Counting Room Voices in the Farm Publisher-Reader-Advertiser Triad

This study is part of a series that examines changing power relationships among commercial farm periodicals, their readers, and advertisers. The series focuses upon the health, vigor, and credibility of a complex information system in which the U.S. food enterprise and society in general have an important stake. Authors employed a “contractualist model” in which power requires mutual agreement by all parties. Two previous studies in the series identified concerns of farm periodical journalists and readers about advertiser-related pressures on editorial content. Through qualitative research methods, the study reported here examined related views among a sample of agricultural publishers and advertisers. Both groups expressed the most concern about the consolidation taking place among producers, marketers, and publishers, but they focused on different sectors. All three kinds of consolidation have the effect of giving the advertiser more power within the triad. Publishers and advertisers emphasized the need to maintain editorial credibility of commercial farm periodicals, acknowledged advertiser-related pressures, but shared a feeling that such pressures can be controlled and should not influence the independent stance of editorial content. They differed somewhat, however, in views on managing the editorial-advertising “wall.” Publishers also identified ways in which they are adapting, through diversification, to changing strategies of advertisers in an era of consolidation and new information technologies. By revealing perspectives of all partners in the triad, findings provide a useful staging point for interactions and understandings

Farmers’ Voices: Concerns within the Agricultural Advertiser-Media-Reader Triad

This study continues an examination of power relationships within the agricultural publishing triad: advertisers, periodicals, and producer readers. It focuses on the views of farmers about the farm periodicals they read and the agricultural marketers that advertise in those periodicals. A mail survey was used to learn the opinions and observations of farmers in a nationwide sample. The sample of 497 was randomly drawn from a government database by a commercial data supply service. Three waves of letters were used along with a $1 incentive. The 198 completed responses came from 29 states. Results indicate that producers are quite discerning and insightful in what they read. Furthermore, a majority expressed concern about advertiser-editorial relationships. Most said they see evidence of advertiser influence in the form of editorial trade-offs and bias in what stories are covered (or not covered) and how topics are handled. Results of a credibility index indicate there is much room for improvement. Authors suggest that farm publishers and advertisers should reconsider their relationships if they wish to address readers’ concerns and improve their credibility. In a highly competitive environment, increased credibility has positive bottom-line implications for all partners in the triad

Fading Voices: A 10-Year Trend Within an Agricultural Advertiser-Media-Reader Triad

Research reported here addresses effective communications within agriculture by examining power relationships within the agricultural publishing triad: advertisers, periodicals and producer readers. A 10-year analysis using mail surveys among agricultural print journalists explores recent changes within this triad, including perceptions of trends in the levels, kinds, and effects of advertiser influence on editorial content of U.S. commercial farm periodicals. Results reveal increasing advertiser-related pressure on the journalists. Other findings examine perceived harm to the profession, publication policies used, and differences in response related to gender and age. Authors discuss implications and offer steps for follow-up through research and professional education

Experiences in Youth Sports: A Comparison Between Players’ and Parents’ Perspectives

vol. 2, no.

Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?

Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. In this setting, the index of microcirculatory resistance emerged as an accurate tool to identify patients at risk of suboptimal myocardial reperfusion after primary percutaneous coronary intervention who may benefit from novel adjunctive therapies. In the context of non-ST-elevation ACS, coronary physiology should be carefully interpreted and often integrated with intracoronary imaging, especially in cases of ambiguous culprit lesion. Conversely, the functional assessment of bystander coronary disease is favoured by the available evidence, aiming to achieve complete revascularisation. Based on everyday clinical scenarios, the authors illustrate the available evidence and provide recommendations for the functional assessment of infarct-related artery and non-culprit lesions in patients with ACS

Gender Disparities in Authorships and Citations in Transplantation Research

Background: Over the past decades, there has been a rapid change in the gender ratio of medical doctors, whereas gender differences in academia remain apparent. In transplantation research, a field already understaffed with female doctors and researchers, there is little published data on the development in proportion, citations, and funding of female researchers over the past years. Methods: To evaluate the academic impact of female doctors in transplantation research, we conducted a bibliometric analysis (01 January 1999 to 31 December 2018) of high-impact scientific publications, subsequent citations, and funding in this field. Web of Science data was used in combination with software R-Package "Gender," to predict gender by first names. Results: For this study, 15 498 (36.2% female; 63.8% male) first and 13 345 (30.2% female; 69.8% male) last author gender matches were identified. An increase in the percentage of female first and last authors is seen in the period 1999-2018, with clear differences between countries (55.1% female authors in The Netherlands versus 13.1% in Japan, for example). When stratifying publications based on the number of citations, a decline was seen in the percentage of female authors, from 34.6%-30.7% in the first group (≤10 citations) to 20.8%-23.2% in the fifth group (>200 citations), for first (P < 0.001) and last (P = 0.014) authors, respectively. From all first author name-gender matches, 6574 (41.6% female; 58.4% male, P < 0.001) publications reported external funding, with 823 (35.5% female; 64.5% male, P = 0.701) reported funding by pharmaceutical companies and 1266 (36.6% female; 63.4% male, P < 0.001) reporting funding by the National Institutes of Health. Conclusions: This is the first analysis of gender bias in scientific publications, subsequent citations, and funding in transplantation research. We show ongoing differences between male and female authors in citation rates and rewarded funding in this field. This requires an active approach to increase female representation in research reporting and funding rewarding

The Effect of Frailty on Outcome After Vascular Surgery

OBJECTIVES: Frailty is a state of increased vulnerability and is a stronger predictor for post-operative outcome than age alone. The aim of this study was to determine whether frailty is associated with adverse 30 day outcome in vascular surgery patients. METHODS: This was a prospective cohort study. All electively operated vascular surgery patients between March 2010 and October 2017 (n = 1201), aged ≥ 60 years were evaluated prospectively. Exclusion criteria were arteriovenous access surgery, percutaneous interventions and minor amputations, resulting in 825 patients for further analysis whereas 195 had incomplete data on Groningen Frailty Indicator (GFI) and were excluded. Frailty was measured using the GFI, a screening tool covering 16 items in the domains of functioning. Patients with a total score of ≥4 were classified as frail. The primary outcome parameter was 30 day morbidity (based on the Comprehensive Complication Index). Secondary outcome measures were 30 day mortality, hospital readmission, and type of care facility after discharge. Outcomes were adjusted for sex, body mass index, smoking status, hypertension, Charlson Comorbidity Index, and type of intervention. RESULTS: There was an unequal sex distribution (77.6% male). The mean age was 72.1 years. One hundred and eighty-four patients (22.3%) were considered frail. The mean Comprehensive Complication Index was 8.5. Frail patients had a significantly higher Comprehensive Complication Index (3.7 point increase, p = .005). Patients with impaired cognition and reduced psychosocial condition, two domains of the GFI, had a significantly higher Comprehensive Complication Index. Also, the 30 day mortality rate was higher in frail patients (2.7 point increase; p = .05), and they were discharged to a care facility more often (7.7 point increase; p < .001). There was no significant difference in readmission rates between frail and non-frail patients. CONCLUSIONS: Frailty is associated with a higher risk of post-operative complications and discharge to a nursing home after vascular surgery. Some frailty domains (mobility, nutrition, cognition and psychosocial condition) appear to have a more pronounced impact

The double-kissing nano-crush for bifurcation lesions : development, bioengineering, fluid dynamics and initial clinical testing

Background When possible, a single stent technique to treat coronary bifurcation disease is preferable. However, when two stents are required, there is scope to improve upon existing techniques. The crush technique has already been improved with the introduction of double kissing (DK) and mini-crush. We sought to refine and simplify the mini-crush technique, retaining its advantages whilst avoiding its disadvantages, by developing a DK nano-crush technique. Methods The DK nano-crush method allows complete lesion coverage of a bifurcation lesion without excessive metal layers. This is achieved by positioning the SB stent with minimal protrusion into the main branch (MB), implantation of the SB stent with an undeployed balloon in the MB, immediate kissing balloon inflation with formation of a minimal neocarina, stenting the MB, re-crossing the proximal part of the SB without crossing double metal layer, and final kissing. We demonstrate this technique with benchtop implantation, micro computed tomography reconstruction, computational fluid dynamics (CFD) modelling and clinically with angiographic and intravascular imaging. Results The DK nano-crush was practically feasible and resulted in full ostial coverage. CFD analysis demonstrated minimally disturbed blood flow. The technique was successfully utilised in nine patients with bifurcation lesions with excellent angiographic outcomes and no adverse events over twelve months. Conclusions The DK nano-crush technique may represent the ultimate refinement of the original ‘crush’ with a number of practical and theoretical advantages. It remains to be tested against other bifurcation techniques in prospective trials