bluuebunny/crossref_metadata_2025 huggingface dataset:
“Fear of the Unknown”: Coparenting With an Incarcerated Individual
Authors: Tadros Eman , Presley Sarah
Published: June 2022

Over 2.2 million individuals are currently incarcerated in prisons and jails across the United States. Having a family member incarcerated impacts the entire family system. Recent research has shown the relational consequences of incarceration, such as adjusting to and negotiating new rules and roles within the coparenting relationship. The coparenting relationship is multifaceted and necessitates empirical evidence that significantly honors the voices that are at the center of experience but typically silenced by the stigma and prejudice nature of incarceration and its coinciding consequences. Coparenting partners of incarcerated individuals were interviewed to understand the lived experience of incarcerated coparenting using a phenomenological approach. Four themes (positive relationship, stigma, seeking and providing support, and impact of incarceration) emerged from eleven interviews. Implications are provided on how to best advocate for this population through research, clinical work, and policy.
The COVID-19 Pandemic and the Gender Gap in Newly Created Domains of Household Labor
Authors: Abromaviciute Jurgita , Carian Emily K.
Published: June 2022

In this study, we draw on interview data from 62 matched different-sex, dual-career spouses raising young children to examine the mechanisms behind the gender gap in household labor during the COVID-19 pandemic. We argue that the pandemic represents a unique case of social uncertainty and an opportunity to observe how structural conditions shape the gendered division of household labor. We find that under the rapid social transformation imposed by the pandemic, gender serves as an anchor and orienting frame for couples with young children. We argue that the pandemic (1) expanded traditional gender expectations to new domains of household labor and (2) heightened the importance of gendered explanations for the division of labor that justified intra-couple inequality. Our findings suggest that the particular structural conditions that characterize different times of uncertainty work through slightly different mechanisms, yet produce the same outcome: gender inequality, with long-lasting and wide-ranging implications.
Remote Teaching of Multidigit Multiplication for Students With Learning Disabilities
Authors: Flores Margaret M. , Hinton Vanessa M. , Blanton Erin Noelle
Published: June 2022

State standards include fluent use of standard computational algorithms. However, learning and using them require conceptual understanding of numbers and operations. Previous research using the concrete–representational–abstract (CRA) sequence has been effective in teaching computational algorithms to students at risk of and students with learning disabilities by emphasizing conceptual understanding. However, all the research was face-to-face and few captured the impact of the intervention on students’ conceptual understanding. The current study occurred during the COVID-19 pandemic, so researchers modified CRA for remote instruction. This study investigated the effects of modified CRA on the fluency and accuracy of three sixth-grade students with learning disabilities. They also included an assessment of conceptual understanding. The researchers used a multiple probe across participants design, demonstrating a functional relation between CRA and students’ fluency and accuracy. Researchers assessed conceptual understanding with informal measures that required application of their conceptual understanding. The results and implications are discussed.
A full-scale black soldier fly larvae (Hermetia illucens) bioconversion system for domestic biodegradable wastes to resource
Authors: Yang-Jie Deng , Xiang Fang-Ming , Tao Xing-Hua , Jiang Cheng-Liang , Zhang Ting-Zhou , Zhang Zhi-Jian
Published: June 2022

Domestic biodegradable wastes (DBW) pose a threat to environmental quality and human health. Bioconversion via black soldier fly larvae (BSFL; Hermitia illucens L.) is an expedient way for converting ‘waste to resource’ (insect protein and biofertilizer). Although researches abounded in laboratory-reared experiments and bioconversion mechanisms were pertinent, the void of data from actual and full-scale operation restricts the intensification of BSFL technology and its global adoption. Hence, a full-scale BSFL bioconversion system lasting 4 years in Hangzhou (China) was investigated, and the feasibility and efficiency of 15 tonnes of DBW per day were studied. Through continuous technical optimization, the average production of fresh larvae was increased from 8.5% in 2017 to 15.3% in 2020, along with bioconversion rate of final vermicompost decreased from 35.4% to 14.5%. The total biomass reduction rate in 2020 was 68.7 ± 17.4 kg/(m3 d), equivalent to 0.735 ± 0.215 kg/(kg d) in the form of fresh larvae. Crude fat in fresh larvae accounted for 13.4%, and crude protein accounted for 16.2% in which the determined amino acid profile bore a strong resemblance to fish meal only except histidine and tyrosine. Its economic benefits proved the feasibility of this technology, and the profit reached up to 35.9 US$ per tonne of DBW in 2019. In conclusion, BSFL bioconversion system under current ‘insect-farm’ operation was a promising solution for DBW treatment with value-added waste recycling.
The normalisation of the far right in the Dutch media in the run-up to the 2021 general elections
Authors: de Jonge Léonie , Gaufman Elizaveta
Published: June 2022

Although there is widespread agreement in the literature that the media play an instrumental role in furthering or limiting the spread of right-wing populism, there are few studies that examine the micro-mechanisms at play that facilitate the normalisation of the far right in and by the media. This contribution seeks to redress that gap. Focussing in particular on the Netherlands, we trace the ways in which the media have accommodated populist radical right politicians and their parties in the run-up to the 2021 Dutch general elections, thereby discursively shifting the boundaries of what is considered appropriate or ‘normal’. We do so by concentrating on the far-right political newcomer, Thierry Baudet, who is the leader of the Forum voor Democratie (Forum for Democracy or FvD, also referred to as Forum). Using discourse-conceptual analysis of Dutch newspaper articles, the article provides illustrative evidence that Dutch mainstream media outlets adopted an accommodative stance towards Baudet and his party in the run-up to the elections. The findings suggest that this media strategy contributed to the normalisation of the far right in the Dutch public sphere.
Feminine sexuality, religiousness and psychotic distress: Tracing a pattern
Authors: Georgaca Eugenie , Fenekou Vasiliki , Katsouli Aikaterini , Kyriakou-Chatziapostolou Evangelia
Published: June 2022

This paper describes a pattern regarding the relationship between feminine sexuality, religiousness and psychotic distress that was discerned in two independent multiple case studies in Greece. One study utilized grounded theory to develop a model of therapeutic change through recording the development of voice hearers’ understanding and coping with their voices during a therapeutic intervention. The other study applied biographical and thematic analysis to interviews with persons with psychosis and their families, in order to explore family narratives regarding life with a family member with psychosis. A common pattern was detected for all the female participants, whereby following a religious upbringing in childhood and pursuing independence from the family together with social and sexual exploration in early adulthood, the onset of psychosis marked a return to the family home and a religious frame of reference. The psychotic experiences seemed to resemble engrained experiences of shaming regarding sexual and gender norms. Moreover, they had the effect of re-signifying female identity and sexuality, bringing them into line with conservative religious principles. This pattern suggests that psychotic experiences may not only express culturally prescribed female gender norms but also may serve to regulate women’s sexuality in conservative religious cultural environments.
Examining Medicaid Participation and Medicaid Entry Among Senior Medicare Beneficiaries With Linked Administrative and Survey Data
Authors: Garrow Renee , Mellor Jennifer M. , McInerney Melissa , Sabik Lindsay M.
Published: June 2022

Because Medicare beneficiaries can qualify for Medicaid through several pathways, duals who newly enroll in Medicaid may have experienced various financial and/or health changes that impact their Medicaid eligibility. Alternatively, new enrollment could reflect changes in awareness of the program among those previously eligible. Using monthly enrollment data linked to Health and Retirement Study survey data, we examine financial and health changes that occur around the time new Medicaid participants enter the program, and we compare those with changes experienced by both those continuously enrolled in Medicaid and those not enrolled. We find that Medicaid entry is often timed with a marked increase in out-of-pocket medical expenses, a substantial decrease in assets for some, and increases in activities of daily living (ADL) limitations. We also observe financial changes among persons continuously enrolled in Medicaid. Our results inform discussions about Medicaid eligibility policies and potential gaps in the protection that Medicaid offers from financial risk.
C-Reactive Protein and Specific Depression Symptoms Among Older Adults: An Exploratory Investigation of Multi-Plane Networks Using Cross-Sectional Data From NHANES (2017–2020)
Authors: Lee Chiyoung , Min Se Hee , Niitsu Kosuke
Published: June 2022

Introduction

Studies investigating the association between C-reactive protein (CRP) and depression among older adults have yielded inconsistent results. We suspect that this may be due to varying associations between CRP and particular depression symptom criteria, and we addressed this challenge using network analysis.

Methods

We used cross-sectional data from prepandemic National Health and Nutrition Examination Survey questionnaires (2017–2020) and included a sample of 1698 adults aged 65 years or older. Depression symptoms were assessed using the Patient Health Questionnaire-9. Unregularized Mixed Graphical Models were estimated using the R package mgm before and after adjusting for relevant sociodemographic, clinical, and lifestyle covariates.

Results

In the model with no covariates, the only symptom criterion associated with CRP was “appetite problems.” This association remained robust after controlling for all covariates. Although not associated with CRP, other criteria such as “fatigue” and “concentration difficulty” showed associations with important covariates for older adults such as white blood cell count or hemoglobin, respectively.

Discussion

The CRP-related variability in the depression symptom network that we have demonstrated may help explain the reported inconsistencies. The present study stands as exploratory, and future research should focus on applying longitudinal designs and including several other inflammatory proteins and covariates that were not measured in the current network model.
Why Architecture?
Authors: McCarthy Christine
Published: June 2022

This paper is the introduction to the Space and Culture special issue “Inside inside,” which examines the persistent use of architecture as punishment. It provides an overview of the use of architecture as punishment with specific reference to Anglo-American prison architecture. It additionally examines developments occurring in architecture and the architectural profession contemporary with the emergence of the modern prison and acknowledges the geospatial politics of Guantánamo Bay Detention Center on the year of its 20th anniversary.
Patterns of longitudinal medical treatment of pediatric patients ever-diagnosed with attention deficit hyperactive disorder: A community-based, retrospective, naturalistic study
Authors: Ben Shoham Assaf , Shefer Galit , Tsafrir Shlomit
Published: June 2022

Background

Pharmacological treatment for ADHD exhibits much variation. Longitudinal prescription-filling trajectories are interesting objects to explore. The goal of this study is to identify distinct patterns of longitudinal prescription filling among pediatric patients who were ever diagnosed with ADHD.

Methods

Longitudinal data of ADHD-specific prescription filling during 2010–2019 of children diagnosed with ADHD during 2000–2019 who were 4–17-years-old at the time of diagnosis was obtained. Clustering of prescription-filling vectors was performed using K-means.

Results

Analysis of 57,110 prescription vectors yields five distinct patterns: high intensity treatment, from early childhood to late teens (5.7%); moderate intensity, from early childhood to late teens (13.3%); high intensity, from late childhood to late teens (6.1%); moderate intensity, from late childhood to late teens (14.2%); and low intensity, sporadic treatment (60.7%). These patterns correspond with observed clinical presentations.

Conclusions

Identifying longitudinal prescription-filling patterns substantiates and qualifies the variation in long-term efficacy of pharmacological treatment for ADHD in a treatment-as-usual community setting. Prescription-filling implies that symptoms are present, and that treatment is efficacious, as perceived by parents' and carers. Prolonged pharmacological treatment was perceived to have had a positive net value for 40% of the children, which under appropriate reservations, provides weak evidence of efficacy.
Effects of Preoperative Radiotherapy on Long-Term Bowel Function in Patients With Rectal Cancer Treated With Anterior Resection: A Systematic Review and Meta-analysis
Authors: Liang Zongyu , Zhang Zhaojun , Wu Deqing , Huang Chengzhi , Chen Xin , Hu Weixian , Wang Junjiang , Feng Xingyu , Yao Xueqing
Published: June 2022

Background: Anterior resection is a common surgical approach used in rectal cancer surgery; however, this procedure is known to cause bowel injury and dysfunction. Neoadjuvant therapy is widely used in patients with locally advanced rectal cancer. In this study, we determined the effect of preoperative radiotherapy on long-term bowel function in patients who underwent anterior resection for treatment of rectal cancer. Methods: We performed a comprehensive literature search of the PubMed, Embase, Web of Science, and the Cochrane Library databases. A random-effects model was used in the meta-analysis by the Review Manager software, version 5.3. Results: This systematic review and meta-analysis included 12 studies, which used low anterior resection syndrome score with a total of 2349 patients. Based on them, we concluded that low anterior resection syndrome was significantly more common in the preoperative radiotherapy group (odds ratio 3.59, 95% confidence interval 2.68-4.81, P < .00001) and that major low anterior resection syndrome also occurred significantly more frequently in the preoperative radiotherapy group (odds ratio 3.28, 95% confidence interval 2.05-5.26, P < .00001). Subgroup analyses of long-course radiation, total mesorectal excision, and non-metastatic tumors were performed, and the results met the conclusions of the primary outcomes. Conclusions: Preoperative radiotherapy negatively affects long-term bowel function in patients who undergo anterior resection for rectal cancer.
Progesterone Receptor Membrane Component-1 May Promote Survival of Human Brain Microvascular Endothelial Cells in Alzheimer’s Disease
Authors: Xu Xin , Ruan Xiangyan , Ju Rui , Wang Zhikun , Yang Yu , Cheng Jiaojiao , Gu Muqing , Mueck Alfred O.
Published: June 2022

Cerebrovascular changes occur in Alzheimer’s disease (AD). The progesterone receptor membrane component-1 (PGRMC1) is a well identified hormone receptor with multiple functions in AD. This study aims to explore the involvement of PGRMC1 in the regulation of vascular endothelial function, providing new therapy options for AD. Single-cell sequencing revealed that the expression of PGRMC1 is lower in AD. By bioinformatics analysis, we found PGRMC1 was associated with regulation of cell proliferation, angiogenesis and etc. To understand the functional significance of PGRMC1, knockdown and overexpression were performed using human brain microvascular endothelial cells (HBMVECs), respectively. Cell proliferation assay, migration assay, tube formation assay were performed in experiments. We demonstrated that the overexpression of PGRMC1 promoted the cellular processes associated with endothelia cell proliferation, migration, and angiogenesis, significantly. In conclusion, PGRMC1 may contribute to the modulation of HBMVECs function in AD. This finding may offer novel targets for AD treatment.
Invisible ghosts of care and penality: Exploring Canadian correctional workers’ perceptions of prisoner well-being, accountability and power
Authors: Johnston Matthew S , Ricciardelli Rosemary
Published: June 2022

Much correctional work is generally misunderstood by the mainstream media and many public circles as solely punitive and authoritative, which has fueled many politicized outcomes for correctional policy, practice and intervention. Reasonably, critical criminological discourse is steered primarily by the perspectives and voices of prisoners and victims. Yet this privileging leaves many questions remaining about how correctional workers in the contemporary era negotiate their complex duties of both prisoner care and accountability. Drawing on data garnered from open-ended survey responses of provincial and territorial correctional employees (n = 876) in Canada, we explore how Canadian correctional workers balance their emotional and occupational framework and perspectives with integrity. Informed through a lens of emotional labour, we find that many Canadian correctional workers recognize the need for, and gap in, prisoner care, mental health and rehabilitation, while also problematizing the shift and decline in prisoner accountability, which they believe jeopardizes both correctional worker and prisoner safety. We discuss the implications our findings present in relation to questions of power and control in prison spaces.
When to suspect dementia
Authors: Morris Charlotte , Tomkow Louise , Blakeman Thomas
Published: June 2022

With global dementia cases approaching 50 000 000, the importance of early and accurate diagnosis is crucial. Primary care clinicians are often the initial point of contact for people, their family and caregivers when dementia is first suspected. People who suspect they, or their loved one, may have dementia often experience significant fear and distress. Timely and accurate diagnosis, with an honest but compassionate discussion of dementia and its prognosis, may alleviate some distress by reducing time to diagnosis. Timely diagnosis may also enable opportunities to use disease-limiting treatments, reduce unnecessary testing and investigations and provides an opportunity to undertake advance care planning.
Patient-reported outcome measures in MS: Do development processes and patient involvement support valid quantification of clinically important variables?
Authors: Bharadia Trishna , Vandercappellen Jo , Chitnis Tanuja , Eelen Piet , Bauer Birgit , Brichetto Giampaolo , Lloyd Andrew , Schmidt Hollie , King Miriam , Fitzgerald Jennifer , Hach Thomas , Hobart Jeremy
Published: June 2022

Background

Patient-reported outcomes (PROs) are widely measured in multiple sclerosis (MS) studies. However, the quality of instrument development processes varies, raising concerns about the meaningfulness of associated data.

Objectives

To review the development of selected PROs commonly used in MS studies, including definitions of the concepts measured, use of conceptual frameworks, and degree of input from people living with MS (PlwMS). To gain insights and recommendations from PlwMS on their experience with these PROs.

Methods

We assessed 6 PROs (FSIQ-RMS, modified-FIS, MSQoL-54, Leeds 8-item MSQoL, MSIS-29 and EQ-5D) for alignment with regulatory and scientific requirements on PRO structure/development. PlwMS evaluated the degree to which the PROs reflect disease aspects they perceive important.

Results

Definitions, clarifications and conceptualisations of the measurement variables were often lacking. PlwMS were variably involved in PRO development. Ethnic diversity was rarely documented. PlwMS identified individualisation, ease of understanding, time burden, and mode of administration as factors affecting PRO usability.

Conclusions

To date, the PRO development process has consistently lacked clear definitions of concepts of interest, use of conceptual frameworks and patient involvement, thereby compromising the validity of data they generate. PRO instrument development must be conducted more robustly to maximise the value of pivotal clinical trials.
Understanding the Reasons of Decline of Pasmanda Movement: Insights from a Region
Authors: Alam Shamsher
Published: June 2022

The Pasmanda Movement is nearly a 100-year-old discourse. However, this movement is not competent enough to unite Muslims, particularly the Pasmanda Muslims, under one banner. It could not develop as a vigorous sociopolitical movement to gain political benefit. In this context, this article attempts to divulge the causes of its deterioration. Analysing so, it tries to trace the unity among Muslims with regard to this discourse. This article also attempts to understand the political philosophy of this movement. This article aims to underline the protests managed by the followers of the movement regarding the Scheduled Caste status for Dalit Muslims. It highlights the assertion of movement in the upsurge of right-wing and secular versus communal politics. This also strives to understand the nature of this discourse in terms of its independency. This article analyses its silence upon the orthodoxy among the Muslim community and their activism through social media to continue this movement.
Management of Frontal Bone Fracture in the Pediatric Population: A Literature Review
Authors: Ho Kelly , Larson Jordan H. , Reid Russell R. , Naran Sanjay
Published: June 2022

Background:

The purpose of this study was to review the published literature in an effort to compare conservative and surgical interventions for pediatric frontal bone fractures and to create a treatment schematic that would result in the lowest morbidity.

Methods:

A literature review was performed to evaluate all publications related to frontal bone fracture treatments in the pediatric population. Patient age, fracture location, treatment modality, and complications were analyzed to elucidate whether conservative or surgical management is better for pediatric frontal bone fractures and to determine which type of management yields the lowest morbidity.

Results:

Sixteen articles met inclusion criteria. 88.89% of the included patients who underwent surgical repair did not experience any postoperative complications. The surgical treatments employed included craniotomy, implantation of custom macroporous hydroxyapatite prostheses, split calvarial graft, cranialization, and open reduction and internal fixation with either non-resorbable or resorbable plating systems. There were 17 cases of frontal bone fractures that were treated conservatively. Eleven of the 17 cases (61.1%) that were initially treated with conservative management resulted in complications; either a growing fracture or infection.

Conclusions:

No clear treatment algorithm for frontal bone fractures in each pediatric age group could be generated from the published literature. We likewise could not determine a clear distinction between the indications for conservative versus surgical management. However, we were able to conclude that primary surgical management for pediatric frontal bone fractures yields high success rates and few complications, regardless of the patient’s age.
Decreasing Skin Breakdown Around Central Lines in Patients Receiving Thiotepa Prior to Bone Marrow Transplantation
Authors: Melhorn Jami L. , Burkett Marnie
Published: June 2022

Skin breakdown occurring around central line dressings increases the risk for infection and bacteremia in all patients. The risk is magnified when experienced in pediatric patients receiving marrow-ablative therapy. A staff nurse on an inpatient pediatric oncology and bone marrow transplant unit noted an increased incidence of skin breakdown around central line dressings in patients receiving Thiotepa prior to bone marrow transplantation. Although there is a wealth of information surrounding routine care of central venous access devices, there is little evidence surrounding care with impaired skin integrity. A staff nurse turned to expert opinion and consensus revealed the use of nonocclusive dressings for central lines. A new protocol for changing central line dressings was developed to decrease the rate of skin breakdown. The protocol utilized gauze and a self-adherent wrap instead of tape to secure central lines. Bone marrow transplant staff nurses were educated prior to the practice change, and compliance was monitored through observation and review of documentation in the electronic medical record. A retrospective chart review compared the rate of skin breakdown and central line associated blood stream infections pre- and postpractice change. The overall percentage of skin breakdown surrounding central lines was reduced by over 80%.
Bacterial diversity in Haemagogus leucocelaenus (Diptera: Culicidae) from Vale do Ribeira, São Paulo, Brazil
Authors: da Silva Herculano , Oliveira Tatiane M. P. , Sabino Ester C. , Alonso Diego Peres , Sallum Maria Anice M.
Published: June 2022

Introduction

Mosquitoes (Diptera: Culicidae) are vectors that transmit numerous pathogens to humans and other vertebrates. Haemagogus leucocelaenus is a mosquito associated with transmission of yellow fever virus. The insect gut harbors a variety of microorganisms that can live and multiply within it, thus contributing to digestion, nutrition, and development of its host. The composition of bacterial communities in mosquitoes can be influenced by both biotic and abiotic factors. The goal of this study was to investigate the bacterial diversity of Hg. leucocelaenus and verify the differences between the bacterial communities in Hg. leucocelaenus from three different locations in the Atlantic tropical rain forest and southeastern state of São Paulo State, Brazil.

Results

The phylum Proteobacteria was found in mosquitoes collected from the three selected study sites. More than 50% of the contigs belong to Wolbachia, followed by 5% Swaminathania, and 3% Acinetobacter. The genus Serratia was found in samples from two locations.

Conclusions

Wolbachia was reported for the first time in this species and may indicates that the vector competence of the populations of the species can vary along its geographical distribution area. The presence of Serratia might facilitate viral invasion caused by the disruption of the midgut barrier via action of the SmEnhancin protein, which digests the mucins present in the intestinal epithelium.
Risk factors of postoperative septic cardiomyopathy in perioperative sepsis patients
Authors: Xin Yuchang , Ge Ying , Chang Liuhui , Ni Yong , Liu Hairui , Zhu Jiang
Published: June 2022

Objective

This study aimed to clarify the relevant risk factors of septic cardiomyopathy (SCM) in perioperative sepsis patients.

Methods

This retrospective study evaluated patients who were diagnosed with sepsis during the perioperative period and postoperatively admitted to the intensive care unit (ICU) in the Second Affiliated Hospital of Soochow University, the First Affiliated Hospital of Soochow University, and the Suzhou Municipal Hospital between January 2017 and November 2020. They were divided into two groups as the septic cardiomyopathy group (SCM group) and the non-SCM group (NSCM group). Factors with P < 0.1 were compared between groups and were analyzed by multivariate logistic regression to screen the risk factors of sepsis cardiomyopathy. The area under the receiver operating characteristic (ROC) curve was used to verify the discriminative ability of multivariate logistic regression results. Hosmer-Lemeshow goodness of fit test was used to verify the calibration ability of multiple logistic regression results.

Result

Among the 269 patients, 49 patients had SCM. Sequential Organ Failure Assessment (SOFA) score (adjusted odds ratio [AOR] = 2.535, 95% confidence interval (CI): 1.186-1.821, P = 0.000]) and endoscopic surgery (AOR = 3.154, 95% CI: 1.173-8.477, P = 0.023]) were identified to be independent risk factors for SCM. Patients with a SOFA score ≥ 7 had a 46.831-fold higher risk of SCM (AOR =46.831, 95% CI: 10.511-208.662, P < 0.05). The multivariate logistic regression results had good discriminative (area under the curve: 0.902 [95% CI: 0.852-0.953]) and calibration (c2 = 4.401, P = 0.819) capabilities. The predictive accuracy was 86.2%. The rates of mechanical ventilation and tracheotomy were significantly higher in the SCM group than in the NSCM group (both P < 0.05). The SCM group also had a significantly longer duration of mechanical ventilation (P < 0.05) and significantly higher rates of continuous renal replacement therapy (CRRT) and CRRT-related mortality (P < 0.05). Further, the total length of stay and hospitalization cost were significantly higher in the SCM group than in the NSCM group (P < 0.05).

Conclusion

Endoscopic surgery and SOFA score ≥ 7 during postoperative ICU admission were independent risk factors for SCM within 48 hours postoperatively in patients with perioperative sepsis.
The priorities, challenges, and scope of clinical communication teaching perceived by clinicians from different disciplines: a Hong Kong case study
Authors: Pun Jack
Published: June 2022

Background

In the absence of a well-rounded syllabus that emphasises both interpersonal and medical dimensions in clinical communication, medical students in the early stages of their career may find it challenging to effectively communicate with patients, especially when dealing with perceived priorities and challenges across different disciplines.

Methods

To explore the priorities, challenges, and scope of clinical communication teaching as perceived by clinicians from different clinical disciplines, we recruited nine medical educators, all experienced frontline clinicians, from eight disciplines across seven hospitals and two medical schools in Hong Kong. They were interviewed on their clinical communication teaching in the Hong Kong context, specifically its priorities, challenges, and scope. We then performed interpretative phenomenological analysis of the interview data.

Results

The interview data revealed five themes related to the priorities, challenges, and scope of clinical communication teaching across a wide range of disciplines in the Hong Kong context, namely (1) empathising with patients; (2) using technology to teach both the medical and interpersonal dimensions of clinical communication; (3) shared decision-making with patients and their families: the influence of Chinese collectivism and cultural attitudes towards death; (4) interdisciplinary communication between medical departments; and (5) the role of language in clinician–patient communication.

Conclusions

Coming from different clinical disciplines, the clinicians in this study approached the complex nature of clinical communication teaching in the Hong Kong context differently. The findings illustrate the need to teach clinical communication both specifically for a discipline as well as generically. This is particularly important in the intensive care unit, where clinicians from different departments frequently cooperate. This study also highlights how communication strategies, non-verbal social cues, and the understanding of clinical communication in the Hong Kong Chinese context operate differently from those in the West, because of differences in sociocultural factors such as family dynamics and hierarchical social structures. We recommend a dynamic teaching approach that uses role-playing tasks, scenario-based exercises, and similar activities to help medical students establish well-rounded clinical communication skills in preparation for their future clinical practice.
Spatio-temporal distribution of tuberculosis and the effects of environmental factors in China
Authors: Li Hao , Ge Miao , Zhang Mingxin
Published: June 2022

Background

Although the World Health Organization reports that the incidence of tuberculosis in China is decreasing every year, the burden of tuberculosis in China is still very heavy. Understanding the spatial and temporal distribution pattern of tuberculosis in China and its influencing environmental factors will provide effective reference for the prevention and treatment of tuberculosis.

Methods

Data of TB incidence from 2010 to 2017 were collected. Time series and global spatial autocorrelation were used to analyze the temporal and spatial distribution pattern of tuberculosis incidence in China, Geodetector and Geographically Weighted Regression model were used to analyze the environmental factors affecting the TB incidence.

Results

In addition to 2007 and 2008, the TB incidence decreased in general. TB has a strong spatial aggregation. Cities in Northwest China have been showing a trend of high-value aggregation. In recent years, the center of gravity of high-value aggregation area in South China has moved further south. Temperature, humidity, precipitation, PM10, PM2.5, O3, NO2 and SO2 have impacts on TB incidence, and in different regions, the environmental factors show regional differences.

Conclusions

Residents should pay more attention to the risk of developing TB caused by climate change and air pollutant exposure. Increased efforts should be placed on areas with high-value clustering in future public resource configurations.
Sustainability capacity of a vegetable gardening intervention for cancer survivors
Authors: Cases Mallory G. , Blair Cindy K. , Hendricks Peter S. , Smith Kerry , Snyder Scott , Demark-Wahnefried Wendy
Published: June 2022

Background

Health behavior interventions, especially those that promote improved diet and physical activity, are increasingly directed toward cancer survivors given their burgeoning numbers and high risk for comorbidity and functional decline. However, for health behavior interventions to achieve maximal public health impact, sustainability at both the individual and organizational levels is crucial. The current study aimed to assess the individual and organizational sustainability of the Harvest for Health mentored vegetable gardening intervention among cancer survivors.

Methods

Telephone surveys were conducted among 100 cancer survivors (mean age 63 years; primarily breast cancer) completing one-of-two Harvest for Health feasibility trials. Surveys ascertained whether participants continued gardening, and if so, whether they had expanded their gardens. Additionally, surveys were emailed to 23 stakeholders (Cooperative Extension county agents, cancer support group leaders, and healthcare representatives) who were asked to rate the intervention’s ability to generate sustained service and produce benefits over time using the eight-domain Program Sustainability Assessment Tool (PSAT).

Results

The survey among cancer survivors (91.9% response rate) indicated that 85.7% continued gardening throughout the 12 months following intervention completion; 47.3% expanded their gardens beyond the space of the original intervention. Moreover, 5.5% of cancer survivors enrolled in the certification program to become Extension Master Gardeners. The survey among stakeholders generated a similar response rate (i.e., 91.3%) and favorable scores. Of the possible maximum of 7 points on the PSAT, the gardening intervention’s “Overall Capacity for Sustainability” scored 5.7 (81.4% of the maximum score), with subscales for “Funding Stability” scoring the lowest though still favorably (5.0) and “Program Evaluation” scoring the highest (6.3).

Conclusions

Data support the sustainability capacity of the Harvest for Health vegetable gardening intervention for cancer survivors. Indeed, few interventions have proven as durable in terms of individual sustainability. Furthermore, Harvest for Health’s overall organizational score of 5.7 on the PSAT is considered strong when compared to a previous review of over 250 programs, where the mean overall organizational PSAT score was 4.84. Thus, solutions for long-term funding are currently being explored to support this strong, holistic program that is directed toward this vulnerable and growing population.

Trial registration

ClinicalTrials.gov Identifier: NCT02150148
How does mode of delivery associate with double burden of malnutrition among mother–child dyads?: a trend analysis using Bangladesh demographic health surveys
Authors: Sutopa Tasmiah Sad , Bari Wasimul
Published: June 2022

Background

The simultaneity of undernourishment among child and overweight/obesity among mothers in lower-and-middle-income-countries (LMICs) introduces a new nutrition dilemma, known as double burden of malnutrition (DBM). Amidst of such paradox, the hike of caesarean section (CS) delivery is also triggering child undernutrition and maternal obesity. A gap of knowledge regarding the effect of mode of delivery on DBM still persists. The study aims to explore the association between DBM at household level and mode of delivery over time in LMICs.

Method

The study used data from recent four consecutive waves of Bangladesh Demographic and Health Survey (BDHS) ranging from BDHS 2007 to BDHS 2017. It considered the mother–child pairs from data where mothers were non-pregnant women aged 15–49 years having children born in last 3 years preceding the survey. Bivariate analysis and Logistic Regression were performed to explore the unadjusted and adjusted effect of covariates on DBM. An interaction term of mode of delivery and survey year was considered in regression model.

Results

The study evinces a sharp increase of DBM rate in Bangladesh from 2007 to 2017 (2.4% vs. 6.4%). The prevalence of DBM in household level among the children delivered by CS is more than two times of those born by normal delivery (8.2% vs. 3.5%). The multivariate analysis also indicates that the children born by CS delivery are more likely to be affected by DBM at household level significantly than those born by normal delivery in each waves. Moreover, the odds ratio (OR) of DBM at household is increased by 43% for one unit change in time for normal delivery whereas CS delivery births have 12% higher odds of DBM at household level with one unit change in time.

Conclusion

The study discloses a drastic increase of rate of DBM among mother–child pairs over the time. It stipulates inflated risk of DBM at household with time for both mode of delivery but the children with CS delivery are at more risk to the vulnerability of DBM at household level. The study recommends a provision of special care to the mothers with CS delivery to reduce DBM at household.
A radiographic model predicting the status of the anterior cruciate ligament in varus knee with osteoarthritis
Authors: Liu Changquan , Ge Juncheng , Huang Cheng , Wang Weiguo , Zhang Qidong , Guo Wanshou
Published: June 2022

Purpose

The study aims to investigate the accuracy of different radiographic signs for predicting functional deficiency of anterior cruciate ligament (ACL) and test whether the prediction model constructed by integrating multiple radiographic signs can improve the predictive ability.

Methods

A total number of 122 patients from January 1, 2018, to September 1, 2021, were enrolled in this study. Among them, 96 patients were classified as the ACL-functional (ACLF) group, while 26 patients as the ACL-deficient (ACLD) group after the assessment of magnetic resonance imaging (MRI) and the Lachman’s test. Radiographic measurements, including the maximum wear point of the proximal tibia% (MWPPT%), tibial spine sign (TSS), coronal tibiofemoral subluxation (CTFS), hip–knee–ankle angle (HKA), mechanical proximal tibial angle (mPTA), mechanical lateral distal femoral angle (mLDFA) and posterior tibial slope (PTS) were measured using X-rays and compared between ACLF and ACLD group using univariate analysis. Significant variables (p < 0.05) in univariate analysis were further analyzed using multiple logistic regression analysis and a logistic regression model was also constructed by multivariable regression with generalized estimating models. Receiver-operating-characteristic (ROC) curve and area under the curve (AUC) were used to determine the cut-off value and the diagnostic accuracy of radiographic measurements and the logistic regression model.

Results

MWPPT% (odds ratio (OR) = 1.383, 95% confidence interval (CI) = 1.193–1.603, p < 0.001), HKA (OR = 1.326, 95%CI = 1.051–1.673, p = 0.017) and PTS (OR = 1.981, 95%CI = 1.207–3.253, p = 0.007) were shown as predictive indicators of ACLD, while age, sex, side, TSS, CTFS, mPTA and mLDFA were not. A predictive model (risk score = -27.147 + [0.342*MWPPT%] + [0.282*HKA] + [0.684*PTS]) of ACLD using the three significant imaging indicators was constructed through multiple logistic regression analysis. The cut-off values of MWPPT%, HKA, PTS and the predictive model were 52.4% (sensitivity:92.3%; specificity:83.3%), 8.5° (sensitivity: 61.5%; specificity: 77.1%), 9.6° (sensitivity: 69.2%; specificity: 78.2%) and 0.1 (sensitivity: 96.2%; specificity: 79.2%) with the AUC (95%CI) values of 0.906 (0.829–0.983), 0.703 (0.574–0.832), 0.740 (0.621–0.860) and 0.949 (0.912–0.986) in the ROC curve.

Conclusion

MWPPT% (> 52.4%), PTS (> 9.6°), and HKA (> 8.5°) were found to be predictive factors for ACLD, and MWPPT% had the highest sensitivity of the three factors. Therefore, MWPPT% can be used as a screening tool, while the model can be used as a diagnostic tool.
Risk factor analysis of postoperative pancreatic fistula after distal pancreatectomy, with a focus on pancreas-visceral fat CT value ratio and serrated pancreatic contour
Authors: Maeda Koki , Kuriyama Naohisa , Yuge Takuya , Ito Takahiro , Gyoten Kazuyuki , Hayasaki Aoi , Fujii Takehiro , Iizawa Yusuke , Murata Yasuhiro , Tanemura Akihiro , Kishiwada Masashi , Sakurai Hiroyuki , Mizuno Shugo
Published: June 2022

Background

In pancreaticoduodenectomy, the pancreas-visceral fat CT value ratio and serrated pancreatic contour on preoperative CT have been revealed as risk factors for postoperative pancreatic fistulas. We aimed to evaluate whether they could also serve as risk factors for postoperative pancreatic fistulas after distal pancreatectomy.

Methods

A total of 251 patients that underwent distal pancreatectomy at our department from 2006 to 2020 were enrolled for the study. We retrospectively analyzed risk factors for postoperative pancreatic fistulas after distal pancreatectomy using various pre and intraoperative factors, including preoperative CT findings, such as pancreas-visceral fat CT value ratio and serrated pancreatic contour.

Results

The study population included 147 male and 104 female participants (median age, 68 years; median body mass index, 21.4 kg/m2), including 64 patients with diabetes mellitus (25.5%). Preoperative CT evaluation showed a serrated pancreatic contour in 80 patients (31.9%), a pancreatic thickness of 9.3 mm (4.0–22.0 mm), pancreatic parenchymal CT value of 41.8 HU (4.3–22.0 HU), and pancreas-visceral fat CT value ratio of − 0.41 (− 4.88 to − 0.04). Postoperative pancreatic fistulas were developed in 34.2% of the patients. Univariate analysis of risk factors for postoperative pancreatic fistulas showed that younger age (P = 0.005), high body mass index (P = 0.001), absence of diabetes mellitus (P = 0.002), high preoperative C-reactive protein level (P = 0.024), pancreatic thickness (P < 0.001), and high pancreatic parenchymal CT value (P = 0.018) were significant risk factors; however, pancreas-visceral fat CT value ratio (P = 0.337) and a serrated pancreatic contour (P = 0.122) did not serve as risk factors. Multivariate analysis showed that high body mass index (P = 0.032), absence of diabetes mellitus (P = 0.001), and pancreatic thickness (P < 0.001) were independent risk factors.

Conclusion

The pancreas-visceral fat CT value ratio and serrated pancreatic contour evaluated using preoperative CT were not risk factors for postoperative pancreatic fistulas after distal pancreatectomy. High body mass index, absence of diabetes mellitus, and pancreatic thickness were independent risk factors, and a close-to-normal pancreas with minimal fat deposition or atrophy is thought to indicate a higher risk of postoperative pancreatic fistulas after distal pancreatectomy.
Non-Wilms' renal tumors in children: experience with 139 cases treated at a single center
Authors: Fang Yi Wei , Song Hong Cheng , Sun Ning , Zhang Wei Ping
Published: June 2022

Background

Pediatric non-Wilms renal tumors (NWRTs), which comprise a small proportion of renal tumors, are a heterogeneous group of neoplasms with variable malignant potential, mortality, and response to treatment. We performed this study to determine the clinical characteristics, management and prognosis of children with Pediatric NWRTs.

Methods

Medical records of all patients (n = 139) treated for NWRTs over a 12-year period (2008.01–2019.10) at a single center were reviewed retrospectively.

Results

The histopathological groups of NWRTs included malignant rhabdoid tumor of the kidney (MRTK) (n: 30, 21.6%), renal cell cancer (RCC) (n: 26,18.7%), clear cell sarcoma of the kidney (CCSK) (n: 24,17.3%), congenital mesoblastic nephroma (CMN) (n: 21,15.1%), cystic nephroma (CN) (n: 16,11.5%), metanephric tumors (n: 12, 8.6%), renal angiomyoliporma (RAML) (n: 3, 2.2%), renal primitive neuroectodermal tumor (n: 2, 1.4%), renal hemangioma (n: 2, 1.4%), inflammatory myofibroblastic tumor (n: 2, 1.4%), ossifying renal tumor of infancy (ORTI) (n: 1, 0.7%). The distribution of all malignant NWRTs, including MRTK, CCSK, RCC and PNET, according to stage was as follows: stages I (n = 26), II (n = 16), III (n = 29), and IV (n = 11). The summary table shows the treatment offered to children with NWRTs. A total of 123 children were followed up for an average of 42 months. Sixteen children were lost to follow-up. Tumor-free survival was observed in 94 children. One patient who suffered from RCC is currently receiving targeted therapy and survives with the tumor. Twenty-eight children (22.8%) died.

Conclusions

Pediatric NWRTs comprise 19.1% of all renal tumors in our single center. Most NWRTs can readily be distinguished using a range of immunohistochemical markers. Molecular genetic profiling has allowed much progress in the understanding of this group of tumors, making diagnosis and classification less difficult. The mainstay treatment of malignant NWRTs, including MRTK, CCSK, RCC and PNET, is comprehensive treatment. The mainstay treatment of benign NWRTs, including RAML, CN, ORTI, CMN, metanephric tumors, and renal hemangioma, is surgical resection alone and when the tumor diameter is smaller than 7 cm and the tumor locates in one pole, NSS can be performed.