How The Prospect of Fault Influences Managers\u27 Compliance

The SEC relies heavily on ‘no-fault’ settlements in its enforcement, where targets avoid costly litigation by accepting sanctions without admitting or denying fault. This policy is argued to enable the agency to pursue greater numbers of violators. However, opponents argue that no-fault sanctions may be less effective, reducing fines to a ‘cost of business’. In an experiment, I examine the effects of fault assignment on managers’ cost perceptions, ethical framing and compliance. I manipulate the presence of fault assignment in prospective sanctions, and additionally manipulate sanction strength and sanction target - attributes that commonly vary in sanctions and which may interact with fault assignment. I find that all manipulated sanction attributes increase managers’ cost perceptions, and that managers’ cost perceptions are associated with greater compliance frequency and compliance quality. I also find that managers facing fault assignment in manager-targeted sanction conditions perceive their compliance differently – as an ethical, rather than economic choice. Consequently, these managers comply more frequently with costly regulations and select higher quality compliance than do managers in manager-targeted no-fault conditions. Targeting firms with sanctions also increases managers’ ethical perceptions, but adding fault to firm-targeted sanctions does not further increase ethical perceptions or compliance. My findings are consistent with sanctions facilitating greater ethical awareness and compliance when fault targets managers or when sanctions target firms, and with ethical awareness facilitating greater compliance. Supplementary analysis suggests that results are stronger among individuals high in ‘dark triad’ personality traits (narcissism, machiavellianism, and psychopathy), suggesting that findings generalize to subpopulations thought to be high in dark triad traits such as firm managers (O’Reilly et al. 2014)

Slow Foods for Health Increasing Knowledge of Glycemic Index in Adolescents for Healthier Food Choices

Obesity has reached epidemic proportions through the United States affect all age groups, genders, and races. This is especially troubling in the pediatric population where 12.5 million children were found to be overweight in 2010. Many adolescents have inadequate knowledge of nutrition basics to make healthy choices. Based on interviews within the community of Colchester, VT a need for information about the glycemic index was seen. A handout geared towards adolescents was created with information about the glycemic index and using this information to make healthy food choices. This handout was made available to all providers of Colchester Family Practice for use with their adolescent patients.https://scholarworks.uvm.edu/fmclerk/1130/thumbnail.jp

Professionalization of occupational therapists: A study of emergent identities

The unprecedented demand for occupational therapists and resulting growth in student numbers necessitates the need to understand how students acquire professional ideology, learn expected role behavior, and identify themselves as occupational therapists. This ethnographic study includes interview data from a series of three interviews with 37 trainees, from freshmen to the first year of employment, who had been or were in the occupational therapy program at Worcester State College, in central Massachusetts. Students included women and men who were preparing for either a first or second career. Interviews with six academic faculty and seven fieldwork supervisors in three areas of practice; observations in classes; and analysis of 11 frequently used occupational therapy textbooks have enabled me to identify the role of each in professional development. Students in this study follow steps of professionalization suggested by sociological literature beginning with entry, followed by acquisition of the professional language and ideology, then role-performance. Reflecting on feedback received after role-performance is essential for a positive self-image as a professional, as noted in the theory of Symbolic Interactionism. Learning opportunities which enable students to connect new information with experiences are essential to develop desired role behavior and promote identification with the profession. Academic faculty use activities, role playing, and clinical examples to promote student learning. Fieldwork supervisors model professional behavior, direct students, and facilitate thinking by constantly asking questions. Being well-trained as well as attached to one\u27s role as a faculty member or field supervisor is of crucial importance in professionalization of students

Attitudes Towards Vaccination Among Medical Students: A Two-Site Study

Introduction: Mandatory immunization for school age children in the 20th Century led to a substantial decline in infectious disease. All US states allow medical exemptions from immunizations with 49 permitting additional religious exemptions and 19 permitting additional philosophical exemptions. Vaccine exemptions have lead to an increase in the incidence of disease outbreaks. Healthcare providers play a critical role in educating parents about the benefits and risks of immunizations. This project compares student attitudes and knowledge regarding vaccination at medical schools in two distinct states: one with no additional exemptions (West Virginia) and one with both additional exemptions (Vermont).https://scholarworks.uvm.edu/comphp_gallery/1218/thumbnail.jp

5α-TETRAHYDROCORTICOSTERONE: A TOPICAL ANTI-INFLAMMATORY GLUCOCORTICOID WITH AN IMPROVED THERAPEUTIC INDEX IN A MURINE MODEL OF DERMATITIS

Background and PurposeGlucocorticoids are powerful anti-inflammatory drugs, but are associated with many side-effects. Topical application in atopic dermatitis leads to skin thinning, metabolic changes, and adrenal suppression. 5α-Tetrahydrocorticosterone (5αTHB) is a potential selective anti-inflammatory with reduced metabolic effects. Here, the efficacy and side-effect profile of 5αTHB were compared with hydrocortisone in preclinical models of irritant dermatitis.Experimental ApproachAcute irritant dermatitis was invoked in ear skin of male C57BL/6 mice with a single topical application of croton oil. Inflammation was assessed as oedema via ear weight following treatment with 5αTHB and hydrocortisone. Side-effects of 5αTHB and hydrocortisone were assessed following chronic topical steroid treatment (28 days) to non-irritated skin. Skin thinning was quantified longitudinally by caliper measurements and summarily by qPCR for transcripts for genes involved in extracellular matrix homeostasis; systemic effects of topical steroid administration also were assessed. Clearance of 5αTHB and hydrocortisone were measured following intravenous and oral administration.Key Results5αTHB suppressed ear swelling in mice, with ED50 similar to hydrocortisone (23 μg vs. 13 μg). Chronic application of 5αTHB did not cause skin thinning, adrenal atrophy, weight loss, thymic involution, or raised insulin levels, all of which were observed with topical hydrocortisone. Transcripts for genes involved in collagen synthesis and stability were adversely affected by all doses of hydrocortisone, but only by the highest dose of 5αTHB (8× ED50). 5αTHB was rapidly cleared from the systemic circulation.Conclusions and ImplicationsTopical 5αTHB has potential to treat inflammatory skin conditions, particularly in areas of delicate skin

Acute Phosphate Restriction Leads to Impaired Fracture Healing and Resistance to BMP-2

Hypophosphatemia leads to rickets and osteomalacia, the latter of which results in decreased biomechanical integrity of bones, accompanied by poor fracture healing. Impaired phosphate-dependent apoptosis of hypertrophic chondrocytes is the molecular basis for rickets. However, the underlying pathophysiology of impaired fracture healing has not been characterized previously. To address the role of phosphate in fracture repair, mice were placed on a phosphate-restricted diet 2 days prior to or 3 days after induction of a mid-diaphyseal femoral fracture to assess the effects of phosphate deficiency on the initial recruitment of mesenchymal stem cells and their subsequent differentiation. Histologic and micro-computed tomographic (µCT) analyses demonstrated that both phosphate restriction models dramatically impaired fracture healing primarily owing to a defect in differentiation along the chondrogenic lineage. Based on Sox9 and Sox5 mRNA levels, neither the initial recruitment of cells to the callus nor their lineage commitment was effected by hypophosphatemia. However, differentiation of these cells was impaired in association with impaired bone morphogenetic protein (BMP) signaling. In vivo ectopic bone-formation assays and in vitro investigations in ST2 stromal cells confirmed that phosphate restriction leads to BMP-2 resistance. Marrow ablation studies demonstrate that hypophosphatemia has different effects on injury-induced intramembranous bone formation compared with endochondral bone formation. Thus phosphate plays an important role in the skeleton that extends beyond mineralized matrix formation and growth plate maturation and is critical for endochondral bone repair. © 2010 American Society for Bone and Mineral Research

Prehabilitation for Shoulder Dysfunction in Breast Cancer

Objective: To evaluate prehabilitation exercises to improve shoulder pain and abduction range of motion (ROM) after breast cancer surgery; to evaluate methods of exercise teaching; to assess postsurgical seroma formation. Design: Pilot study Setting: Academic medical center Participants: 60 breast cancer patients were randomly assigned to either personal exercise instruction, group 1, n=36, or video only instruction, group 2, n=24. Interventions: Shoulder exercises were assigned to both groups 1 month prior to surgery at an outpatient visit. Group 1 received personal instruction on exercises, plus written exercise instruction, and a link to access an online video. Group 2 received only written exercise instruction and a link to access the online video. Main Outcome Measures: Exercise compliance, pain (via visual analog scale), shoulder abduction ROM (via goniometer), and presence or absence of seroma. Results or Clinical Course: 76% of study patients chose to exercise. There was no difference in exercise compliance between personal instruction versus video teaching. (75%, 24/32 in-person vs. 77%, 10/13 video only, OR=1.03). 66% of patients (20/30) lost greater than 10 degrees shoulder abduction ROM at 1 month post surgery. 29% of patients (9/31) had worse shoulder pain at one month post surgery than at baseline (24%, 6/25 exercisers, and 50%, 3/6 non-exercisers). 15% of patients (4/27) had worse shoulder pain at 3 months post surgery than at baseline (8%, 2/25 exercisers, and 100%, 2/2 non-exercisers). Prehabilitation exercise program inferred no additional risk of seroma formation (21%, 7/33 exercisers vs. 22%, 2/9 non-exercisers OR=.94). Conclusion: In-person teaching does not appear superior to video teaching for prehabilitation exercises in breast cancer. A high quality randomized controlled trial is necessary to assess efficacy of prehabilitation for improving post surgical outcomes. Prehabilitation exercises do not appear to increase risk of seroma formation in breast cancer surgery

Cognitive and disease-modifying effects of 11ß-hydroxysteroid dehydrogenase type 1 inhibition in male Tg2576 mice, a model of Alzheimer's disease

Chronic exposure to elevated levels of glucocorticoids has been linked to age-related cognitive decline and may play a role in Alzheimer's disease. In the brain, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) amplifies intracellular glucocorticoid levels. We show that short-term treatment of aged, cognitively impaired C57BL/6 mice with the potent and selective 11β-HSD1 inhibitor UE2316 improves memory, including after intracerebroventricular drug administration to the central nervous system alone. In the Tg2576 mouse model of Alzheimer's disease, UE2316 treatment of mice aged 14 months for 4 weeks also decreased the number of β-amyloid (Aβ) plaques in the cerebral cortex, associated with a selective increase in local insulin-degrading enzyme (involved in Aβ breakdown and known to be glucocorticoid regulated). Chronic treatment of young Tg2576 mice with UE2316 for up to 13 months prevented cognitive decline but did not prevent Aβ plaque formation. We conclude that reducing glucocorticoid regeneration in the brain improves cognition independently of reduced Aβ plaque pathology and that 11β-HSD1 inhibitors have potential as cognitive enhancers in age-associated memory impairment and Alzheimer's dementia