Engaging Caregivers and Providers of Children With Sickle Cell Anemia in Shared Decision Making for Hydroxyurea: Protocol for a Multicenter Randomized Controlled Trial

BACKGROUND: Sickle cell anemia (SCA) is a genetic blood disorder that puts children at a risk of serious medical complications, early morbidity and mortality, and high health care utilization. Until recently, hydroxyurea was the only disease-modifying treatment for this life-threatening disease and has remained the only option for children younger than 5 years. Evidence-based guidelines recommend using a shared decision-making (SDM) approach for offering hydroxyurea to children with SCA (HbSS or HbS/β0 thalassemia) aged as early as 9 months. However, the uptake remains suboptimal, likely because caregivers lack information about hydroxyurea and have concerns about its safety and potential long-term side effects. Moreover, clinicians do not routinely receive training or tools, especially those that provide medical evidence and consider caregivers' preferences and values, to facilitate a shared discussion with caregivers. OBJECTIVE: The aim of this study is to understand how best to help parents of young children with sickle cell disease and their clinicians have a shared discussion about hydroxyurea (one that considers medical evidence and parent values and preferences). METHODS: We designed our study to compare the effectiveness of two methods for disseminating hydroxyurea guidelines to facilitate SDM: a clinician pocket guide (ie, usual care) and a clinician hydroxyurea SDM toolkit (H-SDM toolkit). Our primary outcomes are caregiver reports of decisional uncertainty and knowledge of hydroxyurea. The study also assesses the number of children (aged 0-5 years) who were offered and prescribed hydroxyurea and the resultant health outcomes. RESULTS: The Ethics Committee of the Cincinnati Children's Hospital Medical Center approved this study in November 2017. As of February 2021, we have enrolled 120 caregiver participants. CONCLUSIONS: The long-term objective of this study is to improve the quality of care for children with SCA. Using multicomponent dissemination methods developed in partnership with key stakeholders and designed to address barriers to high-quality care, caregivers of patients with SCA can make informed and shared decisions about their health. TRIAL REGISTRATION: ClinicalTrials.gov NCT03442114; https://clinicaltrials.gov/ct2/show/NCT03442114. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/27650

Valence-Specific Modulation in the Accumulation of Perceptual Evidence Prior to Visual Scene Recognition

Visual scene recognition is a dynamic process through which incoming sensory information is iteratively compared with predictions regarding the most likely identity of the input stimulus. In this study, we used a novel progressive unfolding task to characterize the accumulation of perceptual evidence prior to scene recognition, and its potential modulation by the emotional valence of these scenes. Our results show that emotional (pleasant and unpleasant) scenes led to slower accumulation of evidence compared to neutral scenes. In addition, when controlling for the potential contribution of non-emotional factors (i.e., familiarity and complexity of the pictures), our results confirm a reliable shift in the accumulation of evidence for pleasant relative to neutral and unpleasant scenes, suggesting a valence-specific effect. These findings indicate that proactive iterations between sensory processing and top-down predictions during scene recognition are reliably influenced by the rapidly extracted (positive) emotional valence of the visual stimuli. We interpret these findings in accordance with the notion of a genuine positivity offset during emotional scene recognition

Innovation in Entrepreneurship Education: Developing Competitive Advantages for MBA Students

For the last decade entrepreneurship education has grown to become a major discipline in several universities and colleges, particularly in the United States, Europe, and other developed nations. Nevertheless, comprehensive entrepreneurship programs are starting to be implemented in higher-education institutions across emergent economies as well. Everywhere around the world, entrepreneurship students need to gain skills and knowledge that can help them get started and have better opportunities to succeed with their ventures. At CETYS Universidad, a private non-for-profit school in Mexico, an Entrepreneurship Concentration MBA program was designed and developed around the Entrepreneurial Life Cycle and Entrepreneurship Process frameworks. The program is intended to build entrepreneurship competencies in MBA students, nurture an innovative mindset, and help them increase their entrepreneurial self-confidence and capabilities. It is the first program of its kind to be offered in the northwest region of the country, and one of the few in Mexico. RESUMEN Durante la última década, la educación empresarial ha crecido hasta convertirse en una disciplina importante en varias universidades y colegios, particularmente en los Estados Unidos, Europa y otras naciones desarrolladas. Sin embargo, los programas integrales de emprendimiento también están comenzando a implementarse en instituciones de educación superior en economías emergentes. En todo el mundo, los estudiantes de emprendimiento necesitan adquirir habilidades y conocimientos que puedan ayudarlos a comenzar y tener mejores oportunidades para tener éxito con sus empresas. En CETYS Universidad, una escuela privada sin fines de lucro en México, se diseñó y desarrolló un programa de MBA de Concentración en Emprendimiento en torno a los marcos de Ciclo de Vida Emprendedor y Proceso de Emprendimiento. El programa está destinado a desarrollar competencias empresariales en los estudiantes de MBA, fomentar una mentalidad innovadora y ayudarlos a aumentar su confianza en sí mismos y sus capacidades empresariales. Es el primer programa de este tipo que se ofrece en la región noroeste del país y uno de los pocos en México.First editio

“Entrepreneur as a Person at Crossroads”: A Reflection on Kets de Vries (1977)

Kets de Vries (1977) provided novel insights regarding the impact of environments on entrepreneurial personality when entrepreneurship research was in its infancy

Management theories linking individual and organizational level analysis in entrepreneurship research

This paper carries out a bibliographical review of the evolution of the individual level research, the new individual approaches and analyzes possible methods for the extension of entrepreneurship research to the organizational level. We also discuss about the suitability of the resource based view and network approaches. We review the management theories and paradigms which are capable of incorporating and linking individual and organizational level studies to the external context where entrepreneurs compete and seek opportunities. In this sense we refer to the resource based view and the network theory as they have been deemed the most adequate to incorporate micro level theories through a convergence of concepts, rather than by a combination or confrontation of ideas. 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Beyond survival: achieving new venture growth by building legitimacy. Academy of Management Review, 27(3), 414–431

45-year trends in women's use of time and household management energy expenditure

Context: Relationships between socio-environmental factors and obesity are poorly understood due to a dearth of longitudinal population-level research. The objective of this analysis was to examine 45-year trends in time-use, household management (HM) and energy expenditure in women. Design and Participants: Using national time-use data from women 19-64 years of age, we quantified time allocation and household management energy expenditure (HMEE) from 1965 to 2010. HM was defined as the sum of time spent in food preparation, post-meal cleaning activities (e.g., dish-washing), clothing maintenance (e.g., laundry), and general housework. HMEE was calculated using body weights from national surveys and metabolic equivalents. Results: The time allocated to HM by women (19-64 yrs) decreased from 25.7 hr/week in 1965 to 13.3 hr/week in 2010 (