The impact of mindfulness-based yoga interventions on fifth-grade students’ perceived stress and anxiety

© IEJEE. With rising pressure and an increase in expected academic performance in schools across the United States, students are experiencing higher levels of stress than ever before. To address this issue, the present study examined the impact of mindfulness-based yoga interventions on fifth-grade students’ perceived stress and anxiety levels through a mixed methods research approach. Quantitative data were collected from students through a pre-and post-questionnaire while qualitative data were garnered through an interview with the classroom teacher. Findings revealed that following the intervention period, students reported a decrease in stress levels (9.29%) and a slight increase in anxiety levels (1.9%). Particularly, males in the remedial class displayed changes in both a decrease in stress (16.68%) and anxiety (31.58%) levels. Additionally, the following themes emerged from the qualitative data: (a) teacher perceptions of students’ anxiety and stress in the classroom; (b) transfer of mindfulness-based yoga skills; and (c) creating a positive transition. These results suggest that mindfulness-based yoga can be a positive tool for the classroom to reduce students’ anxiety and stress

Negotiating Stances Used with Minority Suppliers: A Research Note

While new ways of organizing exchange have become prominent in business-to-business markets, the function of corporate minority supplier purchasing programs in this changing organizational environment has received scant attention. Specifically, the extent to which the present structure of minority supplier purchasing programs enhances -- or deters -- the creation of strategic partnerships, impacts the way buyers and suppliers interact, and ultimately determines the efficacy of these exchange relationships has not been sufficiently addressed in the literature. The present study examines the relationship between the minority supplier categorization (versus those not classified as such) and the negotiation stances that purchasing agents undertake with these suppliers. Data were collected using a mail survey of university purchasing agents. The purchasing agents were asked to select a supplier which is a participant in his or her organization’s minority supplier purchasing program and answer questions about a recent negotiation with that supplier. For purposes of comparison, a random sample of purchasing agents was asked to respond with regard to negotiations with a supplier which was not a participant in any of the organization’s supplier purchasing programs. Cluster analysis was used to examine the negotiation stances used by the purchasing agents

Evaluation of Bleeding Disorders in Patients With Noonan Syndrome: A Systematic Review

Background: Noonan syndrome (NS) is an autosomal dominant genetic condition that has a number of clinical features, including bleeding diathesis and a number of hematological abnormalities including clotting factor deficiencies, von Willebrand disease and abnormal platelet count/function. Methods: We evaluated the frequency/types of bleeding disorders, and associated hematological laboratory findings, in patients with NS, using published data from 1965 to 2014. Results: Of 45 studies identified, 31 included data for 428 patients with NS. Of these patients, 43% had reported bleeding, 26% had no reported bleeding and no bleed data was reported for 31%. Most patients (90%) had bleeding-related laboratory test abnormalities, but only 194 (45%) had a confirmed diagnosis of a specific bleeding disorder. Abnormal laboratory tests included: prolonged prothrombin time, activated partial thromboplastin time, and other platelet-related disorders. Of the 194 patients with a confirmed diagnosis of a specific bleeding disorder, 153 (79%) had single clotting factor deficiencies, von Willebrand disease or platelet-related disorders, and 41 (21%) had multiple deficiencies including platelet-related disorders. Conclusion: As patients with NS can experience multiple bleeding disorders, including abnormal platelet function, clinical evaluations should be performed at diagnosis, after diagnosis, before any surgery is undertaken, and if patients become symptomatic

Labelling of mental illness in a paediatric emergency department and its implications for stigma reduction education

Introduction: Stigmatizing attitudes and behaviours towards patients with mental illness have negative consequences on their health. Despite research regarding educational and social contact-based interventions to reduce stigma, there are limitations to the success of these interventions for individuals with deeply held stigmatizing beliefs. Our study sought to better understand the process of implicit mental illness stigma in the setting of a paediatric emergency department to inform the design of future educational interventions. Methods: We conducted a qualitative exploration of mental illness stigma with interviews including physician, nurse, service user, caregiver and administrative staff participants (n = 24). We utilized the implicit association test as a discussion prompt to explore stigma outside of conscious awareness. We conducted our study utilizing constructivist grounded theory methodology, including purposeful theoretical sampling and constant comparative analysis. Results: Our study found that the confluence of socio-cultural, cognitive and emotional forces results in labelling of patients with mental illness as time-consuming, unpredictable and/or unfixable. These labels lead to unintentional avoidance behaviours from staff which are perceived as prejudicial and discriminatory by patients and caregivers. Participants emphasized education as the most useful intervention to reduce stigma, suggesting that educational interventions should focus on patient-provider relationships to foster humanizing labels for individuals with mental illness and by promoting provider empathy and engagement. Discussion: Our results suggest that educational interventions that target negative attributions, consider socio-cultural contexts and facilitate positive emotions in healthcare providers may be useful. Our findings may inform further research and interventions to reduce stereotypes towards marginalized groups in healthcare settings

Labelling of mental illness in a paediatric emergency department and its implications for stigma reduction education

Introduction: Stigmatizing attitudes and behaviours towards patients with mental illness have negative consequences on their health. Despite research regarding educational and social contact-based interventions to reduce stigma, there are limitations to the success of these interventions for individuals with deeply held stigmatizing beliefs. Our study sought to better understand the process of implicit mental illness stigma in the setting of a paediatric emergency department to inform the design of future educational interventions. Methods: We conducted a qualitative exploration of mental illness stigma with interviews including physician, nurse, service user, caregiver and administrative staff participants (n = 24). We utilized the implicit association test as a discussion prompt to explore stigma outside of conscious awareness. We conducted our study utilizing constructivist grounded theory methodology, including purposeful theoretical sampling and constant comparative analysis. Results: Our study found that the confluence of socio-cultural, cognitive and emotional forces results in labelling of patients with mental illness as time-consuming, unpredictable and/or unfixable. These labels lead to unintentional avoidance behaviours from staff which are perceived as prejudicial and discriminatory by patients and caregivers. Participants emphasized education as the most useful intervention to reduce stigma, suggesting that educational interventions should focus on patient-provider relationships to foster humanizing labels for individuals with mental illness and by promoting provider empathy and engagement. Discussion: Our results suggest that educational interventions that target negative attributions, consider socio-cultural contexts and facilitate positive emotions in healthcare providers may be useful. Our findings may inform further research and interventions to reduce stereotypes towards marginalized groups in healthcare settings

Assessment of Muscle Activation of Caregivers Performing Dependent Transfers With a Novel Robotic-Assisted Transfer Device Compared With the Hoyer Advance

OBJECTIVE: The purpose of this study was to compare muscle activity in caregivers while using a novel robotic assistive transfer device (Strong Arm) to a clinical standard of care (Hoyer Advance). DESIGN: A Quasi-Experimental design was used in which twenty caregivers (33±15 years old) performed transfers with three surfaces (toilet, bench and shower chair) with the Strong Arm and Hoyer Advance. Transfer completion time (sec), peak percentage surface electromyography (EMG) and integrated EMG of the bilateral erector spinae, latissimus dorsi, pectoralis major and anterior deltoid were measured. RESULTS: Caregivers required less transfer time when transferring from wheelchair to surface using the Hoyer Advance (p=.011, f=.39). Lower back: significantly lower pEMG were found using Strong Arm in 50% and for the iEMG in 25% of the cases, with the remaining cases showing no significant differences. Shoulder: significantly lower pEMG were found using Strong Arm in 19% of transfers and lower iEMG was found in 25% of transfers when using the Hoyer Advance, with the remaining cases showing no significant differences. CONCLUSION: While back muscle activation during Strong Arm transfers is statistically, but not clinically, lower, additional features that couple with significantly lower muscle activation make it an alternative to the clinical standard for further research and possible clinical applicability

Regulation of B-cell development and tolerance by different members of the miR-17∼1/492 family microRNAs

The molecular mechanisms that regulate B-cell development and tolerance remain incompletely understood. In this study, we identify a critical role for the miR-17∼1/492 microRNA cluster in regulating B-cell central tolerance and demonstrate that these miRNAs control early B-cell development in a cell-intrinsic manner. While the cluster member miR-19 suppresses the expression of Pten and plays a key role in regulating B-cell tolerance, miR-17 controls early B-cell development through other molecular pathways. These findings demonstrate differential control of two closely linked B-cell developmental stages by different members of a single microRNA cluster through distinct molecular pathwaysThis study is supported by the PEW Charitable Trusts, Cancer Research Institute, Lupus Research Institute and National Institute of Health (R01AI087634, R01AI089854, R56AI110403 and R56AI121155 to C.X.

Conducting qualitative research within Clinical Trials Units: Avoiding potential pitfalls

The value of using qualitative research within or alongside randomised controlled trials (RCTs) is becoming more widely accepted. Qualitative research may be conducted concurrently with pilot or full RCTs to understand the feasibility and acceptability of the interventions being tested, or to improve trial conduct. Clinical Trials Units (CTUs) in the United Kingdom (UK) manage large numbers of RCTs and, increasingly, manage the qualitative research or collaborate with qualitative researchers external to the CTU. CTUs are beginning to explicitly manage the process, for example, through the use of standard operating procedures for designing and implementing qualitative research with trials. We reviewed the experiences of two UK Clinical Research Collaboration (UKCRC) registered CTUs of conducting qualitative research concurrently with RCTs. Drawing on experiences gained from 15 studies, we identify the potential for the qualitative research to undermine the successful completion or scientific integrity of RCTs. We show that potential problems can arise from feedback of interim or final qualitative findings to members of the trial team or beyond, in particular reporting qualitative findings whilst the trial is on-going. The problems include: 1. Unplanned modifications of the trial intervention during the full RCT 2. Selection bias and threats to external validity 3. Unblinding of group allocation 4. Breach of participant anonymity and confidentiality in small RCTs 5. Unplanned modifications of the trial processes and procedures 6. Threats to completion of recruitment, retention and outcome measurement. We make recommendations for improving the management of qualitative research within CTU

Recording harms in randomized controlled trials of behavior change interventions: a scoping review and map of the evidence

Objectives: Randomized controlled trials evaluate diverse interventions. This can include medical interventions such as drugs or surgical procedures, or behavior change interventions (BCIs) that aim to change a habit, belief, or attitude to improve health, for example, healthy eating, psychological wellbeing. Harms are often recorded poorly or inconsistently within randomized controlled trials of BCIs. This scoping review aimed to collate and describe literature on categories, definitions, and mechanisms of harms from BCIs; methods of identifying plausible harms; and recommendations for recording harms. Study Design and Setting: A scoping review was conducted. Three databases (MEDLINE, PsycINFO, and CINAHL) were searched. Reference list checking and citation searching were performed. Articles were included if they discussed (1) interventions that aimed to modify behavior, (2) categories or mechanisms of harms, and (3) methods or recommendations for recording harms. All research designs were included. One reviewer reviewed titles, abstracts, and full texts; queries were checked with another reviewer. Data were extracted and synthesized descriptively by one reviewer and checked by another reviewer. A thematic map was constructed to summarize the review findings. Harms described from specific BCIs were identified, and examples were selected and summarized. Results: The review included 37 articles. Nineteen of 37 articles contributed to a thematic review. Three articles described categories of harms; categories of harm included physical, psychological, group and social interactions, cultural, equity, opportunity cost, environmental, and economic. Seven articles included mechanisms or underlying factors for harms including feelings of failure leading to shame or stigma, and group interventions enabling knowledge exchange on unhealthy behaviors. Twelve articles provided recommendations for recording harms, including taking a proportionate approach by focusing on the most plausible and important harms, collecting different perspectives on whether harms had occurred (eg, caregivers and family members), and using qualitative research methods to identify harms. One article described a three-step method to identify plausible harms from an intervention, and six articles supported aspects of the method. Eighteen of 37 articles contributed to a review which collated harms arising from specific interventions, for example, a peer support intervention in inflammatory bowel disease caused distressing conversations which might lead to anxiety and confrontation with a possible negative future. Conclusion: BCIs can cause harm. This review identified categories and proposed mechanisms of harms, as well as methods and recommendations for identifying and recording harms in BCIs for inclusion in forthcoming recommendations

Heterogeneous Variances in Multi-Environment Yield Trials for Corn Hybrids

Recent developments in statistics and computing have enabled much greater levels of complexity in statistical models of multi-environment yield trial data. One particular feature of interest to breeders is simultaneously modeling heterogeneity of variances among environments and hybrids. Our objective was to estimate the level of heterogeneity of genotype by environment interaction variance and error variance in the Iowa Crop Performance Test for Corn. A Bayesian approach was used to estimate variance components in a hierarchical model that allows for heterogeneous error and genotypeby- environment interaction (GEI) variances applied to corn yield data from the Iowa Crop Performance Test performed between 1995 and 2005. An average of 508 hybrids were tested per year with very little overlap between locations and years, which resulted in a very unbalanced data set. We divided the data into 16 subsets to study the effect of variability across locations and years. We found GEI and error variances to be heterogeneous among both environments and genotypes. Our results for corn contrasted previous work on oat (Avena sativa L.) in which very little heterogeneity was found for error variance among cultivars suggesting that different corn (Zea mays L.) hybrids can have different genotype by environment interaction variances and different error variances