From Cultural Amnesia to ‘Anamnesia’ in Reading Life-Writing Narratives of the French Occupation: The Lost Manuscript, the ‘Handwritingness’ of History and the Broken Narrative

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Secrecy in the organizational romance

This thesis examined why and how organizational romance participants keep their relationships secret. Disclosure to others in the organization was also examined. The literature review focused on definitions and antecedent conditions of organizational romance, the decision to enter into the relationship, internal dynamics of the relationship, external impacts of the relationship, coworker reaction, and management\u27s perspective. The first research question asked why do organizational romance participants keep their relationship a secret from others? The second research question asked how do organizational members keep an organizational romance secret from fellow associates?! The third research question asked what behavioral changes occur amid trying to keep an organizational romance secret? The fourth research question asked how do participants decide if and at what point to reveal the relationship to others in the organization? Ninetynine graduate students were asked to complete a questionnaire containing a hypothetical case scenario. In response to the first research question, intra-office gossip was the primary reason, cited by respondents, for keeping a relationship secret. Respondents were also concerned over others\u27 perceptions of favoritism. In response to the second research question, respondents indicated it was important to maintain a professional demeanor at work, avoiding any public displays of affection. With regard to the third research question, respondents recommended avoiding one\u27s partner at work, as well as cutting off social ties with office friends and coworkers. Finally, in response to the fourth research question, the majority of respondents felt disclosure was inevitable, simply due to the serious nature of the relationship. Although, some respondents adhered to the notion that a personal relationship is a private matter and should not ever be disclosed. Discussion, interpretation of results, and direction for future research are explored

The development of a core outcome set for crisis helplines:A three-panel Delphi study

Background: Evidence for the effectiveness of crisis helplines is limited by inappropriate and inconsistent outcome measurement. The aim of this study was to develop a core outcome set that reflects the most relevant and important outcomes to help-seekers accessing a crisis helpline via any delivery mode (e.g., phone, SMS text, online chat). Method: We used a three-panel Delphi method to compare and integrate the views of three expert groups: people with lived experience of accessing crisis helplines (n = 32), researchers with experience assessing crisis helpline outcomes (n = 25), and crisis helpline supporters (n = 58). Across two online survey rounds (89 % retention rate), participants rated the importance of 33 potential outcomes for help-seekers accessing a crisis helpline. Participants also provided open-text comments and suggestions. Outcomes that reached consensus (≥75 % agreement) by at least two panels were included in the core outcome set. Results: Ten outcomes met the criteria for inclusion in the core outcome set. In order of importance, these were: distress, feeling heard, suicide risk, connectedness/support, hopelessness, overwhelm, non-suicidal self-injury risk, service experience, helplessness, and next steps. Limitations: Participants self-selected and were mainly from English-speaking countries. Conclusions: We recommend future outcome and evaluation studies minimally measure and report the 10 outcomes identified in this study. Assessing an agreed set of meaningful outcomes will improve comparability and facilitate a deeper understanding of crisis helpline effectiveness. More work is needed to determine how best to assess these outcomes in the crisis helpline context.</p

Convective response of a wall-mounted hot-film sensor in a shock tube

Shock tube experiments were performed in order to determine the response of a single hot-film element of a sensor array to transiently induced flow behind weak normal shock waves. The experiments attempt to isolate the response due only to the change in convective heat transfer at the hot-film surface mounted on the wall of the shock tube. The experiments are described, the results being correlated with transient boundary layer theory and compared with an independent set of experimental results. One of the findings indicates that the change in the air properties (temperature and pressure) precedes the air mass transport, causing an ambiguity in the sensor response to the development of the velocity boundary layer. Also, a transient, local heat transfer coefficient is formulated to be used as a forcing function in an hot-film instrument model and simulation which remains under investigation

Social influences on seeking help from mental health services, in-person and online, during adolescence and young adulthood

BACKGROUND: This study provides the first comprehensive empirical evidence of developmental changes in the social influences on seeking mental health care, both in-person and online, during the critical lifestages for mental health of adolescence and young adulthood. METHODS: Main source of help-seeking influence was determined via self-report for all young people accessing youth-targeted mental health services in Australia for a first episode of care over a 12 month period during 2013. This comprised 30,839 young people who accessed in-person services and 7,155 clients of the online service. RESULTS: Results show a major developmental shift in help-seeking influence across the age range, which varied for males and females, and a striking difference between the online and in-person service modalities. The dominant influence online, regardless of age, was the young person themself. In contrast, for in-person services, the dominant influence during adolescence was family, but this changed markedly in late adolescence to favour self-influence, with a lessor, but still substantial effect of family. The influence of friends was surprisingly low. CONCLUSIONS: To support young people with mental health problems to access mental health care, the personal connection of parents and family needs to be engaged to encourage in-person service use through better mental health literacy, particularly for adolescents. In the online environment, ways to ensure that young people themselves are guided to appropriate services are required

Symptoms, Cytokines, and Quality of Life of Patients with Chronic Graft-versus-Host Disease following Allogeneic Hematopoietic Stem Cell Transplantation

Introduction: Chronic graft-versus-host disease (cGVHD) is a serious complication following allo-HSCT characterized by immune dysregulation, organ dysfunction, risk for infection, and distressing symptoms. Complications may include scleroderma, hepatic dysfunction and bronchiolitis obliterans. Advances in allo-HSCT for many hematologic dyscrasias (e.g. acute and chronic leukemias, aplastic anemia, and myelodysplastic syndrome) have improved survival which has generated a renewed focus on survivorship issues. Distressing symptoms are noted as negatively impacting quality of life (QoL). The relationship between inflammation and behavioral responses may impact symptoms. Examining patterns and levels of inflammation with symptoms is relevant. Objective: The aims of this study were to examine: 1) levels of symptoms (cGVHD specific, general symptoms, and cluster symptoms [pain, depression and fatigue]), inflammation (cytokines [Interleukin {IL}-1β, IL-6, IL-10, TNF, and INF-γ] and C-reactive protein [CRP]) and QoL in patients diagnosed with cGVHD and 2) relationships between and among symptoms, inflammation and QoL in individuals with cGVHD. Methods: A cross-sectional study design examined 24 individuals (ages 29-79) with cGVHD enrolled from an NCI-designated cancer center after obtaining informed consent. Data were collected using medical record and validated questionnaires. Plasma cytokine levels were measured using BioRad® multiplex assay. C-reactive protein levels were measures using an enzyme-linked immunosorbant assay. Statistical analyses included descriptive statistics and pairwise correlations. Results: A total of 24 participants (58.3% female) with cGVHD enrolled in this study. Multiple, concurrent symptoms were noted. Several pro-inflammatory cytokines were higher in participants with symptoms versus those without symptoms. IL-6 correlated with lack of energy (r= .42; p= .04) and dry mouth (r= .42; p= .04). IL-10 was correlated with difficulty sleeping (r= .43; p= .03). Sexual dysfunction correlated with social well-being (r= -.44; p=.03). Many symptoms negatively correlated with QoL. Conclusion: Findings from this study, one of the first to examine levels of symptoms and inflammatory markers in individuals with cGVHD, demonstrate significant relationships among symptoms, inflammation, and quality of life. The relationship of inflammatory biomarkers with symptoms emphasizes the need for further interdisciplinary research. Better understanding mechanisms associated with symptoms is necessary for the development and testing of targeted interventions to improve QoL for individuals with cGVHD

External Validation and Modification of a 30-day Readmission Risk Prediction Model for Heart Failure Patients

The development and validation of 30-day readmission risk prediction models, such as the LACE index, have been of interest to researchers and healthcare organizations, especially since the Centers for Medicare and Medicaid Services began to impose monetary penalties on hospitals with higher than expected 30-day readmission rates. However, there is a lack of consensus concerning the efficacy of the LACE index in the heart failure population. The purpose of the study was to examine the discriminative accuracy of the LACE index to predict all-cause 30-day readmission for heart failure patients and to build a modified 30-day readmission risk prediction model based on variables known to influence the risk of readmission. Andersen’s behavioral model of health services was used to understand how the patient level variables of interest contributed to readmission risk as predisposing, enabling, and need factors. Using a correlational study design, quantitative data were retrospectively collected from the electronic medical records (n=655) of heart failure patients. The Receiver Operating Characteristic curve and simple binary logistic regression were used to answer the research questions. The results of the analyses revealed that both the LACE index and the modified risk prediction model had poor discriminatory accuracy for predicting the risk of 30-day readmission for the sample population. The results of the simple binary logistic regression indicated several of the independent variables were statistically significantly associated with all-cause 30-day readmission. Healthcare facilities operate with limited resources, and the identification of patients at a higher risk for 30-day readmission would allow healthcare professionals to initiate preventive measures before and after discharge

The nuanced negative: Meanings of a negative diagnostic result in clinical exome sequencing

Genomic sequencing technology is moving rapidly from the research setting into clinical medicine but significant technological and interpretive challenges remain. Whole exome sequencing (WES) in its recent clinical application provides a genetic diagnosis in about 25% of cases (Berg 2014). While this diagnostic yield is substantial, it also indicates that in a majority of cases, patients are receiving negative results (i.e., no explanatory genetic variant found) from this technology. There are a number of uncertainties regarding the meaning of a negative result in the current context of WES. A negative result may be due to current technological limitations that hinder detection of disease-causing variants or to gaps in the knowledge base that prohibit accurate interpretation of their pathogenicity; or it may indicate that there is not a genetic etiology for the disorder. In this paper we examine the uncertainties and nuances of the negative result from genome sequencing and how both clinicians and patients make meaning of it as revealed in ethnographic observations of the clinic session where results are returned, and in interviews with patients. We find that clinicians and patients construct the meaning of a negative result in ways that are uncertain, contingent, and multivalent; but invested with optimism, promise, and potentiality