Non-traditional Strategies Research Articles

Targeted electronic health record-based recruitment strategy to enhance COVID-19 vaccine response clinical research study enrollment

Efficient recruitment of eligible participants is a significant challenge for clinical research studies. This challenge was exacerbated during the COVID-19 pandemic when in-person recruitment was not an option. In 2020, the University of Minnesota was tasked, as part of the National Cancer Institute's Serological Sciences Network for COVID-19 (SeroNet), to recruit participants for a longitudinal serosurveillance clinical research study with a goal of characterizing the COVID-19 vaccine-elicited immune response among immunocompromised individuals, which necessitated reliance on non-traditional strategies for participant recruitment. To meet our enrollment target of 300 transplant patients, 300 cancer patients, 100 persons living with HIV, and 200 immunocompetent individuals, we utilized targeted electronic health record (EHR)-based recruitment in addition to traditional recruitment tools, which was an effective combination of recruitment strategies. A significant advantage of patient portal messaging or other digital recruitment strategies such as email communication is timing. We reached 85 % (769 out of 900) of our enrollment target within one year with a 14.3 % response rate to invitations to participate in our study. This achievement is perhaps more salient given the COVID-19 pandemic-related constraints within which we were operating. We demonstrated that the EHR can be leveraged to quickly identify potentially eligible study participants either via EHR communication or mail. We also illustrate how the online portal MyChart can be used to efficiently send targeted recruitment messages.

Protocol for developing a set of performance measures to monitor and evaluate delirium care quality for older adults in the emergency department using a modified e-Delphi process

IntroductionOlder adults are at high risk of developing delirium in the emergency department (ED). Delirium associated with an ED visit is independently linked to poorer outcomes such as increased length...

Love, Little Rock:

In early September 2017, Little Rock, Ark., through Mayor Mark Stodola, initially threw its hat into the competition ring in an effort to entice Amazon to its city, as the company announced it was searching for a second headquarters. After a few weeks, city officials realized Little Rock did not meet many of the requirements put forth by Amazon and would never be a serious contender. At that point, an unorthodox city branding campaign was born, which included a new slogan, “Love, Little Rock,” and messaging designed in the form of a “break-up” letter, as a way of bowing out of the competition for Amazon’s new headquarters. This case study uses agenda-setting theory and visual and textual analysis to examine the Love, Little Rock campaign. In particular, this paper explores how the city set an agenda in today’s attention economy through non-traditional strategies and tactics through thematic analysis of news coverage of the campaign.

Methodological adaptations to a theory of change model: Experiences from the ARTEMIS cluster randomized trial in India

This article discusses methodological adaptations that were made to the Theory of Change (ToC) process by incorporating imagery during a ToC workshop organized as part of a cluster randomize control trial in India, entitled ARTEMIS. The objective of this adaptation was to make the ToC interesting and interactive for adolescents who are the primary stakeholders in the project. This in turn led to a demystification of the concepts of ToC making it easier for participants of the workshop to contribute more effectively. An added advantage of such adaptations was that it allowed for engaging with specific groups using non-traditional strategies and adapting methods to local needs to make them more effective. Such an exercise will contribute to strengthening of the evidence base on the usefulness of adapting and simplifying methods as well as add to the body of participatory or collaborative visual research by promoting the use of visual material.

Parental perspectives on attention-deficit/hyperactivity disorder treatments for children.

This study investigated parental perspectives and experiences on the evaluation and treatment process associated with attention-deficit/hyperactivity disorder (ADHD). Five hundred sixty-eight parents of youth 2-28years-old (M = 9.37; SD = 4.11) diagnosed with ADHD responded to a 14-item online survey about their child's diagnosis and treatment. Parents reported that they had tried an average of 4.49 interventions (SD = 2.63). Parents further shared factors in treatment selection, most helpful parenting strategies, and preferences for types of treatments and treatment targets. A majority of parents reported incorporating many non-traditional strategies (e.g., exercise, healthy eating, outdoor activities) with goals of improving their child's coping skills, study habits, and anger management. The findings show that treatment choices were often selected based on trust in the provider, research support, and the child's preference. Given parental preferences for non-traditional strategies, treatment development efforts should consider these strategies as a component of a broader multimodal treatment approach to ADHD.

0622 Influence of Cannabis Use Disorder on Sleep Quality among College Students

Abstract Introduction Poor sleep, which has numerous deleterious effects, is one of the most common health complaints among college students. Both race/ethnicity and sex are associated with poor sleep outcomes, with Black college women potentially having higher risk. The college experience is often associated with an increase in stress, as well as drastic shifts in lifestyle and sleep patterns. Research indicates that college students report cannabis use enables them to cope with life stressors and negative emotions and is often used as a sleep aid. The use of cannabis as a to cope may lead to more chronic cannabis use, and the development of Cannabis Use Disorder (CUD), which is most prevalent in individuals aged 18-25. Therefore, this study examined the influence of CUD symptomatology on sleep among Black female college students. Methods Participants included 200 Black/African American women (age range: 18-25 years) attending a Historically Black College/University. Each participant completed an Qualtrics online survey including assessment of DSM-5 CUD criteria, and validated measures of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and perceived stress (Perceived Stress Scale [PSS]). Results 11.5% of the sample met criteria for CUD. There were no significant differences between the CUD and non-CUD groups in perceived stress, however, all participants endorsed moderate stress levels (M=19.51, SD=5.33). Additionally, all participant’s PSQI scores met criteria for impaired sleep (score >5). [MOU1] [TAD2] T-test analyses indicate that the CUD subgroup reported poorer sleep quality (M=9.04, SD=3.69 vs M=7.07, SD=3.28), more sleep disturbances (M=1.52, SD=0.59 vs M=1.15, SD=0.74), and longer sleep latency (M=37.70, SD=25.28 vs M=25.92, SD=23.95), than the non-CUD group (all p<.05). Conclusion Black/African American female college students who met criteria for CUD reported more sleep disturbances, longer sleep latencies, and poorer overall sleep quality. Given the lack of difference in perceived stress, these results suggest that the use of cannabis as a coping aid may exacerbate poor sleep. Previous research indicates that Black women are not only more likely to report poor sleep, but that they also report exploring non-traditional strategies to address their sleep problems. These findings suggest a need to examine these non-traditional coping strategies for possible paradoxical and deleterious effects. Support (If Any) Funding: R01HL142066, R01HL095799, RO1MD004113, R01HL152453, 1R15 DA052886-01A1

Beyond “Good-Faith” Efforts: Diversifying the Faculty Ranks in Teacher Education through Equity-Conscious Recruitment Practices

ABSTRACT This autoethnographic cross-case study articulates a set of field-tested strategies, focusing on how White-dominated teacher-preparation programs (TPPs) could recruit a greater number of teacher educators who are Black, Indigenous, and People of Color (BIPOC) by actively designing, implementing, and modeling equity-conscious recruitment practices. The conceptual framework describes the instrumental value that BIPOC teacher educators bring to Predominantly White Institutions (PWIs) by drawing on a sociocultural assets-based view of racially diverse professionals in historically White settings. Methods involved a directed approach to content analysis of 50 search-related documents across 10 faculty searches that the author facilitated between the years 2009–2018 that led to all-BIPOC hires. The findings focus on three major milestones during a typical faculty search with an emphasis on the contexts of TPPs: (a) planning for equitable and inclusive practices from start to finish through a model of shared accountability, (b) encouraging search committees to actively engage in innovative approaches to recruitment, including traditional and non-traditional strategies, and (c) supporting stakeholders, such as committee members and voting faculty who have direct or indirect decision-making power in faculty searches, in reducing cognitive errors throughout the evaluation and selection process. Implications are offered for practice and theory.

Effects of local and global orientation on popular support for policy strategies to create a stronger Chinese Men’s football team

ABSTRACT The aim of the study is to explore and describe the support of Chinese football fans for policy strategies to create a stronger men’s national football team based on their local and global orientation. Drawing uponsocial theory of globalisation, we distinguish between football fans with local and global orientations. Using survey questionnaires, we investigated Chinese football fans (n = 546) support for five strategies to improve the men’s football team: controlling the number of international players, controlling costs with international players, supporting young national players, promoting academy system, and promoting naturalisation. Results show that globally engaged fans offer higher support for strategies to create a stronger national football in China when compared to all other groups. Fans support promoting young national players more than either controlling for international players or naturalising foreign players. Fans with a rooted cosmopolitan orientation are the ones who offer higher support for non-traditional strategies, such as naturalisation. Findings can have direct impact on how the Chinese government and sport authorities propose strategies to create a stronger national team.

Pediatric Mechanical Circulatory Support: Pathophysiology of Pediatric Hemostasis and Available Options.

Pediatric mechanical circulatory support (MCS) is considered a strategy for heart failure management as a bridge to recovery and transplantation or as a destination therapy. The final outcome is significantly impacted by the number of complications that may occur during MCS. Children on ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) are at high risk for bleeding and thrombotic complications that are managed through anticoagulation. The first detailed guideline in pediatric VADs (Edmonton Anticoagulation and Platelet Inhibition Protocol) was based on conventional antithrombotic drugs, such as unfractionated heparin (UFH) and warfarin. UFH is the first-line anticoagulant in pediatric MCS, although its profile is not considered optimal in pediatric setting. The broad variation in heparin doses among children is associated with frequent occurrence of cerebrovascular accidents, bleeding, and thrombocytopenia. Direct thrombin inhibitors (DTIs) have been utilized as alternative strategies to heparin. Since 2018, bivalirudin has become the chosen anticoagulant in the long-term therapy of patients undergoing MCS implantation, according to the most recent protocols shared in North America. This article provides a review of the non-traditional anticoagulation strategies utilized in pediatric MCS, focusing on pharmacodynamics, indications, doses, and monitoring aspects of bivalirudin. Moreover, it exposes the efforts and the collaborations among different specialized centers, which are committed to an ongoing learning in order to minimize major complications in this special pediatric population. Further prospective trials regarding DTIs in a pediatric MCS setting are necessary and in specific well-designed randomized control trials between UFH and bivalirudin. To conclude, based on the reported literature, the clinical use of the bivalirudin in pediatric MCS seems to be a value added in controlling and maybe reducing thromboembolic complications. Further research is necessary to confirm all the results provided by this literature review.

What is the association between income loss during the COVID-19 pandemic and children’s dental care?

BackgroundThe degree to which children experience unmet need for dental care during the COVID-19 pandemic and its association with pandemic-related household job or income loss are unknown. MethodsThe authors performed a cross-sectional household survey of 348 families in Pittsburgh, Pennsylvania, from June 25 through July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report. ResultsCaregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%), followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. The authors found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P = .022). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (relative risk, 1.77; 95% confidence interval, 1.08 to 2.88). ConclusionsIn this sample, 3 times as many households reported unmet dental care for a child compared with unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred. Practical ImplicationsIf unmet dental care continues as a result of the COVID-19 pandemic, nontraditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.

Effects of Health on Academic Performance Trajectories in Children: a Two-Year Follow-Up Study in Córdoba-Argentina

This study assessed the effects of self-perceived health on the trajectories of academic performance (TAP) in children from Cordoba-Argentina, taking into account socioeconomic characteristics and intellectual capacity. A total of 494 children (mean = 9.5 years old) who attend public schools were followed-up from fourth to six grade to measure their TAP. Self-perceived health was measured at baseline using the KIDSCREEN-52 questionnaire, which provided information of ten health’s dimensions. Means and standard deviations of health scores at baseline were compared between TAP by calculating the effect size (ES) and logistic regression models were run to evaluate the effect of each dimension of health on children’s school outcomes. Lower average scores in almost all psychosocial dimensions of health corresponded to worse TAP. Children ‘self-perceived health at baseline showed more pronounced differences as more contrastive were TAP to each other. Self-perception, autonomy and school environment showed to have the most pronounced effects on TAP. Students with poorer psychosocial health showed a disadvantage as such students were more likely to get an educational risk TAP. These findings are important to develop nontraditional school achievement strategies potential to enhance both student health and academic achievement.

Variations on Exposure Therapy: Best Practices for Managing Public Speaking Anxiety in the Online Communication Classroom

Exposure and response prevention (ERP) therapy techniques offer unique opportunities for comprehensive management of public speaking anxiety in the online public speaking classroom beyond exposure to only the speech-giving act itself. This best practices article outlines nontraditional strategies for incorporating ERP practices in a distance-learning setting.

From “love actually” to love, actually: The sociometer takes every kind of fuel

ABSTRACT Belongingness needs have generally been thought to be filled through traditional strategies, but recent research suggests that nontraditional strategies (e.g., parasocial relationship partners, TV shows) may work as well. No work has yet examined the comparative importance of these different social behaviors in contributing to social need fulfillment. The current work utilized a visual measure to assess frequency, variety, and degree of contribution to social fulfillment of 17 social behaviors. Overall, the conceptualization of the need to belong as flexible and able to be satisfied by a variety of social behaviors was supported; both traditional and nontraditional social strategies were related to positive outcomes. Results suggest that nontraditional strategies may contribute an added layer of vibrancy to our social lives.

The Paci-Feminist Ethic of Virginia Woolf and Malala Yousafzai: Rhetorics of Care and Justice in the Face of Tyranny

The Paci-Feminist Ethic of Virginia Woolf and Malala Yousafzai: Rhetorics of Care and Justice in the Face of Tyranny Hillary Coenen (bio) In August of 1940, the United States had yet to enter the Second World War, and Virginia Woolf wrote the widely circulated “Thoughts on Peace in an Air Raid” in part to advise Americans on their approach to the war. Many of Woolf’s works address issues of peace and women’s rights, as does this one. The brief entreaty was written for a symposium addressing “current matters concerning women” (Woolf, “Thoughts” 243). Less than one month after writing the piece, Woolf’s London home was destroyed by a bomb during the London Blitz, and the address was never delivered to the American symposium. Just days before the address was published in The New Republic, Woolf witnessed the bombing and destruction of Tavistock Square, a significant local landmark. “Thoughts on Peace in an Air Raid” is an essay inseparable from its time. Over seventy years later, in a notable 2013 interview with Jon Stewart of the Daily Show, Malala1 Yousafzai made her first appearance on a major late-night news program. There she described her experience of being threatened and attacked by the Taliban, and she shared why she took on what she knew to be the dangerous task of advocating for girls’ education. The interview occurred three months after she delivered a highly publicized speech at the United Nations General Assembly on what was her 16th birthday, and a year after she was shot in the head by a Taliban gunman for her advocacy of the rights of women and girls. Both Woolf’s undelivered (but later published) address and Malala’s interview represent public assertions that highlight how investing in education for women and girls can promote peace and justice while resisting violence. Rejection of violence has a long history in feminist scholarship and literature, and this theme has often been linked to care as a value that informs feminine ethics. In philosophy, care as an ethical and moral value has often been contrasted with the more traditional (and supposedly masculine) value of justice.2 While feminist scholars have acknowledged that both care and justice are essential values for ethical thinking and decision-making, in recent years feminist scholarship has fully embraced an ethic of care as a guiding principle. With the landmark publication of Jaqueline Royster and Gesa Kirsch’s Feminist Rhetorical Practices: New Horizons for Rhetoric, Composition, and [End Page 139] Literacy Studies (2012), feminist rhetorical studies developed a renewed interest in the connection between feminism and care. Scholars in feminist rhetoric have taken up an “ethos of humility, respect, and care” that Royster and Kirsch claim is essential for excellent feminist inquiry (21). This research stance is consistent with the portrayal of feminist thought that Virginia Held upholds in The Ethics of Care. Held claims that “the ethics of care now has a central, though not exclusive, place in feminist moral theorizing” (28). Held responds to Carol Gilligan’s earlier work that distinguishes a “care perspective” from a “justice perspective.” In that response, Held explains that, although feminists who work within an ethic of care “share the goals of justice and equality,” this approach challenges traditional moral theories, in part because it is feminist (26). Feminists have long been faced with the violence of oppression and tyranny supported by willful ignorance and overt hatred. Appropriate and effective responses to these forces need to balance the need for justice and equity with a need to educate and build empathetic communities. Acknowledging these tensions, a pacifist and feminist response would necessarily incorporate care and justice perspectives, as well as notions of humility and respect. Feminist Rhetorical Practices provides “critical terms of engagement” that guide the rhetorical study of texts and contexts that have traditionally been excluded from the rhetorical canon or that apply non-traditional strategies (21). One of these terms is critical imagination, an approach that prompts us to rethink “what is there and not there” (20). Drawing from Jaqueline Royster’s Traces of a Stream, Royster and Kirsch explain that critical imagination involves “account[ing] for what we ‘know’ by...

Mathematical Modelling of Material Removal Rate and Diameter of overcut for Sodalime glass through pressurized flow ECDM Process by Response Surface Methodology

The effect of electrolyte concentration, voltage, duty factor and electrolyte flow rate on material removal rate (MRR) and diameter of overcut (DOC) of the micro-hole machining of sodalime has been studied. The experimental values changed with the theoretical calculation in the range of 3 – 10 %. This mathematical model showed that decreasing electrolytic concentration reduces MRR and DOC. Pressurized flow Electrochemical DischargeMachining (pf-ECDM) can meet these differences. In order to put this phenomenon to use many experiments were experimented to machine holes on glass. Since parameters like electrolyte concentration, voltage, duty factor and electrolyte flow rate play an important role in MRR and DOC it needs to be calculated in order to improve the capability of this technology in machining difficult and high aspect ratio features. A mathematical model has been extensively developed to know the role of electrolyte concentration, voltage, duty factor and electrolyte flow in MRR and DOC of the process. However, machining excessive component ratio elements on ceramics like glass stays an ambitious challenge due to overcut. Although, electrical discharge machining (EDM) and electrochemical machining (ECM) are properly set up non-traditional strategies to meet these challenges, they are restrained to electrically conductive materials. In order to execute functionalities like excessive power and sustainability with minimal use of space, the raw substances used need to possess desirable mechanical, chemical and physical properties. Experimental research has been conducted, and the model was proven below various machining parameters. Demand for miniaturized merchandise is ever growing as they accomplish the venture of supplying the preferred functionalities with high efficiency using minimalistic raw material. These researches proved that growing the voltage in pf-ECDM plays a primary function in growing the MRR of the machined features.

Non-traditional melanoma prevention strategies in the young adult and adolescent population.

Non-traditional melanoma prevention strategies in the young adult and adolescent population.

Advanced Research on Healthcare using Bigdata Analytics

Big data is a blanket term for the non-traditional strategies and technologies needed to organize, process, and gather insights from large datasets. While the problem of working with data that exceeds the computing power or storage of a single computer is not new, the pervasiveness, scale, and value of this type of computing has greatly expanded in recent years. Big Data can also play a role for small or medium-sized companies and organizations that recognize the possibilities (which can be incredibly diverse) to capitalize upon the gains. Now many organizations in this data-rich industry are focused on using big data and analytics to make life-altering changes in patient education, treatment and more. This paper provides a general survey of recent progress and advances in Big Data science, healthcare, and biomedical research. We have mainly focused on the recently proposed methods based on various issues in medical domain. Nevertheless there are many challenges in implementing big data in healthcare especially in relation to privacy, security, standards, governance, integration of data, data accommodation, data classification, incorporation of technology etc. Further it includes research applications, technical tools of big data in healthcare and the opportunities inside this quickly emerging scientific field are explored.

The Changing Landscape of HIV Prevention in the United States: Health Department Experiences and Local Adaptations in Response to the National HIV/AIDS Strategy and High-Impact Prevention Approach.

HIV prevention has changed substantially in recent years due to changes in national priorities, biomedical advances, and health care reform. Starting in 2010, motivated by the National HIV/AIDS Strategy (NHAS) and the Centers for Disease Control and Prevention's (CDC's) High-Impact Prevention (HIP), health departments realigned resources so that cost-effective, evidence-based interventions were targeted to groups at risk in areas most affected by HIV. This analysis describes how health departments in diverse settings were affected by NHAS and HIP. We conducted interviews and a consultation with health departments from 16 jurisdictions and interviewed CDC project officers who monitored programs in 5 of the jurisdictions. Participants were asked to describe changes since NHAS and HIP and how they adapted. We used inductive qualitative analysis to identify themes of change. Health departments improved their HIV prevention practices in different ways. They aligned jurisdictional plans with NHAS and HIP goals, increased local data use to monitor program performance, streamlined services, and strengthened partnerships to increase service delivery to persons at highest risk for infection/transmission. They shifted efforts to focus more on the needs of people with diagnosed HIV infection, increased HIV testing and routine HIV screening in clinical settings, raised provider and community awareness about preexposure prophylaxis, and used nontraditional strategies to successfully engage out-of-care people with diagnosed HIV infection. However, staff-, provider-, and data-related barriers that could slow scale-up of priority programs were consistently reported by participants, potentially impeding the ability to meet national goals. Findings suggest progress toward NHAS and HIP goals has been made in some jurisdictions but highlight the need to monitor prevention programs in different contexts to identify areas for improvement and increase the likelihood of national success. Health departments and federal funders alike can benefit from the routine sharing of successes and challenges associated with local policy implementation, considering effects on the overall portfolio of programs.

Risky Business: An Integrated Institutional Theory for Understanding High-Risk Decision Making in Higher Education

Lauren A. Turner and A. J. Angulo explore how institutional theory can be applied to explain variance in higher education organizational strategies. Given strong regulatory, normative, and cultural-cognitive pressures to conform, they ask, why do some colleges engage in high-risk decision making? To answer this, they bring together classic and contemporary approaches to institutional theory and propose an integrated model for understanding outlier higher education strategies. The integrated model offers a heuristic for analyzing external and internal pressures that motivate colleges to implement nontraditional strategies. Through an analysis of recent trends among outlier colleges and their approaches to the Scholastic Aptitude Test, Turner and Angulo contextualize the model and consider its potential for understanding why higher education organizations adopt characteristics that differentiate them from their peers.

Synthetic Immunobiotics: A Future Success Story in Small Molecule-Based Immunotherapy?

Drug resistance to our current stock of antibiotics is projected to increase to levels that threaten our ability to reduce and eliminate bacterial infections, which is now considered one of the primary health care crises of the 21st century. Traditional antibiotic agents (e.g., penicillin) paved the way for massive advances in human health, but we need novel strategies to maintain the upper hand in the battle against pathogenic bacteria. Nontraditional strategies, such as targeted immunotherapies, could prove fruitful in complementing our antibiotic arsenal.