bluuebunny/crossref_metadata_2025 huggingface dataset:
“By the time she got sick it was just kind of too late”: A qualitative study on advanced care planning among bereaved lesbian, gay, and bisexual older women
Authors: Valenti Korijna G , Janssen Leah M , Enguidanos Susan , de Medeiros Kate
Published: December 2021

Background:

Lesbian, gay, and bisexual (LGB) older women have unmet communication needs around palliative and end-of-life care. Past research has found communication differences for LGB women patients. Consequently, older LGB women may experience healthcare communication barriers around advance care planning.

Aim:

To explore experiences of bereaved LGB older women to understand perspectives regarding advance care planning communication between clinicians, patients, and dyads.

Design:

Guided by queer gerontology as a theoretical framework, this qualitative descriptive study employed individual interviews with purposively recruited participants. Interviews were conducted in person using a semi structured protocol and analyzed using inductive thematic analysis.

Setting/participants:

Sixteen LGB women, age 60 years or older from across the United States who had lost a spouse/partner within the past 5 years.

Results:

Four main themes emerged from the transcripts, LGB older women: (1) experience unclear advance care planning communication and end-of-life care support from clinicians, (2) often avoid advance care planning discussions with spouse or partners, (3) lack of knowledge about palliative or end-of-life care, and (4) have more positive experiences when there is consistent communication with spouse or partner and clinicians during a spouse/partner’s illness and end-of-life.

Discussion:

While certain experiences and opinions may reflect those of non-LGB older adults, novel advance care planning barriers exist for LGB older women. Greater understanding among clinicians is needed regarding advance care planning conversations with LGB dyads. We recommend four improvements in training, recognition, acceptance, and dyad-based communication interventions.
At Work with Practice Theory, ‘Failed’ Fieldwork, or How to See International Politics in An Empty Chair
Authors: Eggeling Kristin Anabel
Published: December 2021

IR practice theorists advocate studying international relations through its manifold practices. On the question of methodology, they thus promote a simple slogan: start with practices! But how do we first capture an international practice? Surprisingly, this crucial question often remains abstract or hidden in methodological metaphors like ‘leaving the armchair’. Reflecting on a supposedly failed fieldwork experiment, I introduce two heuristics in this article on how to make this hidden work transparent. In particular, I argue that capturing practice happens through abductive movements between site, scrap, screen, and seminar work that is similarly enabled and constrained by practical, epistemic, professional, and political positionalities. Using this vocabulary will advance IR practice research in three ways: first, pedagogically, in transferring a more accurate impression of what the approach entails; second, normatively, in accounting for where our arguments come from; and third, epistemically, to avoid only seeing what we were looking for.
Adverse Childhood Experiences and Mild Cognitive Impairment in Later Life: Exploring Rural/Urban and Gender Differences Using CHARLS
Authors: Zhang Keqing , Zhang Wei
Published: December 2021

This paper aims to examine whether and how adverse childhood experiences are associated with mild cognitive impairment among middle-aged and older adults in China, and if the associations vary by gender and rural/urban residence. Using four waves of data from the China Health and Retirement Longitudinal Study, cox proportional hazard models were applied. Results showed that the rural and female subsamples were significantly disadvantaged and were more likely to be cognitively impaired. Moreover, childhood family socioeconomic status and childhood social relationships were significantly associated with the risk of mild cognitive impairment for the study sample. Our findings suggest that, for middle-aged and older Chinese adults, adverse childhood experiences could have long-lasting impacts on cognitive functioning throughout the life course.
Between Architecture and Planning: Urban Design Education in Poland against a Background of Contemporary World Trends
Authors: Belof Magdalena , Kryczka Piotr
Published: December 2021

Urban design, as an academic discipline, was born in the 20th century in response to challenges related to the planning, design, and renewal of urbanized areas. Since then, there has been an ongoing debate about the scope, scientific basis, and teaching formula of the discipline. The aim of this article was to assess the formula for teaching urban design at an academic level in Poland, considering global trends in this field. The theoretical framework involved a review of contemporary scientific concepts, which provided the basis for extracting the most popular and well-recognized domains, definitions, and dimensions of urban design. The research results confirm that urban design has permanently taken its place between architecture and urban planning. In Poland, but not only, the elements of both the theory and practice of urban design are dispersed among various master’s degree courses. This is not conducive to strengthening the position of urban design as such, and in Poland, it may be one of the reasons for deepening spatial chaos.
What Are the Characteristics of the Parish Nursing Research Literature and How Can it Inform Parish Nurse Practice and Research in Canada? A Scoping Review
Authors: Millerd Elsie , Fisher Andrea , Lambert Jeanne M. , Pfaff Kathryn A.
Published: December 2021

Background

Parish nursing is a specialized branch of professional nursing that promotes health and healing by integrating body, mind and spirit as a practice model. Parish nurses contribute to the Canadian nursing workforce by promoting individual and community health and acting as system navigators. Research related to parish nursing practice has not been systematically collated and evaluated.

Purpose

This review seeks to explore, critically appraise and synthesize the parish nurse (PN) research literature for its breadth and gaps, and to provide recommendations for PN practice and research.

Methods

A scoping review was conducted using Levac and colleagues’ procedures and Arksey and O’Malley's enhanced framework. The CINAHL, ProQuest and PubMed databases were comprehensively searched for original research published between 2008 and 2020. The final sample includes 43 articles. The Mixed Methods Appraisal Tool was used to critically assess literature quality.

Results

There is a significant gap in PN research from Canada and non-U.S. countries. Methodological quality is varied with weak overall reporting. The literature is categorized under three thematic areas: (1) practice roles of the PN, (2) role implementation, and (3) program evaluation research. Research that evaluates health promotion program interventions is prominent.

Conclusions

More rigorous research methods and the use of reporting checklists are needed to support evidence-informed parish nursing practice. Building relationships among parish nurses, nursing researchers and universities could advance parish nursing research and improve evidence-based parish nursing practice. Research into the cost effectiveness, healthcare outcomes, and the economic value of PN practice is needed.
Nonprofit Financial Response to Immigration
Authors: Le Barbenchon Claire , Keister Lisa A.
Published: December 2021

Nonprofit organizations are important actors in local communities, providing services to vulnerable populations and acting as stewards for charitable contributions from other members of the population. An important question is whether nonprofits spend or receive additional revenues in response to changes in the populations they serve. Because immigrant populations both receive and contribute to nonprofit resources, changes in immigrant numbers should be reflected in changing financial behavior of local nonprofits. Using data from the National Center for Charitable Statistics and the American Community Survey, we study whether nonprofit financial transactions change in response to changes in the local immigration population, the nature of the change, and the degree to which these changes vary by nonprofit type. Findings suggest that nonprofit financial behavior changes with growth and decline in immigrant populations underscoring the importance of nonprofits as service providers and contribute to an understanding of how organizations respond to external forces.
Dynamic failure analysis of static seals under pressure fluctuation in an ultrahigh-pressure water piston pump
Authors: Cheng Qian , Liu Yinshui , Wang Zhenyao , Wu Defa , Ma Yunxiang
Published: December 2021

For ultrahigh-pressure piston pumps, in the reciprocating action of the piston, the fretting between the static face seal and the mating surface occurs with the change of the pressure in the piston chamber. This phenomenon will seriously affect the service life of the seal ring and lead to the failure of the pump. However, the failure of static seals used to seal ultrahigh-pressures is usually studied from the directions of shear, stress, or rubber material. These studies cannot explain the failure phenomenon of the sealing ring found in our experiment. This paper analyzed the failure of the face seal ring in a piston pump with a maximum pressure of 120 MPa. A two-dimensional axisymmetric finite element model was established based on the Mooney-Rivlin constitutive relation of the rubber material, and the fretting conditions of the sealing ring were analyzed. Combined with the wear scars observed by the scanning electron microscope the face seal ring’s dynamic failure mechanism on the ultrahigh-pressure piston pump was determined. A better sealing scheme was proposed and verified by the duration test of the pump, which provided a basis for the design of the sealing of the ultrahigh-pressure fluid with high-frequency fluctuations.
Impact of nanoparticle shape on magnetohydrodynamic stagnation-point flow of Carreau nanoliquid: A comparative study
Authors: Sandeep N. , Ashwinkumar G.P.
Published: December 2021

In this paper, a numerical computational work is carried out to investigate the significance of nanoparticle shape on magnetohydrodynamic stagnation-point flow of Carreau nanoliquid caused by a horizontally moving thin needle. The drive and thermal transport nature of Ti6Al4V+Ethylene glycol nanoliquid under the stimulus of space-dependent heat source and magnetized force is discussed numerically. The novelty of this work is to obtain the simultaneous solutions for three different shapes of nanoparticles namely spherical, cylindrical and laminar. The flow governing partial differential equations are transformed into ordinary differential equations with appropriate similarity variables and solved numerically by using Runge–Kutta and Newton's approach. Numerical outcomes of velocity and thermal distributions under the influence of different physical parameters are illustrated via graphical trends, wall friction and rate of heat transfer are interpreted using tabular values. It reveals from results that the thermal transfer performance of the Carreau nanoliquid is advanced when spherical shaped nanoparticles are used as compared with cylindrical and laminar-shaped nanoparticles. Also, it is witnessed that needle thickness parameter plays vital role in augmenting thermal transport rate of the nanoliquid.
‘A landmark in psychiatric progress’? The role of evidence in the rise and fall of insulin coma therapy
Authors: Freudenthal Robert , Moncrieff Joanna
Published: December 2021

This paper examines the evidence behind the use and decline of insulin coma therapy as a treatment for schizophrenia and how this was viewed by the psychiatric profession. The paper demonstrates that, from the time of its introduction, there was considerable debate regarding the evidence for insulin treatment, and scepticism about its purported benefits. The randomized trials conducted in the 1950s were the result, rather than the origins, of this debate. Although insulin treatment was subsequently abandoned, it was still regarded as a historic moment in the modernization of psychiatry. Then, as now, evidence does not speak for itself, and insulin continued to be incorporated into the story of psychiatric progress even after it was shown to be ineffective.
Gender Bias in Education Expenditure among Religious and Social Groups: A Case Study for Below Class 10 Level in West Bengal
Authors: Mitra Chayanika
Published: December 2021

This article attempts to capture gender bias in education expenditure among the religious (Hindu, Muslim and others) and the social groups (SC, ST and General) in West Bengal. Oaxaca–Blinder decomposition technique is used to obtain gender bias for a specific demographic group. Further, an attempt has been made to identify the religious or social groups with the acute problem of gender bias. In this work, 71st round (January–June 2014) education expenditure data (individual level) provided by NSSO (National Sample Survey Office) is used.

JEL: I24, R1, C55
Typologies of Posttraumatic Stress Disorder in the Bam Adult Population: 17 Years After Bam Earthquake
Authors: Rezapour Maysam , Amiri Hadis , Nakhaee Nouzar , Nekoei-Moghadam Mahmoud , Jahani Yunes , Riyahifar Sevda
Published: December 2021

Posttraumatic stress disorder (PTSD) is one of the most important issues after earthquakes. Following the Bam earthquake, much of the literature has documented the prevalence and correlates of PTSD, but no study has evaluated predominant typologies of PTSD in this population. The present study aims to investigate PTSD typologies among adults exposed to the Bam earthquake after 17 years. The data were collected 17 years after the 2003 Bam earthquake using multistage cluster sampling, in a historical cohort study. In total, 917 people participated in the study. Latent class analyses (LCA) were conducted to identify predominant typologies of PTSD symptoms and associated correlates. The LCA identified four meaningfully different classes that were characterized based on the PTSD items. The common profile was class 1 with 36.1% of the study population, which reported medium on “Re-experiencing” and “avoidance” items and high for “dysphoria” item. Also, the results showed significant differences for marital status, death relative, and age across the four classes of PTSD.

The results indicated after 17 years of the Bam earthquake, people who were exposed to this earthquake were divided into subgroups based on the severity and prevalence of PTSD symptoms. These findings highlighted the existence of experimental subgroups of PTSD symptoms following an earthquake, which can help us find those who are most in need of mental health services and also which can find specific interventions for any subgroups.
Balancing of parallel U-shaped assembly lines with a heuristic algorithm based on bidirectional priority values
Authors: Jiao Yuling , Deng Xue , Li Mingjuan , Xing Xiaocui , Xu Binjie
Published: December 2021

Aiming at improving assembly line efficiency and flexibility, a balancing method of parallel U-shaped assembly line system is proposed. Based on the improved product priority diagram, the bidirectional priority value formula is obtained. Then, assembly lines are partitioned into z-q partitions and workstations are defined. After that, the mathematical model of the parallel U-shaped assembly line balancing problem is established. A heuristic algorithm based on bidirectional priority values is used to solve explanatory examples and test examples. It can be seen from the results and the effect indicators of the assembly line balancing problem that the heuristic algorithm is suitable for large balancing problems. The proposed method has higher calculation accuracy and shorter calculation time. The balancing effect of the parallel U-shaped assembly line is better than that of single U-shaped assembly line, which verifies the superiority of the parallel U-type assembly line and effectiveness of the proposed method. It provides a theoretical and practical reference for parallel U-type assembly line balancing problem.
Patient Selection for Surgery vs Radiotherapy for Early Stage Oropharyngeal Cancer
Authors: Hilal Lara , Moukarbel Roger , Ollaik Farah , Yang Pei , Youssef Bassem
Published: December 2021

Surgery and radiation therapy are both commonly used in the treatment of early stage (AJCC stages T1-T2 N0-M0) oropharyngeal squamous cell carcinoma (OPSCC). Transoral robotic surgery (TORS) and intensity modulated radiation therapy (IMRT) have been reported to result in similar survival and disease control outcomes. However, their side effect profiles widely differ. Nevertheless, patients who experience the worst side effects and quality of life are the ones who receive the combination of TORS and adjuvant radiation or chemoradiation therapy. Thus, appropriate patient selection for surgery to minimize the need for multimodality therapy is key. We propose, in this paper, the use of sentinel lymph node biopsy in the node negative (N0) neck as a means that is worth exploring for selecting patients to either radiation therapy or surgery. Patients with a positive sentinel lymph node (SLN) would be better directed to upfront radiation. On the contrary, patients with a negative SLN biopsy would be more confidently directed towards TORS and neck dissection alone.
Hemostatic System (Fibrinogen Level, D-Dimer, and FDP) in Severe and Non-Severe Patients With COVID-19: A Systematic Review and Meta-Analysis
Authors: Mehrdad Rostami , Zahra Khoshnegah , Mansouritorghabeh Hassan
Published: December 2021

SARS-CoV-2 in COVID-19 triggers abnormalities in coagulation parameters that can contribute to thrombosis. The goals of this research were to determine the levels of fibrinogen, D-dimer and FDP in COVID-19 patients. Following a systematic study, among 1198 articles, 35 studies were included in the meta-analysis of fibrinogen levels in both severe and non-severe groups. The funnel plot, Egger’s regression asymmetry test, and Begg’s test used to measure the bias of publications. All meta-analysis performed by comprehensive meta-analysis version 2 (CMA2). The pooled findings of fibrinogen levels revealed a significant rise in fibrinogen levels in severe COVID-19 than non-severe patients with COVID-19. The D-dimer and FDP levels were significantly higher in severe patients than non-severe patients with COVID-19 were. The levels of fibrinogen, D-dimer, and FDP have increased significantly in ICU patients compared to non-ICU patients. Although, levels of clotting parameters do not always correlate with the severity of disease, these findings showed the diagnostic importance for fibrinogen, D-dimer, and FDP in COVID-19. The presence of a continuous rise in serial measurements of fibrinogen, D-dimer, and FDP may predict that patients with COVID-19 may become critically ill.
Medial rectus disinsertion for management of chronic complete sixth nerve palsy
Authors: Bagheri Abbas , Veisi Amirreza , Tavakoli Mehdi
Published: December 2021

Purpose

To report the outcomes of the medial rectus (MR) disinsertion procedure for the management of refractory esotropia (ET) with or without Abnormal head posture (AHP) in chronic complete sixth nerve palsy.

Methods

This is a retrospective case series of patients with sixth nerve palsy who suffered from residual ET and diplopia following the conventional strabismus surgeries and underwent MR disinsertion procedure between April 2017 and February 2020. This procedure was offered to the patients who declined to use prism and did not wish to perform surgery on the fellow eye. The demographic and clinical data, including sex, age, visual acuity, pre and postoperative angle of strabismus, duction limitations, results of forced duction and force generation tests, details of prior strabismus surgeries, orbital CT scan findings, and follow up duration were collected from the medical records.

Results

Six patients were enrolled in this study. Mean age was 35.0  ±  14.0 years, and mean follow-up was 15.3  ±  5.9 months. The ET at the Primary position (PP) was 35.0  ±  18.4 prism dioptre (PD) before MR disinsertion, which decreased to 14.2  ±  17.4 PD after MR disinsertion procedure. Four cases needed additional complementary surgeries to improve residual ET in PP. No case developed overcorrection. Abduction deficiency was −5.0  ±  1.3 before MR disinsertion, which improved to − 2.8  ±  0.5 units at last follow-up. The mean of induced adduction deficiency was − 2.9  ±  0.4 at last follow-up.

Conclusions

MR disinsertion can be considered in patients with chronic complete sixth nerve palsy and refractory diplopia when the conventional methods have failed.
Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic
Authors: Neves Ana Luisa , van Dael Jackie , O’Brien Niki , Flott Kelsey , Ghafur Saira , Darzi Ara , Mayer Erik
Published: December 2021

Introduction

With the onset of Coronavirus disease (COVID-19), primary care has swiftly transitioned from face-to-face to virtual care, yet it remains largely unknown how this has impacted the quality and safety of care. We aim to evaluate patient use of virtual primary care models during COVID-19, including change in uptake, perceived impact on the quality and safety of care and willingness of future use.

Methodology

An online cross-sectional survey was administered to the public across the United Kingdom, Sweden, Italy and Germany. McNemar tests were conducted to test pre- and post-pandemic differences in uptake for each technology. One-way analysis of variance was conducted to examine patient experience ratings and perceived impacts on healthcare quality and safety across demographic characteristics.

Results

Respondents (n = 6326) reported an increased use of telephone consultations ( + 6.3%, p < .001), patient-initiated services ( + 1.5%, n = 98, p < 0.001), video consultations ( + 1.4%, p < .001), remote triage ( + 1.3, p < 0.001) and secure messaging systems ( + 0.9%, p = .019). Experience rates using virtual care technologies were higher for men (2.4  ±  1.0 vs. 2.3  ±  0.9, p < .001), those with higher literacy (2.8  ±  1.0 vs. 2.3  ±  0.9, p < .001), and participants from Germany (2.5  ±  0.9, p < .001). Healthcare timeliness and efficiency were the dimensions most often reported as being positively impacted by virtual technologies (60.2%, n = 2793 and 55.7%, n = 2,401, respectively), followed by effectiveness (46.5%, n = 1802), safety (45.5%, n = 1822), patient-centredness (45.2%, n = 45.2) and equity (42.9%, n = 1726). Interest in future use was highest for telephone consultations (55.9%), patient-initiated digital services (56.1%), secure messaging systems (43.4%), online triage (35.1%), video consultations (37.0%) and chat consultations (30.1%), although significant variation was observed between countries and patient characteristics.

Discussion

Future work must examine the drivers and determinants of positive experiences using remote care to co-create a supportive environment that ensures equitable adoption and use. Comparative analysis between countries and health systems offers the opportunity for policymakers to learn from best practices internationally.
Predicting intentions to practice COVID-19 preventative behaviors in the United States: A test of the risk perception attitude framework and the theory of normative social behavior
Authors: Cheng Ying , Liu Rain Wuyu , Foerster Taylor Ann
Published: December 2021

This study examined risk perceptions, efficacy beliefs, social norms, and their interactions as predictors of people’s intention to practice four COVID-19 preventative behaviors among a U.S. sample with quotas on age, sex, ethnicity, and region ( N = 336). This online survey found that perceived injunctive norms predicted intentions to clean and disinfect (β = 0.20), practice social distancing (β = 0.14), and wear a face mask (β = 0.24). Additionally, efficacy beliefs were found to attenuate the association between descriptive norm perceptions and intention to wash hands ( B = −0.15) and wear a face mask( B = −0.12). The results revealed the importance of considering both psychological and social factors to promote COVID-19 preventative behaviors.
The household economic cost of caregivers: children with congenital heart diseases attending to Pediatric Hospital, Sri Lanka
Authors: Warnakulasooriya Pavithra Harshani , Kasturiaratchi Kaushalya
Published: December 2021

Introduction

Congenital heart disease is the commonest type of birth defect of which the estimated prevalence is around 8–12/1,000 worldwide. Caregivers of children with congenital heart diseases are easy victims of high economic burdens and economic instability.

Objective

The aim was to describe the household economic cost for a clinic visit, of primary caregivers having children with CHDs who are awaiting cardiac surgery attending a cardiology clinic at a major pediatric hospital in Sri Lanka.

Methodology

A descriptive cross-sectional study was conducted over three months among 427 samples of caregivers of children with congenital heart diseases at Cardiology clinic, Lady-Ridgeway Hospital Sri Lanka. A consecutive convenient sampling method was used to recruit the participant and economic cost was developed based on previous studies, surveys and opinions of an expert in economics.

Results

Out of caregivers, 75% were unemployed, and the median income was ₹30,000. The median direct cost per clinic visit was ₹1,800. A large proportion of direct cost was showed in traveling expenses. The median indirect cost was ₹1,000. Of the caregivers, 28.7% were falling into catastrophic expenditure during that particular month of the clinic visit. The mean waiting time per clinic visit was 53 minutes. Statistically significant association found distance with transport cost (Chi-square value = 25.14, df = 1, p & .001, OR = 3.4 (CI: 2.1–5.5). There was no statistically significant association between the income of the caregiver and expenditure (Chi-square value = 0, df = 1, p = .998, OR = 1 (CI: 0.678–1.473).

Conclusions

Assessment of economic burden and its associated factors is vital to recognize high-risk caregivers early, and improvement of monetary support methods.
Optimization of the exergy efficiency, exergy destruction, and engine noise index in an engine with two direct injectors using NSGA-II and artificial neural network
Authors: Shirvani Saeid , Shirvani Sasan , Jazayeri Seyed Ali , Reitz Rolf
Published: December 2021

Direct Dual Fuel Stratification (DDFS) strategy is a novel Low Temperature Combustion (LTC) strategy that has comparable thermal efficiency to the Reactivity Controlled Compression Ignition (RCCI) strategy, while it offers more control over the combustion process and the rate of heat release. The DDFS strategy uses two direct injectors for the low- and high-reactivity fuels (gasoline and diesel) to benefit from the RCCI concept. In this study, the injection strategy of the injectors of a gasoline/diesel DDFS engine was optimized from the thermodynamic perspective to maximize exergy efficiency and minimize exergy destruction and an engine noise index. An artificial neural network was developed with 576 samples from a CFD code to predict the DDFS mode behavior, and the non-dominated sorting genetic algorithm (NSGA-II) was used to obtain the Pareto Front and the optimal solutions. Compared to the base case, the exergy efficiency of the optimal cases increased by up to 2%, exergy destruction and Peak Pressure Rise Rate (PPRR) reduced by about 2.3%, and 2 bar/deg, respectively, in the optimal solutions. NOX and soot emissions were reduced by 40% and 35%, respectively, in the best-case scenarios.
A critical review of the Cabinet Circular on Te Tiriti o Waitangi and the Treaty of Waitangi advice to ministers
Authors: O’Sullivan Dominic , Came Heather , McCreanor Tim , Kidd Jacquie
Published: December 2021

The New Zealand state developed from a treaty between the British Crown and hapū (sub-tribes) in 1840. The te Reo (Māori language) text and the English version of the agreement are fundamentally different. Breaches of this treaty and tension over how the political relationship between Māori and the Crown should proceed are ongoing. In 2019, the Cabinet Office issued a Circular instructing bureaucratic advisers of the questions they should address when providing advice to ministers on the agreement’s contemporary application. In this article, we use Critical Tiriti Analysis (CTA) – an analytical framework applied to public policies – to suggest additional and alternative questions to inform bureaucratic advice. The article defines CTA in detail and shows how using it in this way could protect Māori rights to tino rangatiratanga (a sovereignty and authority that is not subservient to others) and substantive engagement, as citizens, in the formation of public policy. This article’s central argument is that the Circular reflects an important evolution in government policy thought. However, in showing how the Circular privileges the English version (the Treaty of Waitangi) over the Māori text (Te Tiriti o Waitangi), the article demonstrates how Māori political authority remains subservient to the Crown in ways that Te Tiriti did not intend. We show through the conceptual illustration of the care and protection of Māori children, despite the significant evolution in government thought that it represents, these rights are not fully protected by the Circular. This is significant because it was Te Tiriti, with its protection of extant Māori authority and sovereignty, that was signed by all but 39 of the more than 500 chiefs who agreed to the British Crown establishing government over their own people, but who did not agree to the colonial relationship which may be read into the English version.
Medical students positions regarding resource allocation in times of crisis
Authors: Minkin Levy Daniel , Sagy Iftach , Johansson Lipinski Lubianiker Margaret , Jotkowitz Alan
Published: December 2021

Objective

To compare the perspectives of medical students in the preclinical and clinical phases of medical training on the issue of rationing scarce medical resources in times of crisis.

Methods

Questionnaire-based cross-sectional study.

Results

A total of 201 participants took part in the study, with 100 participants in the preclinical phase group, and 101 in the clinical phase group. A multivariable analysis found that just 14.9% (n = 34) of the clinical phase students were willing to give a short-supplied blood unit to the first-arrived patient to the emergency department when more patients are expected compared to 63.9% in the preclinical group (n = 62) ( p < 0.001, OR = 0.75 95% CI: 0.029−0.192). Seventy-four percent (n = 74) of the clinical phase students were found to be willing to remove a patient from a respirator to allocate it to an ill child compared to 35.7% (n = 35) in the preclinical phase group ( p < 0.001, OR = 4.168 95% CI: 1.931−8.998). Of the clinical phase group, 46.6% (n = 41) were willing to allocate a short supplied flu medicine to a patient with poor prognosis compared to 57.7% (n = 56) in the preclinical phase group ( p = 0.04, OR = 0.457 95% CI: 0.216−0.966).

Conclusion

Clinical exposure during training may affect the way medical students make ethical decisions, independent of age, sex, as well as marital and parental status.
Median Nerve and Carpal Tunnel Morphology Before and After Endoscopic Carpal Tunnel Release: A 6-Year Follow-up Study
Authors: Grandizio Louis C. , Rocha Daniela F. Barreto , Beck John D. , Hostmeyer Sean , Chorney Matthew L. , Udoeyo Idorenyin F. , Malone W. James , Klena Joel C.
Published: December 2021

Background:

Our purpose was to describe structural and morphological features of the median nerve and carpal tunnel on magnetic resonance imaging (MRI) studies obtained before, immediately after, 6 weeks after, and 6 years after endoscopic carpal tunnel release (ECTR).

Methods:

In this prospective cohort study, 9 patients with a diagnosis of carpal tunnel syndrome (CTS) underwent ECTR. Standardized MRI studies were obtained before ECTR, immediately after ECTR, and 6 weeks and 6 years after surgery. Structural and morphological features of the median nerve and carpal tunnel were measured and assessed for each study with comparisons made between each time point.

Results:

All 9 patients had complete symptom resolution postoperatively. On the immediate postoperative MRI, there was a discrete gap in the transverse carpal ligament in all patients. There was retinacular regrowth noted at 6 weeks in all cases. The median nerve cross-sectional area and the anterior-posterior dimension of the carpal tunnel at the level of the hamate increased immediately after surgery and these changes were maintained at 6 years.

Conclusions:

We defined structural and morphological changes on MRI for the median nerve and carpal tunnel in patients with continued symptom resolution 6 years after ECTR. Changes in median nerve and carpal tunnel morphology that occur immediately after surgery remain unchanged at mid-term follow-up in asymptomatic patients. Established imaging criteria for CTS may not apply to postoperative patients. Magnetic resonance imaging appears to be of limited clinical utility in the workup of persistent or recurrent CTS.
A comparison of caregiver burden between long-term care and developmental disability family caregivers
Authors: Pattison Alison , Torres Elissa , Wieters Lori , Waldschmidt Jennifer G.
Published: December 2021

Background

As the United States’ population ages and health concerns rise, the family caregiver occupation will continue to be an integral part of the health care system.

Aims

It is important to examine the burden that family caregivers experience so they can seek out additional training and services to maintain their own well-being. The researchers examined caregiver burden from a perspective of developmentally disabled and long-term care.

Methods

The researchers examined difference in Zarit scores, guilt, burden and personal strain for 72 caregivers of people with developmental disability (DD) or people with long-term care (LTC) needs. The researchers also examined differences in these based on whether the individual was caregiving for family or “others”.

Results

For DD, there were significant differences in Zarit, role strain and personal strain; caring for others has significantly lower scores on these. Role strain was significantly higher than personal strain, which was significantly higher than guilt for both LTC and DD groups.

Conclusions

Given these findings, it is important to support family caregivers first and foremost with role strain, especially for those caring for family members with DD. This support could be given through personal counselling, caregiver training, non-profit social service resources, and support groups for family caregivers.
The European Union–Azerbaijan high-level transport dialogue: A timely reaction to the structural changes?
Authors: Abilov Shamkhal , Hajiyev Beyrak
Published: December 2021

The European Union (EU) and Azerbaijan high-level transport dialogue is the continuation of the long period of cooperation between the EU and Azerbaijan in the area of transport since the early 1990s. The geopolitical and geo-economic maps of Eurasia, the South Caucasus, and the regions around have significantly changed since then thanks to rise of China, India, and other regional actors. These actors in their turn began to initiate competitive logistical and transportation projects to define terms and conditions of the making of Eurasian transport and trade routes. The ultimate goal is to have a share in controlling global flows passing through the strategic spots of Eurasian landmass. The EU’s recent transport dialogue with Azerbaijan reflects and is reaction to those changes that happened in the wider Europe, in Eurasia, and in the globe. This paper tries to place the EU and Azerbaijan transport dialogue to a broader picture to find out what changes conditioned and necessitated the upgraded dialogue between the EU and Azerbaijan. To do so, it traces the EU and Azerbaijan’s transport policies and cooperation since the early 1990s.
Aquatic Phlorotannins and Human Health: Bioavailability, Toxicity, and Future Prospects
Authors: Okeke Emmanuel Sunday , Nweze Ekene John , Chibuogwu Christian Chiazor , Anaduaka Emeka Godwin , Chukwudozie Kingsley Ikechukwu , Ezeorba Timothy Prince Chidike
Published: December 2021

Medicinal chemists and pharmacognosists have relied on terrestrial sources for bioactive phytochemicals to manage and treat disease conditions. However, minimal interest is given to sea life, especially macroalgae and their inherent phytochemical reserves. Phlorotannins are a special class of phytochemicals mainly predominant in brown algae of marine and estuarine habitats. Phlorotannins are formed through the polymerization of phloroglucinol residues and derivatives via the polyketide (acetate–malonate) pathway. Studies over the past decades have implicated phlorotannins with several bioactivities, including anti-herbivory, antioxidants, anti-inflammatory, anti-microbial, anti-proliferative, anti-diabetic, radio-protective, adipogenic, anti-allergic, and anti-human immunodeficiency virus (anti-HIV) properties. All these activities are reflected in their applications as nutraceuticals and cosmeceutical agents. This article reviews the chemical composition of phlorotannins, their biological roles, and their applications. Moreover, very few studies on phlorotannin bioavailability, safety, and toxicity have been thoroughly reviewed. The paper concludes by suggesting exciting research questions for further studies.
Political public relations within foreign affairs: Ireland’s public diplomacy campaign for a security council seat
Authors: Arceneaux Phillip
Published: December 2021

This study investigates the storytelling discourse in Ireland’s public diplomacy campaign to win a seat on the UN Security Council. It dissects public relations materials to ascertain what system, identity, and issue narratives constructed the narrative component of Ireland’s UNSC campaign. Results of a strategic narrative analysis suggest Ireland built the campaign around themes of Empathy, Partnership, and Independence. System narratives featured Ireland as a revisionist actor seeking to rebalance the UN toward more equal and participatory representation. Identity narratives emphasized Ireland as a small island-state whose past of economic hardship and struggle for independence drives its desire to help those in need globally. Issues narratives highlighted Ireland’s commitment to global peacekeeping, fighting climate change, and promoting humanitarian aid through gender equality, food security, and refugee assistance. Findings elucidate the strategic storytelling role of public relations and public diplomacy communications within foreign affairs.
Effect of Character Marketing and Marketing Mix on Usage Intention of Internet-Only Banks: Evidence From South Korea
Authors: Lee Jong Ho , Park Heejun
Published: December 2021

Two South Korean internet-only banks were established around the same time, but their performances differ significantly when the product is similar to intangible values such as brand equity and marketing efforts. This study credits brand equity with causing performance difference and proposes a research model to examine which marketing activities construct brand equity. Traditional 4P marketing activities and character marketing are selected as marketing mix activities. Additionally, this research examines whether marketing activity effectiveness is affected by gender and evaluates customer perception about internet-only banking based on a survey. The results show that all the considered marketing activities are significant in establishing brand equity; however, their effect on brand equity is moderated by gender. This research contributes to marketing by considering brand equity in the internet-only banking context and emphasizing the effect of marketing activities using characters. Industry managers could use these results to achieve competitiveness by fostering brand equity.
Exploring Fidelity in School-Based Mindfulness Programs
Authors: Broderick Patricia C. , Schussler Deborah L.
Published: December 2021

A small but growing body of research on school-based mindfulness programs (SBMPs) has demonstrated benefits for students’ cognitive and affective functioning and overall wellbeing. Yet, lack of fidelity in SBMP implementation may diminish these programs’ purported benefits. This commentary presents 4 current challenges that need to be addressed so that questions of whether and how mindfulness improves student functioning can be clarified and implementation of programs can be strengthened and sustained. These challenges include coming to consensus on the definition and intention of mindfulness training, balancing adherence with flexibility in SBMP delivery, determining the role SBMP teachers’ mindfulness experience plays in program fidelity, and delineating distinctive features of mindful pedagogy. Some suggestions for addressing each of these challenges are provided.
Book review:Review of “research handbook on university rankings: theory, methodology, influence and impact”
Authors: Yung Chi Hou Angela
Published: December 2021

This article reviews ‘The Research Handbook on University Rankings- Theory, Methodology, Influence and Impact’ edited by Ellen Hazelkorn and Georgiana Mihut. This informative book looks at the worldwide impact of university rankings. With 37 chapters grouped into six themes, the book discusses the challenges, imperatives and innovation facing rankings into the future. The book makes a comprehensive contribution to higher education research and practice.
Spatial Resolution of Late Reverberation in Virtual Acoustic Environments
Authors: Kirsch Christoph , Poppitz Josef , Wendt Torben , van de Par Steven , Ewert Stephan D.
Published: December 2021

Late reverberation involves the superposition of many sound reflections, approaching the properties of a diffuse sound field. Since the spatially resolved perception of individual late reflections is impossible, simplifications can potentially be made for modelling late reverberation in room acoustics simulations with reduced spatial resolution. Such simplifications are desired for interactive, real-time virtual acoustic environments with applications in hearing research and for the evaluation of hearing supportive devices. In this context, the number and spatial arrangement of loudspeakers used for playback additionally affect spatial resolution. The current study assessed the minimum number of spatially evenly distributed virtual late reverberation sources required to perceptually approximate spatially highly resolved isotropic and anisotropic late reverberation and to technically approximate a spherically isotropic sound field. The spatial resolution of the rendering was systematically reduced by using subsets of the loudspeakers of an 86-channel spherical loudspeaker array in an anechoic chamber, onto which virtual reverberation sources were mapped using vector base amplitude panning. It was tested whether listeners can distinguish lower spatial resolutions of reproduction of late reverberation from the highest achievable spatial resolution in different simulated rooms. The rendering of early reflections remained unchanged. The coherence of the sound field across a pair of microphones at ear and behind-the-ear hearing device distance was assessed to separate the effects of number of virtual sources and loudspeaker array geometry. Results show that between 12 and 24 reverberation sources are required for the rendering of late reverberation in virtual acoustic environments.
Clinical, Laboratory, Instrumental, Anamnestic Characteristics in Children With Type I Diabetes Mellitus and Early Stage of Diabetic Nephropathy
Authors: Burlaka Ievgeniia A. , Mityuryayeva Inga O. , Shevchenko Tetiana A. , Holoborodko Anastasiia D. , Kovalchuk Ihor V. , Lantukh Lilia O.
Published: December 2021

Type 1 diabetes (T1D) is mainly a disease of children and young adults. Diabetic nephropathy (DN) is a common finding in diabetic patients. Microalbuminuria is the earliest clinical evidence of DN. Aim of the study was analysis of clinical, laboratory, instrumental, anamnestic examinations data in pediatric patients with T1D and early stage of DN in order to evaluate possible factors associated with early stage of DN and predictors of DN development and progression. A survey of 105 children (62 males, 43 females) with T1D and DN aged 5 to 17 years in Endocrinology unit on Clinical Pediatric Hospital №6 (Kyiv, Ukraine) done. Following clinical and biochemical characteristics found associated with an early DN: inflammatory phenotype (increased ESR, decreased albumin/globulin ratio), functional cardiovascular disorders (increased systolic blood pressure, “minor” ECG changes), signs of secondary metabolic disorders (high HbA1c, increased serum cholesterol level, increase ALAT and ASAT levels). Kidney function impairment at early stage of DN shows: higher MAU grade, GFR decline, rise in serum creatinine level as compared to T1D group. Presence of concomitant kidney and endocrine disease; positive family history found in a bigger number of patients with DN. DKA episodes number found as a factor associated with higher levels of MAU in children with DN. Patients who had microalbuminuria and more than 5 episodes of DKA/year (poorly controlled T1D) have higher progression rate to macroalbuminuria as compared to those who have less than 5 episodes of DKA/year after a 6-year follow-up study.
Family Planning Practices in Kerala: A Critical Appraisal Using National Family Health Survey Data
Authors: Ramesh Reshma , Prajitha Kannamkottapilly Chandrasekharan
Published: December 2021

Background

Adequate attention to family planning can not only reduce poverty and hunger in countries with high birth rates but also avert maternal and childhood deaths. Kerala, the southernmost state of India, has achieved its replacement level fertility rate far ahead of India. The study aims to analyze the contraceptive prevalence of the state over the years and also at the district level and the choices of different family planning methods in the state.

Methodology

This study is a secondary data analysis using the available information from the National Family Health Survey (NFHS) available from “The demographic health survey program’s data distribution system.”

Results

The contraceptive prevalence rate (CPR) of Kerala showed an initial increase followed by a sudden fall by more than 10% in 10 years period during the 2015 survey, thereafter stabilized in 2019. Among the modern contraceptive methods, the most commonly used method consistently over the years was female sterilization (46.6%) and the least common method was male sterilization (0.1%). The unmet needs in family planning in the state varied across the districts from as high as 19.3% to 5.6% though it was reduced by 1.2 percentage units as compared to NFHS-4 data.

Conclusion

The findings contradict the assumption that the use of modern spacing techniques will increase with female literacy and a higher standard of living. Female-oriented nature of family planning practices in the state should be revisited and strategies should be brought to bring equal participation of males and females. Districts with reduced CPR should be prioritized and region-specific policy recommendations are necessary to address specific needs.