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Introduction Many studies of Black–White disparities in living donor kidney transplantation hypothesize that they were partially due to Black–White differences in candidate social network access to healthy, willing donors. This differential access hypothesis has not been tested using directly measured social network data. Research Questions Do black kidney transplant candidates have perceived lower social network access to health and/or willing living donors than white candidates? Design A cross-sectional survey that measured the social network members was collected in 2015. Black–White differences in patient counts of perceived healthy and/or willing potential donors in social networks, and individual network members’ probability of being perceived healthy and/or willing, were compared using logistic and negative binomial regression models. Results The survey included 66 kidney transplant candidates reporting on 1474 social network members at a large Southeastern US transplant center in 2015. Black and White patients had similar access to perceived healthy, likely potential donors (86% vs 87% had 1 or more, P = .92; 5.91 vs 4.13 mean counts, P = .20) and perceived healthy, agreed potential donors (56% vs 48%, P = .54; 1.77 vs 1.74, P = .97). Black patients’ network members were individually more likely to be perceived healthy and likely potential donors (26% vs 21%, P = .04), and White patients’ network members were more likely to have agreed (13% vs 9%, P = .03), but these differences were statistically insignificant in demographically adjusted models. Conclusion Black and White transplant candidates perceived access to similar numbers of potential donors in their social networks. This result does not support the differential access hypothesis.

Glacier forelands provide important sites to study climate-forced ecological succession because a chronosequence is apparent along a single valley. However, most studies of invertebrate succession in forelands provide a single snapshot of community assemblage patterns. With glaciers retreating rapidly worldwide, it is important to begin re-surveying community composition and assessing changes in relation to new terrain revealed by the retreating ice. In this study, we repeat a survey of spiders and beetles along the glacier foreland of the sub-alpine glacier Austerdalsbreen in western Norway, 15 years after an initial assessment in 2004, during which time the glacier has retreated 400 m. Invertebrates were sampled in 18 sites that represent a terrain age gradient of approximately 10–250 years since glacier recession. Forty spider species and 70 beetle species were identified, constituting the richest record in Nordic glacier forelands for these two taxonomic groups. Furthermore, three distinctive stages of succession were determined using TWINSPAN and NMDS: (1) a pioneer colonizer stage; (2) an intermediate successional stage; and (3) two late colonizer stages. Additionally, a species group of omnipresent species was identified. The transition from pioneer stage to early succession was characterized by a high degree of taxonomic replacement. Compared to the findings in 2004, we found that the composition of species groups on relatively old terrain is becoming more similar, while the differences between the species groups on the younger terrain are widening. This discrepancy is discussed in relation to climate warming, which potentially facilitates faster establishment of vegetation and early successional invertebrates and may therefore increase competition stress for cold-adapted pioneer species.

Background The Fontan circulation challenges the lymphatic system. Increasing production of lymphatic fluid and impeding lymphatic return, increased venous pressure may cause lymphatic dilatation and decrease lymphatic contractility. In-vitro studies have reported a lymphatic diameter-tension curve, with increasing passive stretch affecting the intrinsic contractile properties of each thoracic duct segment. We aimed to describe thoracic duct occlusion pressure and asses if thoracic duct dilation impairs contractility in individuals with a Fontan circulation and lymphatic failure. Methods Central venous pressure and thoracic duct measurements were retrospectively collected from 31 individuals with a Fontan circulation. Thoracic duct occlusion pressure was assessed during a period of external manual compression and used as an indicator of lymphatic vessel contractility. Measurements of pressure were correlated with measurements of the thoracic duct diameter in images obtained by dynamic contrast-enhanced MR lymphangiography. Results The average central venous pressure and average pressure of the thoracic duct were 17 mm Hg. During manual occlusion, the thoracic duct pressure significantly increased to 32 mm Hg. The average thoracic duct diameter was 3.3 mm. Thoracic duct diameter correlated closely with the central venous pressure. The rise in pressure following manual occlusion showed an inverse correlation with the diameter of the thoracic duct. Conclusion Higher central venous pressures are associated with increasing diameters of the thoracic duct. When challenged by manual occlusion, dilated thoracic ducts display a decreased ability to increase pressure. Dilatation and a resulting decreased contractility may partly explain the challenged lymphatic system in individuals with a Fontan circulation.

High-profile charity scandals have always represented a threat to the nonprofit sector, which relies on public trust and funding to operate. We systematically review 30 years of empirical research on scandals involving nonprofits and present both quantitative and qualitative syntheses of the 71 articles identified. Informed by this review, we generate a conceptual model theorizing the causes and consequences of scandals, as well as how nonprofits can best prevent and respond to organizational transgressions. We then put forward a research agenda that elaborates five key factors that are especially important for understanding nonprofit scandals but remain understudied: (a) integrity versus competence violations, (b) moral licensing, (c) the multilevel nature of organizational transgressions, (d) sectoral causes of scandal, and (e) effective responses. We close the article with recommendations for nonprofit managers about how to conceptualize, prevent, plan for, and respond to transgressions occurring within their organizations, and any resulting scandals.

Objectives: This paper compares the evolution of the psychosocial sector in two Australian regions pre and post introduction of the National Disability Insurance Scheme – a major reform to the financing, planning and provision of disability services in Australia, intended to create greater competition and efficiency in the market, and more choice for service users. Methods: We used a standardised service classification instrument based on a health ecosystems approach to assess service availability and diversity of psychosocial services provided by non-government organisations in two Primary Health Network regions. Results: We identified very different evolutionary pathways in the two regions. Service availability increased in Western Sydney but decreased in the Australian Capital Territory. The diversity of services available did not increase in either Primary Health Network 4 years after the reform. Many services were experiencing ongoing funding uncertainty. Conclusion: Assumptions of increased efficiency through organisational scaling up, and a greater diversity in range of service availability were not borne out. Implications: This study shows the urgent need for evaluation of the effects of the NDIS on the provision of psychosocial care in Australia. Four years after the implementation of the NDIS at vast expense key objectives not been met for consumers or for the system as a whole, and an environment of uncertainty has been created for providers. It demonstrates the importance of standardised service mapping to monitor the effects of major reforms on mental health care as well as the need for a focus at the local level.

Workplace violence (WV) is a significant occupational hazard for home health care workers (HHCWs). HHCWs are frequently exposed to Type II (customer/client) WV incidents but minimal evidence exists about exposure to Type III (coworker) WV and exposure to Type IV (personal relationship) WV is unknown. Furthermore, exposure to WV incidents is often underreported by HHCWs. The Haddon Matrix guided this research study. A cross- sectional research design was used with HHCWs (n = 50) working in Southwest Ohio in April 2020. HHCWs completed the Workplace Violence Reporting Survey, a 76-item tool used to estimate the frequency and reporting of WV incidents. Data were analyzed using frequencies, percentages, means, and standard deviations. HHCWs were 86% female (n = 43). Patients (28.3%) followed by their families (17.4%) and intimate partners (10.9%) are the primary aggressors of verbal abuse. The incident was too minor (6.5%), no action would be taken (6.5%), and it’s part of the job (4.3%) are major reasons HHCWs underreported WV. Type II WV is most pervasive when the aggressor is the patient. HHCWs experience physical assault and sexual abuse in their work environment. HHCWs underreported verbal abuse and physical assault when the aggressor was an intimate partner.

Introduction: The primary self-assessment questionnaire used for patients with chronic cough is the Leicester Cough Questionnaire (LCQ). The LCQ is a validated questionnaire that ranges in total score from 3 to 21. While it is known that a higher score on the LCQ reflects a better quality of life, normative data have not been reported for this questionnaire. Objective: The purpose of this study was to determine normative LCQ scores on a healthy population without cough. Methods: The LCQ was distributed via electronic survey to the authors’ universities, professional affiliation email lists, and personal contacts. Participants were included if they were at least 18, nonsmokers, and without abnormal cough, without pulmonary disease, and without neurological disease. Participants answered questions regarding age, gender, and race/ethnicity, and completed the 19 LCQ questions. Results: One hundred forty-three (118 women) LCQ responses were analyzed. Average participant age was 47 years (SD = 13) and 133 (93%) were Caucasian. The mean LCQ Total score was 20.23 (SD = 0.85) with scores ranging from 17.05 to 21. Conclusions: This study determined the following LCQ scores should be considered normal threshold scores: Total score – 17.68, Physical domain – 5.36, Psychological domain – 5.81, and Social domain – 6.06. The findings of this study will assist clinicians in determining severity of cough impact on quality of life using the LCQ. Further research is needed to ensure more complete participant demographic representation.

This article addresses the following research question: does the entrepreneurial orientation of a university influence the entrepreneurial propensity of its academics? To answer this question, the authors conducted a two-phase study. First, based on a literature review of the entrepreneurial university and Nelles and Vorley’s theoretical framework on entrepreneurial architecture, they developed a conceptual model and research instrument to assess academics’ perceptions of the characteristics most likely attributed to the entrepreneurial university and their effects on an academic’s entrepreneurial propensity. Second, the authors used the research instrument to conduct a pilot study of the effect of a Canadian university’s entrepreneurial orientation on its academics’ entrepreneurial propensity. The pilot study, using the proposed methodology with detailed accounts of collecting, analyzing and interpreting the data, suggests that the proposed methodology is appropriate for measuring the relationship alluded to in the research question. Furthermore, the methodology can help university leadership in designing possible interventions to correct identified deficiencies in the university’s entrepreneurial architecture to stimulate academic entrepreneurship on campus.

Autistic students experience strengths and challenges that can impact their full inclusion in higher education, including stigma. A participatory team of autistic and non-autistic scholars developed an autism and universal design (UD) training. This participatory approach centered the voices of autistic collaborators in training design and evaluation. Ninety-eight educators from 53 institutions across five countries completed assessments before training (pre-tests), 89 completed post-tests (after training), and 82 completed maintenance assessments (a month after post-test). Pre-test autism stigma was heightened among males, educators with less autism knowledge, and those who reported heightened social dominance orientation. Autism knowledge, autism stigma, and attitudes toward UD improved with training. Improvements remained apparent a month after post-test but were somewhat attenuated for knowledge and stigma. To the best of our knowledge, this is the first evidence of maintenance of benefits of an autism training over time. Participants’ main reason for enrolling in the study was to gain a better understanding about neurodiversity. Feedback indicates that this goal was reached by most with the added benefit of gaining understanding about UD. Results suggest that interest in one type of diversity (e.g. autism) can motivate faculty to learn UD-aligned teaching strategies that benefit diverse students more generally. Lay abstract Autistic university students have many strengths. They also go through difficulties that professors may not understand. Professors may not understand what college life is like for autistic students. They might judge autistic students. A team of autistic and non-autistic researchers made a training to help professors understand autistic students better. This training also gave professors ideas to help them teach all of their students. Ninety-eight professors did an online survey before the autism training. They shared how they felt about autism and teaching. Before our training, professors who knew more about autism appreciated autism more. Professors who thought people should be equal and women also appreciated autism more. Then, 89 of the professors did our training and another survey after the training. This helped us see what they learned from the training. They did one more survey a month later. This helped us see what they remembered. Our training helped professors understand and value autism. It also helped them understand how they can teach all students better. The professors remembered a lot of what we taught them. This study shows that a training that autistic people helped make can help professors understand their autistic students better.

This study examined the associations between remote acculturation to European American culture of the United States (U.S.), and physical activity levels among Jamaican mother-adolescent dyads. Remote acculturation, a modern type of globalization-facilitated acculturation to a distant non-native culture, is a demonstrated risk factor for some health outcomes, but the association with physical activity has not previously been examined. Mothers and adolescents ( N = 660; 330 dyads) were recruited from schools in Kingston, Jamaica. Actor-Partner Interdependence Moderation Models tested hypotheses about actor and partner effects of U.S. cultural orientation on moderate and vigorous physical activity (MVPA), and the moderation of these effects by developmental stage, socioeconomic status (SES), and gender. We observed a contrast pattern of moderation consistent with increased autonomy granting across adolescence, such that the signs (positive/negative) of the actor and partner effects depended on adolescent developmental stage. The actor effect of adolescents’ U.S. orientation on their own MVPA was negative for early adolescents (unexpected) and positive for mid-adolescents (expected); by contrast, the partner effect of mother’s U.S. orientation on adolescents’ MVPA was positive for early adolescents (expected) and negative for mid-adolescents (unexpected). SES and gender did not moderate the associations. This study contributes to an emerging body of literature on the health correlates of remote acculturation. Our results suggest that whether remote cultural orientation is a risk or protective factor varies based on the health domain in question, developmental stage, the remote culture, and the context.

Background: The threat of workplace violence (WPV) is a primary safety concern for home health care workers (HHCWs). WPV prevention training is a critical tool for HHCWs’ safety. Yet, most existing WPV prevention training is limited or not specific to HHCWs’ environment, the patient’s home, and neighborhood. The purpose of this study was to describe WPV prevention training, resources used, and commitment to HHCWs’ safety. Methods: Using a cross-sectional design, HHCWs from two sites located in Southwestern Ohio completed the Violence Against Home Healthcare and Hospice Workers survey, a 37-item survey used to describe frequency and characteristics of WPV prevention training and resources. Descriptive statistics were used to analyze the data. Findings: Half ( n = 25) of the HHCWs received WPV prevention training. Training content focused on characteristics of aggressive/violent patients and family members ( n = 19, 82.6%), but limited content about characteristics of hazardous neighborhoods ( n = 15, 65.2%). Cellular phones ( n = 43, 97.7%) were primarily used as a resource to promote safety, few cellular phones ( n = 1, 2.3%) were provided by the agency. Conclusions/Application to Practice: HHCWs described WPV prevention training content and resources used to promote safety. WPV prevention training is deficient in procedures for seeking psychological care, screening patients for violent behavior, skills for self-protection, characteristics of hazardous neighborhoods, and physical maneuvers and verbal methods to diffuse or avoid aggressive behavior. Access to WPV prevention training and resources for HHCWs needs to be strengthened. Occupational Health Nurses can assist their employers with developing WPV prevention training for HHCWs.

Background: Monitoring of capillary refill time (CRT) is a common bedside assessment used to ascertain peripheral perfusion in a patient for a vast array of conditions. The literature has shown that a change in CRT can be used to recognize life-threatening conditions that cause decreased perfusion, such as sepsis, and aid in resuscitation. The current practice for calculating CRT invites subjectivity and produces a highly variable result. Innovative technology may be able to standardize this process and provide a reliable and accurate value for use in diagnostics and treatment. This study aimed to assess a new technology (DCR by ProMedix Inc.) for rapid, bedside, and noninvasive detection of CRT. Methods: This was a secondary analysis of a prospective observational study evaluating the accuracy of new technology towards CRT-guided diagnosis of sepsis. It was carried out in the adult emergency departments (ED) of an academic tertiary care medical center. Patients seeking care in the ED were determined eligible if they were > 18 years in age and exhibited chief complaints suggestive of possible sepsis. The CRT produced by the technology was compared to the gold standard manual waveform assessment. Results: 218 consecutive subject enrollments were included and multiple measurements were made on each patient. Data with irregular waveforms were excluded. A total of 692 waveforms were evaluated for CRT values by a pair of trained PhD biomedical engineers. The average age of the cohort was 50.62 and 51.4% female. Results showed a Pearson correlation coefficient of 0.91 for the device CRT compared to the CRT gold standard. The Pearson correlation coefficient for the two independent engineering review of the waveform data was 0.98. This device produces accurate, consistent results and eliminates the subjectivity of CRT measurements that is in practice currently.

Identifying family strengths is central to early childhood practices. Moving beyond identification to exploring and explicitly applying those strengths can evolve strengths-based and family capacity-building practices. Assessment and planning processes that focus on the strategies families use to help their child learn can give agency to families in this parenting role. This exploratory study examined the perspectives of seven families who participated in an early intervention assessment-to-planning approach that sought to uncover, understand, and utilize the strategies families used to help their child learn and their appraisals of those strategies. Family responses during qualitative interviews were analyzed into three themes: (1) naturalistic observations yield naturalistic understandings, (2) practices that honor family strengths and family fit, and (3) self-discovery and self-affirmation. Implications for evolving family capacity-building approaches are discussed.

Chronic pelvic pain (CPP) is a common and complex condition. It affects up to 24% of women worldwide (1:6) and has a prevalence rate similar to asthma or back pain. The International Association for the study of Pain defines it as: ‘chronic or persistent pain perceived in structures related to the pelvis of either men or women. It is often associated with negative cognitive, behavioural, sexual, and emotional consequences as well as with symptoms suggestive of lower urinary tract, sexual, bowel, pelvic floor or gynaecological dysfunction.’ CPP lasts over 6 months and causes functional problems to the lives of sufferers.