The Core of Care Management: The Role of Authentic Relationships in Caring for Patients with Frequent Hospitalizations.

In the movement to improve the health of patients with multiple chronic conditions and vulnerabilities, while reducing the need for hospitalizations, care management programs have garnered wide attention and support. The qualitative data presented in this paper sheds new light on key components of successful chronic care management programs. By going beyond a task- and temporal-based framework, this analysis identifies and defines the importance of authentic healing relationships in driving individual and systemic change. Drawing on the voices of 30 former clients of the Camden Coalition of Healthcare Providers, the investigators use qualitative methods to identify and elaborate the core elements of the authentic healing relationship-security, genuineness, and continuity-a relationship that is linked to patient motivation and active health management. Although not readily found in the traditional health care delivery system, these authentic healing relationships present significant implications for addressing the persistent health-related needs of patients with frequent hospitalizations. (Population Health Management 2016;19:248-256)

Predicting morphotropic phase boundary locations and transition temperatures in Pb- and Bi-based perovskite solid solutions from crystal chemical data and first-principles calculations

Using data obtained from first-principles calculations, we show that the position of the morphotropic phase boundary (MPB) and transition temperature at MPB in ferroelectric perovskite solutions can be predicted with quantitative accuracy from the properties of the constituent cations. We find that the mole fraction of PbTiO$_3$ at MPB in Pb(B$'$B$''$)O$_3$-PbTiO$_3$, BiBO$_3$-PbTiO$_3$ and Bi(B$'$B$''$)O$_3$-PbTiO$_3$ exhibits a linear dependence on the ionic size (tolerance factor) and the ionic displacements of the B-cations as found by density functional theory calculations. This dependence is due to competition between the local repulsion and A-cation displacement alignment interactions. Inclusion of first-principles displacement data also allows accurate prediction of transiton temperatures at the MPB. The obtained structure-property correlations are used to predict morphotropic phase boundaries and transition temperatures in as yet unsynthesized solid solutions.Comment: Accepted for publication in J. Appl. Phy

The US-Japan alliance and the relocation of Futenma : sites of discursive exchange in the reproduction of security alliances

Using the US-Japan alliance as its institutional setting and the political conflict over the relocation of Marines Air Base Futenma from Ginowan City to Nago, Okinawa as its case study, this research seeks to examine how alliances are discursively reproduced by analysing – through interviews, public speeches, and government publications – how they are publicly framed and deliberated not only by ‘elite’ actors (e.g. those in the US and Japanese governments) who seek to maintain the US-Japan alliance in its current form, but also by those within Okinawan local government and civil society who contest the alliance’s sustainability. This research sits in contrast to the prevailing arguments in the existing literature on alliance persistence, which tend to have a top-down focus and privilege the cooperative discourses of elite actors with direct access to the inner-workings of the alliance over the lived experience of ‘everyday’ actors excluded from the central policymaking process. Furthermore, these arguments tend to ignore the possibility of internal divisions amongst these 'elite' and 'everyday' actors, representing any debates within an alliance as taking place between the central governments of the member states rather than exploring the many divergences of opinion that exist within their central political parties, military bureaucracies, civil societies, and other groups concerned. By identifying a wide variety in the sites of discourse production both inside and outside of this institutionalised alliance, this research helps to bridge the disconnect between top-down and bottom-up analyses of alliance persistence, illustrate the processes by which discourses from seemingly irreconcilable sources may actually interact, influence, and shape each other in the realm of security policymaking, and broaden the conversation from one focused on 'persistence' to include an understanding of how an alliance is actively reproduced through discourse

Estimates for measures of sections of convex bodies

A $\sqrt{n}$ estimate in the hyperplane problem with arbitrary measures has recently been proved in \cite{K3}. In this note we present analogs of this result for sections of lower dimensions and in the complex case. We deduce these inequalities from stability in comparison problems for different generalizations of intersection bodies

Protein Quality Control Disruption by PKCβII in Heart Failure; Rescue by the Selective PKCβII Inhibitor, βIIV5-3

Myocardial remodeling and heart failure (HF) are common sequelae of many forms of cardiovascular disease and a leading cause of mortality worldwide. Accumulation of damaged cardiac proteins in heart failure has been described. However, how protein quality control (PQC) is regulated and its contribution to HF development are not known. Here, we describe a novel role for activated protein kinase C isoform βII (PKCβII) in disrupting PQC. We show that active PKCβII directly phosphorylated the proteasome and inhibited proteasomal activity in vitro and in cultured neonatal cardiomyocytes. Importantly, inhibition of PKCβII, using a selective PKCβII peptide inhibitor (βIIV5-3), improved proteasomal activity and conferred protection in cultured neonatal cardiomyocytes. We also show that sustained inhibition of PKCβII increased proteasomal activity, decreased accumulation of damaged and misfolded proteins and increased animal survival in two rat models of HF. Interestingly, βIIV5-3-mediated protection was blunted by sustained proteasomal inhibition in HF. Finally, increased cardiac PKCβII activity and accumulation of misfolded proteins associated with decreased proteasomal function were found also in remodeled and failing human hearts, indicating a potential clinical relevance of our findings. Together, our data highlights PKCβII as a novel inhibitor of proteasomal function. PQC disruption by increased PKCβII activity in vivo appears to contribute to the pathophysiology of heart failure, suggesting that PKCβII inhibition may benefit patients with heart failure. (218 words

Cross-relaxation and phonon bottleneck effects on magnetization dynamics in LiYF4:Ho3+

Frequency and dc magnetic field dependences of dynamic susceptibility in diluted paramagnets LiYF$_4$:Ho$^{3+}$ have been measured at liquid helium temperatures in the ac and dc magnetic fields parallel to the symmetry axis of a tetragonal crystal lattice. Experimental data are analyzed in the framework of microscopic theory of relaxation rates in the manifold of 24 electron-nuclear sublevels of the lowest non-Kramers doublet and the first excited singlet in the Ho$^{3+}$ ground multiplet $^5I_8$ split by the crystal field of S$_4$ symmetry. The one-phonon transition probabilities were computed using electron-phonon coupling constants calculated in the framework of exchange charge model and were checked by optical piezospectroscopic measurements. The specific features observed in field dependences of the in- and out-of-phase susceptibilities (humps and dips, respectively) at the crossings (anti-crossings) of the electron-nuclear sublevels are well reproduced by simulations when the phonon bottleneck effect and the cross-spin relaxation are taken into account