A single, complete touch: Population health, the health contact center, and the patient experience

As healthcare organizations turn to population health in order to more effectively manage the health and well-being of their patients, many need to ensure that these new strategies include a directive to improve the patient experience. Fortunately, healthcare systems can turn to an existing entity within its ranks, the health contact center, in order to execute a successful strategy and ensure that the individual patient never feels lost amongst the population crowd. Fran Horner from Singola Consulting and Susan Marks from Amati Health explore the ways in which population health and the health contact center work collaboratively to keep patient populations well cared for, healthy, and ultimately improve the patient experience for every individual

The 'glass-ceiling' phenomenon in the career development of successful academic women.

The research makes an original contribution to social psychology theory related to the success of academic women in higher education. The literature review reveals that there are differing views on the reasons for women failing to break through the glass ceiling in the higher education setting. Some authors concentrate on the environmental factors that are having an effect on women. Others concentrate on the effects of patriarchal organisational structures. Fewer commentators make reference to the notion of the female psyche. The existence of the glass ceiling phenomenon in the higher education setting is attributed to psychological, cultural, and technical factors. Little primary research has been conducted on the perceptions of female academics at the middle management level in the higher education setting, and much of the published work is anecdotal in nature. It is the aim of this research to give new insights into the perceptions of women at middle management level. The research makes no prior assumptions about the nature or categorisation of the mental constructions that emerge, but produces a more informed and sophisticated perceptual map. It investigates the respondents' perceptions of the glass ceiling phenomenon in relation to the features of their lifeworld. The research uses the essences of the lifeworld approach to analyse the views and feelings of the women participants. The perceptions that emerge from the research include the issue of a long term juggling act that the respondents have to achieve to be successful (Temporality). The women also demonstrate a ruthless pursuit for a voice in an increasingly difficult environment (Selfhood). The relationship of the women to other people in their lives is one of the most important findings in the research. The women always find that they have a series of bitter-sweet relationships with others and often feel guilt about missed opportunities (Sociality). The respondents also demonstrate that they feel that it is better to have suffered hardship to enable them and others to progress (Embodiment). One of the respondents graphically illustrates the development of academic women with reference to the metaphor - the relay race in time which emphasises the importance of influence and mentoring that the respondents think is important but often find difficult to achieve (Spatiality). The women often appear to have conflicting projects and address this issue with passion which often leads to conflict (Project). The language that the women use often portrays their disappointment with the emerging emphasis on management and administration rather than research and discovery (Discourse). The accounts do have some flashes of joy and celebration but overall they tend to epitomise feelings of sadness and regret. The thesis ends by suggesting that there are certain typologies for successful academic women based on their relationship to others or their inner psychological state. These are used to make some suggestions in relation to practical steps that could be taken to help women to achieve greater academic success. The new insights in the thesis will hopefully enable organisations to take positive steps to encourage more women into senior academic posts

Widespread Increases in Malondialdehyde Immunoreactivity in Dopamine-Rich and Dopamine-Poor Regions of Rat Brain Following Multiple, High Doses of Methamphetamine

Treatment with multiple high doses of methamphetamine (METH) can induce oxidative damage, including dopamine (DA)-mediated reactive oxygen species (ROS) formation, which may contribute to the neurotoxic damage of monoamine neurons and long-term depletion of DA in the caudate putamen (CPu) and substantia nigra pars compacta (SNpc). Malondialdehyde (MDA), a product of lipid peroxidation by ROS, is commonly used as a marker of oxidative damage and treatment with multiple high doses of METH increases MDA reactivity in the CPu of humans and experimental animals. Recent data indicate that MDA itself may contribute to the destruction of DA neurons, as MDA causes the accumulation of toxic intermediates of DA metabolism via its chemical modification of the enzymes necessary for the breakdown of DA. However, it has been shown that in human METH abusers there is also increased MDA reactivity in the frontal cortex, which receives relatively fewer DA afferents than the CPu. These data suggest that METH may induce neuronal damage regardless of the regional density of DA or origin of DA input. The goal of the current study was to examine the modification of proteins by MDA in the DA-rich nigrostriatal and mesoaccumbal systems, as well as the less DA-dense cortex and hippocampus following a neurotoxic regimen of METH treatment. Animals were treated with METH (10 mg/kg) every 2 h for 6 h, sacrificed 1 week later, and examined using immunocytochemistry for changes in MDA-adducted proteins. Multiple, high doses of METH significantly increased MDA immunoreactivity (MDA-ir) in the CPu, SNpc, cortex, and hippocampus. Multiple METH administration also increased MDA-ir in the ventral tegmental area and nucleus accumbens. Our data indicate that multiple METH treatment can induce persistent and widespread neuronal damage that may not necessarily be limited to the nigrostriatal DA system

Transmission of Multiple Traditions within and between Chimpanzee Groups

SummaryField reports provide increasing evidence for local behavioral traditions among fish, birds, and mammals [1–7]. These findings are significant for evolutionary biology because social learning affords faster adaptation than genetic change and has generated new (cultural) forms of evolution [8–10]. Orangutan and chimpanzee field studies [3, 4, 11–13] suggest that like humans [14, 15], these apes are distinctive among animals in each exhibiting over 30 local traditions. However, direct evidence is lacking in apes and, with the exception of vocal dialects [16, 17], in animals generally for the intergroup transmission that would allow innovations to spread widely and become evolutionarily significant phenomena. Here, we provide robust experimental evidence that alternative foraging techniques seeded in different groups of chimpanzees spread differentially not only within groups but serially across two further groups with substantial fidelity. Combining these results with those from recent social-diffusion studies in two larger groups [18–20] offers the first experimental evidence that a nonhuman species can sustain unique local cultures, each constituted by multiple traditions. The convergence of these results with those from the wild implies a richness in chimpanzees' capacity for culture, a richness that parsimony suggests was shared with our common ancestor

Donepezil Effects on Mood in Patients with Schizophrenia and Schizoaffective Disorder

Donepezil, 5 mg/d for 6 wk then 10 mg/d for 6 wk, and placebo daily for 12 wk in a double-blind cross-over paradigm, was added to the therapeutic regimen of 13 patients with schizophrenia or schizoaffective disorders, clinically stable on atypical antipsychotic medications. Patients had varying degrees of depressive symptoms, ranging from no depression to clinically significant depression. There was no worsening or induction of depression in individual patients or the group as a whole. In addition there was a statistically significant antidepressant effect in the group as a whole during the donepezil condition and a clinically significant antidepressant effect in the patients with clinically significant depressive symptoms, although there were not enough depressed patients in the group to conclude that donepezil may have antidepressant effects. Thus, in this study, donepezil did not induce or worsen depressive symptoms in schizophrenic and schizoaffective disorder patients

Positive correlation of employment and psychological well-being for veterans with major abdominal surgery

Background Intestinal stomas (ostomies) have been associated negatively with multiple aspects of health-related quality of life. This article examines the relationship between employment status and psychological well-being (PWB) in veterans who underwent major bowel procedures with or without ostomy. Methods Veterans from 3 Veterans Affairs (VA) medical centers were surveyed using the City of Hope ostomy-specific questionnaire and the Short Form 36 item Veteran’s version (SF-36V). Response rate was 48% (511 of 1,063). Employment and PWB relationship was assessed using multiple regression with age, income, SF-36V physical component summary (PCS), and employment status as independent variables. Results Employed veterans reported higher PWB compared with unemployed veterans (P = .003). Full-time workers also reported higher PWB than part-time or unemployed workers (P = .001). Ostomy was not an independent predictor of PWB. Conclusions Employment among veterans after major abdominal surgery may have intrinsic value for PWB. Patients should be encouraged to return to work, or do volunteer work after recovery

Avian tail ontogeny, pygostyle formation, and interpretation of juvenile Mesozoic specimens

The avian tail played a critical role in the evolutionary transition from long- to short-tailed birds, yet its ontogeny in extant birds has largely been ignored. This deficit has hampered efforts to effectively identify intermediate species during the Mesozoic transition to short tails. Here we show that fusion of distal vertebrae into the pygostyle structure does not occur in extant birds until near skeletal maturity, and mineralization of vertebral processes also occurs long after hatching. Evidence for post-hatching pygostyle formation is also demonstrated in two Cretaceous specimens, a juvenile enantiornithine and a subadult basal ornithuromorph. These findings call for reinterpretations of Zhongornis haoae, a Cretaceous bird hypothesized to be an intermediate in the long- to short-tailed bird transition, and of the recently discovered coelurosaur tail embedded in amber. Zhongornis, as a juvenile, may not yet have formed a pygostyle, and the amber-embedded tail specimen is reinterpreted as possibly avian. Analyses of relative pygostyle lengths in extant and Cretaceous birds suggests the number of vertebrae incorporated into the pygostyle has varied considerably, further complicating the interpretation of potential transitional species. In addition, this analysis of avian tail development reveals the generation and loss of intervertebral discs in the pygostyle, vertebral bodies derived from different kinds of cartilage, and alternative modes of caudal vertebral process morphogenesis in birds. These findings demonstrate that avian tail ontogeny is a crucial parameter specifically for the interpretation of Mesozoic specimens, and generally for insights into vertebrae formation

Bioactive Trace Metals and Their Isotopes as Paleoproductivity Proxies: An Assessment Using GEOTRACES-Era Data

86 pages, 33 figures, 2 tables, 1 appendix.-- Data Availability Statement: The majority of the dissolved data were sourced from the GEOTRACES Intermediate Data Products in 2014 (Mawji et al., 2015) and 2017 (Schlitzer et al., 2018), and citations to the primary data sources are given in the caption for each figure. Data sources for Figure 1 are given below. Figure 1: Iron: Conway & John, 2014a (Atlantic); Conway & John, 2015a (Pacific); Abadie et al., 2017 (Southern). Zinc: Conway & John, 2014b (Atlantic); Conway & John, 2015a (Pacific); R. M. Wang et al., 2019 (Southern). Copper: Little et al., 2018 (Atlantic); Takano et al., 2017 (Pacific); Boye et al., 2012 (Southern). Cadmium: Conway and John, 2015b (Atlantic); Conway & John, 2015a (Pacific); Abouchami et al., 2014 (Southern). Molybdenum: Nakagawa et al., 2012 (all basins). Barium: Bates et al., 2017 (Atlantic); Geyman et al., 2019 (Pacific); Hsieh & Henderson, 2017 (Southern). Nickel: Archer et al., 2020 (Atlantic); Takano et al., 2017 (Pacific); R. M. Wang et al., 2019 (Southern). Chromium: Goring-Harford et al., 2018 (Atlantic); Moos & Boyle, 2019 (Pacific); Rickli et al., 2019 (Southern). Silver: Fischer et al., 2018 (Pacific); Boye et al., 2012 (Southern)Phytoplankton productivity and export sequester climatically significant quantities of atmospheric carbon dioxide as particulate organic carbon through a suite of processes termed the biological pump. Constraining how the biological pump operated in the past is important for understanding past atmospheric carbon dioxide concentrations and Earth's climate history. However, reconstructing the history of the biological pump requires proxies. Due to their intimate association with biological processes, several bioactive trace metals and their isotopes are potential proxies for past phytoplankton productivity, including iron, zinc, copper, cadmium, molybdenum, barium, nickel, chromium, and silver. Here, we review the oceanic distributions, driving processes, and depositional archives for these nine metals and their isotopes based on GEOTRACES-era datasets. We offer an assessment of the overall maturity of each isotope system to serve as a proxy for diagnosing aspects of past ocean productivity and identify priorities for future research. This assessment reveals that cadmium, barium, nickel, and chromium isotopes offer the most promise as tracers of paleoproductivity, whereas iron, zinc, copper, and molybdenum do not. Too little is known about silver to make a confident determination. Intriguingly, the trace metals that are least sensitive to productivity may be used to track other aspects of ocean chemistry, such as nutrient sources, particle scavenging, organic complexation, and ocean redox state. These complementary sensitivities suggest new opportunities for combining perspectives from multiple proxies that will ultimately enable painting a more complete picture of marine paleoproductivity, biogeochemical cycles, and Earth's climate historyThis contribution grew (and grew) out of a joint workshop between GEOTRACES and Past Global Changes (PAGES) held in Aix-en-Provence in December 2018. The workshop was funded by the U.S. National Science Foundation (NSF) through the GEOTRACES program, the international PAGES project, which received support from the Swiss Academy of Sciences and NSF, and the French program Les Envelopes Fluides et l'Environnement. [...] T. J. Horner acknowledges support from NSF; S. H. Little from the UK Natural Environment Research Council (NE/P018181/1); T. M. Conway from the University of South Florida; and, J. R. Farmer from the Max Planck Society, the Tuttle Fund of the Department of Geosciences of Princeton University, the Grand Challenges Program of the Princeton Environmental Institute, and the Andlinger Center for Energy and the Environment of Princeton University. [...] With the institutional support of the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S