A phenomenological case study of finding meaning through the developmental nature of a doctoral program in organization change

This phenomenological case study of finding meaning explored the developmental nature of Pepperdine University’s Doctor of Education in Organization Change (EDOC) program through graduates, who as students, found deep, visceral, and life changing meaning. The primary request of participants, identified as co-inquirers, was to: describe in as much detail as possible how meaning was found through their participation in the EDOC program. Detailed storied descriptions from 10 graduates were gathered through interviews. Anecdotes were gathered by email from other graduates concerning the meaning found, relational experiences, and vivid program experiences. In my analysis of data, I explicated the structure (the relationship among the most invariant constituents of the phenomenon) and meaning (implications) from their lived experience. Though particulars differed, the interview data revealed a structure surrounding each of the ten co-inquirers as being (a) self-aware learners who joined the program with assumptions concerning the challenging nature of the learning experience; (b) a socially constructed environment that facilitates the formation of relational sets and community engagement; (c) deep and rich dialogic relationships among participants within the learning community; (d) co-constructed learning through collaboration with faculty and fellow students; (e) abundant free-space in learning enabling the transcendence of boundaries to personal growth; (f) an immensely helping and caring environment; (g) significant opportunities to challenge and broaden worldviews through program experiences; and (h) consistent validation of progress toward personal, educational and life goals. In coming to understand the phenomenon for finding meaning, I used descriptive phenomenology and given my presence as a student in the program being studied, I offered my own observations. I framed propositions from the study’s findings for progressive educators and organization development professions. Meaning found led to life changes such as improved personal and professional effectiveness, a deeper sense of self and self-worth, a clearer view of the world, and an ability to enact what had been taken from the experience; a significant educational outcome in addition to cognitive competencies, field knowledge and application. Those who have experienced the program came away with a deeper sense of purpose and far reaching capabilities to serve

Decentralized Infrastructure for Reproducible and Replicable Geographical Science

The I-GUIDE cyberinfrastructure project for convergence science is a leading example of the possibilities the geospatial data revolution holds for scientific discovery. However, rapidly expanding access to increasingly complex data sources and methods of computational analysis also presents a challenge to the research community. With more data and more potential analyses, researchers face the possibility of jeopardizing the inferential power of convergence research with selection bias. Well-designed infrastructure that can flexibly guide researchers as they record and track decisions in their research designs opens a path to mitigating this problem, while also expanding the reproducibility and replicability of research. Much of the infrastructure needed for convergence research can be borrowed and adapted from other disciplines, but geographic convergence research confronts at least five novel challenges. These are the need for geographically-explicit project metadata, managing diverse and complex data inputs, handling restricted data, specifying and reproducing computational environments, and disclosing researcher decisions and threats to validity that are unique to geographic research. We introduce a template research compendium and analysis plan for study preregistration to address these novel challenges

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Objective To systematically evaluate the efficacy of treatments for tics and the risks associated with their use. Methods This project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology\u27s guideline development process manual. We included systematic reviews and randomized controlled trials on the treatment of tics that included at least 20 participants (10 participants if a crossover trial), except for neurostimulation trials, for which no minimum sample size was required. To obtain additional information on drug safety, we included cohort studies or case series that specifically evaluated adverse drug effects in individuals with tics. Results There was high confidence that the Comprehensive Behavioral Intervention for Tics was more likely than psychoeducation and supportive therapy to reduce tics. There was moderate confidence that haloperidol, risperidone, aripiprazole, tiapride, clonidine, onabotulinumtoxinA injections, 5-ling granule, Ningdong granule, and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated, including weight gain, drug-induced movement disorders, elevated prolactin levels, sedation, and effects on heart rate, blood pressure, and ECGs. Conclusions There is evidence to support the efficacy of various medical, behavioral, and neurostimulation interventions for the treatment of tics. Both the efficacy and harms associated with interventions must be considered in making treatment recommendations

Practice Guideline Recommendations Summary: Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders

Objective To make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders. Methods A multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine–compliant process to ensure transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence. Results Forty-six recommendations were made regarding the assessment and management of tics in individuals with Tourette syndrome and chronic tic disorders. These include counseling recommendations on the natural history of tic disorders, psychoeducation for teachers and peers, assessment for comorbid disorders, and periodic reassessment of the need for ongoing therapy. Treatment options should be individualized, and the choice should be the result of a collaborative decision among patient, caregiver, and clinician, during which the benefits and harms of individual treatments as well as the presence of comorbid disorders are considered. Treatment options include watchful waiting, the Comprehensive Behavioral Intervention for Tics, and medication; recommendations are provided on how to offer and monitor these therapies. Recommendations on the assessment for and use of deep brain stimulation in adults with severe, treatment-refractory tics are provided as well as suggestions for future research

Pilot evaluation of a perfused robot-assisted partial nephrectomy procedural simulation platform for single port robotic retroperitoneal approaches

Objective: In this study our objective was to develop a simulation platform for use cases in Laparoendoscopic Single Site (LESS) Surgery intended for patient-specific rehearsal prior to Robot-assisted Partial nephrectomy procedures. Patients and Surgical Procedure: This represents a simulation platform requiring no patients, although the fabrication process allows for the platform to be patient-specific. Tissue phantom 3D models were developed from de-identified CT imaging fulfilling the criteria of tumors located in the posterior lower pole of the kidney. Results: Respondents completed surveys on platform novelty and effectiveness. Agreement on simulator novelty was unanimously positive (100% agree or better). Performance evaluations reached a minimum of 80% agreement for all categories, with zero respondents. Conclusions: We have developed a highly realistic simulation platform for use in single-port robot-assisted partial nephrectomy that can be produced in a patient specific manner, which we believe will be highly useful for trainees as well as experts attempting to transfer skills to the newer platform

Safety and efficacy of defibrotide for the treatment of severe hepatic veno-occlusive disease

Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome, is a potentially life-threatening complication of chemotherapeutic conditioning used in preparation for hematopoietic stem-cell transplantation (SCT). VOD may occur in up to 62% of patients undergoing SCT, with onset generally within the first month after SCT. In severe cases, 100-day mortality is in excess of 80%. Current management consists of best supportive care, with no agents to date approved for treatment in the USA or the EU. Defibrotide, a polydisperse oligonucleotide, has been shown in phase II and III trials to improve complete response and survival in patients undergoing SCT with severe VOD. This article reviews our current understanding of VOD, and examines recent clinical findings on defibrotide for the treatment and prophylaxis of VOD

Physical literacy in Europe: The current state of implementation in research, practice, and policy

Background/objective The holistic concept of physical literacy (PL) embraces different person-centered qualities (physical, cognitive, affective/psychological) necessary to lead physically active lifestyles. PL has recently gained increasing attention globally and Europe is no exception. However, scientific endeavors summarizing the current state of PL in Europe are lacking. Therefore, the goal of this study was to comprehensively assess and compare the implementation of PL in research, policy, and practice across the continent. Methods We assembled a panel of experts representing 25 European countries. Employing a complementary mixed-methods design, the experts first prepared reviews about the current state of PL in their countries (categories: research, practice/policy). The reviews underwent comparative document analysis, ensuring a transnational four-eyes principle. For re-validation purposes, the representatives completed a quantitative survey with questions reflecting the inductive themes from the document analysis. Results The document analysis resulted in ten disjunct themes (related to “concept”, “research”, “practice/policy”, “future/prospect”) and yielded a heterogenous PL situation in Europe. The implementation state was strongly linked to conceptual discussions (e.g., existence of competing approaches), linguistic issues (e.g., translations), and country-specific traditions. Despite growing scholarly attention, PL hesitantly permeates practice and policy in most countries. Nevertheless, the experts largely anticipate increasing popularity of PL for the future. Conclusion Despite the heterogeneous situation across Europe, the analysis has uncovered similarities among the countries, such as the presence of established yet not identical concepts. Research should intensify academic activities (conceptual-linguistic elaborations, empirical work) before PL may gain further access into practical and political spheres in the long term

Essential versus accessory aspects of cell death: recommendations of the NCCD 2015

Cells exposed to extreme physicochemical or mechanical stimuli die in an uncontrollable manner, as a result of their immediate structural breakdown. Such an unavoidable variant of cellular demise is generally referred to as ‘accidental cell death’ (ACD). In most settings, however, cell death is initiated by a genetically encoded apparatus, correlating with the fact that its course can be altered by pharmacologic or genetic interventions. ‘Regulated cell death’ (RCD) can occur as part of physiologic programs or can be activated once adaptive responses to perturbations of the extracellular or intracellular microenvironment fail. The biochemical phenomena that accompany RCD may be harnessed to classify it into a few subtypes, which often (but not always) exhibit stereotyped morphologic features. Nonetheless, efficiently inhibiting the processes that are commonly thought to cause RCD, such as the activation of executioner caspases in the course of apoptosis, does not exert true cytoprotective effects in the mammalian system, but simply alters the kinetics of cellular demise as it shifts its morphologic and biochemical correlates. Conversely, bona fide cytoprotection can be achieved by inhibiting the transduction of lethal signals in the early phases of the process, when adaptive responses are still operational. Thus, the mechanisms that truly execute RCD may be less understood, less inhibitable and perhaps more homogeneous than previously thought. Here, the Nomenclature Committee on Cell Death formulates a set of recommendations to help scientists and researchers to discriminate between essential and accessory aspects of cell death