bluuebunny/crossref_metadata_2025 huggingface dataset:
Creation of a port authority in nineteenth century British India: Organisational structure and administrative procedures in the Port of Calcutta
Authors: Singh Ankita
Published: May 2022

The formation of an ‘Authority’ for port management in nineteenth century British India under a structural legal framework represented a watershed in the economic history of port management and sea-borne trade, one with far-reaching effects on both enterprise and the organisation of labour in the region. This ‘new’ authority structure started in the Port of Calcutta and was adopted for the ports of Bombay, Rangoon and other south Asian port cities. Using unpublished documentation collected from the archives of the first port authority established in British India, Bengal Legislative Council and the archival statistical information of trade and navigation from India Office, this research seeks to trace the genesis and evolution of bureaucratic procedures and organisational management, by anchoring research in the nineteenth century Calcutta port's policies and administrative framework. This article traces the development of the modern port authority structure and its internal administration, which can be found even today.
Silicon-substituted calcium phosphate promotes osteogenic-angiogenic coupling by activating the TLR4/PI3K/AKT signaling axis
Authors: Kong Yuanhang , Zhang Xin , Ma Xinnan , Wu Leilei , Chen Dechun , Su Bo , Liu Daqian , Wang Xintao
Published: May 2022

Silicon-substituted calcium phosphate (Si-CaP) is a promising bioactive material for bone tissue engineering. The mechanism of Si-CaP regulates osteogenic-angiogenic coupling during bone regeneration has not been fully elucidated. In this study, we screened the targets of Si-CaP and osteogenic-angiogenic coupling. 83 common genes were regarded as key targets for Si-CaP regulation of the osteogenic-angiogenic coupling. Then, we performed protein-protein interaction analysis, GO and KEGG enrichment analysis of these 83 targets to further predict their molecular mechanism. Our results showed that Si-CaP treatment could regulate the osteogenic-angiogenic coupling by up-regulating the expression of Toll-like receptor 4 (TLR4), and the phosphorylation of AKT which in turn activating the PI3K/AKT signaling pathway, promoting the expression of RUNX2, OPN, VEGF. In addition, we also found that TLR4 siRNA treatment could block the PI3K/AKT signaling pathway, while inhibiting the promoting effect of Si-CaP. However, although LY294002 can achieve the same inhibitory effect as TLR4 siRNA by blocking the PI3K/AKT signaling pathway, it could not affect the expression of TLR4. This indicates that TLR4 is an upstream activator of PI3K/AKT signaling pathway. These results are highly consistent with the prediction of bioinformatics. In conclusion, we have elucidated the role of TLR4/PI3K/AKT signaling axis in Si-CaP mediated osteogenic-angiogenic coupling for the first time. This study provides new data onto the regulatory role and molecular mechanism of Si-CaP in the process of osteogenic-angiogenic coupling, which strongly supports its wide application for bone tissue engineering.
Pivoting Multiple Liminalities in Working Parenthood: Communicative Negotiations of Permanent, Transitional, and Limbo Liminalities
Authors: Long Ziyu , Buzzanell Patrice M. , King Abigail S.
Published: May 2022

Drawing from the experiences of graduate students who become parents during graduate school in the United States, we argue that working parents encounter multiple liminalities, defined as “betwixt and between the original positions arrayed by law, custom, convention and ceremony” (Turner, 1977, p. 95) in their work-family negotiation. Findings revealed that graduate student parents (GSP) experienced permanent liminality when navigating parental leave policies, transitional liminality when managing work-family demands, and limbo liminality as GSPs are compared against “the ideal worker” in their everyday work. GSPs engaged in pivoting to unleash the agentic potential of their liminal positionality. Pivoting is enacted through (a) stepping into X or Y side of the liminal space to unlock oneself from the inbetweeness, (b) rotating back and forth between X and Y positions to attend to different roles, and (c) turning to an alternative space whereby the hybrid X-Y identities are embraced.
Exploring Meditation Profiles and Predictors in Nursing Students
Authors: Johnson Ann Hammack , Wilson Jennifer , Magner Dionne , Urban Regina Wilder , Martin Shirley , Zhang Yan
Published: May 2022

Background: Nursing students face unique academic and clinical workloads linked to increased stress. Previous studies indicate formal and informal mindfulness meditation provide stress-reducing benefits. This practice aligns with holistic nursing core values of self-care and self-reflection; little is known about meditation practice in nursing students. Objectives: Our study aimed to describe meditation practice and predictors in pre-licensure nursing students. Design: Cross-sectional, multi-site. Methods: Qualtrics surveys queried individual demographics, personal meditation and exercise habits, and indicators of wellbeing. Results: Of 417 participants, 65% (n  =  271) reported at least one type of meditation practice. Prayer/spiritual activities were most prevalent (almost 70%), followed by breathing exercises (41%). Meditators reported good or excellent self-rated health status or engaged in exercise (p < .05). Meditators also reported more self-compassion, happiness, and satisfaction with life, and perceived less stress than non-meditators (p < .05). Of all factors studied, only engaging in exercise significantly predicted practicing meditation (OR = 2.05, 95%CI 1.10-3.82). Conclusion: Nursing students who engage in meditation report signs of health and well-being and utilize holistic methods such as prayer and breathing. The intrinsic motivation to engage in healthy habits such as exercise may also help students engage in mindfulness meditation and is an important finding for nursing educators.
Development of a university innovation ecosystem assessment model for Association of Southeast Asian Nations universities
Authors: Chaipongpati Jirawan , Thawesaengskulthai Natcha , Koiwanit Jarotwan
Published: May 2022

Universities are centres of innovation and technology transfer, and they play a particularly strong role in the countries of the Association of Southeast Asian Nations (ASEAN) with developing technology programs. However, there are only a few assessment tools for evaluating a university’s innovation ecosystem, and these tools are frequently lacking either in terms of process orientation or in other gaps. The objective of this research was to develop a model of an innovation ecosystem for an ASEAN university and to identify the relative importance of each factor. A multi-method approach was used. In the Stage 1 research, a Delphi study of ASEAN-based university innovation experts ( n = 40) was conducted. This research resulted in a preliminary assessment tool. This tool was then evaluated through a broader survey of university innovation experts in ASEAN ( n = 418). The data were analysed using confirmatory factor analysis. The results identified a total of 21 innovation areas in four role-based domains: Leaders and Governors, Educators, Innovators and Connectors. The resulting assessment instrument is suitable for use in university innovation ecosystem development and policy making.
Improving the surface integrity of laser cladded layer by ultrasonic-assisted burnishing at medium temperature with considering initial surface conditions
Authors: Zhang Peirong , Jin Chenglong , Jiang Qichuan , Zhang Zurong
Published: May 2022

Improving the surface integrity of laser cladded layer via burnishing is an important research topic in remanufacturing field. However, the initial surface roughness condition induced by mechanical machining generates great influence on the strengthening mechanism of subsequent burnishing. In this study, the effects of ultrasonic-assisted burnishing (UB) and ultrasonic-assisted warm burnishing (UWB) on the surface integrity of laser cladded layer were analyzed when treated on different surface conditions obtained by turning with different feed parameters. The results indicated that both the UB and UWB treatments would cause great improvements in microhardness, surface roughness including height and functional parameters, and residual stress of the laser cladded layer when compared to those by turning. First, the severe plastic deformation in UB and UWB treatments counteracted the thermal softening effect in turning process, so that the machined surface could maintain high hardness. Second, UB treatment reduced the roughness by 70% compared with turning, while the surface roughness after UWB treatment was even 30% lower than that obtained by UB. Third, the tensile residual stress shifted to deep compressive state by both UB and UWB treatments, though the thermal load in UWB generated a negative effect on generating compressive residual stress. According to the surface integrity evaluation results by radar diagrams, turning with feed f = 0.2 mm/r and UWB is preferred in machining of the laser cladded layer for enhanced surface integrity. On the basis of this research, it is expected to achieve the purpose of high-efficiency and high-quality cutting of the laser cladded layer.
Buckling behavior of laminated composite stiffened cylindrical shell panels having cutout for different parametric variations
Authors: Sahoo Sarmila
Published: May 2022

Buckling of composite stiffened cylindrical shell panels having cutout is analyzed using the finite element approach. Shell panel and stiffeners are modeled using first-order shear deformation theory and considering displacement compatibility at the stiffener-panel interface. Convergence and validation studies are conducted to establish the accuracy of the present approach. An attempt is made to maximize the uniaxial and biaxial buckling loads by varying the lamination, boundary conditions, load position, depth of stiffeners, and their arrangements. Parametric studies show that buckling load and mode shapes depend on the size of cutout, ratio of shell width to thickness, degree of orthotropy, and fiber orientation angle. The parametric variations considered here may help the practicing engineers to have an elaborate design aid for improving the buckling strength of such shell panels.
Research on optimization method of process parameters for SiC components robotic bonnet polishing
Authors: Huang Xuepeng , Wang Zhenzhong , Shen Bingyi , Lei Pengli , Fu Zhenfeng
Published: May 2022

Silicon carbide (SiC) materials are widely used in the fields of advanced optics, such as SiC mirrors. To improve the polishing efficiency and surface quality of SiC components, reduce the cost of polishing equipment and shorten the production cycle, a robotic bonnet polishing (RBP) technology based on industrial robots was proposed. To obtain the global optimal parameters, a regression orthogonal experiment was designed by using the response surface methodology (RSM). The material removal model capturing the main process parameters was established successfully. The predicted optimal process parameters were verified by experiments. Under the optimal process parameters, the predicted material removal rate (MRR) is 0.0543 mm³/min , with an error of 9.8%. The relationship between main process parameters and surface roughness (RMS) was established by the support vector machine (SVM), and the predicted optimal value is 8.58 nm, with an error of 10.26%. Thus, the precise and controllable polishing of SiC components can be realized by RBP technology.
Acoustic performance of architected hybrid metamaterials for sound attenuation applications
Authors: Medhin Yacob , Khan Kamran A
Published: May 2022

Acoustic insulators in sound attenuation applications usually have a structure with a characteristic dimensions equivalent to the operating wavelength, posing significant challenges in low-frequency sound attenuation applications. Recent advancements in material science, advanced materials called acoustic metamaterials (AMMs) have paved the way for designing efficient noise insulation passive and active devices. This paper proposes heterogeneous integrated passive metamaterials for enhanced sound insulation in broad frequency bands. Six acoustic meta-unit cells (UCs) with deep subwavelength thickness were proposed and analyzed numerically for the acoustic band structure and transmission characteristics. Out of these six UCs, three high-performing UCs were chosen for further analysis. Finite element (FE) analysis results showed that the maximum transmission loss conforms with the computed band structures. Next, we proposed several heterogeneous meta-structures consisting of different combinations of chosen meta-unit cells. The FE analysis results showed that a broader band of sound absorptions can be achieved through the hybrid design of AMMs. Our research revealed that the suggested structures may be utilized to create metamaterials with a wider absorption band, making them suitable for a variety of applications.
Spike type of stall inception in the tandem rotor
Authors: Kumar Amit , Kumar Akshay , Pradeep A. M.
Published: May 2022

There are two known mechanisms of inception of rotating stall in the compressor, modal wave inception and spike inception. However, the stall inception mechanisms for a tandem-rotor have not been explored so far in detail. The paper explores the unsteady behaviour of the tandem rotor. Unsteady casing pressure measurements are carried out with the help of seven equispaced unsteady pressure sensors. The casing pressure traces are analysed using wavelet transforms, fast Fourier transform, discrete spatial Fourier series, travelling wave energy method and correlation techniques to identify the nature of the stall cells. The changes observed in the stall cells during the transition from the stable mode of operation to the fully stalled mode and back from the stall regime to the stable operating condition are investigated in detail. It is observed that the stall incepts in the form of a low-intensity spike, which later evolves as a long-length scale disturbance in the fully developed stall region. The initial stall disturbance is found to be rotating with 75% of the rotor speed. The speed of the stall cells is reduced to 61% of the rotor speed in a fully developed region. The number and size of stall cells increase as the mass flow is throttled. The number and size of the stall cells are strongly coupled with the leading-edge incidence pattern. During the transition from the stall regime to the stable operating condition, the mass flow of the compressor increases, which reduces the flow incidence angle of the tandem rotor. Thus, the separation region shrinks during this transition leading to a reduction in the size of the stall cells. The stall in the tandem-rotor is primarily associated with the tip leakage flow. The rotating disturbances in the tandem-rotor originate due to the leading-edge flow separation of the forward rotor blade. Leading-edge separation of the aft rotor, which arises due to interaction of the forward rotor tip leakage vortex, is effectively suppressed with the help of the gap-nozzle flow. For a comprehensive unsteady analysis, the different techniques need to be used in combination.
MHD 3D flow of powell eyring fluid over a bidirectional non-linear stretching surface with temperature dependent conductivity and heat absorption/generation
Authors: Meenakumari R. , Lakshminarayana P.
Published: May 2022

The Present work addresses the MHD three-dimensional boundary layer flow of Powell Eyring fluid over a bidirectional non-linear stretching surface in the presence of thermal radiation and heat generation/absorption. We also considered the temperature dependent thermal conductivity. The governing flow partial differential equations are transmuted into ordinary differential equations with the help of suitable similarity transformations. The resultant non-linear coupled system is solved numerically by the shooting technique. This article presents the novel exploration of radiative heat transport of Powell Eyring fluid by considering temperature dependent conductivity over a bidirectional non- linear stretching sheet. The effects of various pertinent parameters on the present flow are presented graphically and explained in detail. We noticed that the velocity and temperature fields can be reduced by applying a strong magnetic field. The progress in Prandtl number condenses the temperature field but it improves the rate of heat transfer. Further, it is concluded that the large values of Powell Eyring fluid parameters enhance the skin friction.
Vibration analysis and reduction optimization study of a reciprocating compressor piping system under multi-boundary coupling
Authors: Zhang Kehai , Huang Zhiqiang , Chen Zhen , Li Tao , Yu Hongmei
Published: May 2022

In response to the characteristics of variable working conditions of shale gas extraction, in order to ensure the operational safety of shale gas compressors, this paper takes a certain type of shale gas compressor piping system in Weiyuan as the research object. Based on the plane wave theory and vibration theory, the research on the distribution law of gas pulsation of the piping system and the vibration characteristics under multi-boundary coupling was carried out, and the area of gas pulsation exceeded and the part of amplitude exceeding the piping system were locked. The vibration test of the piping system was carried out and the results showed that the amplitude of the piping system exceeded the standard and the agreement between the test and simulation results was high, which verified the correctness of the simulation model. In response to the problem of excessive vibration of the piping system, orifice plate aperture ratio orthogonal test and piping system structure optimization were carried out. After optimization, the amplitude of gas pulsation and vibration was significantly reduced, and they all met the requirements of the API 618 standard, which reduced the risk of structural damage to the piping system and improved the reliability and safety of the shale gas compressor unit.
Pyrolysis characteristics and kinetic analysis of Indian almond fruit biomass by thermogravimetric analysis for the potential source of bioenergy
Authors: Suresh Kumar P. , Edwin M. , Bensam Raj J.
Published: May 2022

Pyrolysis has recently emerged as a viable and sustainable approach for assessing the bioenergy potential of agricultural waste. Indian almond fruit (IAF) has the potential for bioenergy recovery for heat and electricity generation, whereas, the characterization and the kinetics data of IAF have never been explored. In this research, the IAF biomass was involved in proximate, ultimate and chemical analysis for the complete characterization of biomass. Further, the pyrolysis behaviour and kinetic analysis of IAF were investigated by thermogravimetric analysis (TGA) technique using five heating rates such as 5°C/min, 10°C/min, 15°C/min, 20°C/min and 25°C/min, respectively. Kinetic analysis was performed on the IAF biomass using different kinetic models such as Kissinger, Friedman, Kissinger–Akahira–Sunose (KAS) and Flynn–Wall–Ozawa (FWO). Furthermore, thermodynamic parameters were determined using the decomposition data obtained from the TGA curve. A characterization study revealed that the IAF biomass displayed a heating value of 18.31 MJ/kg. The carbon and hydrogen contents were noted as 50.72% and 4.98%, respectively, and no traces of sulphur were observed. The IAF biomass exhibited the maximum lignin content of 21.14%. TGA results revealed that the IAF biomass decomposed in three stages, stage 1: 35°C to 110°C, stage 2: 110 °C to 240°C and stage 3: 240°C to 400°C. Higher mass loss was seen in stage 3 due to the simultaneous degradation of cellulose, hemicelluloses and lignin. Activation energy calculated by Kissinger, Friedman, KAS and FWO exhibited as 12.23 and 9.15 kJ/mol – 19.09 and 26.10 kJ/mol – 132.57 and 32.60 kJ/mol – 142.33 kJ/mol, respectively. Furthermore, thermodynamic analysis of IAF biomass displayed that the pyrolysis process was a spontaneous and endothermic process. In addition, the pyrolysis characterization of various biomass investigated by the previous researchers has been compared with the present results.
Sexual satisfaction and its associations with patient-reported outcomes in a cohort of women living with human immunodeficiency virus in Sweden
Authors: Carlsson-Lalloo Ewa , Berg Marie , Rusner Marie , Svedhem Veronica , Mellgren Åsa
Published: May 2022

Background: Sexual satisfaction is an important dimension of health-related quality of life that needs to be addressed. Various factors may influence sexual satisfaction in women living with HIV (WLHIV); however, research in this area is limited. The aim of this study was to investigate patients’ self-reported sexual satisfaction and its associations with patient-reported outcomes in WLHIV in Sweden. Methods: Data was retrieved from the InfCareHIV registry for the years 2011–2016. The registry includes a self-reported validated 9-item health questionnaire to assess patient-reported outcomes, side effects and adherence. In total, 1292 WLHIV aged ≥18 years were included, corresponding to 42.8% of the female Swedish InfCareHIV cohort 2011–2016. A total of 2444 questionnaires were included in the study. The patient-reported outcomes used were satisfaction with physical health and psychological health, sexual satisfaction, and experiencing side effects from HIV-medication. Associations were tested in univariable and multivariable models. Results: The study shows that there was a significant association between sexual satisfaction and satisfaction with psychological health ( p ≤ 0.0001). There was a lower probability of reporting sexual satisfaction in women who were of an older age when they received an HIV-diagnosis ( p = 0.033), who had lived for more years with HIV ( p = 0.0004), or who had experienced side effects ( p = 0.028). Conclusions: This national register-based study identified that sexual satisfaction in WLHIV is associated with psychological health and with having experienced side-effects. Patient-reported outcomes can provide valuable information so that the care of WLHIV covers all aspects of health and supports sexual satisfaction, which is an important part of quality of life.
Viral load scale-up in south Sudan: Strategic implementation of tools to monitor HIV treatment success among people living with HIV
Authors: Chun Helen , Russell Anna , Abe Gordon , Katoro Joel , Songok Jackson , Lesuk Grace , Worku Habtamu , Ukaejiofo Onyekachi , Lodiongo Dennis , Olemukun Robert , Kenigsberg Tat’Yana , Aragaw Shambel , Deng Lul Lojok , Bunga Sudhir , Ellenberger Dennis
Published: May 2022

Introduction

As access to antiretroviral therapy (ART) for people with HIV (PWH) in the Republic of South Sudan (RSS) increases, viral load (VL) suppression is critical to protect global HIV response investments. We describe VL scale-up between 2017–2020 in the RSS President’s Emergency Plan for AIDS Relief (PEPFAR)-supported program.

Methods

President’s Emergency Plan for AIDS Relief (PEPFAR) South Sudan developed a VL scale-up plan and tools spanning the VL cascade: pre-test, test and post-test and included assessment of clinical facility and laboratory readiness; clinical and laboratory forms and standard operating procedures for test ordering, specimen collection, processing, results return and utilization; procedures to map clients, monitor turn-around-times (TAT), and an electronic system to monitor VL performance.

Results

Between 2017 to 2020, VL monitoring was established in 58 facilities, with 59,600 VL samples processed, and improvements in TAT (150–28 days) and rejection rates (1.9%–0.8%). VL documentation improved for dates of ART initiation, VL test request and dispatch, and HIV regimen. Total average time from high VL to repeat VL decreased from 15.9 months to 6.4 months in 2017 and 2019, respectively.

Conclusions

A concerted approach to VL scale-up has been fundamental as South Sudan strives towards UNAIDS 95-95-95 targets for PWH on ART.
Prevalence of Mycoplasma genitalium and other sexually transmitted pathogens in male urethritis in a sexual health centre in New Caledonia
Authors: Blanco Patrick , Rachline Anne , Tarantola Arnaud , Biron Antoine , Pereyre Sabine , Coutherut Julie , Patoureau Marion
Published: May 2022

Background: The prevalence of sexually transmitted infections (STIs) is high in New Caledonia (NC), but there are no data on Mycoplasma genitalium (MG). However, the syndromic treatment of urethritis used in the territory includes a single dose of azithromycin, which could generate resistance in MG.

Methods: We recruited 217 men referred to the Noumea public medical centre (CMP) with signs of urethritis and meeting the inclusion criteria from May 2016 to March 2018. Each was tested for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and for the first time in NC for MG by polymerase chain reaction (PCR).

Results: The prevalence of MG was 10.1% (22/217). Azithromycin resistance of MG (mutation in the 23S rRNA gene) could only be assessed for 10 of the 22 strains. Only one (1/10; 10%) was resistant. The prevalence of other STIs tested was high, as CT, NG and/or TV were associated in 77.3% (17/22) of MG-positive cases.

Conclusions: Although co-infections further justify syndromic management, the presence of MG in NC urethritis cases could call treatment guidelines into question.
Orthographe et éducation des citoyens dans les dictées françaises de Gouzien
Authors: Vajta Katharina
Published: May 2022

Orthography and education of the citizens in texts for dictation by Gouzien. During the 19th century, dictation was probably the most current exercise in French schools and therefore the content of the texts dictated must not be neglected. Hence, we here intend to examine how they can contribute to constructing France, building national identity and forming citizenship during the first years of the French Third République. The first part of the study will give a historical background to the teaching of spelling. Then, we will present the theoretical and methodological frame of the study, before examining the double aim of dictation (to instruct and to educate) and the themes contributing to the discursive construction of the nation and the pupil’s education to citizenship, i.e. History, Homeland and National imaginary.
Mean-line model development for off-design performance prediction of transonic axial compressor of an industrial gas turbine based on computational fluid dynamics database
Authors: Mohammadian Poorya Keshavarz , Saidi Mohammad Hassan
Published: May 2022

In this work, a mean-line model with the row-by-row stacking scheme is developed to simulate the off-design operation of a multi-stage transonic axial compressor of an industrial gas turbine. A database of computational fluid dynamics (CFD) simulation results validated with the field data is generated at different rotating speeds and pressure ratios by using CFD simulation tools and available detail geometry of the studied compressor. The compressor characteristic parameters including inlet/exit blockage factor, deviation angle parameter, rotor temperature and pressure coefficients, and the pressure loss of the stator for all stages, plus variable inlet guide vane, are extracted from CFD simulation results. Based on analytical/empirical relations in the literature, a generic formulation for the characteristic parameters is defined as a function of airflow parameters such as inlet Mach number, inlet flow angle, and velocity ratio. Since the accuracy of this type of model depends on the formulated characteristic parameters, and due to the error propagation potential of the sequential stacking solutions, a multi-objective optimization program is developed to specify the coefficients and exponent values of the generic formulations. The functionality of characteristic curves versus airflow parameters for different compressor rows is comprehensively investigated. The comparison between the results of the mean-line model and CFD simulations shows the high accuracy of the model. The developed model can be used in applications such as condition monitoring of in-service gas turbines, studying the effects of rescheduling the variable stator vanes, and investigating the wet compression process.
Anticipated impacts of voluntary assisted dying legislation on nursing practice
Authors: Snir Jessica T , Ko Danielle N , Pratt Bridget , McDougall Rosalind
Published: May 2022

Background:

The Voluntary Assisted Dying Act 2017 passed into law in Victoria, Australia, on the 29 November 2017. Internationally, nurses have been shown to be intimately involved in patient care throughout the voluntary assisted dying process. However, there is a paucity of research exploring Australian nurses’ perspectives on voluntary assisted dying and, in particular, how Victorian nurses anticipate the implementation of this ethically controversial legislation will impact their professional lives.

Objectives:

To explore Victorian nurses’ expectations of the ethical and practical impacts the voluntary assisted dying legislation will have on their professional lives.

Research design:

This qualitative study analysed nurses’ free text responses collected as part of a larger mixed methods online survey investigating staff views on the Voluntary Assisted Dying Act. Data were collected during the period between the passing of the voluntary assisted dying legislation and the start date and were analysed using inductive content analysis.

Participants and research context:

Free text survey responses were analysed from 1873 nurses employed across seven Victorian health services located in both metropolitan and regional areas of the state.

Ethical considerations:

The study obtained research ethics approval and all participants were informed of the voluntary and anonymous nature of their participation.

Findings:

This study identified three broad areas of Victorian nurses’ professional lives that they expected to be impacted by the implementation of voluntary assisted dying: professional identity, career development and workplace relationships.

Conclusion:

Participants anticipate diverse and nursing-specific impacts of the implementation of voluntary assisted dying in Victoria. Their insights can inform health services in jurisdictions considering or already implementing voluntary assisted dying, to develop policies, procedures and staff training programmes that safeguard the well-being and legal rights of their nursing staff.
Ethical challenges and lack of ethical language in nurse leadership
Authors: Storaker Anne , Heggestad Anne Kari Tolo , Sæteren Berit
Published: May 2022

Background:

In accordance with ethical guidelines for nurses, leaders for nurse services in general are responsible for facilitating professional development and ethical reflection and to use ethical guidelines as a management tool. Research describes a gap between employees’ and nurse leaders’ perceptions of priorities.

Objective:

The purpose of this article is to gain deeper insight into how nurses as leaders in somatic hospitals describe ethical challenges.

Design and method:

We conducted individual, quality interview with 10 nurse leaders, nine females and one male nurse aged 34–64 years. We used a hermeneutical approach to analyse the data.

Ethical considerations:

The participants received oral and written information about the study. Participation in the study was voluntary, and the participants were given the opportunity to withdraw. All of them gave written consent. The Norwegian Centre for Research Data approved the research project. In addition, the head of the hospitals gave permission to conduct our study.

Findings:

Four main areas were identified: deficient ethical language, conflicting demands on nurse leaders regarding staff management, concerns regarding young nurses’ ethical consciousness and restricting factors on the creation of a climate of ethics. The nurse leaders experienced considerable pressure. An unexpected finding was the lack of – and even disregard for – an ethical language.

Discussion and conclusion:

It is crucial to recognise ethics in all types of nursing approaches and to make it explicit. Ethical language must be implemented in nursing education. It must be recognised and used in clinical practice.

Recommendations:

We recommend further research be conducted into how nurses understand the concept of ethics and how to incorporate ethical principles into clinical nursing and nurse leadership.
CURA: A clinical ethics support instrument for caregivers in palliative care
Authors: Metselaar Suzanne , van Schaik Malene , Widdershoven Guy , Pasman H. Roeline
Published: May 2022

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA.
Predictors of Mortality in Neonatal Tetanus: A Retrospective Study From a Medical College in Rural North India
Authors: Ahmed Ayaz , Yadav Meetu , Dhingra Arti , Jain Rakhi , Singh Maha
Published: May 2022

Background

Studies on factors affecting mortality in neonatal tetanus (NNT) are mostly from other developing countries. Although NNT has been eliminated from India, cases are still occasionally reported from rural areas. Moreover, there is paucity of such studies from India. Hence, this study was aimed to identify risk factors affecting NNT mortality so that case fatality can be minimized especially in resource-limited settings.

Methods

The records of the 32 neonates diagnosed as NNT over a period of 8 years (2013-2020) were reviewed, and a statistical comparison of various variables between survivors and nonsurvivors was made.

Results

The overall case fatality rate in our study was 75%. Determinants of mortality in these cases were low birthweight, short incubation period, short period of onset, delay in seeking medical attention, presence of comorbidity, dose of tetanus immunoglobulin < 250 IU, and an unknown entry site of infection. Gender and place of delivery were not associated with increased mortality.

Conclusion

Improved maternal antenatal care (birthweight and gestation), recognition of the disease at onset of symptoms, and early hospital contact are important, in addition to optimum supportive care, to reduce NNT mortality.
Successful Management of a Case of Congenital Dislocation of Knee With Ipsilateral Developmental Dysplasia of Hip
Authors: Kumar Chandra Mohan , Munshi Sukrit , Asghar Adil , Pandey Ritesh Arvind , Chowdhry Bhabesh Kant
Published: May 2022

Introduction

Congenital dislocation of the knee (CDK) is a rare condition and includes a characteristic hyperextension deformity at the knee with varying degrees of anterior and lateral subluxation. Developmental dysplasia of the hip (DDH) is a common disorder and presents frequently to a pediatrician. DDH with CDK is common, but hip pathology usually remains unnoticed because of more obvious deformity at the knee. Through this case, we aim to highlight the association of CDK with DDH and discuss its management.

Case Presentation

A preterm, 31-week baby girl, appropriate for gestational age, delivered to a primigravida mother with early antenatal oligohydramnios. At birth, the baby had an externally rotated left lower limb and the knee in hyperextension. A clinical diagnosis of CDK with ipsilateral DDH was confirmed further with a radiological evaluation of the left hip and knee. Staged correction of deformities was done starting with the knee, followed by the hip joint. By the 12th week of life, the knee and hip dislocations were corrected satisfactorily, which remained stable till the last follow-up (6 months).

Conclusion

CDK can present with an ipsilateral DDH, and this possibility needs attention. Newborns having congenital knee dislocation should undergo hip screening for instability by clinical methods. Ultrasound screening of the hip can be done if clinical examination is inconclusive. Such cases can be managed successfully by staged knee and hip disorder correction.
Retrieval of a Broken Umbilical Artery Catheter in a Neonate
Authors: Doodnath Reshma , Landreth-Smith Barrie , Rampersad Barbara
Published: May 2022

Background

Umbilical arterial catheterization is an extremely useful tool in the premature, sick neonate for intensive monitoring and as a source of arterial blood sampling. We describe the case of an inadvertent breakage of an umbilical artery catheter (UAC), to replace it, and the potential complications that can arise.

Case Report

A premature 33-week infant weighing 1.965 kg was admitted to the neonatal intensive care unit (NICU) and had umbilical catheterization. An abdominal X-ray (AXR) was done following the procedure to confirm the position, and the UAC was found to be too low, between T11 and T12. In attempting to replace it, the UAC was transected, with the umbilical stump bleeding, and the internal tip not seen. The patient underwent laparotomy and examination under anesthesia revealed a UAC that was palpable in the right lower quadrant and fluoroscopy revealed a tip in the external iliac artery. This migrated with each subsequent palpation. Meticulous dissection revealed a catheter which was palpable in the right internal iliac artery. The bifurcation was cleared, and vascular slings applied, getting proximal and distal control. The vessel was opened, and the catheter retrieved in its 15-cm entirety. The vessel was repaired with 7/0 Prolene suture.

Conclusions

This case is intended to highlight that even a trivial procedure of UAC removal must be done carefully with appropriate instrumentation to prevent this complication. For retrieval of this type of vascular foreign body, an open technique can be used with the assistance of fluoroscopy. Endovascular retrieval techniques are also an option but are not available in our setting for this age group.
Merit, Capital and Middle Class: Exploring the Linkages
Authors: Chakrabarty Taniya
Published: May 2022

Earlier this year in January 2022, the Supreme Court of India in its judgement on the counselling process for the stalled centralised medical entrance validated the need for reservations and elaborated on the much-debated issue of merit vs. reservation. In India, there has been a long-standing debate over whether reservations impinge on the idea of merit. This article attempts to crucially appraise the very idea of merit in contemporary societies. Further, through an exploration of its characteristics and the process of its construction and reproduction, this article attempts to trace the origins of merit in the Indian context and understand its importance in relation to caste as well as class, particularly in relation with the middle classes; in doing so, this article will seek to understand how merit as a notion is constructed and operationalised in academic and employment discourse and whether the claim of equality of opportunity translates into equality of outcome.
Managing Uncertainty for and With Family: Communication Strategies and Motivations in Familial Uncertainty Management for Hereditary Cancer
Authors: Campbell-Salome Gemme , Barbour Joshua B.
Published: May 2022

The management of uncertainty is integral to health and illness. Individuals manage uncertainty about their health through communication enmeshed in family systems, but existing theorizing focuses on individuals without accounting for family processes. An iterative qualitative analysis of 42 dyadic, family interviews ( N = 84) revealed (a) moments in the context of hereditary cancer that involved individual-centered and familial uncertainty appraisal and management, (b) family members’ communication strategies to prompt relatives to engage familial uncertainty, and (c) the communicative (re)creation and negotiation of family models for uncertainty management. The findings illuminate tensions that individuals encounter across their lifespan as they appraise and manage uncertainty about hereditary cancer risks. This study extends uncertainty management theory to encompass familial uncertainty management and contributes insights useful for the management of hereditary cancer.
Perceptions of Inuit Women and Non-Inuit Healthcare Providers on the Implementation of Human Papillomavirus Self-Sampling as an Alternative Cervical Cancer Screening Method in Nunavik, Northern Quebec
Authors: Santella Christina , Tratt Elyse , Nyamiaka Joy , Whiteley Tukkiapik Louisa , Styffe Claire , Gamelin Rachel , Macdonald Mary Ellen , Brassard Paul
Published: May 2022

Human papillomavirus (HPV) self-sampling offers a cervical cancer (CC) screening alternative that can address certain barriers to the Papanicolaou test. As part of a larger community-based participatory project in Nunavik, Northern Québec, we travelled to two communities to gather perspectives from Inuit women and healthcare professionals (HCPs) on CC screening services and the possible implementation of HPV self-sampling. We held 10 group discussions with 28 Inuit women and 10 semi-structured interviews with 20 HCPs. The thematic analysis extracted themes reflecting one barrier and seven facilitators to accessing CC screening and the implementation of HPV self-sampling in Nunavik. Themes included, though not limited to, language and communication in health settings, access to culturally responsive educational resources on CC, and the noninvasive nature of HPV self-sampling. This study may serve to contribute to the co-development of a strategy for implementation that is designed according to the needs and priorities of the communities.
“Into the Lion’s Den”: COVID-19 Experiences of Black Adults with Sickle Cell Disease
Authors: Matthie Nadine S. , Clayton-Jones Dora L. , Jenerette Coretta M.
Published: May 2022

Adults living with sickle cell disease are at risk for experiencing severe illness from coronavirus disease 2019 (COVID-19) due to the complexity of their disease. Additionally, self-management and navigating the healthcare system may be challenging during the COVID-19 pandemic. Therefore, we conducted telephone interviews with 25 participants to explore the experiences of Black adults living with sickle cell disease during the early months of the pandemic in the United States. Three overarching themes characterize their experiences: management of sickle cell disease was further complicated by the pandemic, fear of the virus contributed to physical and social isolation, and employment and financial challenges affected well-being. The pandemic contributed to changes in health care maintenance and had a disproportionate impact on this population. Addressing social and structural determinants of health and disruptions in health care accessibility is critical to advancing health and health care equity for individuals living with sickle cell disease.
Hip-Hop History: A Course for Change
Authors: Ring Sean , Cristol Dean
Published: May 2022

Hip-Hop History exposes inequities within the social studies curriculum and the challenges facing those who seek to change it. In this article, we share the process for creating a new social studies course in a suburban high school in central Ohio, the need for the course, and the resources created to assist in its adoption. The article argues for the theoretical need for change in the social studies curriculum. Using Critical Race Theory (CRT) and Hip-Hop Pedagogies, we use Hip-Hop as a medium to shift the lens through which events are viewed. We use this course as an attempt to deconstruct the white, male, privileged version of American history and provide space for voices previously silenced by the dominant narratives. The article also outlines the many challenges educators and local school boards encounter trying to make such changes in current bureaucratic systems designed to perpetuate those narratives.
Practice, enactivism, and ecological psychology
Authors: McKinney Jonathan , Steffensen Sune Vork , Chemero Anthony
Published: May 2022

The Course-of-Experience Framework (CEF) represents a promising path forward for embodied and enactive approaches to cognitive science. It aims to provide a comprehensive explanation of representation-hungry activities by grounding cognition in practice. Practice is not merely something that we do as a means to an end, but is constitutive of cognition. Puzzlingly, however, the CEF begins to develop a distributed approach to cognition by viewing individuals through their cultural-cognitive ecology or milieu, before shifting focus to an internalist interpretation of enactive agency. CEF states that the agent enacts their world and discovers themselves through practice, but provides no clear account of organism-environment mutuality. This is problematic because CEF’s notion of practice depends on organism-environment mutuality in its first core assumption. The tendency to downplay the importance of the environment is likely due to a holdover of early enactivist ideas that have sparked tensions between ecological psychology and enactivism in the past. We attempt to re-align the CEF with the enactive project, which we think is gradually shifting away from individualistic concepts like autopoiesis and sense-making toward social and ecological concepts like participatory sense-making and affordances.
COVID Issues: Impact on Families and Family Planning
Authors: Noble Nicole , Bradley Loretta , Lock Robin , Winkelman Logan , Ayala-Conesa Maria , Lei Xinyue
Published: May 2022

In response to the global COVID-19 pandemic, many changes occurred worldwide to policies that influence an individual's reproductive autonomy and families’ wellbeing. Specifically, many reproductive treatments including abortions, contraceptive procedures, infertility treatments, and pregnancy protocols were delayed or altered in an attempt to reduce the spread of the COVID-19 virus. In order to assist families, counselors need to be aware of the implications of pandemic-related reproductive regulations affecting the overall mental health of families, especially women.