Search

Indigenous Elder advisors in Pelican Narrows, a Cree community in Northern Saskatchewan, have indicated that Western pain scales may not be responsive tools for pain assessments within their community. This study employed a mixed methods research design that involved two phases. Phase one was the development of a pain scale in collaboration with an Elder and a Knowledge Keeper. Phase two was a pilot of the CDPS utilised during virtual physiotherapy sessions for chronic back pain. Twenty-seven participants completed the pre-physiotherapy treatment questionnaires, and 10 participants engaged in semi-structured interviews (9 community members; 1 healthcare provider). A weighted kappa analysis yielded k = 0.696, indicating a good agreement between the CDPS and Faces Pain Scale-Revised in terms of documenting participants' pain. Qualitative data from interviews with community members revealed three major themes: 1) Learnings Regarding Pain Scales, 2) Patient Centered Care; and 3) Strength-Based Solutions for Improving Pain Communication. Two themes were uncovered through conversations with the HCP: 1) Perspectives on CDPS and 2) Healthcare Provider Experiences Communicating about Pain. Moreover, a patient-centredcentred approach is important to ensure comprehensive pain assessments. [ABSTRACT FROM AUTHOR]

Chronic graft-versus-host-disease (cGVHD) is one of the primary causes of morbidity and mortality for patients who undergo allogeneic hematopoietic stem cell transplantation (allo-HCT). In recent years, advancements in allo-HCT have allowed a broader range of patients to receive transplant, particularly older patients. We sought to assess the impact of cGVHD on outcomes in patients undergoing allo-HCT, for older patients as compared to their counterparts. We performed a retrospective analysis of all patients who underwent allo-HCT 1999–2018. Our results showed that those patients who developed cGVHD by D + 180 had an increased risk and incidence of NRM as compared to those patients without cGVHD. There was no significant difference in outcomes for those patients with cGVHD by age (≥60 years old [yo] and <60 yo). These findings suggest the significant morbidity of cGVHD, regardless of age. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of the HealthPrize RespiPoints™ program on treatment adherence and persistence in adults with chronic obstructive pulmonary disease (COPD). Methods: In this retrospective cohort study, program participants and nonparticipants receiving tiotropium bromide (TIO) or TIO and olodaterol between 1 January 2015–31 March 2020 were propensity score matched (PSM), from the linked database of the HealthPrize patient list and IQVIA PharMetrics® Plus. Treatment adherence, persistence, healthcare resource utilization, and costs were compared. Multivariable logistic regression models assessed the odds of adherence (≥80% proportion of days covered [PDC]), adjusted risk of discontinuation, and adjusted total healthcare costs. Results: Program participants (n = 262) demonstrated a 44% greater adherence during followup than nonparticipants (n = 262) (mean [standard deviation] PDC: 0.72 [0.27] vs 0.50 [0.36], p < 0.0001). Participants had higher odds of adherence vs nonparticipants (adjusted odds ratio: 2.51; 95% confidence interval: 1.72–3.66, p < 0.0001) and a lower percentage of participants discontinued their index medication (19.85% vs 33.59%, p = 0.0004). Fewer participants were hospitalized during follow-up (13.74% vs 17.56%, p = 0.23); adjusted total medical costs were 24% lower (p = 0.08). Higher pharmacy costs partially offset lower healthcare costs. Conclusions: Program participants showed improved COPD medication adherence and persistence compared to nonparticipants. [ABSTRACT FROM AUTHOR]

Over the past two decades, antibody-drug conjugates (ADCs) have emerged as a highly effective drug delivery technology. ADCs utilise a monoclonal antibody, a chemical linker, and a therapeutic payload to selectively deliver highly potent pharmaceutical agents to specific cell types. Challenges such as premature linker cleavage and clearance due to linker hydrophobicity have adversely impacted the stability and safety of ADCs. While there are various solutions to these challenges, our team has focused on replacement of hydrophobic ValCit linkers (cleaved by CatB) with Asn-containing linkers that are cleaved by lysosomal legumain. Legumain is abundantly present in lysosomes and is known to play a role in tumour microenvironment dynamics. Herein, we directly compare the lysosomal cleavage, cytotoxicity, plasma stability, and efficacy of a traditional cathepsin-cleavable ADC to a matched Asn-containing legumain-cleavable ADC. We demonstrate that Asn-containing linker sequences are specifically cleaved by lysosomal legumain and that Asn-linked MMAE ADCs are broadly active against a variety of tumours, even those with low legumain expression. Finally, we show that AsnAsn-linked ADCs exhibit comparable or improved efficacy to traditional ValCit-linked ADCs. Our study paves the way for replacement of the traditional ValCit linker technology with more hydrophilic Asn-containing peptide linker sequences. [ABSTRACT FROM AUTHOR]

The purpose of this article is to trace the academic lineage of models of inclusive education in Kenya, as some large international development organisations look to the region as a guide for disability inclusive education programs and projects. With the current focus on developing sustainable inclusive education systems in low-resourced countries in the global South, it is critical to situate this work within the constellation of inclusive education research that came from scholars, from both the global North and South, collaborating in Kenya. In this article, we highlight Kenya as a leader in inclusive education in low-resourced contexts, and we cite recent policies, laws, and research that make this disability inclusive development work innovative and progressive. Specifically, we describe foundational inclusive education teacher training modules and provide appendices with steps for how we applied this work to schools in rural western Kenya. [ABSTRACT FROM AUTHOR]

The debate on the benefits of renewable electrification in late industrializing economies has mostly focused on improved electricity access and climate mitigation arguments. The literature pays less attention to understanding the opportunities for sustainable industrialization. This paper contributes to the latter with insights from a case study of Solinc East Africa, a Kenyan solar module manufacturer that has remained in the market, despite intense competition from imports of low-cost solar panels. Drawing on in-depth fieldwork in the solar energy sector in Kenya, we apply a global value chain framework to explore how and why Solinc has been able to sustain its business. Our findings highlight the challenges of localizing solar manufacturing in Kenya and suggest it may only be possible in rare instances. Specifically, a unique combination of circumstances and factors were revealed that enabled Solinc to gain several advantages including (i) initial access to knowledge and materials from upstream linkages; (ii) downstream integration and partnerships with key distributors and customers; (iii) close proximity to customers; and (iv) provision of complementary and increasingly high value-added services. Our findings present a more positive perspective on the localization of related services, which we argue deserves more attention in the sustainable industrialization debate. [ABSTRACT FROM AUTHOR]

Massive amount of downed timber is generated by hurricanes and tornados. This research studied the properties of wood fibers (WFs) generated from downed loblolly pine (Pinus taeda L.) trees at different maturity (ages 15, 30, and 39 years) with various natural environmental exposure periods (0, 6, and 12 months) for wood polymer composite (WPC) manufacturing. The wood fiber critical properties for WPC manufacturing, including particle size and morphologies, physical and chemical properties, and thermal stability, were characterized. Prolonged environmental exposure increased WF surface roughness. The density and 1% sodium hydroxide solubility of WFs for the 15 – and 30-year-old tree decreased after 12 months of environmental exposure. The WFs generated from the 39-year-old tree contain extractives due to heartwood development, resulting in significantly less moisture absorption. Thermogravimetric analysis results showed no significant change in the thermal stability of WFs generated from the 15 – and 30-year-old trees after natural environmental exposure because of the loss of degraded wood components. The cellulose and lignin thermal degradation peak temperatures decreased by up to 9 and 6 °C for WFs extracted from the 39-year-old tree. The degraded wood components were fixed within WFs due to extractives, causing thermal degradation peak temperatures to decrease. [ABSTRACT FROM AUTHOR]

Background: Pelvic pain is a common complaint among individuals assigned female at birth. However, few studies have explored pelvic pain among transmasculine patients on gender-affirming testosterone treatment, and most of these were performed in adult populations. Aims: The aim of our study was to investigate the prevalence, risk factors, nature and treatment of pelvic pain among trans adolescents on testosterone. Methods: A retrospective cohort study was performed on all trans adolescents started on gender-affirming testosterone treatment at our institution between 2007 and 2020. Results: Among 158 trans adolescents who were started on testosterone therapy and followed-up for at least six months, 37 (23.4%) reported pelvic pain, with a median interval between testosterone initiation and reported onset of pain of 1.6 months (range 0.3-6.4). The prevalence of pelvic pain was higher in patients who were receiving menstrual suppression (n = 36, 26.3%) compared to those who were not (n = 1, 4.8%), giving a risk difference of 21.5% (95% CI 9.8% to 33.2%, p = 0.028). The most common descriptive terms were "cramps" (n = 17, 45.9%) and "similar to previous period pain" (n = 8, 21.6%). A range of different pharmacological strategies were employed, including paracetamol, NSAIDs, danazol, norethisterone, medroxyprogesterone, etonogestrel implant, intra-uterine device, goserelin and pelvic floor physiotherapy, with variable outcomes. Conclusion: In conclusion, we report here – in what is to our knowledge the first time – the prevalence rate of pelvic pain in trans adolescents on gender-affirming testosterone treatment, and observe that a quarter of them described pelvic pain. Limitations of our study include its retrospective nature, which is likely to be associated with under-reporting of pelvic pain, and the limited documentation of the nature and likely causes of this pain within the medical records. Prospective longitudinal studies to better understand the nature, etiology and optimal management of testosterone-associated pelvic pain are therefore warranted. [ABSTRACT FROM AUTHOR]

Harmony can be defined in a musical way as art that combines several musical notes reproduced simultaneously to create sounds that are coherent to human ears and serve as accompaniment and filling. However, working out harmony is not a simple task. It requires knowledge, experience, and an intense study of music theory, which takes time to reach good skills. Thus, systems capable of automatically harmonizing melodies are beneficial for experienced and novice musicians. In this paper, a comparative study between distinct architectures and ensembles of Artificial Neural Networks was proposed to solve the problem of musical harmonization, seeking consistent results with rules of music theory: Multilayer Perceptron (MLP), Radial Basis Function network (RBF), Echo State Network (ESN), Extreme Learning Machines (ELM), and Long Short-Term Memory (LSTM). For this, a processed and defined melody with symbolic musical data serves as input to the system, having been trained from a musical database that contains melody and harmony. The output is the chord sequence to be applied to the melody. The results were analyzed with quantitative measures and the ability to melody adaptation. The performances were favorable to the MLP, which could generate harmonies according to the objectives. [ABSTRACT FROM AUTHOR]

The genus Andropogon sensu lato is known to be polyphyletic. Accordingly, we here adjust part of the classification of the genus to reflect its evolutionary history and morphological diversity. A plastome phylogeny including 20 new plastome sequences confirms a well-supported clade of species broadly corresponding to Andropogon section Leptopogon. Morphological diversity was assessed across Andropogon sensu lato using specimens held at the K, MO, and A/GH herbaria, GrassBase, and photographs of spikelet pairs, with an emphasis on identifying members of this clade and their distinguishing features. The genus Anatherum is here reestablished, expanded to incorporate 45 of the 131 of Andropogon sensu lato species worldwide, and described and illustrated. Five species names in Anatherum are reinstated and new combinations are made for 40 species and one subspecies. Anatherum is most common and diverse in the Americas but also commonly found across Africa. Few species occur in Europe or Asia. Anatherum inflorescences generally have 2 branches, linear and slender internodes and pedicels with long trichomes, small elliptic to lanceolate spikelets, and flat to concave 2-keeled lower glumes with no intercarinal veins visible. Generic circumscription in this group is complicated by its polyploid history and limited understanding of the relationship between genomic composition and key morphological characters. Five species of doubtful generic affiliation are listed for future analysis. [ABSTRACT FROM AUTHOR]

We analysed whether the credibility of the Central Bank of Brazil (CBB) influences the substitution effect between the interest channel and the inflation expectations channel. Specifically, based on a DSGE model, we investigate the effects of central bank credibility on key domestic macroeconomic variables. The results show that higher central bank credibility reduces the harmful effect of fighting inflation on domestic macroeconomic variables. [ABSTRACT FROM AUTHOR]

Wing morphology has been used in taxonomic and systematic studies of insects, often enabling the identification of groups based on the variation. In this study, wing Geometric Morphometrics was used to verify if eastern and western populations of Partamona rustica, separated by the São Francisco River, are discriminated, thus confirming previous molecular data. The two groups of P. rustica exhibited significant differences in wing size and shape. Better differentiation of populations and groups was achieved with the centroid size. We generated dendrograms using Mahalanobis and Procrustes distances, which discriminated the eastern and western populations. Isolation by the distance between morphometric and geographic distances was found. The confirmation of the two population groups points out the need for further studies investigating the occurrence of barriers to gene flow and colonization history in the semiarid region by this stingless bee. [ABSTRACT FROM AUTHOR]

Infertility affects 15% of women of reproductive age in the United States. The use of assisted reproductive technology (ART) has been rising globally, as well as a growing recognition of reproductive factors that increase risk for cardiovascular disease (CVD). Women with infertility who use ART are more likely to have established CVD risk factors, such as obesity, dyslipidemia, hypertension, and diabetes. They are also more likely to experience adverse pregnancy outcomes, which are associated with both peripartum and long-term cardiovascular complications. ART may lead to increased cardiometabolic demands due to ovarian stimulation, pregnancy itself, and higher rates of multifetal gestation. Preeclampsia risk appears greater with frozen rather than fresh embryo transfers. The use of ART and its association with long term CVD has not been well-studied. Future prospective and mechanistic studies investigating the association of ART and CVD risk may help determine causality. Nevertheless, CVD risk screening is critical pre-pregnancy and during pregnancy to reduce pregnancy complications that elevate future CVD risk. This also offers a window of opportunity to connect patients to longitudinal care for early management of cardiometabolic risk profile and initiation of preventive lifestyle and pharmacotherapy interventions tailored toward patient-specific risk factors. [ABSTRACT FROM AUTHOR]

The standard preparative regimen for autologous stem cell transplant (ASCT) in multiple myeloma (MM) is 200 mg/m2 of intravenous melphalan; however, a dose of 140 mg/m2 is often used when concerns exist related to patient age, performance status, organ function, and other factors. It is unclear whether a lower dose of melphalan impacts post-transplant survival outcomes. We performed a retrospective review of 930 patients with MM who underwent ASCT with 200 mg/m2 versus 140 mg/m2 melphalan. On univariable analysis, no difference in progression-free survival (PFS) was observed, however, an overall survival (OS) benefit was observed in patients receiving 200 mg/m2 melphalan (p = 0.04). Multivariable analyses showed patients receiving 140 mg/m2 faired no worse than those receiving 200 mg/m2. While a subset of younger patients with normal renal function may achieve superior OS with a standard dose of 200 mg/m2 melphalan, these findings suggest an opportunity to individualize the ASCT preparative regimen to optimize outcomes. [ABSTRACT FROM AUTHOR]

Research necessarily entails the close interrelation of concepts and arguments, including solutions to a range of meta-questions, whether acknowledged explicitly or not. Despite this, few detailed accounts currently exist that support researchers to develop their complex conceptual architectures, especially in critical realist spheres. Indeed, many published accounts often omit much of this 'messiness' that sits behind, yet is foundational to, research projects. Those accounts that do seek to portray how/why researchers have made decisions (e.g. about connections between research philosophy, methodology, methods, theory and empirical evidence) tend to focus on one set of meta-questions, or occasionally on the relationships between two sets, at a time. Therefore, this paper presents a flexible framework – supported by specific examples from studies – that we hope will be useful in supporting researchers from all traditions, but especially critical realists, to carefully think through and develop more holistic connections in their conceptual architecture. [ABSTRACT FROM AUTHOR]

The concept of the three domains of reality is widely used in empirical critical realist research. However, there has been little scrutiny of how the domains are conceptualized and what they contribute to critical realism and how they should be applied in empirical research. This paper involves four arguments. First, Tom Fryer and Cristián Navarrete argue that the three domains of reality are redundant, confusing, and unsupported by Bhaskar's theorizing. Second, Dave Elder-Vass argues that the three domains schema embodies a distinction between the actual and the non-actual real. Regardless of whether we call them domains we need to retain this distinction. Third, Tobin Nellhaus argues that there are several reasons to uphold the three domains, but 'the empirical' is flawed and must be enfolded within a more encompassing theory. Fourth, Ruth Groff argues that the metaphor of ontological stratification is a problem when readers take it literally, often misconstruing the actual metaphysical content that it is meant to capture. [ABSTRACT FROM AUTHOR]

Empathy and empowerment are crucial person-centered therapeutic processes that are interrelated and co-constructed in discourse by therapist-client dyads. Recently, research recommendations have been made for linguistic analyses of therapeutic processes. The interrelatedness of processes has often been overlooked when these recommendations have been progressed. Research so far has also tended to favor therapist discourse instead of focusing on the co-construction of processes. The publication of protocols enables researchers and therapists to access information about emerging research. Protocol publication can reduce dissemination bias and promotes credibility and trustworthiness of qualitative methodologies. The proposed development and application of a linguistic framework for analyzing empathic and empowering communications by therapist-client dyads in person-centered therapy is described in this protocol. The present status of the study is given, including why and how hybrid linguistic features identified in discourse analysis, pragmatics, and conversation analytic approaches are included. Information about the therapeutic transcripts used as data for framework development is also given for illustrative purposes. The anticipated theoretical and methodological contributions of this research are summarized. Suggested applications of the research outcomes for practice are also described, including their usefulness for trainee person-centered therapists, or for person-centered therapists or researchers who are interested in linguistic methodologies. [ABSTRACT FROM AUTHOR]

At another moment, Wilson links subjective experience and art, juxtaposing the realist theory of art 'which accounts for (aesthetic) experience, subjectivity and the relation between imagination and perception' and the realist theory of science (192). Rather, it is because I take as my starting point the idea that our current approaches to art and the arts, and our cultures that sustain these, are characterised by a TINA compromise form: where the truth in practice - that art is (only) what artists do in the arts, is combined with the falsity in theory - that art is (only) what artists do in the arts. To the extent that my argument enables art to be liberated from the culturally limiting contexts of "aesthetics" or "sciences", I would say I am for aesthetics (and art) in science, just as I am for science in the arts. The "bold" and "ambitious" claim of my realist theory of art is just this - in all instances of art, not just those where the designation "art" is conferred by representatives of "the arts" or the "artworld", art is caring about experience. This is all very reasonable until art is connected back to Wilson's particular view of the aesthetic: 'I have defined aesthetic experience as our emergent experience of being-in-relation with the natural necessity of the world ... and art as the skilled practice of giving shareable form to our aesthetic experience' (192). [Extracted from the article]

To characterize adolescents' practical knowledge of asthma self-management and experiences during acute asthma episodes, and compare practical knowledge between minority and non-minority groups. We conducted a secondary analysis using a qualitative descriptive design of textual data collected from 126 adolescents that participated in a randomized controlled trial of an asthma self-management program. Directed content analysis was conducted using four constructs of asthma self-management including symptom prevention, symptom monitoring, acute symptom management, and symptom communication. Most of the adolescents knew how to prevent exercised-induced bronchoconstriction, but had limited understanding about how to assess and monitor the severity of acute symptoms, appropriately use bronchodilators, seek timely medical help, and communicate acute symptoms to caregivers or healthcare providers during a slow-onset and rapid-onset asthma attack. More minority participants monitored asthma using peak expiratory flow than non-minority participants, who often relied on symptom-based monitoring. Minority adolescents more frequently mentioned bronchodilator use to manage asthma attacks, while non-minority adolescents often reported use of complementary and alternative approaches. Minority youth mentioned accessing healthcare services for acute episodes more often than their non-minority counterparts. Minority participants mentioned communicating acute symptoms to their providers, or family members less frequently than non-minority youth. Adolescents have insufficient practical knowledge about ways to prevent and manage acute asthma. Periodic assessment of learning needs related to asthma attacks should be considered a routine part of clinical visits for adolescents to provide targeted information support to address their identified needs. [ABSTRACT FROM AUTHOR]

IgD multiple myeloma is uncommon. Patients generally present at a younger age and have shorter progression free and overall survivals (OSs). Its rarity has inhibited development of a specific risk stratification system or informed best treatment protocols. We present interphase fluorescence in situ hybridization results from a group of 29 cases. These showed evidence of a decreased male to female ratio, decreased OS in patients aged 70 and over, better outcomes in those with kappa light chain restriction, and CD56 positive patients had longer survivals than those lacking CD56. We discuss the biology of IgD multiple myeloma, the need for prospective studies, and challenges for improvements in diagnosis and treatment. We suggest an International Register to accelerate development of best practice guidelines for diagnosis, risk stratification, and treatment. [ABSTRACT FROM AUTHOR]

Elder reflects - in three parts - on family and friendship, noting references and past/present connections to art, music, Mardi Gras, and sites of cultural heritage. [ABSTRACT FROM AUTHOR]

This is an edited transcript of a keynote paper given at IACR's 2021 Annual Conference. The paper outlines a critical realist approach to critique and illustrates its application to the contemporary economy. It argues that responsible, constructive critique depends on ethics, on causal explanation, and on the development of utopian visions. Utopias are tools, and concrete utopias are not visions of whole alternative ready-made societies, but rather partial models that can be built in practice as elements of the larger social world. The argument is illustrated with three cases of digital utopianism, which help to demonstrate the practical challenges facing utopian schemes. Concrete utopias are a vehicle for combining our theoretical understandings of possibilities with an ethical analysis of needs in order to offer practical schemes for improving human flourishing. [ABSTRACT FROM AUTHOR]

The idea that motherhood primes women to support stronger gun control policy permeates our contemporary politics. Motherhood shapes views on a variety of issues, but the question remains whether mothers hold distinctive views on gun control policies relative to their non-parent peers. We draw on 2017 Pew Research Center data to explore the ways gender, parenthood, and race intersect to shape attitudes on gun policy in the post-Sandy Hook era when gun violence has become prominently linked with schools and children, and during a time when the Black Lives Matter movement has drawn national attention to the relationship of gun violence and racial inequality. Most notably, we find that contemporary depictions of mothers as a distinctively pro-gun control constituency are largely inaccurate. The very real gender gap in gun policy attitudes appears to be falsely attributed to motherhood, rather than gender. We also find very little impact of parenthood for men. Finally, we generally fail to see much relationship between race, parenthood, and gun attitudes. Overall, despite common belief and media reporting to the contrary, the story is very much one where parenthood seems to play little role in gun policy attitudes. [ABSTRACT FROM AUTHOR]

Those disagreements have sometimes become quite heated, such as the debate between Christian Smith and John Levi Martin, although it is intriguing that the critical realist Smith begins with an olive branch and it is the pragmatist Martin who chooses battle instead (Martin [14], [15]; Smith [20], [21]). Jamie Morgan, for example, has suggested that critical realists would find value in the work of the leading contemporary pragmatist Nicholas Rescher (Morgan [16]). Bhaskar himself thus appears to take something like an "overlapping patchworks" approach to the relation between pragmatism and critical realism. Pragmatists have sometimes been positively hostile towards critical realist ontology (e.g. Kivinen and Piiroinen [12]), and critical realists have sometimes criticized pragmatism in fairly robust terms, as Doug Porpora does in his first contribution to our roundtable (Barman, Porpora, and Carrigan [2]). [Extracted from the article]

One theme of this special issue is an incitement to reconsider the relationship between pragmatism and critical realism. While their advocates sometimes come into conflict, there are also clearly borrowings and overlaps between the traditions, and we therefore invited scholars with feet in either or indeed both camps to discuss their relationship. The discussion was conducted virtually, with participants submitting initial contributions, reviewing each other's submissions, and then responding to each other in their second round of contributions. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between pragmatism and critical realism, first as alternative philosophies for the social sciences in general, and second, as an illustration, in the social study of monetary valuation. The paper argues that both traditions are internally diverse. Hence, the relations between the two are complex, with both substantial overlaps and real differences revealed in encounters between them. Perhaps the most significant difference is pragmatism's distrust of invocations of structural power in social explanations, whereas realism encourages them, in interaction with other explanatory elements. The paper problematizes claims that recent work in the study of value is predominantly pragmatist. Nevertheless, it argues that pragmatist influence has encouraged valuation studies to focus on the micro level at the expense of the macro. From a realist perspective, however, there is much to be gained from an approach that embraces both micro and macro levels and the relations between them. [ABSTRACT FROM AUTHOR]

In this wide-ranging interview, Dave Elder-Vass discusses his main contributions to critical realist theory over two decades. In the first half, he explains his early work on emergence, agency, structure, the concept of culture and norm circles, as well as his work on a broad array of social theorists and positions. Sometimes this has involved differences with other realists, including Tony Lawson, Margaret Archer, Alison Sealey and Bob Carter, which he also comments on here. In the second half, he discusses the common themes of his two most recent books (focused on economic form and value respectively) and current project (focused on the concept of profit), in which he is developing a critical realist approach to political economy. [ABSTRACT FROM AUTHOR]

Background: Collaborative, Indigenous-led pedagogical and research approaches in nursing education are fundamental to ensuring culturally safe curriculum innovations that address institutional racism. These approaches privilege, or make central, Indigenous worldviews in the ways healthcare practices are valued and assessed. With the aim of informing excellence in cultural safety teaching and learning, and research approaches, this study draws on the experiences and key learnings of non-Indigenous nursing academics in the collaborative implementation of First Peoples Health interprofessional and simulation-based learning (IPSBL) innovations in an Australian Bachelor of Nursing (BN) program. Methods: An Indigenous-led sequential mixed method design was used to investigate non-Indigenous nursing academics' experiences in the design, development and delivery of two IPSBL innovations. A validated survey (the Awareness of Cultural Safety Scale, (ACSS)) was administered to nursing academics before and after the innovations were delivered. Phenomenological interviews were also conducted following the implementation of the innovations. Results: Of the 27 staff involved in the delivery of the innovations, six nursing academics completed both pre-and post-surveys (22%). Nine (33%) participated in phenomenological interviews. There was a non-significant trend towards improved scores on the ACSS following the delivery of the innovations. Nursing academics' perceptions of the innovations' relevance to their practice were enhanced. An increased awareness of culturally safe academic practices was reported among those actively involved in innovations. Impact statement: Indigenous-led approaches in teaching and research promote excellence within mandatory cultural safety education for nurses and midwives. Conclusions: This study confirms the importance of educating the educators about cultural safety in teaching and learning, and research approaches. It also provides important insights into how non-Indigenous nursing academics can work within Indigenous-led pedagogical and research approaches to design culturally safe curriculum innovations. [ABSTRACT FROM AUTHOR]

Instructors in medical and health fields have long used experiential learning activities to complement traditional methods of teaching. The following details a scenario developed for a health communication course that simulates a plague outbreak and requires students to draw from best practice related to crisis and emergency risk communication, patient–provider communication, and health promotion targeting behavior change. Sorted into a variety of stakeholder groups, students "win" the game by accomplishing two objectives: (1) assembling puzzle pieces to unlock a cure, and (2) demonstrating effective communication capacities throughout the scenario so that the public accepts the cure. The experience of the coronavirus disease 2019 pandemic has served as a means to reflect on what works and what needs to be modified in this scenario. [ABSTRACT FROM AUTHOR]

This paper presents a systematic review study that aimed to map how the scientific literature is characterized concerning family or couple interventions and therapies regarding lesbian, gay and bisexual (LGB) individuals. The searches were conducted in the Web of Science, BVS, PsycINFO, and PUBMED databases, from 2009 to 2019, in Portuguese and English. The PRISMA protocol guidelines were followed and the CONSORT Statement and its extension for non-pharmacological interventions instruments were used. Frequencies and content analysis were performed at software NVivo. After considering the inclusion and exclusion criteria, gender-nonconforming19 articles were retrieved. The results revealed a greater focus on the North American context, mainly on psychoeducational interventions that worked on marital status and family systems with LGB teenagers or young adults. Adaptation of well-consolidated practical approaches was the most used and multiple formats were applied to conduct interventions, using film-based, cognitive-behavioral and systemic techniques. It is argued that theoretical and empirical research focused on stigma and discrimination at marital and family levels is needed in other contexts, such as Global South countries. Future directions and limitations are presented. [ABSTRACT FROM AUTHOR]

Etuaptmumk or Two-Eyed Seeing (E/TES) is foundational in ensuring that Indigenous ways of knowing are respected, honoured, and acknowledged in health research practices with Indigenous Peoples of Canada. This paper will outline new knowledge gleaned from the Canadian Institute of Health Research and Chronic Pain Network funded Aboriginal Children's Hurt & Healing (ACHH) Initiative that embraces E/TES for respectful research. We share the ACHH exemplar to show how Indigenous community partners take the lead to address their health priorities by integrating cultural values of kinship and interconnectedness as essential components to enhance the process of community-led research. E/TES is conceptualised into eight essential considerations to know in conducting Indigenous health research shared from a L'nuwey (Mi'kmaw) perspective. L'nu knowledge underscores the importance of working from an Indigenous perspective or specifically from a L'nuwey perspective. L'nuwey perspectives are a strength of E/TES. The ACHH Initiative grew from one community and evolved into collective community knowledge about pain perspectives and the process of understanding community-led practices, health perspectives, and research protocols that can only be understood through the Two-Eyed Seeing approach. [ABSTRACT FROM AUTHOR]

The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body – MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112). BCSs were randomly allocated to MyCB (n = 39), MyCB + Meditation (MyCB + M) (n = 17) or an expressive writing (EW) active control arm (n = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month. Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention – state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW. These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs. [ABSTRACT FROM AUTHOR]

In this article, we present DisCrit-informed person-centered strategies to reframe inclusive education in Italy through an equity lens. Our aim is to provide teachers in mainstream primary schools with practices that inform the design and implementation of Individualized Education Programs and Piano Didattico Personalizzato (Personalized Didactic Plans) through nondeficit, intersectional, and culturally relevant approaches. Drawing on an initial pilot case study carried out in a school in Rome, Italy, we analyze the challenges that teachers face in including students at the intersections of race, ability, language, and citizenship. In doing so, we intend to advance critical thinking about the use of inclusive tools, and the importance of reframing them through the DisCrit framework. Finally, we suggest that some of the existing inclusive practices exacerbate the exclusion of migrant students with and without disabilities, despite promises of equality for all students. [ABSTRACT FROM AUTHOR]

Green Infrastructure (GI) is being adopted in cities all around the world as a key piece of climate change adaptation and water management for local governments. Recognizing that there is increasingly a diversity of actors engaged in designing, implementing, and fostering GI policies, we aim to better understand how urban GI policies take shape over time. We draw from two bodies of scholarship – – agency in Earth System Governance and entrepreneurs in public policy scholarship -- to study the agents who come to exercise authority to shape GI governance. We trace the trajectory of urban GI practices and policy over the past two decades, keenly observing how GI policies are adopted and change over time. We focus on Tucson, Arizona and combine document analysis, key informant interviews, and participation in stakeholder meetings with an innovative timeline method we collaboratively developed with stakeholders to identify the key events and actors in GI policy adoption. Our findings suggest diverse yet, interconnected roles for entrepreneurs highlighting how agency is exercised, how learning occurs and takes shape across entrepreneurs and scales, and how inequities are realized and addressed. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo implement a job retention vocational rehabilitation (VR) intervention (MSVR) for people with multiple sclerosis (MS) and their employers in the UK National Health Service (NHS).Multicentre, single-arm feasibility study with post-intervention interviews. MSVR was delivered by an occupational therapist (OT). Feasibility was assessed by recruitment rates, compliance, and practicality of delivery. Acceptability was assessed with post-intervention interviews. A survey assessed change in eight vocational outcomes (e.g., vocational goals, work instability) immediately post-intervention and at 3-month follow-up.Recruitment and training an OT was challenging. Twenty participants with MS, three employers, and three healthcare professionals were recruited. All participants but one completed the intervention. Factors affecting intervention adherence included annual leave and family responsibilities.MSVR was associated with improved vocational goal attainment post-intervention (t(18) = 7.41, p = <0.001) and at follow-up (t(17) = 6.01, p = <0.001). There was no change to the remaining outcomes. Interviews identified six themes: intervention impact, accessibility of support, the OT’s role, readiness for support, workplace supportiveness, and barriers to NHS delivery.Challenges with recruitment, identifying newly diagnosed MS participants, and understanding the OT’s training needs to deliver the intervention were identified. The intervention demonstrated acceptability, but participants wanted it to continue for longer to address further needs.Successful implementation of vocational rehabilitation services for people with multiple sclerosis within healthcare services requires multiple environmental and pragmatic changes.Healthcare professionals should record employment status from diagnosis to monitor changes in employment over the disease course, highlighting changes in working hours, occupation type, and employment rates.Vocational rehabilitation has the potential to improve the confidence of people with MS around symptom management and feeling supported and empowered at work.Successful implementation of vocational rehabilitation services for people with multiple sclerosis within healthcare services requires multiple environmental and pragmatic changes.Healthcare professionals should record employment status from diagnosis to monitor changes in employment over the disease course, highlighting changes in working hours, occupation type, and employment rates.Vocational rehabilitation has the potential to improve the confidence of people with MS around symptom management and feeling supported and empowered at work. [ABSTRACT FROM AUTHOR]

This article inquires into the psychic-sensory changes that occurred as the modern era turned into the postmodern era and electromagnetism supplanted dynamics as the basis of the ascendant scientific theory. The article explores communication and how shifting technologies infiltrated modes of expression. Philosophical scholars responding to these changes include Northrop Frye and Marshall McLuhan. Examples of changes in modes of communication will include works from Canada's Group of Seven painters. [ABSTRACT FROM AUTHOR]

Feminism and anti-feminism featured prominently in the 2016 presidential election. Hillary Clinton was the first female major party presidential candidate and self-identified as a feminist speaking openly about the challenges facing women. Clinton faced off against Donald Trump, who was on record making sexist statements and arguing that Clinton's success was from playing the "woman card". We ask several questions: who identifies as a feminist today and how is this different from who identified as a feminist in the previous generation? Who identifies as "anti-feminist"? Are anti-feminists simply a mirror reflection of feminists or is it a distinctive social identity? Finally, the study explores the meaning of these labels by looking at what feminists and anti-feminists believe in terms of public policy and attitudes about gender equality. Thus, this study provides insights into the state of modern feminism and antifeminism in contemporary American politics. [ABSTRACT FROM AUTHOR]

Lawson offers two answers to these questions: first, money is formally established, at least in modern monetary communities, by legal tender laws, and second, to be a successful money it depends on the trust of the community (Lawson [10], 158-161). Tony Lawson's book I The Nature of Social Reality i is an impressive overview of a philosophically coherent social ontology that he has been developing for at least a decade. Lawson proposes "a positioning theory of money" or rather a positioning theory of "successfully functioning" money (Lawson [10], 155-156). Lawson is particularly concerned with a class of totalities that he refers to as I human communities, i although he uses I communities i as a term of art rather than in its everyday sense (Lawson [10], 13). [Extracted from the article]

Expert radiologists can quickly extract a basic "gist" understanding of a medical image following less than a second exposure, leading to above-chance diagnostic classification of images. It is currently unclear whether this pattern of results is applicable to pathology, another medical imaging domain demanding visual diagnostic interpretation. To further characterize the rapid interpretation medical images, this study examined eye movements and diagnostic decision-making when pathologists were briefly exposed to digital whole slide images of melanocytic skin biopsies. Twelve resident (N = 5), fellow (N = 5), and attending pathologists (N = 2) with experience interpreting dermatopathology briefly viewed 48 cases presented for 500 ms each, and we tracked their eye movements towards abnormalities, their ability to classify images as containing or not containing invasive melanoma, and their ability to localize critical image regions. Results demonstrated rapid shifts of the eyes towards critical abnormalities, high diagnostic sensitivity and specificity, and surprisingly high accuracy localizing critical diagnostic regions. Furthermore, when pathologists fixated critical regions with their eyes, they were subsequently more likely to successfully localize that region on an outline of the image. Results are discussed relative to models of medical image interpretation and innovative methods for monitoring and assessing expertise development during medical education and training. [ABSTRACT FROM AUTHOR]

In addition, the GI story in Tucson suggests that GI requires participation from the water utility and virtually all sectors of local government, from transportation to flood control and urban planning, as well as the active participation of community members and NGOs. GI made its way into city plans and reports as well, such as the Tucson Department of Transportation and Mobility's I Active Practice Guidelines i requiring the inclusion of GI in all new and reconstructed publicly funded road and drainage projects.[25] More broadly, I Plan Tucson i , the city's general and sustainability plan adopted by voters in 2013, promotes the use of GI features throughout the city. We highlight three major strategies that reflect this trajectory: (1) the adoption of the One Water approach at Tucson Water, (2) improved city-county collaboration around GI planning, and (3) the GI Fund to finance GI implementation and maintenance in Tucson. 36 C. Rupprecht, Water Conservation Specialist, Tucson Water, Interview, December 12, 2017, Tucson, AZ. 37 N. Freitas, "Tucson at Forefront of Rainwater Harvesting Programs, Incentives", University of Arizona, Department of Soil, Water and Environmental Science (2013), https://swes.cals.arizona.edu/environmental writing/stories/fall%202013/frietas%20.html. 38 S. Hess, "Tucson Water Asks for Public Input For 80-Year Plan I ", Patch Tucson i (2020), https://patch.com/arizona/tucson/tucson-water-asks-public-input-80-year-plan. [Extracted from the article]

In order to understand the acceptance of cultivated meat, we propose experiments regarding (i) a sustainability appeal to increase consumer's purchase intention, (ii) private consumption as a mediator, and (iii) awareness of environmental issues related to the production process and the use of antibiotics and hormones in the production process as moderators. The results showed that the sustainability appeal of cultivated meat raises consumers' intention to buy it, while private consumption explains their low intention to buy it. In addition, the low awareness of the production process and the use of antibiotics and hormones in the production process reduce the consumers' intention to purchase cultivated meat, both directly and indirectly. These results contribute to the literature on the adoption of cultivated meat and sustainable appeals, thus expanding the discoveries regarding a more efficient way of placing it on the market. [ABSTRACT FROM AUTHOR]

A retrospective cohort study was conducted to assess differences in efficacy and tolerability between a busulfan AUC target of 16.4 mg × Hr/L per day (FluBu4K) and a conventional RIC regimen (FluBu2). Adult patients with a diagnosis of AML or MDS who received fludarabine + busulfan conditioning with or without antithymocyte globulin between 2015 and 2018 were included. The primary outcome was relapse free survival. Overall, 74 patients received conditioning with either FluBu4K or FluBu2. At 18 months, relapse-free survival was not significantly different, at 63.9% with FluBu4k compared to 57.5% with FluBu2 (p = 0.49). There was a statistically significant difference in the cumulative incidence of relapse at 18 months in favor of the FluBu4K regimen, at 12.0% vs 32.5% (p = 0.047). The results of this study indicate that for select patients, there may be benefit in choosing targeted FluBu4K over FluBu2. Adverse effects other than mucositis were not significantly different. [ABSTRACT FROM AUTHOR]

Research has thoroughly examined various factors that are related to university student persistence. Studies suggest that a multitude of characteristics are predictive of student success, and theory supports examining these characteristics at the institutional level. However, few studies utilise robust, single-institution samples using a holistic framework. The purpose of this study was to use a comprehensive framework to examine academic, psychosocial, noncognitive, and other background factors that are related to retention at one large, public four-year institution in the southeastern United States. Data for 12,342 students were drawn from multiple sources, and hierarchical generalised linear models were used to identify important predictors of retention both before beginning university and after the first semester. Findings from the study showed that a variety of pre-university factors such as high school performance, institutional fit, and financial scholarships were significant predictors of retention both before and after the first semester. Notably, these important variables were distributed across the categories of the comprehensive framework. Results also revealed moderated relationships between several variables with factors such as ethnicity and first-generation status. The results of this study have important implications for higher education policymakers, administrators, and researchers in terms of variable selection and measurement in predictive retention models for beginning university students. [ABSTRACT FROM AUTHOR]

Giorgos Tsiolis and Michalis Christodoulou have written a deeply theoretical book arguing that we should see reconstructive biographical research as a method for constructing causal accounts of social lives and generalizing beyond the particular cases under study. As I have argued elsewhere, Sawyer's approach is incompatible with the sort of relational approach to emergence that is called for by a critical realist ontology (Elder-Vass [3]). Tsiolis and Christodoulou are tempted by Keith Sawyer's argument that the argument from wildly disjunctive multiple realizability can be transferred to the social realm (Sawyer [4]; Sawyer [5]; Sawyer [6]; Sawyer [7]). [Extracted from the article]

We examine the effects of uncertainty by investigating the effects of oil price uncertainty on employment in domestic oil and gas extraction. This industry is interesting to examine for two reasons. First, employment in this industry should be closely linked to oil prices, facilitating identification of more subtle economic relations related to uncertainty. For example, recent research finds that uncertainty about oil prices tends to diminish drilling activity in a small sample of drilling rigs in Texas. Second, the response of this industry to negative shocks to the supply of oil, for example, should be opposite that of aggregate employment. We characterize the univariate properties of the time series with a two-state Markov switching model, and we then estimate a vector autoregression with conditionally heteroskedastic errors, in which the conditional variance is permitted to interact with the conditional mean. We find that employment in oil and gas extraction cycles through episodes of boom and bust that are tightly linked to oil prices, in contrast to aggregate employment. We also find that uncertainty about oil prices has a negative and quantitatively large effect on employment in this sector. Our analysis is robust to different measures of uncertainty, including stochastic volatility and implied volatility. [ABSTRACT FROM AUTHOR]