University of Mendoza

In 2019, pursuant to a Section 1115 waiver, Florida launched a Statewide Medicaid Managed Care housing assistance pilot to foster housing stability and reduce preventable health care use in adults with serious mental illness (SMI) or substance use disorder (SUD). We conducted a retrospective cohort study to examine the relationship between four housing support services provided in the pilot (transitional housing support, tenancy support, peer support, and crisis management) and health care use and health outcomes among 1,300 pilot enrollees during the period December2017-June2024. Transitional housing support services were associated with a 15percent increase in emergency department (ED) visits. Tenancy support services were associated with 51percent lower odds of all-cause mortality, and peer support was associated with a 20percent reduction in ED use. Crisis management was associated with a 45percent increase in ED visits, a 41percent increase in outpatient visits, and a 90percent increase in psychiatric hospitalizations. Findings highlight the value of tailored Medicaid housing interventions for people with SMI or SUD. Medicaid policy should prioritize high-value, data-driven housing interventions and protect them from budget cuts. Embedding such services within managed care contracts and aligning them with broader care coordination strategies offer a viable path for sustainability.

Prolactinomas account for approximately 45% of pituitary tumors, and dopamine agonists are the first-line treatment. A rare but potentially serious complication of this therapy is cerebrospinal fluid (CSF) leakage, resulting from rapid tumor shrinkage that exposes pre-existing bony and dural defects. We report a case of cabergoline-induced CSF leak in an invasive macroprolactinoma and review key pathophysiological and therapeutic aspects. Case report: A 39-year-old man presented with longstanding migraine-like headaches, decreased libido, and erectile dysfunction. Magnetic resonance imaging revealed an invasive macroprolactinoma (32×25×22.5 mm) involving the right cavernous sinus (Knosp 4) with pituitary stalk deviation; initial prolactin was 1325 ng/mL. Cabergoline 1 mg/week was initiated, leading to rapid clinical improvement and a marked prolactin decline. One month later, he developed continuous unilateral watery rhinorrhea, worsened by leaning forward. Magnetic resonance imaging showed tumor shrinkage with sphenoid sinus involvement. CSF leak was confirmed, and the patient underwent successful endoscopic endonasal repair. He recovered without recurrence, with sustained biochemical control and a stable residual lesion on follow-up imaging. Conclusions: dopamine agonists-induced CSF rhinorrhea occurs in 5-13% of invasive macroprolactinomas, particularly in large tumors with supra- and infrasellar extension and prolactin levels >1000 ng/mL. Given the significant risk of meningitis, early clinical suspicion and prompt endoscopic surgical repair are essential. Conservative management is rarely effective.

The design of hydraulic turbomachines operating at the so-called design point has advanced to a stage where further improvements can only be achieved through a detailed understanding of the internal flow behavior. As an alternative to physical experimentation, numerical methods have become a powerful tool for predicting internal flow characteristics. However, these predictions involve several complex challenges, including the rotating reference frame, the three-dimensional geometry of the impeller, the unsteady and turbulent nature of the flow, and fluid–structure interactions, especially under off-design conditions, where strong interactions between the impeller and the stator or casing occur. These simulations are often computationally demanding due to the fine mesh resolution required and the inclusion of various sub-models, such as moving reference frames, turbulence modeling, and, in some cases, cavitation models when operating away from the design point. This work focuses on evaluating the interplay among different modeling strategies, particularly sub-models related to rotating frames and turbulence. Various combinations of these models are tested to achieve accurate predictions of the mean flow behavior in a radial pump, accounting for some of their important geometrical characteristics. Both open-source and commercial CFD solvers are employed. The simulation results are compared against a standard experimental dataset defined for benchmarking studies.

El artículo indaga cómo emergen el compromiso y la agencia en estudiantes de nivel superior a partir de experiencias significativas de aprendizaje. Al mismo tiempo busca identificar los momentos formativos que contribuyeron a su desarrollo en las trayectorias estudiantiles y recuperar, desde la perspectiva de los propios estudiantes, aquellas experiencias que promovieron instancias de compromiso y agencia a lo largo de su formación. Metodológicamente se trata de un estudio cualitativo, basado en narrativas recogidas de 65 estudiantes de instituciones superiores del sur de Córdoba, Argentina. Los resultados se agrupan en tres categorías clave: (1) momentos situados y progresivos de agencia y compromiso, (2) transformación del entorno a través de la acción docente y estudiantil, y (3) oportunidades de acción y percepción de affordances en el contexto educativo. Las conclusiones principales indican que el compromiso y la agencia no son rasgos individuales fijos, sino prácticas situadas que emergen en contextos educativos que ofrecen relaciones pedagógicas significativas, tareas auténticas y oportunidades reales de participación. La percepción de affordances pedagógicas — entendidas como posibilidades significativas de acción— resulta crucial para activar el compromiso genuino y la agencia estudiantil. El estudio destaca la importancia de asumir el riesgo educativo e insta a transformar las prácticas docentes desde enfoques más dialógicos, flexibles y contextualmente relevantes.

Book Review

We conducted a study of aviators who experienced a close brush with death at work, in an effort to better understand how such events influence thoughts about work. Importantly, our initial interviews suggested that participants used conversational storytelling about their close brush with death as a means of enhancing the meaningfulness of their work. That initial finding presented us with a puzzle, as the literatures connecting storytelling to the meaning of work view stories as useful for meaning as understanding-not meaning as fulfillment (i.e., meaningfulness). Additional interviews culminated in a theoretical model where the raw materials of the close brush with death (loss of life, errors by the crew) created stories with more versus less dramatic tension. Differences in dramatic tension then shaped how story work (humor, poetic license) was used to craft the tale, how the tellings were experienced (teller emotions, audience reactions), and how gains in meaning as fulfillment (significance, belonging, esteem) were realized. In the end, participants with more and less dramatic tension in their stories were both able to use tellings to cultivate meaning as fulfillment, albeit in distinct and varying ways. Our findings therefore illustrate that the literatures connecting storytelling to the meaning of work have given short shrift to the power of stories. We discuss the implications of our theorizing for the meaning of work and storytelling at work literatures. (PsycInfo Database Record (c) 2025 APA, all rights reserved).