoing challenge that lies in studying the identity category 'expatriate' while resisting reproducing a reified understanding of it. [ABSTRACT FROM AUTHOR]

Parental refusal of a recommended treatment is not an uncommon scenario in the neonatal intensive care unit. These refusals may be based upon the parents' perceptions of their child's projected quality of life. The inherent subjectivity of quality of life assessments, however, can exacerbate disagreement between parents and healthcare providers. We present a case of parental refusal of surgical intervention for necrotizing enterocolitis in an infant with Bartter syndrome and develop an ethical framework in which to consider the appropriateness of parental refusal based upon an infant's projected quality of life. [ABSTRACT FROM AUTHOR]

Objective: To use network analysis to describe the pattern of neonatal transfers in California, to compare empirical sub-networks with established referral regions, and to determine factors associated with transport outside the originating sub-network. Study Design This cross-sectional database study included 6546 infants <28 days old transported within California in 2012. After generating a graph representing acute transfers between hospitals (n=6696), we used community detection techniques to identify more tightly connected sub-networks. These empirically-derived sub-networks were compared to state-defined regional referral networks. Reasons for transfer between empirical sub-networks were assessed using logistic regression. Results: Empirical sub-networks showed significant overlap with regulatory regions (p <0.001). Transfer outside the empirical sub-network was associated with major congenital anomalies (p<0.001), need for surgery (p=0.01), and insurance as the reason for transfer (p<0.001). Conclusion: Network analysis accurately reflected empirical neonatal transfer patterns, potentially facilitating quantitative, rather than qualitative, analysis of regionalized health care delivery systems.

Abstract: Background/Purpose: Gastroschisis is the most common congenital abdominal wall defect. Despite advances in the surgical closure of gastroschisis, consensus is lacking as to which method results in the best patient outcomes. The purpose of this meta-analysis was to compare short-term outcomes associated with primary fascial closure and staged repair with a silo in patients with gastroschisis. Methods: We reviewed Medline citations, as well as the Cochrane Database of Systematic Reviews, between January 1, 1996 and June 1, 2012. Articles were identified using the search term “gastroschisis” and [(“treatment outcome” or “prognosis”) or randomized controlled trials]. Case reports, reviews, letters, abstracts only, non-English abstracts, and studies that did not address at least one of the outcomes of interest were excluded from the meta-analysis. Two independent reviewers identified relevant articles for final inclusion. A standard data collection form created by the authors was used to extract study information, including study design, patient characteristics, and reported patient outcomes. The data were analyzed using standard meta-analytic techniques. Results: Twenty studies were included in the meta-analysis. In the five studies that selected closure method randomly or as a temporal shift in practice, silo was associated with better outcomes, with a significant reduction in ventilator days (p<0.0001), time to first feed (p=0.04), and infection rates (p=0.03). When all studies were included, primary closure was associated with improved outcomes. Conclusions: Silo closure is associated with better clinical outcomes in the studies with the least selection bias. Larger prospective studies are needed to definitively determine the best closure technique. [Copyright &y& Elsevier]

The authors discuss a study by Goldin and colleagues, published within the issue which explored a resource use inflection point (RU-IP) for infants in 43 neonatal intensive care units (ICUs). Topics include definition of RU-IP, initial physiologic instability of newborns, and reason that length of stay is of such interest to payers.

Regionalization, which emphasizes matching patient needs with the capabilities of the hospital in which care is provided, has long been a recommended approach to reducing neonatal morbidity and mortality. Over the past decade, research methods surrounding the measurement and evaluation of such programs have improved, thus strengthening arguments for implementation of these strategies. However, regionalization policies vary widely across regions and between countries, with potential impacts on neonatal outcomes as well as costs of care. It is important to account for geographic and other regional differences when determining the feasibility of regionalization for a specific region, as certain areas and populations may need particular consideration in order for regionalization policies to be successful. [ABSTRACT FROM AUTHOR]

Up to 20% of newborn infants retro-transferred to a lower level of care require readmission to a higher-level facility. In this study, we developed and validated a prediction rule (The Rule for Elective Transfer between Units for Recovering Neonates [RETURN]) to identify clinical characteristics of infants at risk for failing retro-transfer. [ABSTRACT FROM AUTHOR]

Objective: Monthly palivizumab injections from November to March decrease risk of respiratory syncytial virus (RSV)-related hospitalization during RSV season in high-risk infants born less than 35 weeks of gestation. Our objective was to investigate compliance with the American Academy of Pediatrics (AAP) recommendations for palivizumab prophylaxis among children who present to the emergency department (ED) with bronchiolitis., Methods: Seventeen centers, from 9 US states, performed a prospective, observational study of ED patients less than 2 years with an attending physician diagnosis of bronchiolitis. Researchers conducted a structured interview, followed by a chart review, and a 2-week follow-up phone call., Results: Of 825 eligible children, 624 (73%) were enrolled. According to AAP recommendations, 35 children (6%) should have received palivizumab, but only 17 (49%; 95% confidence interval, 31%-66%) did. Prophylaxis with palivizumab did not differ by US region (P > 0.50). The ED clinical presentations were similar when comparing those children that did and did not receive prophylaxis (all P > 0.27). Those receiving palivizumab were more likely to come to the ED using systemic corticosteroids (22% vs 7%; P = 0.003) and to be treated with corticosteroids in the ED (31% vs 15%; P = 0.02). The 2 groups were at similar risk of hospitalization (52% vs 39%; P = 0.11)., Conclusions: According to parental report, only half of children presenting to the ED with bronchiolitis who met AAP criteria for palivizumab prophylaxis received this monoclonal antibody. Emergency department visits provide an untapped opportunity for staff to educate families and communicate with PCPs about RSV prophylaxis.

Malignant peripheral nerve sheath tumors (MPNSTs) are diagnostically challenging neoplasms for which sensitive and specific immunohistochemical markers are lacking. Although limited to date, previous studies have suggested that NF1 (17q), NF2 (22q), p16 (9p), and EGFR (7p) alterations may be involved in MPNST tumorigenesis. To determine whether specific genetic changes differentiate between MPNST and morphologically similar neoplasms, we assessed these chromosomal regions in 22 MPNSTs (9 NF1-associated, 13 sporadic), 13 plexiform neurofibromas, 5 cellular schwannomas, 8 synovial sarcomas, 6 fibrosarcomas, and 13 hemangiopericytomas by 2-color FISH. NF1 deletions, often in the form of monosomy 17, were found in MPNSTs (76%). neurofibromas (31%), hemangiopericytomas (17%), and fibrosarcomas (17%), but not in synovial sarcomas or cellular schwannomas. NF1 losses were encountered more frequently in MPNSTs versus other sarcomas (p < 0.001), as were p16 homozygous deletions (45% vs 0%; p < 0.001), EGFR amplifications (26% vs 0%; p = 0.006), and polysomies for either chromosomes 7 (53% vs 12%; p = 0.003) or 22 (50% vs 4%; p < 0.001). Hemizygous or homozygous p16 deletions were detected in 75% of MPNSTs, but not in benign nerve sheath tumors (p < 0.001). Thus, FISH analysis identifies relatively specific genetic patterns that may be useful in selected cases, for which the differential diagnosis includes low- or high-grade MPNST.