bluuebunny/crossref_metadata_2025 huggingface dataset:
Process Evaluation of an Acute-Care Nurse-Centred Hand Hygiene Intervention in US Hospitals
Authors: Sands Madeline , Aunger Robert
Published: August 2023

This paper describes a process evaluation of a ‘wise’ intervention that took place in six acute care units in two medical-surgical teaching hospitals in the United States during 2016–2017. ‘Wise’ interventions are short, inexpensive interventions that depend on triggering specific psychological mechanisms to achieve behaviour change. This study sought to increase the hand hygiene compliance (HHC) rates before entering a patient’s room among nurses. The intervention centred on the use of threat to professional identity to prompt improved HHC. Through questionnaires administered to intervention participants and the implementation facilitator, together with independent observation of intervention delivery, we examined whether the steps in the Theory of Change occurred as expected. We found that aspects of the implementation—including mode of delivery, use of incentives, and how nurses were recruited and complied with the intervention—affected reach and likely effectiveness. While components of the intervention’s mechanisms of impact—such as the element of surprise—were successful, they ultimately did not translate into performance of the target behaviour. Performance was also not affected by use of an implementation intention as repeated performance of HHC over years of being a nurse has likely already established well-ingrained practices. Context did have an effect; the safety culture of the units, the involvement of the Nurse Managers, the level of accountability for HHC in each unit, and the hospitals themselves all influenced levels of engagement. These conclusions should have implications for those interested in the applicability of ‘wise’ interventions and those seeking to improve HHC in hospitals.
Using allophonic variation in L2 word recognition: French listeners’ processing of English vowel nasalization
Authors: Dailey Megan M , Straboni Camille , Peperkamp Sharon
Published: August 2023

During spoken word processing, native (L1) listeners use allophonic variation to predictively rule out word competitors and speed up word recognition. There is some evidence that second language (L2) learners develop an awareness of allophonic distributions in their L2, but whether they use their knowledge to facilitate word recognition online, like native listeners do, is largely unknown. In an offline gating experiment and an online eye-tracking experiment in the visual world paradigm, we compare advanced French learners of English and a control group of L1 English listeners on their processing of English vowel nasalization during spoken word recognition. In the gating task, the French listeners’ performance did not differ from that of the English ones. The eye-tracking results show that French listeners used the allophonic distribution in the same way as English listeners, although they were not as fast. Together, these results reveal that L2 learners can develop novel processing strategies using sounds in allophonic distribution to facilitate spoken word recognition.
Increased Expression of Adipokines in Patients With Frozen Shoulder
Authors: Qiao Yi , Yao Xiangyun , Zhao Yu , Kang Yuhao , Xu Caiqi , Zhao Jinzhong , Zhao Song
Published: August 2023

Background:

Adipokines represent a spectrum of bioactive molecules that could modulate fibroblastic and inflammatory processes. The role of adipokines in the pathogenesis of frozen shoulder (FS), a common musculoskeletal disorder characterized by chronic inflammation, remains obscure.

Purpose:

To evaluate whether adipokines contribute to the pathogenic mechanisms of FS and to evaluate any potential correlation of adipokines with patients’ symptoms.

Study Design:

Controlled laboratory study.

Methods:

Shoulder capsule specimens were obtained from 10 patients with FS and 10 patients with shoulder instability (control group). The specimens were dyed using hematoxylin and eosin and immunohistochemically assessed with antibodies targeting adipokines, collagen I, collagen III, and tumor necrosis factor α. Immunoreactivity was graded from “no” to “strong” in a blinded manner. Reverse transcription–quantitative real-time polymerase chain reaction (RT-qPCR) analysis was conducted. Before the surgery, patient-reported frequency of pain, severity of pain, stiffness, and shoulder range of motion were documented.

Results:

In comparison with the control group, patients with FS had significantly greater pain frequency, pain severity, and stiffness and more limited shoulder range of motion ( P < .001). Hematoxylin and eosin- and Masson trichrome–stained samples from the FS group displayed hypercellularity and increased collagen fibers. Immunohistochemistry and RT-qPCR analyses indicated that expression of adipokines was significantly increased in FS capsules compared with the control group. The expression of collagen I, collagen III, and tumor necrosis factor α was also increased in FS capsules. No significant correlation was noted between adipokine expression and patient-reported outcomes in the control group, whereas in patients with FS, adiponectin expression was correlated with pain frequency ( r = 0.78; P = .01) and stiffness ( r = 0.73; P = .02). Visfatin was also correlated with pain frequency ( r = 0.70; P = .02).

Conclusion/Clinical Relevance:

This study indicated a potential role for adipokines in the pathogenesis of FS and demonstrated a correlation between adipokine expression and patients’ pain and stiffness.
Multiple sclerosing hemangiomas mimicking hepatocellular carcinoma: A case report
Authors: Zhan Xinyu , Gao Yiyun , Xu Jian , Wu Dongming , Wang Ping , Zhou Haoming
Published: August 2023

Hepatocellular carcinoma is a prevalent malignant tumor affecting the liver, and surgical resection and liver transplantation are the primary treatment options for early-stage HCC patients. However, the presence of benign hepatic tumors with similar imaging characteristics to HCC poses challenges in diagnosing and treating the disease, often resulting in misdiagnosis and inappropriate treatment. This case report presents a 52-year-old female patient who exhibited space-occupying liver lesions on abdominal CT and MRI scans. Based on pathological sections from other hospitals, liver malignancy was highly suspected, and hepatocellular tumor was diagnosed preoperatively. But the tumor markers of the patient were all within the normal range. After evaluating the overall condition of the patient, we finally chose the diagnosis and treatment of dissection and partial hepatectomy. Surprisingly, the final diagnosis of postoperative pathology was sclerosing hemangioma. The patient recovered well and was discharged 2 weeks later. Hepatic sclerosing hemangioma is an extremely rare disease that can be easily mistaken for malignant liver tumors due to absence of typical imaging presentations. The diagnosis also needs to be differentiated from other benign tumors, such as liver adenoma and liver abscess, according to the medical history, symptoms, and auxiliary examinations. Therefore, special attention should be given to the diagnosis and treatment of sclerosing hemangioma.
Facing the Music: Speculations on the Dark Side of Our Moon
Authors: Rykov Mary H.
Published: August 2023

Work with people who are dying is painful and no palliative caregiver is exempt from this. The emotional pain associated with being a palliative care music therapist is related to professional training, the experience of being a professional minority and newcomer in the workplace, and the intensity and intimacy of the musical workspace. Questions are posed to facilitate music therapist self-reflection. Therapist self-acceptance includes tolerance for imperfection, which, in turn, affects the music's capacity for containment.
Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model
Authors: Sacco Allegra , Robbins Mark L. , Paiva Andrea L. , Monahan Kathleen , Lindsey Hayley , Reyes Cheyenne , Rusnock Andrea
Published: August 2023

Purpose

In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination.

Design

Cross-sectional measurement development.

Setting

Online survey.

Sample

528 US adults ages 18-75.

Measures

Demographics, stage of change (SOC), DCBL, SE, myths, and barriers.

Analysis

The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs.

Results

For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) ( n 1 = 8, α = .97; n 2 = 5, α = .93; n 3 = 4, α = .84). For SE, two correlated factors were revealed ( n 1 = 12, α = .96; n 2 = 3, α = .89). Single-factor solutions for Myths ( n = 13, α = .94) and Barriers ( n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers.

Conclusion

This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.
Self-esteem and Locus of Control as Predictors of Academic Achievement: A Study Among Graduate Students
Authors: Suraj Shaini , Lohi Rucha , Singh Brij , Patil Pradeep
Published: August 2023

Background

Earlier researchers have explored the individual impacts of locus of control and self-esteem on academic as well as nonacademic success. But limited attention was given to their interplay within a university context. By integrating these variables into a unified framework, a more comprehensive understanding of the learning processes of university students can be achieved, which can further help in developing strategies to improve the overall learning outcome and come out as successful individuals.

Purpose

The aim of this study is to find out the contribution of locus of control and self-esteem toward academic achievement at graduation and across various demographic factors—socioeconomic status, family type, age, and different streams of graduation).

Methods

The sample consists of MBA students ( n = 200) coming from different graduation streams, both male and female, in the age group of 21–27 years. Data was collected through the Rosenberg Self-esteem Scale and Rotter’s Locus of control. A descriptive analysis and Chi-square test were used to analyze the data.

Results

Sixty-two percent had an internal locus of control, and 38% had an external locus of control. Forty-one percent had low self-esteem, and 59% had high self-esteem. There was a significant correlation between self-esteem, locus of control, and academic achievement. Self-esteem and locus of control totally predicted 41% of the variation in academic achievement, with self-esteem and locus of control both being stronger factors to predict academic achievement. Area (rural, urban), family type (nuclear, joint), and academic scores have a strong correlation with locus of control and self-esteem.

Conclusion

MBA students are the future leaders. For them to be successful leaders, interventions can be designed to increase self-esteem, which would help them have faith in their abilities and achieve their objectives by taking responsibility for the outcome of challenging situations.
Can the West Survive?
Authors: Harris Nigel
Published: August 2023

The article discusses the now universal process of macro economic reform or structural adjustment, and its implications for the growing importance of developing countries for the economic growth of the developed countries. However, a negative by-product of this growing integration of the two is seen as the decline in incomes of the lowest stratum of the workforce in developed countries and the increasingly unequal distribution of income, attributed to labour-intensive imports from developing countries. The Stolper-Samuelson theoretical explanation for this is discussed and assessed, along with the now substantial economic literature on the description and explanation of the declining incomes of the low-skilled. The article then discusses the significance of the growing role of services in the developed economies, arguing that developing countries are likely to be increasingly competitive in a growing range of labour-intensive services, without which technically more advanced activity cannot take place. Furthermore, the ageing of the developed countries’ population is likely to increase demand for services, particularly labour-intensive ones, and hence increase the dependence upon the youthful labour forces of developing countries. In sum, these trends seem likely to make the maintenance of the standard of living of the developed countries increasingly dependent upon the labour forces of the developing countries, making the old patterns of political domination impossible to sustain.
Art in Economy: How Aesthetics and Design Build Los Angeles
Authors: Molotch Harvey
Published: August 2023

I trace the way art and play, inclusive of painting, sculpture, and popular expression of all sorts, operates as a potent force in regional economic development. A key linkage between art, on the one hand, and economy on the other, is design. Using the Los Angeles area as case in point, I show how design, and the art on which it rests, propels various industries – toys, film, fast-food, furniture, cars – to build the regional economy.
Harmony, Mood and Turbulence in Corporate Evolution
Authors: Kay Neil M.
Published: August 2023

This paper sets out an approach to analysing corporate strategy that treats the firm as a system that develops according to certain design rules or principles. Harmony, or consistency and balance in systems design, is seen as a broad principle underlying corporate development that joins together apparently disparate specialised, related, and conglomerate strategies at a fundamental level. It is argued that the evidence is consistent with the view of the corporation as being governed by harmony seeking objectives.

The approach is also applied to the evolution of specific strategy types. It is concluded that the nature and scale of conglomerates may be strongly influenced by the route through which they evolve, and that they may be a more persistent phenomenon than some authorities give credit for. Also, implications of the nature of corporate environments are discussed in terms of their potential influence on patterns of strategy design and development.
Global-Local Relations and Time
Authors: Urry John
Published: August 2023

An examination of the connections between “globalisation” and time. A number of different senses of the global are outlined; and one particular version of the “globalisation-thesis” is elaborated. It is argued that part of what is involved in globalisation is a set of temporal changes; and that globalisation is significantly cultural. Some implications of these claims for place are developed – in particular, with whether they presume another kind of time, the glacial, beyond the obviously instantaneous time of globalisation. The connections with the thesis of “de-traditionalisation” are elaborated. Some methodological and ethical considerations are mentioned in conclusion.
“Global Labour” in the Arab Gulf States: Opportunity or Threat to Global/Regional Development and Security?
Authors: Glavanis Pandeli M.
Published: August 2023

This article starts from the premise that the increasing globalisation of economic, political, social and cultural processes reflects a period of simultaneous opportunity and danger. It addresses this with reference to transformations in the Arab regional economy since the mid-1970s, and a focus on the role of the oil-rich Arab Gulf states in the integration of the Arab regional labour market. Furthermore, this contribution relies upon the analysis of the Arab Gulf oil-driven experience in order to underline the centrality of labour mobility in the process of globalisation and thus highlight the profound implications for the future of the nation state, democracy, citizenship, nationalism, and the formation of socio-cultural identities and collectivities in this region of the global economy. This derives from the unprecedented magnitude of labour mobility within the region and the manner in which global labour is socially, politically and culturally excluded in the host societies. In this respect, this is a contribution to the problem of theorising new understandings of national, regional and political identities and a consideration of their implications for broader definitions of such concepts as democracy and citizenship in the wake of globalisation. The contribution concludes with a consideration of the problem of social order in the Arab region, with particular reference to the emergence of Political Islam as a socio-political force which challenges regional and global development and security.
Development of the Semiconductor Industry in Korea: A Stepping Stone to Join the Ranks of Core Countries?
Authors: Chon Soohyun
Published: August 2023

The recent success of Korea's DRAM (dynamic random access memory, commonly known as memory chips) industry has been praised as an exemplary case of a developing economy breaking into a technology intensive and high value added industry. In world-systems theory, high value added production activities are generally concentrated in core countries (developed countries). Thus, successful development of core activities in such high-tech areas as semiconductors in Korea deserves careful attention in evaluating a developing economy's ability to move itself into a developed economy. The paper examines the strengths and limitations of Korea's semiconductor industry to assess its role in transforming the country from a semiperiphery state to a core state. Korea's large conglomerates, called chaebol, were able to get into the DRAM business successfully, thanks to a government policy that gave them lowered bankruptcy risks and higher expected returns on equity. However, given the DRAM industry's present structure in Korea, there is a question as to whether DRAM production in Korea can really be considered a core activity. The paper evaluates DRAM production in Korea in the context of world-systems theory that defines the characteristics of core activities as having: 1) high value added: 2) technology and skill intensity of production: 3) market segmentation that differentiates products from commodities: and 4) backward and forward linkages with local industries. The conclusion drawn from the analysis is that even though the value added from Korea's DRAM production is high at the moment, DRAMs are not a niche market product that have a price inelastic demand curve. With most inputs such as equipment and intermediate materials imported from abroad and the final products sold in the international market, there is an issue as to whether the DRAM production process is a truly technology and skill intensive activity. Also, with DRAMs not having close linkages with the local economy, they are not really conducive to creating the building blocks for flexible high-tech manufacturing districts, an industrial structure that Korea needs to emulate to make the transition from semiperiphery to core.
Flying Geese, Swarming Sparrows or Preying Hawks? Perspectives on East Asian Industrialization
Authors: Hill Richard Child , Fujita Kuniko
Published: August 2023

This paper explicates and evaluates three contending explanations of East Asian development by comparing the conceptual and empirical claims of leading proponents of each viewpoint. We label the Japan centered, developmentalist perspective, “flying geese”; the Japan centered, dependency perspective, “preying hawks”; and the state autonomy perspective, “swarming sparrows”. We conclude that the flying geese model best characterizes the pattern of East Asian industrialization at the present time.
The Effectiveness of Interventions on Improving the Mental Health Literacy of Health Care Professionals in General Hospitals: A Systematic Review of Randomized Controlled Trials
Authors: Cheung Janice , Chan Cheuk Yin , Cheng Ho Yu
Published: August 2023

Background:

Suboptimal mental health literacy levels among general hospital health care professionals negatively impact the care coordination of patients with physical–mental comorbidity.

Aims:

This review is to examine the evidence on the effectiveness of interventions to improve the mental health literacy of general hospital health care professionals.

Methods:

A systematic search of literature was conducted in 13 electronic databases with manual searching of reference lists from 1980 to 2021. Studies were screened by pre-set eligibility criteria, that is, participants who were general hospital health care professionals taking care of adult patients, the interventions aimed at improving any components of participants’ mental health literacy, comparisons were alternative active intervention or no intervention, and the primary outcomes were any aspects of mental health literacy.

Results:

Eight randomized controlled trials ( N = 1,732 participants) were included in this review. Evidence indicated that mental health literacy interventions with educational components can improve components of the health care professionals’ mental health literacy, in terms of mental health knowledge and mental illness–related attitudes/stigma. In addition, few studies evaluated all components of participants’ mental health literacy.

Conclusions:

Based on the available evidence, educational interventions had a positive effect on components of general hospital health care professionals’ mental health literacy. Health care organizations should provide educational programs to enhance general hospital health care professionals’ mental health literacy. Further studies are needed to explore interventions that target all components of general hospital staff’s mental health literacy and to evaluate its impact on the psychiatric consultation–liaison service utilization in general hospitals, as well as patient outcomes.
Comparison of complications after closure of totally implantable venous access devices with non-absorbable suture and n-butyl-2-cyanoacrylate (NBCA) skin adhesive: Propensity score matching analysis
Authors: Lee Su Been , Kwon Lyo Min , Song Kyung Sup , Do Young Soo , Park Jung Ho , Kim Bum Jun
Published: August 2023

Purpose:

This study aimed to compare the complication rates of non-absorbable suture (NAS) and n-butyl-2-cyanoacrylate (NBCA) skin adhesive for skin closure during totally implantable venous access devices (TIVADs) implantation.

Methods:

Between March 2020 and February 2021, 586 consecutive patients who underwent TIVAD implantation were retrospectively analyzed. Two groups of patients suture with NAS ( n = 299) or NBCA ( n = 287) were followed up for 18 months to compare the occurrence of infection, thrombosis, and non-thrombotic malfunction. A total of 364 cases were extracted using propensity score matching in a 1:1 ratio. Mean TIVADs maintenance days were analyzed using Kaplan-Meier survival analysis.

Results:

Nineteen cases of complications occurred (0.294/1000 catheter-days) in the NAS group and 17 cases (0.210/1000 catheter-days) in the NBCA group. The difference in the complication rates between the two groups was not statistically significant ( p = 0.725) after propensity score matching. Mean TIVADs maintenance days were 627.3 days in NAS group and 697.6 days in NBCA group. There was no statistically significant difference in the number of TIVADs maintenance days between the two groups ( p = 0.081).

Conclusion:

In TIVADs implantation, skin closure using NBCA showed no difference in the occurrence of infectious complications compared with conventional non-absorbable skin suture.
Lessons learned from the COVID-19 pandemic: Using telemedicine for pre-operative surgical evaluation in breast disease
Authors: Stafford Arielle P , Hoskin Tanya L , Hieken Tina J , Sanders Stacy , Pruthi Sandhya , Boughey Judy , Degnim Amy
Published: August 2023

Background/Objectives

The COVID-19 pandemic motivated telemedicine care to decrease potential exposures for both patients and staff. We hypothesized that select breast surgical patients can be successfully evaluated pre-operatively with telemedicine.

Methods

With institutional review board approval, patients with telemedicine surgical consults between 1 March 2020 and 31 August 2020 were identified retrospectively from our prospective breast surgical registry. The frequency of successful pre-operative evaluation using telemedicine alone was assessed, defined as cases in which surgery was completed on the planned day without changes to the surgical plan after physical examination in the pre-operative area. Differences in disease presentation, patient characteristics, and complications were evaluated by whether the first in-person visit occurred on the day of surgery versus the prior.

Results

A total of 374 patients underwent breast surgery between 1 March 2020 and 31 August 2020, of which 96 (25.7%) had a telemedicine consultation. After the telemedicine visit, 38 patients (39.6%) had additional in-person visits with the breast surgeon prior to their operative date, and 58 patients (60.4%) did not. Forty-five patients underwent breast-conserving therapies, 41 mastectomies (25 with reconstruction), two axillary dissections, and eight excisional biopsies. All surgeries were completed on the planned operative day, with no changes in surgical plans. Patients with telemedicine only prior to surgery were more likely to speak English (100% vs. 92.1%, p = 0.02) and have lower body mass index (median 24.9 vs. 29.2, p = 0.01). The frequency of in-person pre-operative visits varied significantly by surgeon ( p < 0.001). Age, American Society of Anaesthesiologists score, distance from facility, clinical T/N category, surgery type, and complications did not differ between groups.

Conclusions

Telemedicine can be utilized successfully for select breast surgical patients, with the ability to proceed to surgery in the majority of patients without additional in-person visits.
Design and development of a Telemedicine Assessment Toolkit (TAT) for the assessment of audiovisual telemedicine encounters
Authors: Agbali Raphael , Andrew Balas E , Heboyan Vahe , Silva Jeane , Coughlin Steven , Beltrame Francesco , De Leo Gianluca
Published: August 2023

Although the use of audiovisual telemedicine has grown in recent years especially during recent COVID-19-related lockdowns, evidence shows there is still a lack of tools that can be used for the assessment of telemedicine encounters. The few validated questionnaires that are available for assessing telemedicine encounters are not often used. Non-validated questionnaires dominate research, leading to results that cannot be compared or extrapolated to other research or medical sites. Development of standard measures for the assessment of telemedicine encounters has been advocated by stakeholders. The objective of this study is to provide a comprehensive set of measures by developing a conceptual approach and a preliminary Telemedicine Assessment Toolkit (TAT) for the assessment of audiovisual telemedicine encounters. A two-step conceptual approach was used to identify potential domains and sub-domains by qualitative analysis of a pool of questions from studies published from 2016 to 2021. Questions were adopted from validated questionnaires or generated to represent the underlying concept of each sub-domain, resulting in a core block of comprehensive questions. A toolkit is proposed with question-measures that cover the sub-domains relevant to the assessment of telemedicine encounters. This study recommended 11 domains to be used for the assessment of telemedicine encounters: “usability,” “patient satisfaction,” “patient–provider interaction,” “patient perspectives,” “telemedicine readiness,” “qualitative feedback,” “comparison to standard (in-person) care,” “privacy,” “technology,” “patient feeling,” and “patient costs.” Of the 11 domains, 26 underlying sub-domains were created. From the subdomains, a 30-question core block was proposed. The core-block together with a precursor block aimed to retrieve demographic/patient characteristics and, together with a customizable clinical outcomes block, complete the comprehensive toolkit. The toolkit, upon testing and validation, would enable researchers and system owners to assess patient-oriented aspects of audiovisual telemedicine encounters more accurately and accelerate the adoption of common audiovisual telemedicine assessment measures.
Does L2 assessment make a difference? Testing the empirical validity of applied cognitive linguistics in the acquisition of the Spanish/L2 psych-verb construction
Authors: Martín-Gascón Beatriz , Llopis-García Reyes , Alonso-Aparicio Irene
Published: August 2023

This article lies within the field of applied cognitive linguistics (ACL) and presents empirical work that addresses overlooked effects of assessment typology in second language (L2) learning. It examines whether pairing a cognitive instructional approach with matching assessment design results in greater learning outcomes over the more pervasive notional-functional approaches. The last two decades have witnessed a proliferation of empirical research measuring the effectiveness of ACL-based teaching approaches, yet studies have only been partly fruitful in eliciting data that truly favors ACL. We argue that this is largely due to assessment design, which typically measures performance via correct vs. incorrect tasks. To overcome this caveat, two studies addressing the complex Spanish psych-verb construction (e.g. gustar ‘to like’) were conducted following a pretest/posttest/delayed-posttest design for three empirical conditions (control, cognitive, and traditional): a pilot study ( n = 59) and a larger replication ( n = 160). Data collection entailed ACL-based assessment for interpretation and production tasks. Results showed that after instruction, the cognitive group significantly outperformed the traditional counterpart in both tasks. These findings lend support to the effectiveness of pairing cognitive instruction and cognitive assessment for difficult grammatical constructions.
Evaluation of a culturally adapted reminiscence therapy intervention: Improving mood, family and community connectedness in Spanish- and Vietnamese-speaking older adults
Authors: Diwan Sadhna , Eliazar Angelica , Pham Duy , Fuentes Maria
Published: August 2023

Reminiscence therapy (RT) is an evidence-based treatment for alleviating depression and improving life satisfaction among elders, yet less is known about its efficacy in diverse ethnic groups. We report on the evaluation of a cultural adaptation of the RT intervention that combines reminiscence with three innovative elements: including family members in RT; conducting community events for participants to present their artwork and life-story books created during the intervention; and using ethnically matched bilingual community workers. The 12-week intervention with pre- and post-test assessments was completed by 73 Hispanic and 92 Vietnamese elders (mean age  =  75 years; 62% female; mostly foreign-born, with limited English proficiency). Paired t-tests indicated statistically significant improvement in depression, loneliness, and life satisfaction. Sixty-two percent of participants noted improved relationships with family/friends through improved communication and shared understanding of the participant's life story. Fifty percent of respondents participated in a community event and the qualitative comments noted improved connection with their community through listening to others’ life experiences and sharing their own. Participant perceptions of ethnically matched community workers were positive, but several indicated they could work with someone from a different ethnic background. Similar to general RT findings, the culturally adapted RT intervention demonstrated improvement in depression, loneliness, and life satisfaction among elders from two different ethnic backgrounds. Implications for future projects are discussed based on the findings and experience of conducting this intervention.
Advocacy for territorial and people-centered approaches to development in Romania: Place attachment based on industrial heritage
Authors: Ilovan Oana-Ramona , Mutică Paul
Published: August 2023

This research focuses on the stories of two small yet unique settlements in Transylvania, Romania: the town of Petrila and the village of Roșia Montană, former mining settlements, currently deemed disadvantaged. Our research inquires about the relevance of their industrial heritage for inhabitants’ place attachment during a long-term process of resistance to neoliberal development and change that caused the partial loss of material and immaterial heritage. We used qualitative discourse analysis to process inhabitants’ accounts in two documentaries: Planeta Petrila and Roșia Montană, a Place on the Brink. Our findings show that place attachment is very strong and painful with many of the locals and is closely connected to industrial heritage and the past. Both industrial heritage and inhabitants’ place attachment based on this heritage are crucial resources for any future strategy that considers territorial and people-centered approaches to development, within a paradigm of sustainability and inclusiveness.
System fragility evaluation of a curved highway bridge structure considering multi-direction seismic excitations
Authors: Rashid Muhammad , Nishio Mayuko
Published: August 2023

This paper presents the impact of varying the input seismic excitation directions on the system fragility of a geometrically complex highway bridge structure. The traditional approach of fragility derivation in the principal loading directions (longitudinal and transverse) results in an under/overestimation of the system fragility. To reduce such errors, the contribution of all major vulnerable components to the system fragility in the critical loading direction must be considered. For this purpose, a series of nonlinear time-history analyses were conducted for a testbed configured geometrically curved highway bridge structure in Japan. Shear strain, ductility, and distortion strain were considered as engineering demand parameters for bearings, concrete pier, and steel piers, respectively. The demand dependency among the components was considered using the correlation coefficient matrix for fragility estimation. Subsequently, fragility functions with respect to the input loading directions were generated for the bridge components and system to quantify their sensitivity to seismic input excitation directions. The results show that the component fragility is significantly influenced by the input excitation direction. A relative comparison of the system fragility for different loading directions indicated that a 150° loading direction yielded a higher fragility demand. The findings suggest that the critical fragility assessment should not always be decided only along the principal loading directions.
From attention to action: How board environmental expertise influences corporate environmental performance
Authors: Asad Sarosh , Hennig Jan C , Oehmichen Jana , Wolff Michael , Haas Veronika
Published: August 2023

How do board environmental experts influence corporate environmental performance? Drawing on the advisory role of the board, we examine this question and propose that board environmental expertise fosters attention toward stakeholders through the development of decision-makers’ knowledge structures and the identification of opportunities to address a wider range of stakeholders, ultimately contributing to stronger stakeholder orientation. In addition, we theorize that board environmental expertise fosters substantive actions toward environmental performance by reducing information asymmetry and accurately assessing the risks of investing in pro-environmental initiatives. We also consider how the effects unfold in different institutional contexts. We theorize and find that national stakeholder salience increases attention pressure toward stakeholders and that environment-oriented legislation adds to the action pressure toward environmental performance. Our results, based on 11,634 firm-year observations from 15 countries between 2003 and 2016, support our theoretical predictions.
Mandating COVID-19 Vaccination on Campus: A Qualitative Analysis of a Cross-Sectional Study of California College Students
Authors: Buckner-Capone Anji , Dougan Marcelle
Published: August 2023

The purpose of this study was to examine college student perceptions related to institutional vaccine mandates. We utilized qualitative data ( n = 2,212) from five open-ended questions in a cross-sectional study of students enrolled or intending to enroll in an institute of higher education in California in fall 2021. Data were collected between June and August 2021. Thematic analysis was employed to analyze student beliefs, and four themes were developed from the data: (1) Polarizing views and language, (2) deciding who to trust, (3) conveying rights and risk, and (4) staying focused on education. The themes represented vaccinated and nonvaccinated student perspectives, capturing views about trust, rights, and risk. Many responses were polarizing and included language that was emotional and political. Despite the range of responses, most students expressed appreciation and approval of the vaccination mandate on college campuses. Findings illustrate the important contributions of qualitative research and suggest opportunities for public health practitioners to lead and engage in critical dialogue about science and public health practices as we aim to promote public perceptions of vaccination programs and health promotion practice.
Effect of Traditional Korean Medicine Oncotherapy on the Survival, Quality of Life, and Telomere Length: A Prospective Cohort Study
Authors: Ha Su-Jung , Kwag Eunbin , Kim Soodam , Park Ji-Hye , Park So-Jung , Yoo Hwa-Seung
Published: August 2023

A 4-year prospective cohort study on patients with lung, gastric, hepatic, colorectal, breast, uterine, and ovarian cancer was conducted at the East-West Cancer Center (EWCC) of Daejeon Korean Medicine Hospital in Daejeon, Korea. We divided patients into 2 groups based on how long they had been receiving TKM oncotherapy and compared event-free survival (EFS), telomere length change, and quality of life (QoL). The study collected data on 83 patients from October 2016 to June 2020 and discovered no statistical differences in EFS based on the duration of TKM oncotherapy. In the analysis of changes in QoL outcomes, there were no statistically significant group differences between the groups. After controlling for covariates that could affect telomere length, the long-term TKM oncotherapy group had a higher daily telomere attrition rate. The study of the relationship between telomere length and prognostic factors discovered that patients with advanced N stage at the time of diagnosis and who had previously received radiotherapy had shorter telomere length. When examining associations between SNP genotype and percentile score of telomere length, this study was able to confirm an association between telomere length and rs4387287. This study is significant because it is the first to assess the effects of TKM oncotherapy and investigate telomere length-related factors. To assess the effects of TKM oncotherapy on cancer patients’ survival and QoL, a longer-term observational study with a larger sample size is required.
We Challenged the Kellgren and Lawrence Radiographic Scoring Method and Came Up With Some Interesting Epidemiology for Osteoarthritis of the Hip
Authors: Lane Nancy E.
Published: August 2023

The study of hip osteoarthritis (OA) was slowed due to a lack of a good definition of radiographic hip OA (RHOA). The radiographic changes that occur in hip OA include both joint space narrowing and femoral head osteophytes in the early stages of the disease. This differs from OA of the knee, in which radiographic OA changes initially include osteophytes and only much later is joint space narrowing considered. The modified Croft Score is a novel scoring method for the hip that includes an equal weighting of femoral osteophytes and joint space narrowing. It is used to evaluate the epidemiology of prevalent, incident, and progressive RHOA. Use of the Croft Score found that mild changes in the femoral head or acetabulum could increase the risk of incident RHOA. Pioneering research on active shape modeling was undertaken to provide a more comprehensive assessment of hip shape and define actual femoral head shapes that increased the risk of RHOA. After defining RHOA, investigators found several risk factors, which included higher total hip bone mineral density and polymorphisms of the wnt/β-catenin signaling pathway, to be significant predictors of RHOA in elderly white women. Recently, it was found that RHOA was a strong risk factor for both all-cause mortality and cardiovascular disease mortality in elderly women.
Controls, comparator arms, and designs for critical care comparative effectiveness research: It’s complicated
Authors: Ford Verity J , Klein Harvey G , Danner Robert L , Applefeld Willard N , Wang Jeffrey , Cortes-Puch Irene , Eichacker Peter Q , Natanson Charles
Published: August 2023

Background

Comparative effectiveness research is meant to determine which commonly employed medical interventions are most beneficial, least harmful, and/or most costly in a real-world setting. While the objectives for comparative effectiveness research are clear, the field has failed to develop either a uniform definition of comparative effectiveness research or an appropriate set of recommendations to provide standards for the design of critical care comparative effectiveness research trials, spurring controversy in recent years. The insertion of non-representative control and/or comparator arm subjects into critical care comparative effectiveness research trials can threaten trial subjects’ safety. Nonetheless, the broader scientific community does not always appreciate the importance of defining and maintaining critical care practices during a trial, especially when vulnerable, critically ill populations are studied. Consequently, critical care comparative effectiveness research trials sometimes lack properly constructed control or active comparator arms altogether and/or suffer from the inclusion of “unusual critical care” that may adversely affect groups enrolled in one or more arms. This oversight has led to critical care comparative effectiveness research trial designs that impair informed consent, confound interpretation of trial results, and increase the risk of harm for trial participants.

Methods/Examples

We propose a novel approach to performing critical care comparative effectiveness research trials that mandates the documentation of critical care practices prior to trial initiation. We also classify the most common types of critical care comparative effectiveness research trials, as well as the most frequent errors in trial design. We present examples of these design flaws drawn from past and recently published trials as well as examples of trials that avoided those errors. Finally, we summarize strategies employed successfully in well-designed trials, in hopes of suggesting a comprehensive standard for the field.

Conclusion

Flawed critical care comparative effectiveness research trial designs can lead to unsound trial conclusions, compromise informed consent, and increase risks to research subjects, undermining the major goal of comparative effectiveness research: to inform current practice. Well-constructed control and comparator arms comprise indispensable elements of critical care comparative effectiveness research trials, key to improving the trials’ safety and to generating trial results likely to improve patient outcomes in clinical practice.
Right place, no trace: A case report of postintubation bronchospasm
Authors: King James P , Natarajan Nagendra K
Published: August 2023

Evidence suggests obesity correlates with airway hyperreactivity, which can result in severe bronchospasm. This report presents a 31-year-old female with a high body mass index who presented for a laparoscopic hysterectomy and bilateral salpingo-oophorectomy. She had no past medical or atopic history. After induction of anaesthesia and intubation, O2 saturation fell with no CO2 trace, breathing sounds or chest rise. Despite confirming endotracheal tube position by video laryngoscopy, the CO2 trace remained flat and mechanical ventilation was difficult with high airway pressures. Blood pressure was stable with no mucocutaneous signs of anaphylaxis. Administration of 100% O2, bronchodilators and steroids improved ventilation and oxygenation with a return of a CO2 trace. The operation was postponed. Prior to her subsequent surgery, the patient was premedicated with inhaled steroids and long-acting beta agonist with an uneventful induction and intubation. Giving a rising obese population, this case report aims to educate anaesthetists and anaesthetic practitioners as to the presentation, risk factors, mechanisms and management of uncommon, life-threatening postintubation bronchospasm.
Grandmothers – a cultural resource for women and children’s health and well-being across the life cycle
Authors: Aubel Judi
Published: August 2023

Grandmothers exist in all societies. Especially in the non-western Majority World, where Elders are both highly respected and responsible for transmitting their knowledge to younger generations, there is extensive anecdotal evidence of Grandmothers’ role in health promotion and healing. However, due to Eurocentric and reductionist views of families and communities, in the extensive past research on maternal, child and adolescent health issues across Africa, Asia, Latin America and the Middle East, and in Indigenous societies in North America, Australia and New Zealand, scant attention has been given to the role of Grandmothers. This paper addresses this oversight and supports the imperative to decolonize health promotion in the non-western world by building on non-western worldviews, roles and values. Based on an eclectic body of both published and gray literature, this review presents extensive evidence of Grandmothers’ involvement across the life cycle of women and children and of the similar core roles that they play across cultures. While in some cases Grandmothers have a negative influence, in most cases their involvement and support to younger women and children is beneficial in terms of both their advisory and their caregiving roles. For future research and interventions addressing maternal, child and adolescent health, the conclusions of this review provide strong support for: adoption of a family systems framework to identify both gender-specific and generation-specific roles and influence; and the inclusion of Grandmothers in community health promotion programs dealing with different phases of the life cycle of women and children.