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Does Engaging Commercial Customers in a Shared Social Mission Improve Impact Sourcing Service Provider (ISSP) Success? A Critically Appraised Topic
Get PDFThis topic paper examines whether engaging commercial customers through a shared social mission improves the success of social enterprises. It is based on an examination of a subset of the information technology and business process outsourcing (ITO/BPO) industries, known as impact sourcing service providers (ISSPs). ISSPs are social enterprises – B2R Technologies and Digital Divide Data are two examples – that provide call center, transaction processing, data entry, and other technology-enabled services for commercial customers from remote locations around the globe. What is unique about ISSPs is that they do this with a social mission of creating jobs and economic development in disadvantaged and marginalized communities. The analysis presented in this paper is based on an examination of academic research on ISSPs published in peer-reviewed journals from 2013 through 2022. The findings are that ISSPs that engage commercial customers through a shared social mission develop stronger bonds at both the personal and organizational levels. These bonds, in turn, strengthen the overall relationship between the companies and improve the ISSP’s success. Although specific to the case of ISSPs and the outsourcing industry, these findings offer lessons that can inform other industries and other types of relationships between commercial and social enterprises
Massage Therapy for Children, Adolescents, and Young Adults: Clinical Delivery and Effectiveness in Hematology and Oncology
Get PDFBackground: Children, adolescents, and young adults with hematologic and/or oncologic conditions experience multiple, significant symptoms (e.g., pain, stress, and anxiety), which may be addressed by nonpharmacologic approaches such as massage therapy (MT). The purpose of this study was to describe the clinical delivery of MT provided by a certified pediatric massage therapist and assess effectiveness in two patient groups: those with sickle cell disease (SCD) or hematologic and/or oncologic conditions excluding SCD (HemOnc). Methods: Investigators conducted a retrospective review of MT sessions provided to patients 0–39 years with hematologic and/or oncologic conditions at a large pediatric academic medical center. Results: Between October 2019 and December 2021, 3015 MT sessions were provided to 243 patients (171 HemOnc; 72 SCD) and documented in the electronic health record. Patients (mean age: 12.21 ± 7.19 years) were generally White (49.4%) or Black/African American (43.2%), non-Hispanic (94.2%), and 52.3% female. Patients in the SCD group (vs. patients in the HemOnc group) reported significantly higher (p \u3c.05) pretreatment pain (6.95 vs. 4.46), stress (6.47 vs. 4.58), and anxiety (6.67 vs. 4.59). All patients reported clinically and statistically significant (p \u3c.001) mean reductions in pain (−2.25 ± 1.87), stress (−2.50 ± 1.73), and anxiety (−2.52 ± 1.69), with patients in the HemOnc group reporting greater mean pain change (−2.54 vs. −1.87) than patients in the SCD group. Conclusions: This study supports the clinical effectiveness of MT for addressing acute pain, stress, and anxiety among youth with hematologic and/or oncologic conditions. Future research is needed to identify optimal MT utilization
Evaluation of a Photodynamic Therapy Agent Using a Canine Prostate Cancer Model
Get PDFBackground: Male dogs can develop spontaneous prostate cancer, which is similar physiologically to human disease. Recently, Tweedle and coworkers have developed an orthotopic canine prostate model allowing implanted tumors and therapeutic agents to be tested in a more translational large animal model. We used the canine model to evaluate prostate-specific membrane antigen (PSMA)-targeted gold nanoparticles as a theranostic approach for fluorescence (FL) imaging and photodynamic therapy (PDT) of early stage prostate cancer
Glucose-Dependent Insulinotropic Polypeptide Monoclonal Antibodies Prevent and Treat Obesity in Wild-Type and Hyperphagic Mice
Get PDFObjective: This study aimed to investigate whether a glucose-dependent insulinotropic polypeptide (GIP) monoclonal antibody (mAb) will promote weight loss in wild-type mice and to determine effects of this mAb in preventing weight gain in ob/ob mice. Methods: Phosphate-buffered saline (PBS) or GIP mAb was injected intraperitoneally to wild-type mice fed a 60% high-fat diet (HFD). After 12 weeks, mice that received PBS were divided into two groups and were fed a 37% HFD for 5 weeks; one group received PBS, and one group received GIP mAb. In a separate study, PBS or GIP mAb was injected intraperitoneally to ob/ob mice fed normal mouse chow for 8 weeks. Results: PBS-treated mice gained significantly more than those treated with GIP mAb, with no difference in food consumption detected. Obese mice fed a 37% HFD and PBS continued to gain weight (+2.1% ± 0.9%), whereas mice administered GIP mAb lost 4.1% ± 1.4% body weight (p \u3c 0.01). Leptin-deficient mice consumed similar amounts of chow, and, after 8 weeks, the PBS- and GIP mAb-treated mice gained 250.4% ± 9.1% and 192.4% ± 7.3%, respectively (p \u3c 0.01). Conclusions: These studies support the hypothesis that a reduction in GIP signaling appears to affect body weight without suppressing food intake and might provide a novel, useful method for the treatment and prevention of obesity
Preliminary Content and Construct Validity of a New Model to Differentiate Research Skills from Evidence‐Based Practice Skills: Core, Evidence Application, Research (CEAR) Model
Get PDFBackground: Research is the scientific basis for the profession of dietetics, as it must be located and applied in evidence‐based practice (EBP). EBP is often presented as a foundational skill for research. CEAR – Core, Evidence Application, Research – is a newly proposed model that separates Research and Evidence Application skills into distinct domains, jointly supported by a set of Core skills, thus acknowledging that education and advancement in one domain neither requires nor precipitates education and advancement in the other. The goal was to investigate the content and construct validity of the new CEAR Model. Methods: A cross‐sectional online survey of randomly selected dietitians in the United States was used to collect CEAR domain scores, validated measures of research or EBP skills and self‐reported characteristics. Exploratory factor analysis, Cronbach\u27s α and Pearson correlation between various tools and CEAR domains were used to assess validity and reliability. Analysis of variance (ANOVA) and multiple linear regression between CEAR domains and participant characteristics were used to assess convergent and divergent validity. Results: One hundred and fifty‐four responses with a valid CEAR score were received and led to a three‐factor solution, supporting the theorised differentiation of research from evidence application skills (content validity). Internal reliability for the CEAR Model overall and for each domain was high. The hypothesised correlations between existing research or EBP measurement tools and the relevant CEAR domains were found (construct validity). Known groups analysis demonstrated the expected differences in CEAR domain scores based on participant characteristics. Conclusions: The CEAR Model demonstrates preliminary validity and internal reliability. It adds to the current literature by acknowledging the separateness of evidence application skills from research skills
Selective Infrared Neural Inhibition Can Be Reproduced by Resistive Heating
No full textObjectives: Small-diameter afferent axons carry various sensory signals that are critical for vital physiological conditions but sometimes contribute to pathologies. Infrared (IR) neural inhibition (INI) can induce selective heat block of small-diameter axons, which holds potential for translational applications such as pain management. Previous research suggested that IR–heating-induced acceleration of voltage-gated potassium channel kinetics is the mechanism for INI. Therefore, we hypothesized that other heating methods, such as resistive heating (RH) in a cuff, could reproduce the selective inhibition observed in INI. Materials and Methods: We conducted ex vivo nerve-heating experiments on pleural-abdominal connective nerves of Aplysia californica using both IR and RH. We fabricated a transparent silicone nerve cuff for simultaneous IR heating, RH, and temperature measurements. Temperature elevations (ΔT) on the nerve surface were recorded for both heating modalities, which were tested over a range of power levels that cover a similar ΔT range. We recorded electrically evoked compound action potentials (CAPs) and segmented them into fast and slow subcomponents on the basis of conduction velocity differences between the large and small-diameter axonal subpopulations. We calculated the normalized inhibition strength and inhibition selectivity index on the basis of the rectified area under the curve of each subpopulation. Results: INI and RH showed a similar selective inhibition effect on CAP subcomponents for slow-conducting axons, confirmed by the inhibition probability vs ΔT dose-response curve based on approximately 2000 CAP measurements. The inhibition selectivity indexes of the two heating modalities were similar across six nerves. RH only required half the total electrical power required by INI to achieve a similar ΔT. Significance: We show that selective INI can be reproduced by other heating modalities such as RH. RH, because of its high energy efficiency and simple design, can be a good candidate for future implantable neural interface designs
Phase Shift Between Joint Rotation and Actuation Reflects Dominant Forces and Predicts Muscle Activation Patterns
No full textDuring behavior, the work done by actuators on the body can be resisted by the body\u27s inertia, elastic forces, gravity, or viscosity. The dominant forces that resist actuation have major consequences on the control of that behavior. In the literature, features and actuation of locomotion, for example, have been successfully predicted by nondimensional numbers (e.g. Froude number and Reynolds number) that generally express the ratio between two of these forces (gravitational, inertial, elastic, and viscous). However, animals of different sizes or motions at different speeds may not share the same dominant forces within a behavior, making ratios of just two of these forces less useful. Thus, for a broad comparison of behavior across many orders of magnitude of limb length and cycle period, a dimensionless number that includes gravitational, inertial, elastic, and viscous forces is needed. This study proposes a nondimensional number that relates these four forces: the phase shift (Φ) between the displacement of the limb and the actuator force that moves it. Using allometric scaling laws, Φ for terrestrial walking is expressed as a function of the limb length and the cycle period at which the limb steps. Scale-dependent values of Φ are used to explain and predict the electromyographic (EMG) patterns employed by different animals as they walk
Bacteriuria in Older Adults Triggers Confusion in Healthcare Providers: A Mindful Pause to Treat the Worry
Get PDFThe evidence base for refraining from screening for or treating asymptomatic bacteriuria (ASB) in older adults is strong, but both practices remain prevalent. Clinical confusion over how to respond to a change from baseline, when to order a urinalysis and urine culture, and what to do with a positive urine culture fuels unnecessary antibiotic use for ASB. If the provider can take a mindful pause to apply evidenced-based assessment tools, the resulting increased clarity in how to manage the situation can reduce overtreatment of ASB
Syndromic Antibiograms and Nursing Home Clinicians\u27 Antibiotic Choices for Urinary Tract Infections
Get PDFImportance: Empirical antibiotic prescribing in nursing homes (NHs) is often suboptimal. The potential for antibiograms to improve empirical antibiotic decision-making in NHs remains poorly understood. Objective: To determine whether providing NH clinicians with a urinary antibiogram improves empirical antibiotic treatment of urinary tract infections (UTIs). Design, Setting, and Participants: This was a survey study using clinical vignettes. Participants were recruited via convenience sampling of professional organization listservs of NH clinicians practicing in the US from December 2021 through April 2022. Data were analyzed from July 2022 to June 2023. Interventions: Respondents were randomized to complete vignettes using a traditional antibiogram (TA), a weighted-incidence syndromic combination antibiogram (WISCA), or no tool. Participants randomized to antibiogram groups were asked to use the antibiogram to empirically prescribe an antibiotic. Participants randomized to the no tool group functioned as controls. Main Outcomes and Measures: Empirical antibiotic selections were characterized as microbiologically (1) active and (2) optimal according to route of administration and spectrum of activity. Results: Of 317 responses, 298 (95%) were included in the analysis. Duplicate responses (15 participants), location outside the US (2 participants), and uninterpretable responses (2 participants) were excluded. Most respondents were physicians (217 respondents [73%]) and had over 10 years of NH practice experience (155 respondents [52%]). A mixed-effects logistic model found that use of the TA (odds ratio [OR], 1.41; 95% CI, 1.19-1.68; P \u3c.001) and WISCA (OR, 1.54; 95% CI, 1.30-1.84; P \u3c.001) were statistically superior to no tool when choosing an active empirical antibiotic. A similarly constructed model found that use of the TA (OR, 1.94; 95% CI, 1.42-2.66; P \u3c.001) and WISCA (OR, 1.7; 95% CI, 1.24-2.33; P =.003) were statistically superior to no tool when selecting an optimal empirical antibiotic. Although there were differences between tools within specific vignettes, when compared across all vignettes, the TA and WISCA performed similarly for active (OR, 1.09; 95% CI, 0.92-1.30; P =.59) and optimal (OR, 0.87; 95% CI, 0.64-1.20; P =.69) antibiotics. Conclusions and Relevance: Providing NH clinicians with a urinary antibiogram was associated with selection of active and optimal antibiotics when empirically treating UTIs under simulated conditions. Although the antibiogram format was not associated with decision-making in aggregate, context-specific effects may have been present, supporting further study of syndromic antibiograms in clinical practice
Measuring Galaxy Cluster Mass Profiles into the Low-Acceleration Regime with Galaxy Kinematics
Get PDFWe probed the dynamical mass profiles of ten galaxy clusters from the HIghest X-ray FLUx Galaxy Cluster Sample (HIFLUGCS) using galaxy kinematics. We numerically solved the spherical Jeans equation and parameterize the dynamical mass profile and the galaxy velocity anisotropy profile using two general functions to ensure that our results are not biased toward any specific model. The mass-velocity anisotropy degeneracy is ameliorated by using two virial shape parameters that depend on the fourth moment of velocity distribution. The resulting velocity anisotropy estimates consistently show a nearly isotropic distribution in the inner regions, with an increasing radial anisotropy toward large radii. We compared our derived dynamical masses with those calculated from X-ray gas data assuming hydrostatic equilibrium, finding that massive and rich relaxed clusters generally present consistent mass measurements, while unrelaxed or low-richness clusters have systematically larger total masses than hydrostatic masses by, on average, 50%. This might help alleviate current tensions in the measurement of I8, but it also leads to cluster baryon fractions below the cosmic value. Finally, our approach probes accelerations as low as 10-11 m s-2, comparable to the outskirts of individual late-type galaxies. We confirm that galaxy clusters deviate from the radial acceleration relation defined by galaxies
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