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A high level of transparency in reported research is critical for several reasons, such as ensuring an acceptable level of trustworthiness and enabling replication. Transparency in qualitative research permits the identification of specific circumstances which are associated with findings and observations. Thus, transparency is important for the repeatability of original studies and for explorations of the transferability of original findings. There has been no investigation into levels of transparency in reported technology education research to date. With a position that increasing transparency would be beneficial, this article presents an analysis of levels of transparency in contemporary technology education research studies which employed interviews within their methodologies, and which were published within the "International Journal of Technology and Design Education and Design and Technology Education: An International Journal" (n = 38). The results indicate room for improvement, especially in terms of documenting researcher positionality, determinations of data saturation, and how power imbalances were managed. A discussion is presented on why it is important to improve levels of transparency in reported studies, and a guide on areas to make transparent is presented for qualitative and quantitative research.

Abstract Cancer is a life‐threatening process that stems from genetic mutations in cells, which leads to the formation of tumors, and is a major cause of deaths in the United States, with secondary metastasis being a major driver of fatality. The development of an optimal metastatic environment is an essential process prior to tumor metastasis. This process, called pre‐metastatic niche formation, involves the activation of resident fibroblast‐like cells and macrophages. Tumor‐mediated factors introduced to this environment transform resident cells that secrete additional growth factors and remodel the extracellular matrix, which is thought to promote tumor colonization and metastasis in the secondary environment. Furthermore, an important component of metastasis is the biological process of epithelial–mesenchymal transition, which can be exploited by cancer cells to change their phenotype, to migrate and proliferate as necessary. In this review, we discuss recent advances in the investigation of cancer growth and migration. Computational models that focus on biochemical signaling and multicellular dynamics are examined. Machine learning models and image analysis that classify cancer‐related data are also explored. Through this review, we highlight advances in the study of important aspects of cancer and metastasis signaling and computational tools to study these dynamics.

Abstract Epithelial‐mesenchymal transition (EMT) is the transdifferentiation of epithelial cells to a mesenchymal phenotype, in which cells lose epithelial‐like cell–cell adhesions and gain mesenchymal‐like enhanced contractility and mobility. EMT is crucial for tissue regeneration and is also implicated in pathological conditions, such as cancer metastasis. Prior work has shown that transforming growth factor‐β1 (TGF‐β1) is a potent inducer of this biological process. In this study, we develop a computational model coupling mechanical and biochemical signaling in a multicellular tissue undergoing EMT. Specifically, we utilize a recently developed formulation that integrates a multicellular cellular Potts model (CPM), a lattice‐based stochastic model governing cell movement; a first moment of area model, governing cellular traction and junctional forces; a finite element model, which defines extracellular matrix (ECM) substrate strains; an intracellular signaling TGF‐β1‐mediated EMT model that governs cellular phenotype; and an extracellular signaling component governing ECM and TGF‐β1 signaling. In this study, we modeled the spatial cellular patterns that occur in tissue and the ECM during EMT. Our model predicts that EMT often initially occurs at a tissue boundary due to mechanochemical coupling, which results in transdifferentiation to progress inwards toward the center. Variation in model parameters demonstrated conditions enhancing and suppressing EMT, especially to drive EMT in the absence of TGF‐β1 and inhibit EMT in the presence of TGF‐β1. Specifically, enhancing the mechanochemical feedback typically promoted EMT, whereas greater assembled ECM degradation suppressed EMT. Simulated scratch test experiments illustrate that ECM composition can impact closure directly through EMT signaling. In conclusion, we integrated mechanical, biochemical, and extracellular signaling networks in a novel hybrid computational model to reproduce tissue formation dynamics of EMT.

In the absence of virtually any study on the impact of the global crisis (2008-09) on informal workers, a quick study was conducted on the impact of the crisis on small producers and informal workers in selected sectors. This was followed by another study in one of the sectors (that is, the diamond industry) two years after the crisis to assess whether any lessons have been learnt by policy-makers for protecting workers from the severe impact of such a crisis in the future. This paper presents the findings of the studies. After discussing the major impacts of the crisis and the lessons emerging from the first study as well as the prevalent scenario in the industry after two years, the study observes that though the diamond industry, and particularly large and medium producers, have learnt lessons for strengthening its position, not much attention has been paid towards addressing the interests of small producers and labour. This implies that if a crisis were to recur, they would suffer in the same way as they did in 2008-09. The study also raises questions about the validity of the growth path that the country has chosen, particularly with regard to treating exports as a major growth engine, and about the advantages of globalising at the lowest end of the value chain, wherein the control or the decision-making power lies in the hands of global production networks located in developed countries and wherein cut-throat competition results very poor quality of work. The study concludes that neither have these questions been addressed nor have any significant steps been taken to protect the interests of informal workers by either the Central or the state government. [ABSTRACT FROM AUTHOR]

The National Rural Employment Guarantee Act (NREGA), launched in February 2006, has already completed four years. This paper attempts to draw lessons from the experience of these four years for guiding the future course of NREGA. Section I makes a broad assessment of the performance of NREGA during the past four years and identifies the major concerns, while Section II presents the lessons that can be learnt for the future. The paper argues that the two non-negotiable features of NREGA are: (a) the entitlements guaranteed to workers; and (b) strengthening livelihoods of people through NREGA assets by improved planning and strong convergence. These non-negotiable features need to be implemented in letter and spirit in the coming years. [ABSTRACT FROM AUTHOR]

Studies have shown that administering prophylactic antibiotics within 60 minutes of a surgical incision decreases the chance of postoperative infection. A large women's hospital that performs 8,000 surgical procedures per year committed to preventing infection by participating in a study. The study participants were patients who had undergone an abdominal hysterectomy. For testing and implementing improvements, the Plan-Do-Study-Act cycle performance improvement method was used. In order to benchmark and to share best practices, the hospital joined the Surgical Infection Prevention Collaborative. The result of the study was antibiotic prophylactic delivery 60 minutes prior to incision in the abdominal hysterectomy population from a baseline of 10% to greater than 90% from 2003 to 2005. This result could not have been accomplished without the dedication and teamwork the hospital staff demonstrated. Quality improvement strategies, staff education, and communication of data have resulted in this sustained improvement. [ABSTRACT FROM AUTHOR]

Background: Pediatric distal forearm fractures are one of the most common injuries seen in the emergency department. Orthopedic teaching instructs providers to radiograph the joint above and the joint below the fracture site for concurrent injury. Despite this teaching, there is little evidence to suggest that elbow injuries are common in children with distal forearm fractures. Similarly, there are few data that help the clinician predict which children are at higher risk for co-injury., Methods: We conducted a cross-sectional analysis of the 2011 National Emergency Department Sample data set. Children aged 2 to 17 years with an International Classification of Disease, Ninth Revision, code for a distal forearm fracture were included in the study. The primary outcome of interest was an "elbow" injury, defined as an International Classification of Disease, Ninth Revision, code for proximal radius, proximal ulna, or distal humeral fracture or dislocation. Multivariable logistic regression was performed using patient demographics, injury severity score, mechanism of injury, and underlying medical conditions., Results: A total of 54,262 children with a distal forearm fracture were identified. Of these children, only 0.8% (n = 463) had an elbow injury. Supracondylar fractures of the humerus were the most common elbow injury seen (48.2% of elbow injuries seen). Children were more likely to have a co-injury if they were younger (9.8 years vs 8.3 years, P < 0.01), female (36% vs 44%, P < 0.01), injured via fall (68% vs 76%, P < 0.01), had a higher injury severity score (4.1 vs 4.5, P < 0.01), or were admitted for their injuries (1.5% vs 15.7%, P < 0.01). In the adjusted model, only age and disposition were predictors of co-injury. Isolated buckle fracture of the radius and metaphyseal fracture of the radius with dorsal angulation were protective against elbow injury (odds ratio = 0.39 and 0.60, respectively)., Conclusions: Children with distal forearm fractures very rarely have concurrent elbow injuries. These injuries are more likely in younger female children., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Domestic minor sex trafficking (DMST) is an increasingly recognized traumatic crime premised upon the control, abuse, and exploitation of youth. By definition, DMST is the "recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act" within domestic borders, in which the person is a U.S. citizen or lawful permanent resident under the age of 18 years. The present study described the demographics, psychosocial features, and trafficking experiences (e.g., environments of recruitment, relationship to trafficker, solicitation) of DMST victims. A total of 25 medical records of patients under the age of 18 who disclosed their involvement in DMST to medical providers between August 1, 2013, and November 30, 2015, were retrospectively reviewed. The majority of patients were female, and the mean age was 15.4 years old. Most patients lived at home and/or were accompanied at the evaluation by a parent/guardian. High rates of alcohol or substance use/abuse (92%), being placed in a group home or child protective services (CPS) custody (28%), a history of runaway behavior (60%), and/or exposure to other child maltreatment (88%) were identified. Our data indicated variation in reported trafficking experiences; however, patients commonly reported an established relationship with their trafficker (60%) and recruitment occurred primarily as a result of financial motivation (52%). Patients were prevalently recruited in settings where there were face-to-face interactions (56%), whereas the solicitation of sex-buyers occurred primarily online (92%). Victims who disclosed involvement in DMST had complicated psychosocial histories that may have rendered them susceptible to their exploitation, and reported a variety of DMST experiences perpetuated by traffickers. Although preliminary in nature, this study provided empirical evidence of the predisposing factors, motivations, and experiences of victimized youth uniquely from the perspective of patients who sought medical care.

Objective: To examine the efficacy of an integrated medical/psychiatric partial hospitalization program (PHP) to improve glycemic control in youth with both diabetes mellitus and mental health disorders. Methods: This retrospective chart review is of patients admitted to a PHP between 2005-2015 with concerns about diabetes mellitus care. Clinical characteristics, laboratory data, diabetic ketoacidosis hospitalizations, and outpatient clinic visit frequency were collected from the year prior to the year after PHP admission. Results: A total of 43 individuals met inclusion criteria: 22 (51%) were female, 40 (93%) had type 1 diabetes, the mean age was 15.2 ± 2.3 years, and the mean diabetes mellitus duration was 4.6 ± 3.6 years. Of those individuals, 35 of these patients had hemoglobin A1c (HbA1c) data available at baseline, 6 months, and 1 year after PHP. The average HbA1c before PHP admission was 11.3 ± 2.3% (100.5 ± 25 mmol/mol), and decreased to 9.2 ± 1.3% (76.7 ± 14.8 mmol/mol) within 6 months of PHP admission ( P <.001). The average HbA1c 1 year after PHP was 10.7 ± 1.7 % (93.3 ± 19.1 mmol/mol). Overall, 24 patients (68%) had lower HbA1c, and 75% of those with improvement maintained an HbA1c reduction of ≥1% (≥10 mmol/mol) at 1 year compared to before PHP. Conclusion: Most patients demonstrated improved glycemic control within 6 months of PHP admission, and many of those maintained a ≥1% (≥10 mmol/mol) reduction in HbA1c at 1 year following PHP admission. This program may represent a promising intervention that could serve as a model for intensive outpatient management of youth with poorly controlled diabetes mellitus. Abbreviations: ADA = American Diabetes Association; DKA = diabetic ketoacidosis; EMR = electronic medical record; HbA1c = hemoglobin A1c; ICD-9 = International Classification of Diseases, 9 th revision; PHP = partial hospitalization program.

Objectives: To determine the associations of adverse childhood experiences (ACEs) and protective familial and community factors with school performance and attitudes in children ages 6 to 17., Methods: A cross-sectional analysis of the 2011-2012 National Survey of Children's Health was performed. All data were demographically weighted and included 65 680 children ages 6 to 17. The survey identified up to 9 ACEs in each child. ACE scores were categorized as 0, 1, 2, 3, and ≥4 ACEs. Children's protective factors (PFs) included the following: safe neighborhood, supportive neighbors, 4 neighborhood amenities, well-kept neighborhood, no household smoking, ≥5 family meals per week, and a parent who can talk to the child. PFs were categorized into ≤3, 4, 5, 6, and 7 PFs. School outcomes included the following: child repeated ≥1 grade; never, rarely, or sometimes completes homework; and never, rarely, or sometimes cares about school. χ 2 tests and logistic regressions assessed the relationships between ACEs and school outcomes, PFs and school outcomes, and both ACEs and PFs and school outcomes, adjusting for sex, age, race, ethnicity, and maternal education., Results: Each negative school outcome is associated with higher ACE scores and lower PF scores. After adding PFs into the same model as ACEs, the negative outcomes are reduced. The strongest PF is a parent who can talk to the child about things that matter and share ideas., Conclusions: As children's ACE scores increase, their school performance and attitudes decline. Conversely, as children's PF scores increase, school outcomes improve. Pediatric providers should consider screening for both ACEs and PFs to identify risks and strengths to guide treatment, referral, and advocacy., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2019 by the American Academy of Pediatrics.)

Language barriers and access to telephone advice have been shown to affect patient care. Less is known about access to telephone advice for families whose usual language is not English. The objective was to characterize the use of pediatric primary care telephone advice by families based on usual language spoken at home. A total of 277 surveys were completed by families presenting for sick visits at an academic pediatric primary care practice. No meaningful differences in the use of telephone advice when a child was sick were found by language category. Overall, 80.5% reported calling the clinic first when the clinic was open, but 77.6% went to the emergency department when the clinic closed. In conclusion, use of telephone advice was similar among families regardless of usual language. Most families reported going to the emergency department when the clinic was closed. More research is needed to identify barriers to the use of telephone advice, particularly after hours.

Purpose: Dental pathology is common among refugees. The purpose of this study was to identify pediatric refugees at increased risk of caries, poor clinic attendance, and need for urgent or surgical intervention under general anesthesia. Methods: A retrospective chart review of newly arrived pediatric refugees to the United States was performed. Data collected included demographics, caries risk, treatment urgency, missed appointments, and surgical intervention under general anesthesia. Bivariate analyses were used. Results: A total of 228 subjects were included, most from Africa (44.3 percent) or Asia (50.0 percent). More Asian refugees had a moderate or high caries risk (64 percent versus 44 percent) and need for urgent treatment (45.6 percent versus 30.7 percent) compared to Africans. Adolescents had more missed appointments, and more two- to five-year-olds needed surgical intervention under general anesthesia compared to other age groups. Conclusion: Asian refugees had a higher caries risk and need for urgent treatment. Younger children were more likely to require general anesthesia for surgical intervention, and adolescents were more likely to miss appointments. These findings can improve triage of pediatric refugees and allocation of resources.

Background: Families limited in English proficiency (LEP) often do not receive appropriate medical language services, resulting in health disparities. Little is known about the use and effectiveness of language services provided via telephone when families call for medical advice., Objective: To characterize language service provision to LEP families calling for medical advice in a pediatric primary care setting., Methods: A self-administered survey was given to parents of children presenting for sick visits at an urban academic pediatric primary care practice., Results: 277 out of 300 surveys were completed, 92% in English and 8% in Spanish. 7% (19/271) of those who answered the language proficiency question reported LEP (spoke English "not well," or "not at all"). Among LEP parents, 68% calling for advice during clinic hours received appropriate language services (a trained interpreter or a bilingual provider). 53% received these services when calling after hours., Conclusions: Over half of LEP families seeking telephone advice from their pediatric primary care office received adequate language services. Future research should identify barriers to providing telephone language services to LEP families.

Ukraine has the second largest HIV epidemic in Eastern Europe/Central Asia. This study characterizes the demographics of HIV-infected women in the Lviv region of western Ukraine, patterns in their clinical presentation, and factors associated with delays in seeking care. A retrospective chart review was conducted of 622 HIV-infected women who registered for HIV treatment at the Lviv AIDS Center between 2008 and 2013. A total of 81.6% of women were infected through heterosexual transmission and the remaining 18.4% through intravenous drug use. Slightly less than half (45.4%) was between 26 and 35 years old. Slightly more than half (56.7%) listed their residence in a city, 22.6% in villages. One-third (30.0%) of all women presented with AIDS, and 37.7% presented with symptomatic conditions. Women diagnosed with HIV during antenatal care experienced a median delay of 34 days between diagnosis and registration, compared to 87.5 days for nonpregnant women tested in the context of intravenous drug use. Overall, HIV-infected women in western Ukraine experience time delays in care, and often present with advanced HIV disease and secondary complications. Linkage to care in a timely manner is a high priority and substantial challenge for women, particularly for intravenous drug users who may face stigma and other additional barriers.

Background: Many survivors of childhood cancer do not receive recommended longitudinal oncology care. Factors present at the time of childhood cancer diagnosis may identify patients who are vulnerable to poor adherence to follow-up., Methods: This cohort of survivors of acute lymphoblastic leukemia (ALL) diagnosed from 1996 to 1999 at seven Consortium for New England Childhood Cancer Survivors institutions was evaluated for attendance at oncology clinics at 5 and 10 years from diagnosis. Demographic, socioeconomic, disease, and treatment characteristics were analyzed as risk factors for nonadherence to follow-up., Results: Of 317 patients, 90% were alive 5 years from diagnosis and 88% of those remained in active follow-up. At 10 years from diagnosis, 88% were alive, 73% of whom continued in active follow-up. Insurance status at diagnosis was significantly associated with adherence at both 5 and 10 years. At 10 years, initial enrollment on therapeutic study was associated with increased attendance and central nervous system (CNS) leukemia with decreased attendance. In multivariable modeling of follow-up at 5 years, patients who were adults were less likely to participate and those with private insurance at diagnosis more likely to participate. At 10 years, insurance status at diagnosis remained a predictor of adherence to follow-up., Conclusions: In this regional cohort, many patients who are survivors of ALL continue to participate in oncology care at 5 and 10 years from diagnosis. Factors known at diagnosis including insurance status, CNS leukemia, older age, and enrollment on therapeutic study were associated with differential attendance to follow-up visits., (© 2017 Wiley Periodicals, Inc.)

Background: Refugee populations in the US have a higher reported prevalence of latent tuberculosis infection (LTBI). The objective of this study was to assess adherence to LTBI treatment in refugee and non-refugee children living in Rhode Island., Methods: This was a retrospective review of LTBI patients seen in the Hasbro Pediatric Tuberculosis Clinic between August 2009 and September 2011., Results: Of 120 patients with LTBI, 93% were foreign-born and 30% were refugees. Overall, 94 children (78.3%) completed therapy. Higher rates of treatment completion were seen among patients who were female, referred within the same hospital system, used an interpreter, and did not report side effects. Refugees attended more scheduled visits compared to non-refugees (p=0.019)., Conclusions: Overall rates of completion of LTBI treatment were high in this population. Better adherence to clinic visits, likely due to the increased support and care coordination provided to the refugee children, improved treatment completion rates. [Full article available at http://rimed.org/rimedicaljournal-2017-02.asp].

Context: Communal blogs facilitate online narratives by providing opportunities for individuals to co-construct meaning and to engage in discussion about lived health experiences., Objective: To examine the role of health as a connective narrative among individuals organizing collectively in an online community. The "We are the 99 percent" Tumblr blog emerged as a spontaneous community platform of the Occupy Wall Street movement in the US., Design: Researchers conducted a qualitative content analysis of a total of 2003 blog posts., Main Outcome Measures: Data analysis included a process of data reduction, display, and conclusion drawing and verification., Results: Bloggers discussed medical crises and the role of injury and illness in maintaining financial solvency. The difficulty of obtaining health care and the lack of accessible quality care emerged as themes. In particular, unemployment and underemployment limited access to health insurance coverage. The bloggers expressed dissatisfaction with the health care system and the impact of financial status on health. These challenges were exacerbated for marginalized populations, such as women and veterans., Conclusion: Findings offer implications for the value of online narrative to improve health care initiatives and to provide insight to integrated health care systems, including health care practitioners, nonprofit organizations, hospitals, and policy makers. Results suggest opportunities to address the health care gaps of marginalized populations and to develop public health policy., Competing Interests: Statement The author(s) have no conflicts of interest to disclose.

Objective: The Tumor Board (TB) allows for an interdisciplinary approach to cancer treatment designed to encourage evidence-based treatment. However, its role in facilitating clinical trial participation has not been reported. We aimed to determine whether a prospective TB is an effective strategy for trial recruitment and to identify steps within the TB process that facilitate discussion of trial eligibility and optimize accrual., Methods: We conducted a retrospective cross-sectional analysis of women presented to Gynecologic Oncology TB between March and December 2008. Patient demographics, TB recommendations, and post-TB patient discussions were abstracted. These were compared to data derived from the Department of Oncology Research to determine research team awareness of eligible patients and confirm trial enrollment(s). Data analysis was completed with Chi-square test; risk ratios and confidence intervals were calculated as summary measures., Results: We reviewed 1213 case presentations involving 916 women. Overall, 358 TB recommendations (30%) identified eligible patients, of which enrollment consisted of 87 (24%) trials (6% therapeutic trials and 18% non-therapeutic trials). Compared to other types of TB recommendations, those involving trials were discussed less frequently at post-TB patient visits (79% vs. 44%). Documentation of trial discussion at the post-TB visit was more likely to result in trial participation, versus solely relying on the research staff to communicate enrollment eligibility with the treating team (RR 2.5, p=0.006)., Conclusions: Patients identified by the TB were 2.5-times as likely to enroll in a clinical trial, but trials were mentioned only 44% of the time. Interventions that facilitate trial discussions during post-TB meetings are needed to improve trial participation.

Studies have shown that administering prophylactic antibiotics within 60 minutes of a surgical incision decreases the chance of postoperative infection. A large women's hospital that performs 8,000 surgical procedures per year committed to preventing infection by participating in a study. The study participants were patients who had undergone an abdominal hysterectomy. For testing and implementing improvements, the Plan-Do-Study-Act cycle performance improvement method was used. In order to benchmark and to share best practices, the hospital joined the Surgical Infection Prevention Collaborative. The result of the study was antibiotic prophylactic delivery 60 minutes prior to incision in the abdominal hysterectomy population from a baseline of 10% to greater than 90% from 2003 to 2005. This result could not have been accomplished without the dedication and teamwork the hospital staff demonstrated. Quality improvement strategies, staff education, and communication of data have resulted in this sustained improvement.