An examination of the cross-cultural validity of the Identity Capital Model: American and Japanese students compared.

The Identity Capital Model proposes that forms of personal agency are associated with identity development as part of the transition to adulthood. This model was examined in two cultural contexts, taking into account age and gender, among college and university students aged 18 to 24 (N = 995). Confirmatory Factor Analyses verified cultural, age, and gender invariance of the two key operationalizations of the model. A Structural Equation Model path analysis confirmed that the model applies in both cultures with minor variations-types of personal agency are associated with the formation of adult- and societal-identities as part of the resolution of the identity stage. It was concluded that forms of personal agency providing the most effective ways of dealing with "individualization" (e.g., internal locus of control) are more important in the transition to adulthood among American students, whereas types of personal agency most effective in dealing with "individualistic collectivism" (e.g., ego strength) are more important among Japanese students.

Identity in young adulthood: Links with mental health and risky behavior.

The present study was conducted to contribute to our understanding of young adult identity development by deriving latent profiles from intrapersonal and interpersonal indices of identity synthesis and confusion. A sample of 9737 college-attending young adults completed measures of identity, mental health, and health risk behaviors. Four latent profiles emerged: Synthesized (high synthesis, low confusion), Diffused (moderate synthesis, high confusion), Elevated (high synthesis and confusion), and Moderate (moderate synthesis and confusion). The Synthesized profile was associated with the highest well-being and the lowest levels of internalizing, externalizing, and health risks. The Diffused and Elevated profiles were both associated with low well-being and with high internalizing, externalizing, and risky behaviors - with the Elevated profile highest on all of the negative outcomes. The Moderate profile scored intermediately on well-being, internalizing, externalizing, and health risks. These results are discussed in terms of the role of identity within a successful transition to adulthood.

Improving chronic care through continuing education of interprofessional primary healthcare teams: a process evaluation.

Process evaluations assess program structures and implementation processes so that outcomes can be accurately interpreted. This article reports the results of a process evaluation of Partnerships for Health, an initiative targeting interprofessional primary healthcare teams to improve chronic care in Southwestern Ontario, Canada. Program documentation, participant observation, and in-depth interviews were used to capture details about the program structure, implementation process, and experience of implementers and participants. Results suggest that the intended program was modified during implementation to better meet the needs of participants and to overcome participation barriers. Elements of program activities perceived as most effective included series of off-site learning/classroom sessions, practice-based/workplace information-technology (IT) support, and practice coaching because they provided: dedicated time to learn how to improve chronic care; team-building/networking within and across teams; hands-on IT training/guidance; and flexibility to meet individual practice needs. This process evaluation highlighted key program activities that were essential to the continuing education (CE) of interprofessional primary healthcare teams as they attempted to transform primary healthcare to improve chronic care.

Phase-changing citrate macromolecule combats oxidative pancreatic islet damage, enables islet engraftment and function in the omentum.

Clinical outcomes for total-pancreatectomy followed by intraportal islet autotransplantation (TP-IAT) to treat chronic pancreatitis (CP) are suboptimal due to pancreas inflammation, oxidative stress during islet isolation, and harsh engraftment conditions in the liver's vasculature. We describe a thermoresponsive, antioxidant macromolecule poly(polyethylene glycol citrate-co-N-isopropylacrylamide) (PPCN) to protect islet redox status and function and to enable extrahepatic omentum islet engraftment. PPCN solution transitions from a liquid to a hydrogel at body temperature. Islets entrapped in PPCN and exposed to oxidative stress remain functional and support long-term euglycemia, in contrast to islets entrapped in a plasma-thrombin biologic scaffold. In the nonhuman primate (NHP) omentum, PPCN is well-tolerated and mostly resorbed without fibrosis at 3 months after implantation. In NHPs, autologous omentum islet transplantation using PPCN restores normoglycemia with minimal exogenous insulin requirements for >100 days. This preclinical study supports TP-IAT with PPCN in patients with CP and highlights antioxidant properties as a mechanism for islet function preservation.

Acculturation strategies as predictors of fandom identification in the fanfiction, Star Wars fan, and furry communities.

Research suggests that people at the interface of two different cultures may face a dilemma regarding how or whether to adopt aspects of the new culture in light of their existing cultural identity. A growing body of research in fan communities suggests that similar group processes may operate in recreational, volitional identities. We tested this by examining the associations between acculturation attitudes and identification with fan communities across three studies. Fanfiction fans, Star Wars fans, and furries completed measures of four different acculturation strategies with respect to managing their fan and non-fan communities as well as a measure of their identification with the fan community. Results across the three studies consistently found that integration and assimilation strategies positively predicted fan community identification, while separation and marginalization strategies negatively predicted fan community identification. Together, the results conceptually replicate and find evidence for the acculturation model.

Early and Intensive Motor Training for people with spinal cord injuries (the SCI-MT Trial): protocol of the process evaluation.

INTRODUCTION: People with spinal cord injury receive physical rehabilitation to promote neurological recovery. Physical rehabilitation commences as soon as possible when a person is medically stable. One key component of physical rehabilitation is motor training. There is initial evidence to suggest that motor training can enhance neurological recovery if it is provided soon after injury and in a high dosage. The Early and Intensive Motor Training Trial is a pragmatic randomised controlled trial to determine whether 10 weeks of intensive motor training enhances neurological recovery for people with spinal cord injury. This pragmatic randomised controlled trial will recruit 220 participants from 15 spinal injury units in Australia, Scotland, Italy, Norway, England, Belgium and the Netherlands. This protocol paper describes the process evaluation that will run alongside the Early and Intensive Motor Training Trial. This process evaluation will help to explain the trial results and explore the potential facilitators and barriers to the possible future rollout of the trial intervention. METHODS AND ANALYSIS: The UK Medical Research Council process evaluation framework and the Implementation Research Logic Model will be used to explain the trial outcomes and inform future implementation. Key components of the context, implementation and mechanism of impact, as well as the essential elements of the intervention and outcomes, will be identified and analysed. Qualitative and quantitative data will be collected and triangulated with the results of the Early and Intensive Motor Training Trial to strengthen the findings of this process evaluation. ETHICS AND DISSEMINATION: Ethical approval for the Early and Intensive Motor Training Trial and process evaluation has been obtained from the Human Research Ethics Committee at the Northern Sydney Local Health District (New South Wales) in Australia (project identifier: 2020/ETH02540). All participants are required to provide written consent after being informed about the trial and the process evaluation. The results of this process evaluation will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trial Registry (ACTRN12621000091808); Universal Trial Number (U1111-1264-1689).

"Chasing Tail": Testing the Relative Strength of Sexual Interest and Social Interaction as Predictors of Furry Identity.

Furries can be described as a mediacentric fandom, similar to other fandoms, which organizes around an interest in anthropomorphic art. Past research has also aimed to highlight and understand the sexual motivations of furries, leading to questions regarding the relative strength of fandom and sexual motivations for joining and maintaining membership within the group. The goal of the present study was to test the relative contributions sex- and fandom-related motivations (e.g., social belonging) have in determining furry identity to provide better conceptualizations of this unique community for future research and education. In a sample of furries (n = 1,113), participants reported sexual attraction to facets of their interest and were found to be sexually motivated to engage in specific fan behaviors. However, a series of follow-up analyses revealed that non-sexual motivations were not only stronger in magnitude than sexual motivation was, but were also much more strongly correlated with furry identification.

A comparison of self-reported motor vehicle collision injuries compared with official collision data: an analysis of age and sex trends using the Canadian National Population Health Survey and Transport Canada data.

OBJECTIVE: The purpose of this study was to compare the age and sex trends of motor vehicle collision injuries between a nationally representative self-report survey and official police motor vehicle collision report data. To do this, population-based estimates of motor vehicle collision injuries were established using data from the National Population Health Survey (NPHS), a prospective, population-based, longitudinal survey that was compared to Transport Canada's official motor vehicle collision report statistics. METHODS: Aggregated mean data (1994-1996) were compared for seven age groups (15-19, 20-24, 25-34, 35-44, 45-54, 55-64, and 65+) from both data sets. RESULTS: No significant differences were found between males' and females' MVC injuries for any age category in the NPHS. A comparison of the NPHS and Transport Canada data found two small (significant) within-sex differences between the data sets, but overall, the analysis largely revealed similar trends for self-reported injury for all age categories and sex. CONCLUSIONS: The results indicate that the incidence of injuries based on self-report data in a nationally representative sample is similar to official sources of reporting and are thus a valid indicator or motor vehicle collision injury incidence. The results also confirm that injury trends differ from fatality trends.

The twin peg Oxford knee - Medium term survivorship and surgical principles.

BACKGROUND: A multicentre study of single peg Oxford knees reported failure associated with osteoarthritis progression, femoral component loosening, unexplained pain and meniscal bearing dislocation. Suboptimally positioned femoral components and intraoperative MCL damage could explain these problems. We hypothesised that modifying implantation technique to optimise femoral component positioning and MCL preservation, and introducing the twin peg Oxford knee would address these problems and improve longer term survival. Moreover, its better congruency in high flexion could reduce wear. This study aims to investigate this hypothesis by asking 1) Is the 98% survivorship up to nine years found in an earlier study sustained at longer term (up to 13 years)? 2) What are the remaining causes of failure? METHODS: We described our modified implantation technique. A cohort of all patients treated by the senior author using this modified technique and the Oxford twin peg cemented knee replacement between September 2003 and August 2013 was investigated. A survival analysis was performed and the causes of failure were analysed. RESULTS: The cohort consisted of 468 patients with 554 medial cemented implants. In all, 16 implants were revised and the 12-year survivorship was 95%. Patients with extended indications had a lower survivorship than those with anteromedial osteoarthritis (10-year survival rate 78% vs 97%, p<0.001). There were no failures due to femoral loosening. CONCLUSIONS: Using our surgical principles the cemented twin peg Oxford knee can result in good medium to long-term implant survival, comparable to those obtained by the originating centre for the single peg Oxford knee.

Bacteria as an agent for change in structural plumage color: correlational and experimental evidence.

Recent studies have documented that a diverse assemblage of bacteria is present on the feathers of wild birds and that uropygial oil affects these bacteria in diverse ways. These findings suggest that birds may regulate the microbial flora on their feathers. Birds may directly inhibit the growth of harmful microbes or promote the growth of other harmless microbes that competitively exclude them. If keratinolytic (i.e., feather-degrading) bacteria degrade colored feathers, then plumage coloration could reveal the ability of individual birds to regulate microbial flora. We used field- and lab-based methods to test whether male eastern bluebirds (Sialia sialis) with brighter blue structural plumage coloration were better able to regulate their microbial flora than duller males. When we sampled bluebirds in the field, individuals with brighter color had higher bacterial loads than duller individuals. In the lab, we tested whether bacteria could directly alter feather color. We found that keratinolytic bacteria increased the brightness and purity, decreased the ultraviolet chroma, and did not affect the hue of structural color. This change in spectral properties of feathers may occur through degradation of the cortex and spongy layer of structurally colored barbs. These data suggest that bacteria can alter structural plumage color through degradation.

Impact of a primary healthcare quality improvement program on diabetes in Canada: evaluation of the Quality Improvement and Innovation Partnership (QIIP).

OBJECTIVE: Primary healthcare (PHC) quality improvement (QI) initiatives are designed to improve patient care and health outcomes. We evaluated the Quality Improvement and Innovation Partnership (QIIP), an Ontario-wide PHC QI program on access to care, diabetes management and colorectal cancer screening. This manuscript highlights the impact of QIIP on diabetes outcomes and associated vascular risk factors. RESEARCH DESIGN AND METHODS: A cluster matched-control, retrospective prechart and postchart audit was conducted. One physician per QIIP-PHC team (N=34) and control (N=34) were recruited for the audit. Eligible charts were reviewed for prespecified type 2 diabetes mellitus clinical process and outcome data at baseline, during (intervention range: 15-17.5 months) and post. Primary outcome measures were the A1c of patients above study target and proportion of patients with an annual foot exam. Secondary outcome measures included glycemic, hypertension and lipid outcomes and management, screening for diabetes-related complications, healthcare utilization, and diabetes counseling, education and self-management goal setting. RESULTS: More patients in the QIIP group achieved statistically improved lipid testing, eye examinations, peripheral neuropathy exams, and documented body mass index. No statistical differences in A1c, low-density lipoprotein or systolic/diastolic blood pressure values were noted, with no significant differences in medication prescription, specialist referrals, or chart-reported diabetes counseling, education or self-management goals. Patients of QIIP physicians had significantly more PHC visits. CONCLUSION: The QIIP-learning collaborative program evaluation using stratified random selection of participants and the inclusion of a control group makes this one of the most rigorous and promising efforts to date evaluating the impact of a QI program in PHC. The chart audit component of this evaluation highlighted that while QIIP improved some secondary diabetes measures, no improvements in clinical outcomes were noted. This study highlights the importance of formalized evaluation of QI initiatives to provide an evidence base to inform future program planning and scale-up.

The cemented twin-peg Oxford partial knee replacement survivorship: a cohort study.

BACKGROUND: A new twin-peg version of the Oxford knee was introduced in 2003. However, until now there has been no information about its survivorship. The aim of this study was to determine the survivorship, and the patients' perception of outcome over time. METHODS: A cohort of all patients treated from 2003 until 2009 using the twin-peg Oxford partial knee was contacted. The main indication for treatment was anteromedial osteoarthritis (AMOA). The Oxford Knee Score (OKS), American Knee Society Functional (AKS-F) score and satisfaction rate were obtained, and the time-to-failure was used to perform a survival analysis. RESULTS: There were 249 patients treated, with 288 medial cemented implants. Of these, 248 patients with 287 implants could be contacted and implant survival or failure was verified. Their mean age was 67years (range: 34-94). The mean follow-up time was 5.1years (maximum: 9.2). The nine years cumulative implant survival rate for all cases using revision for any reason to define failure was 98% (95% CI, 84 to 100). There were no cases of femoral loosening. The mean OKS was 22 pre-operatively, 41 at two years, and 41 at final review, at which point 96% of patients were very or fairly pleased with the result. CONCLUSION: The survivorship of the twin-peg knee was better than that of the single peg knee at our centre, and appeared no worse than the results of the single peg knee at the originating centre. It can offer secure femoral fixation, sustained clinical benefit and patient satisfaction. LEVEL OF EVIDENCE: Level IV case-series.

'More than skin-deep': biological essentialism in response to a distinctiveness threat in a stigmatized fan community.

We investigated how group distinctiveness threats affect essentialist beliefs about group membership in a stigmatized fan community. An experiment conducted on 817 members of the fan community revealed that highly identified fans who perceived significant stigmatization were the most likely to endorse essentialist beliefs about group membership when exposed to a distinctiveness threat via comparison to a highly similar (vs. dissimilar) outgroup. These results bridge essentialism research and research on distinctiveness threat by demonstrating the mutability of group essentialism beliefs as a defensive response to distinctiveness threats. Implications for future research are discussed.

Influence of a quality improvement learning collaborative program on team functioning in primary healthcare.

Quality improvement (QI) programs are frequently implemented to support primary healthcare (PHC) team development and to improve care outcomes. In Ontario, Canada, the Quality Improvement and Innovation Partnership (QIIP) offered a learning collaborative (LC) program to support the development of interdisciplinary team function and improve chronic disease management, disease prevention, and access to care. A qualitative study using a phenomenological approach was conducted as part of a mixed-method evaluation to explore the influence of the program on team functioning in participating PHC teams. A purposive sampling strategy was used to identify PHC teams (n = 10), from which participants of different professional roles were selected through a purposeful recruitment process to reflect maximum variation of team roles. Additionally, QI coaches working with the interview participants and the LC administrators were also interviewed. Data were collected through semistructured telephone interviews that were audiotaped and transcribed verbatim. Thematic analysis was conducted through an iterative and interpretive approach. The shared experience of participating in the program appeared to improve team functioning. Participants described increased trust and respect for each other's clinical and administrative roles and were inspired by learning about different approaches to interdisciplinary care. This appeared to enhance collegial relationships, collapse professional silos, improve communication, and increase interdisciplinary collaboration. Teamwork involves more than just physically grouping healthcare providers from multiple disciplines and mandating them to work together. The LC program provided opportunities for participants to learn how to work collaboratively, and participation in the LC program appeared to enhance team functioning.

Impact of a quality improvement program on primary healthcare in Canada: a mixed-method evaluation.

PURPOSE: Rigorous comprehensive evaluations of primary healthcare (PHC) quality improvement (QI) initiatives are lacking. This article describes the evaluation of the Quality Improvement and Innovation Partnership Learning Collaborative (QIIP-LC), an Ontario-wide PHC QI program targeting type 2 diabetes management, colorectal cancer (CRC) screening, access to care, and team functioning. METHODS: This article highlights the primary outcome results of an external retrospective, multi-measure, mixed-method evaluation of the QIIP-LC, including: (1) matched-control pre-post chart audit of diabetes management (A1c/foot exams) and rate of CRC screening; (2) post-only advanced access survey (third-next available appointment); and (3) post-only semi-structured interviews (team functioning). RESULTS: Chart audit data was collected from 34 consenting physicians per group (of which 88% provided access data). Between-group differences were not statistically significant (A1c [p=0.10]; foot exams [p=0.45]; CRC screening [p=0.77]; advanced access [p=0.22]). Qualitative interview (n=42) themes highlighted the success of the program in helping build interdisciplinary team functioning and capacity. CONCLUSION: The rigorous design and methodology of the QIIP-LC evaluation utilizing a control group is one of the most significant efforts thus far to demonstrate the impact of a QI program in PHC, with improvements over time in both QIIP and control groups offering a likely explanation for the lack of statistically significant primary outcomes. Team functioning was a key success, with team-based chronic care highlighted as pivotal for improved health outcomes. Policy makers should strive to endorse QI programs with proven success through rigorous evaluation to ensure evidence-based healthcare policy and funding.

Use of a vesicular stomatitis virus complementation system to analyze respiratory syncytial virus binding.

Respiratory syncytial virus (RSV) can be difficult to manipulate in the laboratory because it produces a fragile, filamentous virion that does not bud efficiently from the cell surface and which is sensitive to purification. These properties have complicated the studies of RSV envelope protein-host cell interactions. In this paper, we have tested the ability of the RSV attachment protein, G, to complement virus attachment of a recombinant vesicular stomatitis virus (VSVdeltaG*), which lacks any viral attachment protein. Using an enzyme-linked immunosorbent assay (ELISA) to detect bound virus, VSVdeltaG* virions were shown to incorporate the RSV G protein and to bind to Hep-2 cells. Binding of RSV G protein-complemented VSVdeltaG* virus was inhibited by incubation with RSV-specific antibodies and by the addition of exogenous sulfated glycosaminoglycans, indicating that binding by the complemented virus exhibited the characteristics of RSV binding rather than those of VSV. These results demonstrate that complementation studies with VSVdeltaG* may be useful in virus-host interaction studies of the RSV G protein.

Effects of Mycoplasma gallisepticum on reproductive success in house finches.

Long known as a pathogen of poultry, Mycoplasma gallisepticum (MG) was first detected in house finches in 1994. The disease rapidly spread throughout the eastern United States and Canada and was associated with debilitating disease and high mortality in house finches. However, in the late 1990s, the proportion of infected finches dying as a result of infection with MG decreased, and asymptomatic infection was more common among wild birds than in the past. We documented MG infections in breeding house finches and concluded that adults of both sexes transmit the infection to dependent young, probably after hatch. MG infections of breeding adults occurred late in the breeding season and were found in birds completing significantly more nests than birds that never tested positive for MG, implying that higher rates of reproduction carry a cost in the form of increased risk of infection. We found evidence of an MG-induced delay in dispersal of nestlings from their natal area and demonstrated a significant impact of infection on nestling growth.

Susceptibility of a naïve population of house finches to Mycoplasma gallisepticum.

Since 1994 an epidemic of mycoplasmal conjunctivitis has spread throughout the eastern house finch (Carpodacus mexicanus) population leading to a significant decline in this population. The infection has not yet been reported from house finch populations west of the Great Plains. We hypothesized that the western population, like the eastern population, is susceptible to infection, and we tested this hypothesis by experimentally infecting house finches from Missoula, Montana (USA) with the house finch strain of Mycoplasma gallisepticum (MG). We compared the response of finches from Montana infected with MG to that of finches from Auburn, Alabama (USA) (October 1999-February 2000). Fifteen house finches from Montana were shipped to Auburn and quarantined for 6 wk at the Auburn University aviary. All birds were negative for MG antibodies when tested by serum plate agglutination assay and MG could not be detected in any bird by polymerase chain reaction. We tested two methods of inoculation, ocular inoculation and contact exposure to an infected finch. Seven house finches from Montana and four house finches from Alabama were infected by bilateral ocular inoculation with 20 microliters of a culture containing 1 x 10(6) color changing units of the house finch strain of MG. The remaining eight house finches from Montana were co-housed with a house finch from Alabama exhibiting mycoplasmal conjunctivitis. After exposure to the pathogen, all house finches became infected, regardless of origin or method of exposure, and all developed conjunctivitis. All birds seroconverted, and evidence of infection could be detected in every bird at some point during the course of disease. Our results suggest that house finches from the western United States are highly susceptible to infection with the house finch strain of MG.

Results of a mixed-methods evaluation of partnerships for health: a quality improvement initiative for diabetes care.

PURPOSE: Quality improvement (QI) initiatives have been implemented to facilitate transition to a chronic disease management approach in primary health care. However, the effect of QI initiatives on diabetes clinical processes and outcomes remains unclear. This article reports the effect of Partnerships for Health, a QI program implemented in Southwestern Ontario, Canada, on diabetes clinical process and outcome measures and describes program participants' views of elements that influenced their ability to reach desired improvements. METHODS: Part of an external, concurrent, comprehensive, mixed-methods evaluation of Partnerships for Health, a before/after audit of 30 charts of patient of program physicians (n = 35) and semistructured interviews with program participants (physicians and allied health providers) were conducted. RESULTS: The proportion of patients (n = 998) with a documented test/examination for the following clinical processes significantly improved (P ≤ .005): glycosylated hemoglobin (A1c), cholesterol, albumin-to-creatinine ratio, serum creatinine, glomerular filtration rate, electrocardiogram, foot/eye/neuropathy examination, body mass index, waist circumference, and depression screening. Data showed intensification of treatment and significant improvement in the number of patients at target for low-density lipoprotein (LDL) and blood pressure (BP) (P ≤ .001). Mean LDL and BP values decreased significantly (P ≤ .01), and an analysis of patients above glycemic targets (A1c >7% at baseline) showed a significant decrease in mean A1c values (P ≤ .01). Interview participants (n = 55) described using a team approach, improved collaborative and proactive care through better tracking of patient data, and increased patient involvement as elements that positively influenced clinical processes and outcomes. CONCLUSIONS: QI initiatives like Partnerships for Health can result in improved diabetes clinical process and outcome measures in primary health care.

The Twin Peg Oxford partial knee replacement: the first 100 cases.

We present the clinical results of the first 100 patients who received the Twin Peg Oxford partial knee replacement which has a 15° extra femoral surface for contact in deep flexion, and has two pegs for more secure fixation. We measured the clinical outcome 2 years after the medial unicompartmental arthroplasty using patient and surgeon derived outcome measures. The results showed a mean Oxford Knee Score of 41, a mean American Knee Society Objective Score of 93 and a Functional Score of 84, a mean range of motion of 130° and a high satisfaction rate. Results were significantly better in male patients. There were no deaths, infections, dislocations, fractures or revisions. There were no pathological radiolucencies suggestive of early loosening. We conclude that the Twin Peg Oxford partial knee replacement shows excellent clinical and radiological results at 2 years. For surgeons who have concern over the risk of femoral loosening with the single peg Oxford knee, or seek an improved surface area of contact in full flexion, this implant offers an excellent alternative.