bluuebunny/crossref_metadata_2025 huggingface dataset:
The to be, or not to be, of acting autistic
Authors: Dean Michelle , Nordahl-Hansen Anders
Published: October 2024

There are an increasing number of autistic characters seen in film and television, and an increasing number of autistic individuals entering the workforce. At the intersection of media and employment, only a small proportion of autistic characters are played by autistic actors. This study examines the experiences of professional autistic actors who have played autistic characters in film and television. Secondary aims examine autistic actors’ impressions of autistic representations. Using thematic analysis grounded in transformative and postpositivist frameworks, nine autistic actors participated in interviews and discussed their experiences as professional actors, and their reactions to autism portrayals. Qualitative analysis of interview transcripts revealed three salient themes: (1) advantages and disadvantages of disclosing autism, (2) professional networks, and (3) windows and mirrors. Actors described trying to balance a desire to distance themselves from their diagnosis with a desire to build their resume and take advantage of opportunities specifically available for autistic actors. Actors benefited from professional support networks who were knowledgeable about autism and who advocated their inclusion and employment. They appreciated seeing autistic characters on the screen, but also expressed concerns with inauthentic casting and overrepresentations of stereotypical and misleading portrayals. Actors’ recommendations for future autistic characterizations are described.

Lay abstract

Autistic characters are becoming more common in film and television, and a growing number of production companies are making efforts to hire autistic actors to play autistic characters. The purpose of this study is to learn about the experiences of professional autistic actors who have played autistic characters in professional media productions. We also explored autistic actors’ impressions of the autistic characters they have seen on screen. We interviewed nine professional autistic actors, who discussed their experiences as professional actors playing autistic characters. Interviews revealed the following themes, including (1) the advantages and disadvantages of disclosing autism, (2) professional networks, and (3) windows and mirrors. Throughout the interviews, the actors discussed instances when they needed to identify as being autistic to take advantage of autism-focused employment opportunities, and other instances when they felt more comfortable not identifying as autistic. Actors’ professional support networks were knowledgeable about autism and advocated for the inclusion and employment of autistic actors. They appreciated the growing number of autistic characters on screen but hoped more production companies invest in authentic casting initiatives. Actors compel production companies to move away from overplayed stereotypical and misleading portrayals. The actors’ recommendations for future autistic characterizations are described.
Evaluating the impact threshold of soluble salts on preservation of earthen site in Emperor Qin Shi Huang’s mausoleum
Authors: Xia Yin , Chang Bin , Yu Chuck Wah , Gu Zhaolin , Luo Xilian
Published: October 2024

The recurrent crystallization and subsequent volumetric expansion of soluble salts pose significant risks to earthen sites, particularly those with archaeological remains on their surfaces. Therefore, timing interventions based on salt content is crucial. This study focuses on the effects of soluble salt content on the earthen site within the burial pits of the Qin Mausoleum, with a particular emphasis on defining safe salinity levels. A mixture of Na2SO4/NaCl salts in a 1:1 mass ratio was added to remodelled soil cakes, which were then aged in a climate chamber for several months. The area of salt expansion on the soil cakes’ surfaces was measured using a deep-focus microscope to assess damage. The results indicate a sudden increase in salt expansion when salinity exceeded 0.1%. Additionally, re-evaluations of these soil cakes years later allowed for the exploration of mechanisms and the feasibility of assessing soil surface expansion and friability at different stages of the earthen site’s lifecycle, including excavation and display. These findings provide preliminary scientific bases and novel methodologies for the further preventive conservation of heritage earthen sites.
“They don’t mean to hurt”: Female gamers’ reluctance in recognizing and confronting sexism in gaming as an online-offline juxtaposition
Authors: Deng Ziyu
Published: October 2024

Female gamers have long suffered from gender-based online abuse in the gaming community. Apart from commonly observed quitting and gender-masking behaviors from female gamers, this study explores what female gamers understand as sexism, how female gamers react to it, and why they choose certain reactions instead of others. Findings show that female gamers are keenly conscious of normalized sexism in gaming culture, and thus often prioritize preventing personal interaction with strangers online, resulting in their shared preference for gaming with trusted acquaintances, which makes gaming an online-offline juxtaposition. Shouldering gender norms in doubled dimensions of gaming and specific real-life relationships, female gamers thus become reluctant to recognize and confront less violent sexism from male acquaintances. Female gamers’ strategic self-protection, although gaining them relatively safer gaming spaces, also consolidates sexism in gaming, and further suggests gaming as a critical social space for reproducing broader gender inequalities.
Experimental study of vegetable oil droplets vaporization under low temperature conditions such as those found in diesel engine cold parts
Authors: Zongo Sampawinde Augustin , Daho Tizane , Vaitilingom Gilles , Piriou Bruno , Valette Jeremy , Caillol Christian , Segda Bila Gérard , Higelin Pascal
Published: October 2024

This paper presents an analysis of three vegetable oil droplets vaporization process in the range temperature from 473 to 723 K corresponding to low temperature conditions found in diesel engine cold parts. This process is analyzed for a droplet evaporating in a hot environment at atmospheric pressure using the fiber-suspended droplet technique well used in the literature, and analyzing the droplet normalized square diameter and temperature evolution surrounding the droplet when vaporizing. The main difference between those already studied in literature is the range temperature which varies between 473 and 723 K in which vegetable oils vaporizing problems leading to deposits formation in the cold regions of diesel engines especially in direct injection. This presents a scientific challenge for resolving deposit formation. The findings reveal that vegetable oil droplets experience expansion and heating for temperatures below 623 K: no other changes are observed. Between temperatures of 623 and 683 K, an increase in temperature, expansion, and an inconsistent vaporization is observed. This is followed by a phase of low and constant vaporization. From 683 K, vegetable oils experience an initial stage of heating and expansion, which is accompanied by a phenomenon of puffing and bursting. Finally, in the last phase, residue formation occurs. Puffing and bursting phenomena manifest once the temperature reaches 683 K, indicating the emergence of substantial quantities of light compounds including carboxylic acids, aromatics, acrolein, ketene, and fatty acids. These compounds are formed through the thermal degradation and polymerization of vegetable oils. This process causes deposits to form in the colder areas of diesel engines.
Performance study of an innovative dual injection mode injector for marine low-speed dual-fuel engine
Authors: Fan Liyun , Xu Jing , Chen Chao , Tu Tianhua , Lu Gangao , Li Bo
Published: October 2024

Marine low-speed dual-fuel engines typically have two sets of fuel injection system, main-injection and micro-injection. In order to make the fuel injection system of marine low-speed dual-fuel engine compact in structure and flexible in injection control, an innovative dual injection mode injector (DIMI) which can achieve both the functions of main-injection and micro-injection was proposed. The switching between main-injection and micro-injection mode of the injector is achieved through the collaborative control of dual solenoid valves. Based on the constructed AMESim model, the injection quantity characteristic and hydraulic efficiency of the DIMI were investigated under different working conditions and injection modes. The results show that, when the DIMI in main-injection mode achieves injection quantity characteristic similar to those of a traditional electronically controlled injector (TECI), the electromagnetic forces of solenoid valves of the DIMI are less required to 80% of that of the TECI, and the fuel return quantity and hydraulic efficiency of the DIMI are comparable to those of the TECI under the same working conditions. By changing the minimum limit height of the needle of the DIMI under micro-injection mode, different ranges of micro-injection quantity could be designed according to the requirements of the engine, and the control accuracy of injection pulse width (IPW) on micro-injection quantity is higher than on main-injection quantity. Both the hydraulic efficiency of the DIMI under main-injection and micro-injection mode increase with the rail pressure and IPW in the small IPW range, then gradually tend to be saturated with the increase of IPW. As the minimum limit height of the needle increases, the injection quantity and hydraulic efficiency of the DIMI under micro-injection mode increases overall, however, the saturation values of the hydraulic efficiency in micro-injection mode under different needle minimum limit heights are still smaller than those in main-injection mode.
Visualizing departures from marginal homogeneity for square contingency tables with ordered categories
Authors: Shinoda Satoru , Yoshimoto Takuya , Tahata Kouji
Published: October 2024

Square contingency tables are a special case commonly used in various fields to analyze categorical data. Although several analysis methods have been developed to examine marginal homogeneity (MH) in these tables, existing measures are single-summary ones. To date, a visualization approach has yet to be proposed to intuitively depict the results of MH analysis. Current measures used to assess the degree of departure from MH are based on entropy such as the Kullback-Leibler divergence and do not satisfy distance postulates. Hence, the current measures are not conducive to visualization. Herein we present a measure utilizing the Matusita distance and introduce a visualization technique that employs sub-measures of categorical data. Through multiple examples, we demonstrate the meaningfulness of our analytical framework approach and validate its usefulness to provide insightful interpretations.
Take root among the stars? Emancipatory homemaking as critical worldbuilding in Octavia Butler’s Parables
Authors: Müller Frank I. , Schwarz Anke
Published: October 2024

This paper draws on geographical literature on home to explore two strategies of emancipatory homemaking in the Science Fiction novels of Octavia Butler. It examines, homemaking as a strategy, first, of persistence and, second, of adaptability. Analyzing these two strategies in the way they combine, we argue, allows us to define the home as a critical place that links various geographical scales, from the most intimate to the planetary. We build our argument by tracing the ways in which the protagonists of Butler’s Parables build homes in respect of a necessary negotation between persistance vis-a-vis violence and threats on the one, and the necessity to adapt to the precarious social institutions that surround them on the other hand. Such critical, multiscalar geography of home is proposed as a middle ground between extraterrestrial escapist tendencies, and the introvert isolationism of the homely enclave. Butler’s novels help critical geographers frame the paradoxical space of the home as a productive tension: Home is as much a place of loss, instability, and uncertainty as it is a locus of political agency, counteracting violence and liberating (inter)subjective kinship.
Watery traces and absences: sensations and speculative histories of an ancient well and a carse landscape
Authors: Edensor Tim
Published: October 2024

This paper explores how mighty earth processes, aquatic agencies and human practical, political, religious, technological, commercial and environmental interventions have shaped and reshaped a now obscure Scottish holy well and the carse landscape to which it belongs. More specifically, I detail the historic pagan rituals, vigilant religious policing, romantic redesign and extensive terraforming that have informed the changing uses and symbolic associations of these watery realms, demonstrating how they testify to ceaselessly changing human-water relations. I explore how an awareness of particular historical events garnered from diverse texts can be supplemented with affective and sensory engagements with the non-human agencies, vestiges and absences of place. Together, they foster intimations and speculative imaginaries that conjure up speculative watery histories and conjectural futures.
Effect of the Radical Remission Multimodal Intervention on Quality of Life of People with Cancer
Authors: Barnett Junaidah B. , Wang George C. , Zeng Wu , Kimokoti Ruth W. , Fung Teresa T. , Chen Yuhan , Kantor Jerry , Wang Wei , Holmes Michelle D.
Published: October 2024

Introduction: The Radical Remission Multimodal Intervention (RRMI) was developed by Kelly A. Turner, PhD, after analyzing more than 1500 cases of cancer survivors experiencing radical remission (a.k.a. spontaneous regression) across all cancer types and extracting key lifestyle factors shared by these cancer survivors. The RRMI workshops provide instruction on these lifestyle factors to participants with cancer and give them tools to help navigate their cancer recovery journey. This pilot study aimed to evaluate the effect of the RRMI on the quality of life (QOL) of people with cancer. Methods: This was a pre-post outcome study. Data were collected, between January 2019 and January 2022, from 200 eligible adults of all cancer types, who attended the RRMI workshops (online and in-person). Participants were asked to complete questionnaires online, at baseline (i.e., before the intervention) and at month 1 and month 6 post-intervention. The RRMI workshops were led by certified Radical Remission health coaches. Participants completed the RRMI with personalized action plans for them to implement. The primary outcome QOL measure was the Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (FACIT-Sp). Mixed-effects regression models were used to examine differences in FACIT-Sp score between month 1 and baseline, as well as month 6 and baseline. Models controlled for baseline score, covariates (including age, ethnic group, and body mass index), timepoints (month 1 or 6), training type (online or in-person), adherence score, and interaction between timepoints and adherence score. Results: 92% of participants were women, 77% were Non-Hispanic White, 88% were living in the US, and 66.5% were not living alone. One-quarter had breast cancer. Mean age ± SD was 55.3 ± 11.5 years. Final mixed-effects model analyses showed a significant increase in FACIT-Sp score of 9.5 (95% confidence interval [CI]: 6.2-12.8) points at month 1 ( P < .0001) and 9.7 (95% CI: 6.4-13.0) points at month 6 ( P < .0001) compared with baseline, a 7.7% and 10.8% improvement, respectively. Conclusion: The RRMI was found to significantly improve the overall QOL of participants at month 1. This improvement was maintained at month 6 post-intervention. Our findings suggest that people with cancer can benefit from the RRMI.
The eyes don’t have it: Coaches’ eye is not a valid method of estimating biological maturation in male Gaelic football
Authors: Fitzgerald F. , Campbell M. , Kearney P. E. , Cumming S.P.
Published: October 2024

In youth sport, coaches often rely on subjective assessments of current ability and future potential, which may favor players advanced in biological maturation. This study evaluated the accuracy of coaches’ maturity assessments and their impact on perceptions of player ability and potential, as well the inter-coach agreement on talent and maturity evaluations. Maturity timing (discrepancy between biological and chronological age) was assessed using the Khamis-Roche method for 247 male players aged 13 to 17 years. Eighteen coaches provided estimations of their players’ maturity timing, ratings of current ability and long-term potential, and selections of top and bottom 5 players. Inter-rater reliability was calculated using weighted Kappa (k) and percentage agreement. Kendall correlation analyses (τ) examined relationships between maturity and coaches’ perceptions, while a Kruskal Wallis test examined differences in maturity between players classified by coaches as top, middle and bottom performers. On average, coaches underestimated the presence of early maturers and overestimated on-time and late maturers. Maturation timing showed weak correlations with current ability (τ = 0.075) and future potential (τ = 0.021). Coaches’ selected “top” players did not differ in maturity from their peers (H2 = 4.844, p = 0.89). Agreement between coaches ranged from none to weak. These findings suggest coaches’ eye may be inaccurate for estimating maturation. Additionally, there is poor inter-coach agreement in identifying talented athletes, indicating the “coach's eye” is subjective and variable. These results may have significant implications for future talent identification research and processes in sport organizations.
Enhancing skill acquisition knowledge and practice design in elite level swimming: Effects of a six-week online coach education intervention
Authors: Powell Danny , Wood G. , Dagnall N. , Payton C.
Published: October 2024

In response to calls for examples from sports settings that highlight successful collaborations between skill acquisition specialists and coaches, this study evaluated the effectiveness of a skill acquisition coach education intervention. After an analysis of practice by a skill acquisition specialist, which provided context to impact learning design, two senior coaches from British Para Swimming with no prior knowledge of skill acquisition principles were observed and interviewed. The intervention harnessed coach experiential knowledge by emphasising development in understanding of theory underpinning three key principles of skill acquisition (i) implicit learning, (ii), focus of attention, and (iii) contextual interference, and encouraging informal and experiential learning between sessions. Following the intervention, coaches had adapted their approach to practice design to incorporate theory-informed techniques. Coach observations and interviews highlighted a range of novel findings in skill acquisition. First, outcomes indicated the use of implicit learning techniques in the form of analogy or metaphor cues can facilitate learning for athletes with intellectual disabilities. Second, coaches reported the learning benefits of utilising external and holistic focus cues in the elite athlete setting. Finally, through an increased understanding of the learning-performance distinction, coaches described the benefits of incorporating contextual interference, which emphasised temporal spacing between learning events. The coaches’ interpretation and implementation of skill acquisition theory are discussed with reference to potential avenues of exploration in future research.
Effect of resilience training in improving the ability to cope with stress and hope of mothers with cancer children
Authors: Khalili Arash , Khatiban Mahnaz , Ebrahimi Sajjad , Oshvandi Khodayar
Published: October 2024

Background:

The present study investigates the effect of resilience training in improving the ability to cope with stress and hope of mothers with cancer children.

Methods:

In this interventional study, 70 mothers parenting children with cancer were selected as available and randomly classified into the control and experimental groups. The mothers of the two groups completed the parenting stress and hope questionnaire. In the test group, nine sessions of resilience training were held by the researcher for 60 min. One month after the intervention, they were again asked to complete the parenting stress and hope questionnaires. Moreover, in the control group, the mothers completed the parenting stress and hope questionnaires again 2 months later without any intervention.

Result:

The difference between the average scores of hope and parental stress showed that the mean score of hope in the intervention and control groups increased by about 5.45 and 2.74 units, and the hope variable was improved in both groups. The mean score of parental stress in the intervention group decreased by 39.62 units. However, in the control group, it increased by 2.45 units, and parental stress in this group declined.

Conclusion:

Resilience training significantly reduced the level of parental stress and increased the level of hope in the mothers of the test group. Therefore, it is recommended to use resilience in reducing the level of parental stress and increasing the hope level of mothers with children with cancer.
Holmium versus thulium fibre laser for ureteroscopy and lithotripsy: When, why and how?
Authors: Fernandez Moncaleano Golena , Higgins Andrew M , Ghani Khurshid R
Published: October 2024

Background:

The holmium: yttrium-aluminum-garnet (Ho:YAG) laser, which has been the gold standard for lithotripsy, has evolved to high frequency systems with pulse modulation. However, there is now an alternative laser for lithotripsy - the thulium fiber laser (TFL).

Purpose:

While bench testing has shown superior fragmentation performance of the TFL compared to Ho:YAG, initial clinical results for ureteroscopy have not been as dramatic. We therefore analyze laboratory and clinical studies comparing these two laser platforms. Our goal is to offer insights into when and why to choose one laser over the other for ureteroscopy, along with strategies for optimal use.

Methods:

In this narrative review we describe the characteristics of each laser and provide an overview of the in vitro studies comparing Ho:YAG and TFL for fragmentation, retropulsion and heat generation. We also review evidence from prospective comparative effectiveness clinical trials for ureteroscopy and lithotripsy. We provide our schema for when we use each laser for ureteroscopy, the rationale and our approach with laser settings.

Conclusions:

Ho:YAG and TFL have distinct wavelengths, pulse duration, peak power, and water absorption parameters that make them suitable for different scenarios. The decision between which laser to choose rests upon individual preferences and confidence levels of use, with the ultimate priority for safe patient use.
Patient Perspectives of Telemedicine in Outpatient Nephrology Clinics During COVID-19: A Qualitative Study
Authors: Osman Abdelhady , Lee Seung Heyck , Noori Mateen , Al-Jaishi Melissa , Gallo Kerri , Harwood Lori , Moist Louise
Published: October 2024

Background:

The COVID-19 pandemic notably disrupted care for patients with chronic kidney disease (CKD) care, necessitating a rapid shift to telemedicine. Despite the growing use of telemedicine, the impact of this transition on patients’ experiences, particularly in Canada and considering sociocultural factors, remains underexplored. This study aims to investigate patients with CKD perspectives on telemedicine versus in-person care and to offer recommendations for enhancing telemedicine services.

Objective:

The objective was to understand patients with CKD views on telemedicine clinics during the pandemic compared to traditional in-person clinics.

Design:

This was a qualitative descriptive study employing semi-structured interviews.

Setting:

This study was conducted in general nephrology and multidisciplinary kidney care clinics in London, Canada.

Population:

The study population was English-speaking patients with CKD with at least one in-person nephrology visit before March 15, 2020, and one telemedicine appointment after March 30, 2020.

Methods:

Interviews were conducted using a structured guide, with transcripts analyzed line-by-line by 3 independent reviewers through directed content analysis. Themes were identified and agreed upon through group consensus.

Results:

Interviews with 12 participants revealed 5 key themes: (1) convenience; (2) building connection and trust; (3) necessity of in-person care; (4) role of family or caregivers; and (5) preferences for clinic types. Most participants (11/12) valued the convenience of telemedicine, noting similar levels of care compared to in-person visits. However, they found it easier to establish personal connections in face-to-face appointments. Most (8/12) preferred in-person visits if their condition worsened. Overall, a combination of in-person and telemedicine was favored, with a preference for video over telephone.

Limitations:

The study’s focus on one academic nephrology center in Ontario and predominantly white participants limits broader applicability. Additionally, recall bias may affect the findings due to the interview-based design.

Conclusions:

Telemedicine will remain integral to CKD care, with a hybrid model combining in-person and telemedicine preferred. Integrating patient feedback into future telemedicine practices is essential to enhance flexibility, access, and patient satisfaction.
Enhancing exercise intervention for patients with post-acute COVID-19 syndrome using mobile health technology: The COVIDReApp randomised controlled trial protocol
Authors: Salvador-Ruiz Andres J , Moral-Munoz Jose A , Salazar Alejandro , Lucena-Anton David , De Sola Helena , Failde Inmaculada , Dueñas María
Published: October 2024

Objectives

To analyse the effectiveness of a physical exercise programme guided by a mobile health technology system (COVIDReApp) for patients with post-acute COVID-19 syndrome. This syndrome is a multisystem disease that occurs in people with a history of COVID-19 between 1 and 3 months after the onset of the disease. This study will assess the impact of the intervention on fatigue, post-exertional dyspnoea, quality of life, pain severity, physical fitness, anxiety, depression and cognitive function. We also aim to analyse whether there are associations between the variables studied and the evolution of these associations during follow-up.

Design

A single-blind randomised controlled trial.

Methods

One hundred patients diagnosed with post-acute COVID-19 will be enrolled and randomly assigned to two groups. The experimental group will perform the intervention through a physical exercise programme guided by the COVIDReApp system, whereas the control group will perform the programme in paper format. Study outcomes will be collected at baseline and at 4, 12 and 24 weeks. Student's t-tests or Mann–Whitney U-tests will be used to analyse differences between groups, mixed ANOVA for differences over time and longitudinal structural equations for associations between variables at follow-up.

Discussion

This study is based on current evidence regarding exercise prescription recommendations for patients with post-acute COVID-19 syndrome. Our intervention is supported by a solid theoretical framework; however, challenges include tailoring the physical exercise programme to everyone's predominant symptoms and ensuring adherence to the programme.

Trial registration number

NCT05725538.
The use of smart technologies for enhancing palliative care: A systematic review
Authors: Maguraushe Kudakwashe , Ndlovu Belinda Mutunhu
Published: October 2024

Introduction

With the rapid advancement of technology, smart technologies have permeated various sectors, including palliative care in healthcare. Based on the available literature, similar studies have elucidated the application of individual and isolated smart technologies in palliative care, with their benefits, and limitations. This research, therefore, focuses on the conceptualisation of various smart technologies and makes holistic recommendations on the effective and efficient use of smart technologies in healthcare to enhance palliative care.

Purpose

The purpose of this study is to systematically review the existing literature to conceptualise the role of various key smart technologies in palliative care, and their benefits and make recommendations on how smart technologies can enhance healthcare in palliative care.

Methodology

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were adopted in this study. Using the keywords: ‘smart technologies’, ‘healthcare’ and ‘palliative care’ (using Booleans AND/OR in different ways, including their synonyms), an exhaustive search was done on four major databases: MEDLINE, PubMed, Scopus and CINAHL. Resultantly, 19 articles met the inclusion criteria and were analysed.

Findings

The main results reveal that smart technologies enhance the quality of life and efficiency of palliative care, notably telemedicine, wearable devices, and mobile health apps. They reduce hospital visits and carer stress by improving patient-doctor communication, enabling remote monitoring, and forecasting health outcomes. However, there are challenges such as the digital divide, privacy issues, and the need for comprehensive integration and training into the current frameworks.

Conclusion and implications

The study emphasises the significant impact of smart technologies in improving palliative care. It emphasises the importance of considering technological, ethical, and practical factors to ensure that these advancements truly enhance palliative care. This research has important implications for healthcare professionals and policymakers, indicating a need for a patient-centred palliative care model that integrates technology more effectively.
Effectiveness of tele-rehabilitation in patients with knee osteoarthritis: A randomized controlled trial
Authors: Tedeschi Roberto , Platano Daniela , Pillastrini Paolo , Berti Lisa , Benedetti Maria Grazia
Published: October 2024

Objective

The primary objective of this randomized controlled trial was to evaluate the effectiveness of tele-rehabilitation (TR) compared to conventional rehabilitation (CT) in reducing pain (as measured by the Numeric Pain Rating Scale [NPRS]) in patients with knee osteoarthritis (OA). Secondary objectives included assessing changes in physical function and quality of life, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) health survey, respectively.

Methods

Fifty-five patients diagnosed with knee OA were randomly allocated to either the TR group ( n = 29), receiving remote physiotherapy sessions three times a week for four weeks, or the CT group ( n = 26), undergoing traditional outpatient rehabilitation with the same exercise regimen. Outcomes were measured at baseline and after a three-month follow-up period.

Results

At baseline, there were no significant differences between groups in terms of NPRS and WOMAC scores. After three months, both the CT and the TR groups showed significant improvements in pain reduction (NPRS, p < 0.001), WOMAC score ( p < 0.001), and in some subscales of the SF-36 (i.e., physical functioning, role limitation attributable to physical problems, energy, and pain).

Conclusion

Tele-rehabilitation is an effective alternative to CT for reducing pain and improving quality of life in patients with knee OA. These findings suggest that TR can be incorporated alongside conventional approaches to provide a comprehensive treatment strategy for managing knee OA, enhancing patient outcomes in various dimensions of well-being. Trial registration NCT05719350; Telerehabilitation in Patients With Osteoarthritis (TABLET).
Needs and Opportunities for Anal Cancer Prevention in Patients Engaged With PrEP Care: Development of Conceptual Model
Authors: Wheldon Christopher W. , Flores Cristian L. , Wilson-Shabazz Imani , Luck Caseem C. , Singley Katie , Bass Sarah B.
Published: October 2024

Introduction:

Populations at risk for HIV infection—including gay, bisexual, and other men who have sex with men (GBM) and transgender/gender diverse people (TGD)—are at disproportionate risk for anal cancer. Most anal cancers are caused by human papillomavirus (HPV) and are preventable with HPV vaccination and screening. Engaging at-risk populations who are already receiving HIV preventive care (eg, pre-exposure prophylaxis [PrEP]) may be an effective implementation strategy. The purpose of this study was to (1) identify the information, motivation, and behavioral skills that influence decisions about anal cancer prevention and to (2) describe the healthcare utilization patterns among PrEP users that impact their engagement in anal cancer prevention.

Methods:

Using purposive sampling in the United States, we ensured diverse representation among PrEP users aged 18 to 45 across gender and ethnoracial identities. Recruitment sources included primary healthcare clinics, social media, and community venues. Semi-structured interviews were recorded, transcribed, and coded using structural, pattern, and theoretical approaches.

Results:

Participants (N = 36) were mostly cisgender gay ethnoracial minority men. We identified 29 unique codes that were nested within 3 categories: individual decision-making, healthcare utilization patterns, and healthcare system influences. Participants commonly lacked essential information about HPV and anal cancer, often holding misconceptions about risks and prevention. Motivation for anal cancer prevention was driven by healthcare interactions and perceived risks, while fragmented healthcare and reliance on telemedicine were potential barriers. Many participants used telehealth services to access PrEP, described it as convenience, cost-effective, and liked the lack of provider interaction. Some participants used telehealth for PrEP and did not have a primary care provider. The importance of access to LGBTQ+-affirmative healthcare services was highlighted.

Conclusions:

Integrating patient education and prevention services into ongoing PrEP management can enhance the reach and equity of anal cancer prevention. Our model underscores critical areas of misinformation, necessary systems-level changes, and unmet needs.
When Chilling Out Casts Doubt: Exploring the Temporal Associations Among Anxiety, Depression, and Cannabis Use in Emerging Adulthood
Authors: Rose Alison L. , Single Alanna , Goldstein Abby L. , Goldberg Joel O. , Keough Matthew T.
Published: October 2024

Research shows that both cannabis use and emotional problems (anxiety and depression) tend to peak in emerging adulthood. There is a relative paucity of research examining the temporal associations between cannabis use and emotional problems among emerging adults. Accordingly, this multi-wave longitudinal study examined three competing models of temporal precedence: the vulnerability model (negative emotions precede cannabis use); the scar model (cannabis use precedes negative emotions), and the reciprocal model (bidirectional associations between cannabis use and negative emotions). A sample of 299 North American emerging adults ( Mage = 23.69 years, 58% female) completed three waves of survey measures and cross-lagged panel models were run to evaluate how anxiety and depression were related to both cannabis use and related problems across the 1-month study period. Regarding anxiety symptoms, some support was found for the vulnerability model, in that anxiety preceded cannabis problems across some waves. No directional or reciprocal associations between anxiety and cannabis use were found. As for depression symptoms, there was support for reciprocal links between cannabis problems and depression across waves. However, consistent with the anxiety-related findings, no directional or reciprocal associations between depression and cannabis use were found. The scientific and practical implications of these findings are discussed.
Temporal and Spatial Dynamics of Preschool Education Resource Allocation in China From 2011 to 2019: Based on Statistical and Spatial Analysis Methods
Authors: Wang Yanan , Calero Jorge , Gao Chuansheng , Ma Jialei
Published: October 2024

Balancing the allocation of preschool education resources is a crucial objective within China’s preschool education reform. Our analysis focused on investigating the disparities between regions and urban-rural areas in China from 2011 to 2019, employing the technique for order preference by similarity to ideal solution (TOPSIS), spatial analysis, and Markov chains. The results demonstrate a gradual reduction in the gaps between regions, and a rapid decrease in urban-rural gaps. Notably, Sichuan stands out with noticeably higher urban-rural differences compared to other provinces. The dynamic evolution revealed by Markov chains illustrates a limited level of fluidity in the observed changes within preschool education resource allocation levels from 2011 to 2019, thereby indicating progression toward a higher-quality allocation process. Additionally, the steady-state formation predicted by Markov chains highlights that if the current investment strategy remains unaltered, the rural areas in middle China will become the least developed in terms of preschool education by 2025. This situation is projected to deteriorate further by 2030. Urgent attention and policy adjustments are therefore imperative to address new trends.
Does a Higher Ratio of Salary-Per-Contribution Impact Employees’ Work Efficiency?
Authors: Wen Riguang , Cai Haijing
Published: October 2024

This study analyzes the effect of the pay gap in salary-per-contribution on employee work efficiency, where salary-per-contribution is the ratio between an employee’s annual salary and his or her contribution to the organization. We find that the efficiency of employees with above-average salary-per-contribution decreases as the difference from the average increases. However, the efficiency of employees with below-average salary-per-contribution increases as the difference from the average increases. Furthermore, the degree of team cooperation mediates the relationship between the pay gap and work efficiency, which is more prominent among low-salary or non-starting players. These conclusions are generally consistent with comparisons of the effects of salary variations in organizations and by industry.
The Trajectory of Parental Psychological Control, Self-Esteem, Language Class Risk-Taking, and EFL Learners’ Confidence in Speaking English
Authors: Kao Po-Chi
Published: October 2024

To best understand foreign language learning, the present study proposes and tests a conceptual model of confidence in speaking English by examining the path effects of three variables. These three variables are parental psychological control, self-esteem, and language class risk taking. Data were collected from 394 Taiwanese undergraduate students. Structural Equation Modeling (SEM) technique was adopted to examine the path effect in the research model. The results confirmed four significant path effects: (1) parental psychological control negatively predicts self-esteem; (2) self-esteem positively predicts language class risk taking; (3) language class risk taking positively predicts confidence in speaking English; (4) self-esteem positively predicts confidence in speaking English. A mediator was also identified in this model. Language class risk taking was found to mediate the relationship between self-esteem and confidence in speaking English. This study might provide one of the very first empirical findings in the exploration of the relationships among these variables. The findings could help applied psychology researchers understand university EFL learners’ parental psychological control, self-esteem, language class risk taking, and confidence in speaking English in psychological, educational and linguistic contexts.
Acute Bilateral Painless Vision Loss in a Pediatric Patient With Infective Endocarditis
Authors: Dachepally Rashmitha , Sarkis Reem , Agarwal Hemant S.
Published: October 2024

Infective endocarditis (IE) is a complex cardiac condition with a myriad of systemic complications, affecting approximately 5% of patients with ocular manifestations. This report details a rare and severe presentation of IE, marked by the acute onset of bilateral vision loss attributed to central retinal arterial occlusion (CRAO) and posterior ischemic optic neuropathy (PION), both critical conditions resulting from vascular impairments associated with IE. CRAO, characterized by the sudden obstruction of blood flow to the retina, leads to rapid vision deterioration, showcasing the critical impact of vascular emboli originating from infective endocardial lesions. On the other hand, PION, a less common vascular disorder, affects the posterior segment of the optic nerve, typically sparing the optic disc from edema but resulting in significant visual impairment. This case emphasizes the importance of recognizing ocular symptoms in patients with IE, as early detection and intervention are vital for managing these rare but devastating complications.
Understanding the Relationship Between Adverse Medication Use and Falls Among Older Patients Receiving Home Medical Care: OHCARE study
Authors: Murakami Naoko , Kabayama Mai , Yano Tomoko , Nakamura Chika , Fukata Yuka , Morioka Chihiro , Fang Wen , Nako Yumiko , Omichi Yuki , Koujiya Eriko , Godai Kayo , Kido Michiko , Tseng Winston , Nakamura Toshinori , Hirotani Atsushi , Fukuda Toshio , Tamatani Michio , Okuda Yoshinari , Ikushima Masashi , Baba Yoshichika , Nagano Masahiro , Nakamura Yukio , Rakugi Hiromi , Kamide Kei
Published: October 2024

Objective: Previous studies suggest older patients with multiple health conditions and medications may experience adverse interactions, leading to negative outcomes. However, there’s limited research on this in older adults receiving home medical care. This study assesses whether polypharmacy is linked to falls or other clinical outcomes. Methods: The study population included 217 participants, aged ≥65 years, receiving home medical care, who consented to participate in the Osaka Home Care Registry (OHCARE) study in Japan. The survey examined the association between polypharmacy and clinical outcomes. We defined “polypharmacy” as six or more medications taken regularly. Results: Of the participants, 135 (62.6%) had polypharmacy and were significantly more likely to have hypertension or diabetes. Common medications included those for hypertension, diabetes, and mental disorders. Participants with polypharmacy experienced significantly more falls. Multivariate analysis showed an association between polypharmacy and falls (odds ratio: 2.81, 95% confidence interval [1.34, 5.92]). Conclusion: Even in older patients receiving home health care, the use of six or more medications poses a risk of falls. Careful observations and life support by medical stuffs are necessary to prevent falls in older patients with polypharmacy receiving home medical care.
Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections: An Evidence-Based Literature Review
Authors: Formosa Marika , Ebejer Stephen J.
Published: October 2024

Background

Surgical site infections (SSIs) are a frequent postoperative complication that nurses commonly need to provide asepsis-specific meticulous care for. The application of a closed-incisional negative pressure wound therapy (iNPWT) device is regarded as a novel technique that aims to lower the risk of external wound contamination.

Aim

The purpose of this review was to evaluate the effectiveness of iNPWT on high-risk closed laparotomy incisions with the aim to inform nursing practitioners and physicians engaged in multieffort wound care practices. Nursing professionals play a crucial role in mitigating the incidence of SSIs, from the time of application, through ongoing assessment tissue condition, and ensuring asepsis, thereby enhancing patient care and safety.

The Research Question

Is prophylactic negative pressure wound therapy effective in reducing the incidence of (closed) surgical site wound infections postlaparotomy?

PICO Elements

The population studied included patients undergoing laparotomy surgery. The intervention under review included the application of iNPWT, compared to the use of standard gauze dressing. The expected outcome was SSI reduction.

Methods and Results

A systematized literature search was conducted using various databases to identify published studies that address the PICO question. The PRISMA checklist and Critical Appraisal Skills Programme tools allowed to exclude irrelevant articles and to critically appraise the evidence, respectively. Eleven key articles were retrieved including four RCTs and seven systematic reviews and meta-analysis. The results indicated an overall positive association between iNPWT and a reduction in SSI in laparotomy surgeries when compared to standard dressings.

Linking Evidence to Action

Data across most studies reviewed support the benefits with the use of iNPWT as a preventive strategy to lower the rates of SSI, with some claiming no difference. Although heterogeneity in the studies precludes a definite conclusion, nurses may make a more informed decision when navigating the demands of SSI prevention targeted nursing care.
Work–Family Care Obstacles and Life Satisfaction among Japanese Working Family Caregivers Living with an Older Care Recipient
Authors: Honda Ayumi , Liu Yin , Fauth Elizabeth B. , Honda Sumihisa
Published: October 2024

Introduction

The growing obstacles to balancing work and family caregiving responsibilities (work–family care obstacles) have led to heightened difficulties in work–life adjustment among employees, potentially resulting in decreased life satisfaction.

Objectives

The aims of this study were to investigate whether facing work–family care obstacles is associated with poor life satisfaction and whether it moderates the association between caregiver burden and life satisfaction among working family caregivers in Japan.

Methods

A cross-sectional descriptive study was conducted involving 141 family caregivers, all of whom were under 65 years old and living with older long-term care recipients. Multiple logistic regression analysis was conducted to examine the primary and moderating effects of work–family care obstacles on life satisfaction in the context of caregiver burden.

Results

Experiencing significant work–family care obstacles was associated with poor life satisfaction among employed family caregivers. Moreover, work–family care obstacles exacerbated the relationship between caregiver burden and poor life satisfaction. Family caregivers who faced work–family care obstacles and experienced two or more caregiver burdens exhibited poor life satisfaction (odds ratio = 5.51, 95% confidence interval = [1.97, 15.43]) compared to those who had one or fewer caregiver burden. For family caregivers without work–family care obstacle, the risk of poor life satisfaction did not vary depending on the number of caregiver burdens.

Conclusion

These findings suggest that work–life adaptation is more important than work–life balance for maintaining feelings of satisfaction in both life and work.