Social exchange theory is one of the prominent paradigms used to explain the processes linking organizational treatment of employees to their job performance. However, the theoretical link between perceived organizational treatment and police deviance has not been fully explored. This research addresses this gap by analyzing the relationship between perceptions of organizational justice and the use of police self-protective behaviors (SPBs) using organizational support and organizational indifference as ad hoc indicators of the social exchange process. Data were collected using an online self-report survey distributed to police officers in a southern state who are members of a police officer association (n = 1,861). Consistent with previous social exchange research, the findings generally support the idea that fairness is related to SPBs, but largely to the extent that it enhances the social exchange in terms of increasing perceptions of organizational support and reducing perceptions of organizational indifference, which both directly affect an officer’s use of SPBs, and are a type of police deviance. Specific findings, relevant policy implications, and directions for future research are discussed.
In autonomous sensor nodes, switching dc/dc converters are usually employed to power the sensor electronics and also to maintain the operating voltage of an energy transducer around its maximum power point. In such a context, this paper optimizes the power efficiency of buck dc/dc converters when operating in burst mode, which is preferable than the conventional pulse-width modulation technique in lowpower sensor applications. The optimization is carried out by selecting an optimal inductor current to efficiently transfer the energy from the input to the output during the burst. Such optimization is applied when regulating the converter’s output voltage, which corresponds to the supply voltage of the sensor electronics, and also the input voltage, which corresponds to the operating voltage of the energy transducer that is here a photovoltaic module. The theoretical analysis and the experimental results reported herein prove the existence of such an optimal inductor current in both scenarios. Experimental tests with a commercial buck dc/dc converter (TPS62750) show that the use of this optimal inductor current provides up to 9% increase in efficiency, thus prolonging the operating lifetime of the sensor node.
This survey of 524 U.S. journalists explores how journalists perceive transparency, an emerging professional knowledge base, ethical value and set of practices, has been managed as a normative innovation. The study follows the recent addition of transparency to the ethics codes of two leading U.S. professional journalism associations: Society of Professional Journalists and Radio Television Digital News Association. The study includes a broad sampling of journalists working for both legacy and online media outlets, and explores the relationship between how journalists perceive transparency has been managed and the extent to which journalists practice transparency in their work. Results indicate journalists perceive transparency has not been a management priority, and how transparency is managed has a significant effect on the extent it is practiced. These results are consistent across media types, coverage areas, demographics and extent of professional experience. The data provide evidence that if the potential of transparency as a digital-age journalistic tool is to be realized, news managers must take a more active role in its development as professional knowledge, a newsroom norm and set of practices.
Despite complete resection, 20% -50% of pediatric craniopharyngiomas experience recurrence. Subtotal resection followed by radiation achieves comparable results. More effective therapies are needed. In tumor cell lines, prolonged exposure to interferon optimizes the anti-proliferative and anti-angiogenic effect. Conjugating proteins with poly-ethylene-glycol (PEG) lengthens the plasma half-life by reducing sensitivity to proteolysis, providing protracted activity. Stratum II of the PBTC-039 study proposed to estimate the sustained objective response rate (ORR=CR + PR) associated with PEGIntron/Sylatron in progressive/recurrent craniopharyngiomas post RT. Simon’s 2-stage design with 10% unacceptable and 35% desirable ORR required a total sample size of 19 (α=β=0.1). An interim analysis was planned after 11 patients and ≥2 objective responses within the first year were needed to expand accrual. 12 patients were enrolled 11, (5 males and 6 females) were eligible and evaluable. Median age at diagnosis was 7.0 years (range, 2.0–12.4) and at study entry was 20.5 years (6.1–25). Median number of cycles received was 6 (1–17). No grade 4 adverse events (AE) were reported. Grade 3 attributable AEs included decreased neutrophil count, nausea, fatigue, fever, headache and anorexia (n=1 each). No objective responses were observed. With a median follow-up 12.9 months (3.2 - 25.7), 5/11 patients have progressed at a median of 8.2 months (2.9–19.5). Other off-treatment reasons were AE, alternative therapy/withdrawal and not meeting weight criteria. PFS estimate at 1-year was 68.2% ± 14.5%. One patient remains on treatment. Although well tolerated, stratum II was permanently closed after interim analysis due to lack of objective responses.
Background: There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). Many barriers (eg, limited transportation, inability to schedule appointments, and limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services. Objective: The aim of the Link2Care study is to assess the effectiveness of a smartphone app for increasing case management and treatment service utilization, and in turn reduce homelessness and rearrest. The goals of this research are to (1) assess the impact of an innovative smartphone app that will prompt and directly link recently incarcerated homeless adults to community-based case management services and resources and (2) utilize in-person and smartphone-based assessments to identify key variables (eg, alcohol or drug use, social support, psychological distress, and quality of life) that predict continued homelessness and rearrest. Methods: Homeless adults (N=432) who enroll in a shelter-based Homeless Recovery Program after release from the Dallas County Jail will be randomly assigned to one of the three treatment groups: (1) usual case management, (2) usual case management plus smartphone, and (3) usual case management with a study-provided smartphone that is preloaded with an innovative case management app (smartphone-based case management). Those assigned to smartphone-based case management will receive smartphones that prompt (twice weekly) connections to shelter-based case managers. The app will also offer direct links to case managers (available during normal business hours) and crisis interventionists (available 24 hours a day, 7 days a week) with the touch of a button. Results: Recruitment began in the spring of 2018, and data collection will conclude in 2021. Conclusions: This research represents an important step toward integrated service connection and health care service provision for one of the most underserved, high need, and understudied populations in the United States. Trial Registration: ClinicalTrials.gov NCT03399500; https://clinicaltrials.gov/ct2/show/NCT03399500
By analyzing data from focus groups in a poor, mostly African American neighborhood in a large U.S. city, we describe how residents in urban food deserts access food, the barriers they experience in accessing nutritious, affordable food, and how community food insecurity exacerbates prior social, built, and economic stressors. Provided the unwillingness of supermarkets and supercenters to locate to poor urban areas and the need for nutritious, affordable food, it may be more efficient and equitable for government programs to financially partner with ethnic markets and smaller locally-owned grocery stores to increase the distribution and marketing of healthy foods rather than to spend resources trying to entice a large supermarket to locate to the neighborhood. By focusing on improving the conditions of the neighborhood and making smaller grocery stores and markets more affordable and produce more attractive to residents, the social, built, and economic stressors experienced by residents will be reduced, thereby possibly improving overall mental and physical health.
Background Early detection of several skin-related neglected tropical diseases (skin NTDs)–including leprosy, Buruli ulcer, yaws, and scabies- may be achieved through school surveys, but such an approach has seldom been tested systematically on a large scale in endemic countries. Additionally, a better understanding of the spectrum of skin diseases and the at-risk populations to be encountered during such surveys is necessary to facilitate the process. Methods We performed a school skin survey for selected NTDs and the spectrum of skin diseases, among primary schoolchildren aged 5 to 15 in Côte d’Ivoire, West Africa. This 2-phase survey took place in 49 schools from 16 villages in the Adzopé health district from November 2015 to January 2016. The first phase involved a rapid visual examination of the skin by local community healthcare workers (village nurses) to identify any skin abnormality. In a second phase, a specialized medical team including dermatologists performed a total skin examination of all screened students with any skin lesion and provided treatment where necessary. Results Of a total of 13,019 children, 3,504 screened positive for skin lesions and were listed for the next stage examination. The medical team examined 1,138 of these children. The overall prevalence of skin diseases was 25.6% (95% CI: 24.3–26.9%). The predominant diagnoses were fungal infections (n = 858, prevalence: 22.3%), followed by inflammatory skin diseases (n = 265, prevalence: 6.9%). Skin diseases were more common in boys and in children living along the main road with heavy traffic. One case of multi-bacillary type leprosy was detected early, along with 36 cases of scabies. Our survey was met with very good community acceptance. Conclusion We carried out the first large-scale integrated, two-phase pediatric multi-skin NTD survey in rural Côte d’Ivoire, effectively reaching a large population. We found a high prevalence of skin diseases in children, but only limited number of skin NTDs. With the lessons learned, we plan to expand the project to a wider area to further explore its potential to better integrate skin NTD screening in the public health agenda.
Background: To prepare patients with traumatic brain injury (TBI) for discharge from inpatient rehabilitation, physical therapists may incorporate dual-task gait activities. Reliability of common dual-task measures for people with TBI in inpatient rehabilitation is undetermined. Our purpose was to assess inter-rater and intra-rater reliability and clinical feasibility of dual-task measures [Walking While Talking Test (WWTT), Modified Walking and Remembering Task (mWART), Timed Up and Go-cognitive (TUG-COG)] in inpatient rehabilitation for patients with TBI. Methods: A total of 22 individuals with TBI completing the dual-task measures (WWTT, Walking and Remembering Task (WART), and TUG-COG) in inpatient rehabilitation were rated concurrently by two physical therapists in a single testing session. Sessions were video recorded and rated by the same raters viewing the video 7-10 days later. Raters completed a survey assessing feasibility of conducting the dual-task measures in patients with TBI in inpatient rehabilitation. Data were analyzed by calculating ICC(2,1) for inter-rater reliability and ICC(3,1) for intra-rater reliability. Results: All dual-task measures (WWTT, mWART, TUG-COG) had excellent inter-rater and intra-rater reliability. Raters considered dual-task measures feasible for patients with TBI during inpatient rehabilitation. Conclusions: The WWTT, mWART, and TUG-COG have excellent reliability and appear clinically feasible for incorporation into clinical practice in inpatient rehabilitation following TBI.
IDH-mutant astrocytomas are significantly less aggressive than their IDH-wildtype counterparts. We analyzed The Cancer Genome Atlas dataset (TCGA) and identified a small group of IDH-mutant, WHO grade II–III astrocytomas (n = 14) with an unexpectedly poor prognosis characterized by a rapid progression to glioblastoma and death within 3 years of the initial diagnosis. Compared with IDH-mutant tumors with the typical, extended progression-free survival in a control group of age-similar patients, the tumors in the rapidly progressing group were characterized by a markedly increased level of overall copy number alterations ([CNA]; p = 0.006). In contrast, the mutation load was similar, as was the methylation pattern, being consistent with IDH-mutant astrocytoma. Two of the gliomas (14%) in the rapidly progressing, IDH-mutant group but none of the other grade II–III gliomas in the TCGA (n = 283) had pathogenic mutations in genes (FANCB and APC) associated with maintaining chromosomal stability. These results suggest that chromosomal instability can negate the beneficial effect of IDH mutations in WHO II–III astrocytomas. The mechanism of the increased CNA is unknown but in some cases appears to be due to mutations in genes with a role in chromosomal stability. Increased CNA could serve as a biomarker for tumors at risk for rapid progression.
Background: Peanut allergy (PA) is a significant and increasing problem, interfering with psychological development and family life. The standard recommendation to avoid peanut products and have access to injectable epinephrine is often inadequate. Oral immunotherapy for PA has been formally studied. Clinical observations of allergen immunotherapy have repeatedly enhanced patient care. Objective: The purpose of this study is to report observations on the treatment of 270 PA patients over 8.5 years. Methods: This is a retrospective record review of patients beginning peanut oral immunotherapy between January 1, 2009 and June 1, 2017 approved by the North Texas Institutional Review Board. Results: 270 patients aged 4 to 18 years comprising 107 girls and 163 boys were treated. 214/270 patients (79%) completed immunotherapy escalation. Age (p<0.001) and peanut IgE (p<0.001) correlate inversely with completing dose escalation. Epinephrine treated reactions in 63 and isolated gastrointestinal symptoms in 101 patients respectively were the most common adverse reactions to treatment but did not preclude success. Peanut IgE decreased by 65% after 3 years of maintenance treatment and 14/214 patients (6.5%) were able to achieve sustained unresponsiveness. Conclusions: In an allergy office practice setting, 79% of patients are able to complete a peanut desensitization protocol and maintain the desensitized state indefinitely with daily dosing. With appropriate planning and precautions, peanut oral immunotherapy may be performed in an allergy office. Careful observations of clinical treatment can contribute to the development of effective treatment strategies.
Conventional implementations of fully integrated, battery-connected, switched capacitor voltage regulators (SCVRs) require either thick-oxide MOSFETs or stacked thin-oxide MOSFETs as power switches to sustain the voltage stress induced by a nominal 3.7-V Li-Ion battery voltage. These approaches, however, exacerbate power loss, thus unable to achieve good power efficiency. Therefore, this paper proposes a solution to overcome the breakdown issue while improving power efficiency by using only non-stacked, thin-oxide MOSFETs. This is realized by using a 3-state, low-voltage-stress SCVR with a cross-phase-switching technique to decrease the output impedance and increase the total equivalent capacitance in a multi-phase configuration. A prototype 3:1 SCVR is implemented fully on-chip in a standard 130-nm CMOS process. The chip is capable of delivering a maximum load current of 45 mA with an input voltage range from 3.2 V to 4 V. Measurement results show 78% - 80% efficiency over a range of output power 4 - 28 mW, and a power density up to 38 mW/nF. The measured output ripple is 30 - 50 mV over a load range of 11 - 45 mA, and the measured voltage droop is 69 mV with 200-ns settling time under a 13-mA load step.
Importance Current comparative outcomes among black and white patients treated with percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) health system are not known. Objective To compare outcomes between black and white patients undergoing PCI in the VA health system. Design, Setting, and Participants This study compared black and white patients who underwent PCI between October 1, 2007, and September 30, 2013, at 63 VA hospitals using data recorded in the VA Clinical Assessment, Reporting, and Tracking System for Cardiac Catheterization Laboratories (CART-CL) program. A generalized linear mixed model with a random intercept for site assessed the relative difference in odds of outcomes between black and white patients. The setting was integrated institutionalized hospital care. Excluded were all patients of other races or those with multiple listed races and those with missing data regarding race or the diagnostic cardiac catheterization. The dates of analysis were January 7, 2016, to April 17, 2017. Exposure Percutaneous coronary intervention at a VA hospital. Main Outcomes and Measures The primary outcome was 1-year mortality. Secondary outcomes were 30-day all-cause readmission rates, 30-day acute kidney injury, 30-day blood transfusion, and 1-year readmission rates for myocardial infarction. In addition, variations in procedural and postprocedural care were examined, including the use of intravascular ultrasound, optical coherence tomography, fractional flow reserve measurements, bare-metal stents, postprocedural medications, and radial access. Results A total of 42 391 patients (13.3% black and 98.4% male; mean [SD] age, 65.2 [9.1] years) satisfied the inclusion and exclusion criteria. In unadjusted analyses, black patients had higher rates of 1-year mortality (7.1% vs 5.9%, P < .001) as well as secondary outcomes of 30-day acute kidney injury (20.8% vs 13.8%, P < .001), 30-day blood transfusion (3.4% vs 2.7%, P < .01), and 1-year readmission rates for myocardial infarction (3.3% vs 2.7%, P = .01) compared with white patients. After adjustment for demographics, comorbidities, and procedural characteristics, odds for 1-year mortality (odds ratio, 1.04; 95% CI, 0.90-1.19) were not different between black and white patients. There were also no differences in secondary outcomes with the exception of a higher rate of adjusted 30-day acute kidney injury (odds ratio, 1.22; 95% CI, 1.10-1.36). Conclusions and Relevance While black patients had a higher rate of mortality than white patients in unadjusted analyses, race was not independently associated with 1-year mortality among patients undergoing PCI in VA hospitals.
This study examined the extent to which a discrepant comprehension-production profile (i.e., relatively more delayed comprehension than production) is characteristic of the early language phenotype in autism spectrum disorders (ASD) and tracked the developmental progression of the profile. Our findings indicated that a discrepant comprehension-production profile distinguished toddlers (30 months) with ASD from late talkers without ASD (91% sensitivity, 100% specificity) in groups that were comparable on expressive language, age, and socioeconomic status. Longitudinal data for children with ASD revealed that the discrepant profile steadily decreased from 30 to 44 months until there was no significant comprehension-production difference at 66 months. In conclusion, results suggest that lower comprehension than production may be an age-specific marker of toddlers with ASD.
Given the importance of amines in a large number of biologically active natural products, active pharmaceutical ingredients, agrochemicals and functional materials, the development of efficient CN bond-forming methods with wide substrate scope continues to be at the frontiers of research in synthetic organic chemistry. Here, we present a general and fundamentally new synthetic approach for the direct, transition metal-free preparation of symmetrical and unsymmetri-cal diaryl-, arylalkyl- and dialkylamines that relies on the facile single or double addition of readily available C-nucleophiles to the nitrogen atom of bench-stable electrophilic aminating agents. Practical single and double polarity reversal (i.e., umpolung) of the nitrogen atom is achieved using sterically and electronically tunable ketomalonate-derived imines and oximes. Overall, this novel approach represents an operationally simple, scalable and environmentally friendly alternative to transition metal-catalyzed CN cross-coupling methods that are currently used to access structurally diverse secondary amines.
Objective: To determine the effects of a 24-month program of Individual Placement and Support (IPS) supported employment (SE) on employment outcomes for veterans with spinal cord injury (SCI). Design: Longitudinal, observational multi-site study of a single arm, non-randomized cohort. Setting: SCI centers in the Veterans Health Administration (VHA) (n=7). Participants: Veterans with SCI (n=213) enrolled during an episode of either inpatient hospital care (24.4%) or outpatient care (75.6%). More than half the sample (59.2%) had a history of traumatic brain injury (TBI). Intervention(s): IPS SE for 24 months. Main outcome measure(s): Competitive employment (CE). Results: Over the 24-month period, 92 of the entire sample of 213 IPS participants obtained competitive jobs for an overall employment rate of 43.2%. For the subsample of participants without TBI enrolled as outpatients (n=69), 36 obtained competitive jobs for an overall employment rate of 52.2%. Overall, employed participants averaged 38.2 ± 29.7 weeks of employment, with an average time to first employment of 348.3 ± 220.0 days. Nearly 25% of 1(st) jobs occurred within 4 to 6 months of beginning the program. Similar employment characteristics were observed in the subsample without TBI histories enrolled as outpatients. Conclusion(s): Almost half of the veterans with SCI participating in the 24-month IPS program as part of their ongoing SCI care achieved CE, consistent with their expressed preferences at the start of the study. Among a sub-sample of veterans without any TBI history enrolled as outpatients, employment rates exceeded 50%. Time to first employment was highly variable, but quite long in many instances. These findings support offering continued IPS services as part of ongoing SCI care to achieve positive employment outcomes.
The intersection of addiction and crime is pervasive. Not only is there a high prevalence of substance use and substance use disorders among criminal justice populations that is substantially higher than in the general population, but also offenders with substance use disorders are more likely to be rearrested. We believe there are several broad points that addiction researchers and criminologists have come to understand that are important to bring together. In this commentary, the asymmetrical nature of crime (i.e., a small subset account for the lion's share of offending) and the value of a developmentally sensitive life-course approach to inform criminal behavior are elucidated and discussed. These two themes are intertwined. High-impact offenders have extensive drug use histories and need intervention (policy or individual-level) but the form and content and ultimately the effectiveness of the intervention may depend on what period in the life-course the intervention is to be implemented.
Purpose of reviewChronic obstructive pulmonary disease (COPD) is often considered to be a disease in which an inevitable decline in lung function results in increasing dyspnea and deteriorating quality of life. This review summarizes recent data that calls this classic paradigm into question. Studies evaluating the effects of chronic sputum production, physical activity, and inhaled medications on quality of life and prognosis are also discussed.Recent findingsChronic sputum production and level of dyspnea contribute at least as much to impairment of quality of life and prognosis as does abnormal lung function. An accelerated decline in FEV1 occurs in only half of the patients who develop COPD. Current pharmacotherapy has been shown to moderate disease progression and quality of life, although the effects are lost when inhaled corticosteroids are discontinued. Declining physical activity begins early in the course of COPD, but increasing activity levels result in improved quality of life and a slower decline in lung function.SummarySymptoms and activity levels are as important as measuring FEV1 in determining disease severity, quality of life, and prognosis of COPD. Therapies exist that moderate the course of the disease, and small sustained increases in physical activity may slow physical deterioration and improve health-related quality of life.
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