bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching Students With Disabilities in Chinese Regular Education Classrooms: Outcomes and Influential Factors
Authors: Li (李佳宁) Jianing , Zan (昝飞) Fei , Chen June L.
Published: May 2024

Purpose

Learning in a regular classroom (LRC) has become the main educational placement for students with disabilities in China. This study investigates the outcomes of LRC and their influential factors from the teachers’ experiences and perspectives.

Design/Approach/Methods

Seven inclusive education teachers participated in semi-structured interviews. Thematic analysis was conducted to analyze the qualitative data.

Findings

The results show that social participation and contribution, physical presence, academic performance, self-concept, and independence are the key outcomes of LRC from inclusive education teachers’ experiences and perspectives. Moreover, the factors influencing the key desired outcomes include the severity of disabilities and problem behaviors, professional support, teaching practice, inclusive climate, and collaboration between schools and families.

Originality/Value

This study provides valuable insights into the outcomes and influential factors of inclusive education in the context of LRC in China. These findings inform efforts to improve inclusive education practices and enhance the educational experiences of students with special needs.
Screening for Food and Nutrition Insecurity in the Healthcare Setting: A Cross-Sectional Survey of Non-Medicaid Insured Adults in an Integrated Healthcare Delivery System
Authors: Byker Shanks Carmen , Gordon Nancy P.
Published: May 2024

Objectives:

Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity among patients being screened for social risks in the healthcare setting.

Methods:

Data from a 2021 English-only mailed/online survey were analyzed for 2791 Kaiser Permanente Northern California (KPNC) non-Medicaid insured members ages 35-85 years. Sociodemographics, financial strain, food insecurity, acquiring free food from community-based organizations, and nutrition insecurity were assessed. Data from respondents’ electronic health records were abstracted to identify adults with diet-related chronic health conditions. Data were weighted to the age × sex × racial/ethnic composition of the 2019 KPNC adult membership. Differences between groups were evaluated for statistical significance using adjusted prevalence ratios (aPRs) derived from modified log Poisson regression models.

Results:

Overall, 8.5% of participants reported moderate or high food insecurity, 7.7% had acquired free food from community-based organizations, and 13% had nutrition insecurity. Black and Latino adults were significantly more likely than White adults to have food insecurity (17.4% and 13.1% vs 5.6%, aPRs = 2.97 and 2.19), acquired free food from community-based organizations (15.1% and 15.3% vs 4.1%, aPRs = 3.74 and 3.93), nutrition insecurity (22.1% and 23.9% vs 7.9%, aPRs = 2.65 and 2.64), and food and nutrition insecurity (32.4% and 32.5% vs 12.3%, aPRs = 2.54 and 2.44). Almost 20% of adults who had been diagnosed with diabetes, prediabetes, ischemic CAD, or heart failure were food insecure and 14% were nutrition insecure.

Conclusions:

Expanding food-related healthcare screening to identify and assess food insecurity, nutrition insecurity, and use of community-based emergency food resources together is essential for supporting referrals that will help patients achieve optimal health.
School Counselors’ Current Experiences in the Classroom in a Post-Pandemic Era: A Mixed-Methods Study
Authors: Slaten Christopher D. , Wachter-Morris Carrie , Williams Michael Steven , Lee Jisu , Haberski Jenny , Hovey Scott
Published: May 2024

School counselors support the academic, career, and social/emotional development of all students in their care, and one important method of delivery of a comprehensive school counseling program is the use of classroom instruction. In this exploratory, sequential mixed-methods study, we examined participant responses from nine focus groups regarding the school counselors’ experiences with delivery of classroom lessons, in combination with a national survey of 247 practicing school counselors. Results underscored participants’ desire to spend more time in classrooms and ongoing barriers to classroom access. We discuss implications for school counseling practice and school counselor education.
Transition in Teacher and Parent Roles, Responsibilities and Relationships Within the “Third Space” of Online Chinese EFL Learning
Authors: Jia Juan , Zhu Lei
Published: May 2024

In the pandemic era, online learning has become the standard mode of learning in China where lockdowns were in place. However, in lockdowns, the roles of guardian, teachers and learners transform and change traditionally-accepted responsibilities and roles as well as relationships, thus warranting an examination of the third space of learning and its implications for the stakeholders’ learning practices and emotions. A review of literature demonstrates a dearth of research on issues of role and practice shifts and power relations changes within the Chinese online English as Foreign Language (EFL) learning context. Using close ended and open-ended questionnaire data from teachers at Chinese school learners studying English as a foreign language, this study inquiries into the (i) changes in roles and emotions of teachers and guardian in the third space of learning in the Chinese online learning context, (ii) changes in the practices of the teachers, and (iii) transformations of power relations between guardian and teachers. The findings of the study contribute to literature on emergent online pedagogical practices and the emotions and roles and relationships of key stakeholders, namely teachers and guardian in the third space of learning mediated by technology.
Exploring Situational Factors for Female International Students and Their Satisfaction in Higher Education Using CB-SEM
Authors: Chang Dian-Fu , Chang Angel , Kang Cheng-Yi
Published: May 2024

While the topic of attracting and maintaining inbound international students has received much scholarly attention in higher education, attracting female international students has rarely been discussed. This study addresses the issue of attracting degree-seeking female international students. Based on the notion of situational factors and total quality management (TQM), we assumed both institutional design and students’ satisfaction are core concepts for attracting and retaining female international students that will make a difference in higher education. A total of 215 survey responses were analyzed, and a covariance-based structural equation modeling (CB-SEM) approach was developed. The results confirm female international students’ perception of 14 observed variables in the three first-order components and suggest that they can create a second-order construct of push factors, institutional situations, and satisfaction (latent variables). This study demonstrates that higher-order modeling leads to theoretical parsimony and reduces model complexity in the proposed CB-SEM. The findings suggest that the casual relationship works well and both institutional leadership and international strategy can play crucial roles in the process of transforming female international students’ learning satisfaction.
Self-Perceptions and Benefits of Psychological Resilience Among Women Academics in the Context of Working in South African Higher Education Institutions (SA-HEIs): A Mixed-Method Approach
Authors: Cadete Nuria , Ruggunan Shaun
Published: May 2024

Higher education institutions (HEIs) globally heavily depend on the resilience of academic staff members to achieve excellence in teaching and learning. The extant scholarly work on resilience seems to take the relationship between workplace environmental factors (WEFs) and the adverse experiences of resilience among women academics for granted. Using South Africa as an example, this research mainly focused on the WEFs acknowledged as the primary sources of adversity and the overall perceptions and experiences of resilience among women academics in South African HEIs. This research employed a mixed methods sequential explanatory design comprising an online quantitative survey of 135 women academics, and individual in-depth/semi-structured qualitative interviews of 27 women academics. The aim of this article was to illustrate how resilience can shape the way women academics interpret and respond to adversity. More specifically, the mixed-method findings presented in this article thought to document the perceived experiences of PR among women academics in South African Higher Education institutions (SA-HEIs), with a particular focus on the University of KwaZulu-Natal (UKZN) which is located in the province of KwaZulu-Natal in South Africa. The findings unpack how four building blocks of psychological resilience (BBPRs)—neuroticism, mindfulness, self-efficacy, and coping—moderated the effects of WEFs-related adversities; and provide insights into the impacts of human resources management practices (HRMP) on women academics’ resilience. We conclude that a higher self-reported level of resilience is not necessarily indicative of positive experiences of WEFs amongst women academics in South African universities.
The Best and the Worst: TEFL Experts’ Opinions of the Most and the Least Important Predictors of Situational Willingness to Communicate
Authors: Rafiee Marzieh , Abbasian-Naghneh Salman
Published: May 2024

The current study aimed to identify the most and the least important situational properties of second language willingness to communicate (L2WTC) in an EFL context. After reviewing the related literature, 24 influencing factors were identified and then they were prioritized. 180 TEFL students participated in the study to answer the research questionnaire. A quantitative research approach applying paired comparison questionnaire was employed. Data analysis was done using Excel spreadsheet for sorting data and calculating the mean and WinQSB software for solving linear programming model. The results showed that, among the selected variables, “the size of the group,”“familiarity with topics under discussion,” and “interlocutors and familiarity with them” were determined to be the first most important situational variables which highly influence L2WTC. The findings also showed that “attitudes toward the learning situation,”“course evaluation criteria,” and “alignment with the classroom norms” were the least important factors influencing L2WTC. The significance of the study lies in its theoretical contributions and pedagogical implications it has for the field of second language teaching and learning.
Voluntary National Reviews on Implementation of Sustainable Development Goals: Key Lessons from East African Member States
Authors: Chisika Sylvester Ngome , Yeom Chunho
Published: May 2024

Regular, inclusive, and country-driven Voluntary National Reviews (VNRs) of sustainable development goals (SDGs) are being conducted by many countries across the globe in the quest to realign development priorities toward Agenda 2030. However, there are limited studies on the progress of the implementation of SDGs. This paper used literature review and document content analysis to review the VNRs from East Africa for the first time in order to explore their reporting practices and document the progress of SDG implementation. Results substantiate that Kenya, Uganda, Tanzania, Rwanda, Burundi, and South Sudan are committed to achieving a high quality of life for their people through periodic VNR reporting. To augment, these positive efforts, countries have established a favorable multi-stakeholder legal and policy environment for SDG implementation. Moreover, remarkable impacts have been witnessed, including; reduced poverty, improved access to basic services, enhanced environmental protection, improved economic growth, improved gender equality, and improved stakeholder participation in sustainable development. Additionally, global best practices on SDG implementation are emerging from the region, especially through the tendency to formulate national strategies and policies targeting specific development sectors and resources. However, results also show that there are numerous social-political, economic, and environmental barriers to achieving the SDGs. As such, this paper recommends increasing SDGs awareness, building technical capacity, leveraging technology, fostering transparency and accountability, encouraging collaboration, addressing cultural barriers, and supporting political stability. Implementing these interventions can help to promote sustainable development in the region.
Antecedents of Feedback-Seeking Behavior and Its Conditional Impacts: Applying the Framework of Workplace Entitlement
Authors: Du Xinqi , Chowdhury Md Sohel , Kang Dae-seok
Published: May 2024

This study proposes and empirically tests a more elaborate model for feedback-seeking behavior (FSB) by including new potential predictors (perceived overqualification, hostile attributional style, and overwork climate) involved with a range of entitlement forms. As well, it aims to identify the extent to which FSB varies within its boundary conditions (i.e., regulatory foci, mutual recognition respect, and motivational climate). A series of hierarchical, moderated regression analyses were used to explore the hypotheses. Data were collected from a stratified sample of 444 employees working largely in manufacturing and IT service industries in eastern China. A hostile attributional style and an overwork climate negatively impact FSB. Although perceived overqualification does not have a direct effect, its interaction with a prevention focus (rather than a promotion focus) easily induces FSB. From the use of the influential predictors and moderators, a thorough understanding of their effects on FSB not only neutralizes the concern over reducing employees’ FSB, but also assists in providing possibilities to create a feedback-rich culture. We provide some insights on how an inflated sense of entitlement can be extended to understand the evolving nature of FSB through another feedback-seeking motive behind the instrumental one. As a different attempt, it adds further value in ongoing feedback research by showing the conditional impacts on such behaviors.
Effects of composition and pH on the degradation of hyaluronate and carboxymethyl cellulose gels and release of nanocrystalline silver
Authors: Nancy Ward Colleen , LeBlanc Payton E. , Edward Burrell Robert
Published: May 2024

Adhesions are fibrous tissue connections which are a common complication of surgical procedures and may be prevented by protecting tissue surfaces and reducing inflammation. The combination of biodegradable polymers and nanocrystalline silver can be used to create an anti-inflammatory gel to be applied during surgery. In this study, sodium hyaluronate and sodium carboxymethyl cellulose were added in concentrations from 0.25% to 1% w/v to aqueous nanocrystalline silver solutions to create viscous gels. Gels were loaded into dialysis cassettes and placed in PBS for 3 days. pH was adjusted using potassium phosphate monobasic and sodium hydroxide. Release of silver into the PBS was measured at several time points. Polymer degradation was compared by measuring the viscosity of the gels before and after the experiment. Gels lost up to 84% of initial viscosity over 3 days and released between 24% and 41% of the added silver. Gels with higher initial viscosity did not have a greater degree of degradation, as measured by percent viscosity reduction, but still resulted in a higher final viscosity. Silver release was not significantly impacted by pH or composition, but still varied between experimental groups.
Revisiting the Eswaran-Kotwal Model of Tenancy
Authors: Ghatak Maitreesh , Mookherjee Dilip
Published: May 2024

Persistence of sharecropping tenancy, and increases in farm productivity resulting from regulations protecting tenant rights have been observed in many developing countries. This paper examines if these can be explained by alternative models of sharecropping with two sided efforts/investments, namely, complete contract models, either without wealth constraints ( Eswaran-Kotwal, 1985 ) or with a wealth constrained tenant ( Mookherjee, 1997 ; Banerjee-Gertler-Ghatak, 2002 ), and incomplete contract holdup models without wealth constraints (Grossman Hart, 1986). In the absence of wealth constraints, the complete contract model always results in (incentive constrained) surplus-maximizing productivity; thus, there can be no scope for tenancy regulations to raise productivity. In the incomplete contract model, tenancy regulations would raise productivity only if the tenant’s investments are more important than the landlord’s investment. But in that case, sharecropping tenancy would not persist in the absence of wealth constraints, as the tenant would have purchased the land right ex ante from the landlord. The model with wealth constraints helps explain both the persistence of tenancy and the productivity/surplus enhancing effects of tenancy regulations.

JEL Classifications: D02, D23, OI2, OI3
Interpreting Workplace Bullying in Higher Education Institutions in India: Through the Lens  of Gender
Authors: Soumyaja Devi , Akella Devi
Published: May 2024

This article attempts to explore the prevalence, forms and responses to workplace bullying through a gendered lens using the theory of gendered organisation and gender role socialisation theory. The study is conducted among faculty in higher education institutions in India, and the article also discusses the context of new managerialism prevalent in higher education institutions. Adopting, interpretive phenomenological analysis, data are collected from 13 respondents using semi-structured in-depth interviews. The data reveal that workplace bullying in higher education institutions is gendered. The five major themes identified are the prevalence of bullying, gender differences in types of bullying, gender and leadership position, gender and responses to bullying and gender roles and reasons for bullying. The article contributes at micro level, the influence of gender in academics on the level of bullying, the types of bullying techniques preferred by them, and the variation in their behavioural reactions. This study broadens the perspective of workplace bullying in higher education institutions through the concepts of gender, culture and new managerialism.
Ethics and AI Assemblages: A Heuristic Analysis of Undergraduate Business Student Perspectives
Authors: McElroy Stephen J. , Girdharry Kristi
Published: May 2024

Drawing upon a framework of “assemblage thinking,” this article offers an approach to considering artificial intelligence (AI) and ethics that seeks to think relationally across the positions occupied as educators and students at a business school. To complement discussions of assemblage and examinations of ethics in the AI era, we draw upon the perspectives of a relatively understudied population in this conversation—students themselves navigating AI and writing within a business-focused context—and extend assemblage thinking to capture important thought toward the future of business communication, pedagogy, ethics, and AI.
Inpatient Psychiatric Care in the United States: Former Patients’ Perspectives on Opportunities for Quality Improvement
Authors: Shields Morgan C. , Davis Kelly A.
Published: May 2024

Patient-centered care is a salient value expressed by stakeholders, but a commitment to implementing patient-centered care environments lags in the context of inpatient psychiatry. The current study aimed to describe patients’ suggestions for improving the quality of inpatient psychiatry. We fielded a national survey online in 2021, in which we asked participants to report their recommendations for care improvement through a free-response box. We used an inductive qualitative approach to synthesize responses into themes. Most responses described negative experiences, with suggested improvements implied as the inverse or absence of the respondent's negative experience. Among 510 participants, we identified 10 themes: personalized care, empathetic connection, communication, whole health approach, humane care, physical safety, respecting patients’ rights and autonomy, structural environment, equitable treatment, and continuity of care and systems. To implement the value of patient-centered care, we suggest that those in positions of power prioritize improvement initiatives around these aspects of care that patients find most in need of improvement.
Antisocial Capital: Community Cohesion and Tax Avoidance among American Elites
Authors: Shiffer-Sebba Doron , Harpaz Yossi
Published: May 2024

Studies of social capital usually emphasize its prosocial, deviance-reducing effects. This article instead explores its negative potential. The authors focus on the relationship between different forms of community-level social capital and tax avoidance by wealthy Americans, using data from the Panama Papers leaks to analyze the residential communities of Americans who engaged in offshore tax avoidance. The analysis demonstrates, first, that communities with more civic organizations are more likely to have tax avoiders. This finding suggests that civic organizations may promote cohesion among wealthy elites, producing insular attitudes and deviance. Second, income inequality correlates with tax avoidance, indicating that highly unequal communities have more insular elites. Finally, more patriotic communities have lower tax avoidance. These findings empirically establish the concept of “negative social capital” and advance the distinction between bridging (or cross-group) social capital, which lowers deviance, and bonding (or within-group) social capital, which is actually associated with greater elite deviance.
Visualizing Daily Time Use on Housework in Canada: Persistence and Patterns
Authors: Kolpashnikova Kamila , Li Zilin , Quesnel-Vallée Amélie
Published: May 2024

Housework is a significant part of our daily lives. In this visualization, the authors consider how time spent on housework varies across gender and age throughout the day. Using the nationally representative 2015 Canadian General Social Survey with detailed time diary information, the authors present how women’s and men’s time allocation patterns on housework vary across age groups. The visualization shows that women and older Canadians engaged more in housework. A clear pattern reveals higher engagement during mealtimes, while participation becomes more evenly distributed throughout the day among older adults compared with younger women and men.
The Evaluation of a 5-miRNA Panel in Patients with Periodontitis Disease
Authors: Baru O. , Pop L. , Raduly L. , Bica C. , Mehterov N. , Pirlog R. , Buduru S. , Braicu C. , Berindan-Neagoe I. , Badea M.
Published: May 2024

Introduction:

Side by side with tooth decay, periodontitis remains one of the most common oral diseases and is increasingly recognized as a serious public health concern worldwide.

Objectives:

The present study aims at comparing the levels of 5 specific miRNAs (miR-29b-3p, miR-34a-5p, miR-155-5p, miR-181a-5p, and miR-192-5p) in patients with periodontal disease and healthy controls.

Methods:

The pathogenic mechanism is related to the activation of immune response and significant alteration of coding and noncoding genes, including miRNA. The study includes 50 subjects (17 with periodontal disease and 33 healthy controls) with a mean age of 45.3 y. In both periodontitis patients and healthy controls, a panel of 5 miRNAs (miR-29b-3p, miR-34a-5p, miR-155-5p, miR-181a-5p, and miR-192-5p) is examined by determining their expression levels with quantitative reverse transcription polymerase chain reaction.

Results:

The periodontitis patients express high levels of all the investigated miRNAs. Receiver operating characteristic curve analysis shows an area under the curve (AUC) of 0.69 to 0.74 for individual transcripts with the highest AUC value observed for miR-192, followed by miR-181a.

Conclusions:

The study indicates that the 5-miRNA panel can be used as biomarker for periodontitis. In this way, all implantology procedures and treatment options for patients diagnosed with periodontitis can be improved for better long-term results, predictability, and follow-up frequency.

Knowledge Transfer Statement:

The discovery of a miRNA panel as a potential biomarker for periodontitis offers major opportunities for practical application. Our study can improve diagnostic accuracy; researchers can develop new theories on molecular mechanisms and biomarker discovery.
Smart City Mission: An Opportunity for Inclusive E-waste Management
Authors: Rastogi Ankita , Khan Adeel , Vasisth Shushant
Published: May 2024

This article examines the opportunity that the Smart City Mission (SCM) provides for the e-waste recycling sector in India. The SCM is aimed at improving the quality of life in 100 cities across the country, but is it in line with responsible consumption and production? A larger reliance on technology and rudimentary methods of e-waste recycling would give rise to more toxins polluting land, water and air. We posit that the SCM provides some leeway to formalise the informal sector, where most of India’s e-waste recycling takes place. The E-Waste Management Rules of 2016 mandate all recycling units to register with the Central Pollution Control Board (CPCB). Formal recycling capacity is lagging behind the domestic generation of e-waste, let alone dealing with imports. An augmentation of recycling capacity is required. Based on interviews with informal and formal e-waste recyclers, we set forth the e-waste recycling of both and suggest alternatives to the malpractices in the informal sector recycling to make it sustainable and safe. We propose a segmented flow of bulk and retail consumer e-waste into large-scale and small-scale e-waste enterprises, respectively. Measures to trace the e-waste flow properly are recommended, and Producer Responsibility Organisations are identified as key facilitators and capacity builders to spearhead the process. The increase in volume of e-waste flow due to SCM will reduce the competitive antagonism between the formal and informal sectors over e-waste flow, making it an opportune moment to strike a separate flow between the formal and formalised small-scale units.
Multimodal mechanisms of pathogenic variants in the signal peptide of FIX leading to hemophilia B
Authors: Gao Meng , Chen Long , Yang Jinlong , Dong Shixia , Cao Qing , Cui Zihan , Dong Yanyan , Liu Hongli , Shen Yan , Yang Haiping , Hao Zhenyu , Zhang Lei , Li Weikai , Tie Jian-Ke , Shen Guomin
Published: May 2024

Signal peptide (SP) is essential for protein secretion, and pathogenic variants in the SP of factor IX (FIX) have been identified in hemophilia B (HB). However, the underlying mechanism for the genotype-phenotype correlation of these variants has not been well studied. Here, we systematically examined the effects of 13 pathogenic point variants in the SP of FIX using different approaches. Our results showed that these point variants lead to HB by missense variants and/or aberrant premessenger RNA (pre-mRNA) splicing. The missense variants in a hydrophobic core (h-region) mainly affected the cotranslational translocation function of the SP, and those in C-terminal containing cleavage site (c-region) caused FIX deficiency mainly by disturbing the cotranslational translocation and/or cleavage of the SP. Almost absolute aberrant pre-mRNA splicing was only observed in variants of c.82T>G, but a slight change of splicing patterns was found in variants of c.53G>T, c.77C>A, c.82T>C, and c.83G>A, indicating that these variants might have different degrees of impact on pre-mRNA splicing. Although two 6-nt deletion aberrant pre-mRNA splicing products caused FIX deficiency by disturbing the SP cleavage, they could produce some functional mature FIX, and vitamin K could increase the secretion of functional FIX. Taken together, our data indicated that pathogenic variants in the SP of FIX caused HB through diverse molecular mechanisms or even a mixture of several mechanisms, and vitamin K availability could be partially attributed to varying bleeding tendencies in patients carrying the same variant in the SP.
Telephone consulting for ‘Personalised Care and Support Planning’ with people with long-term conditions: a qualitative study of healthcare professionals’ experiences during COVID-19 restrictions and beyond
Authors: McCann Sharon , Entwistle Vikki A. , Oliver Lindsay , Lewis-Barned Nick , Haines Rebecca , Cribb Alan
Published: May 2024

Background

Personalised Care and Support Planning (PCSP) replaces conventional annual reviews for people with long-term conditions. It is designed to help healthcare professionals (HCPs) and patients engage in conversations as equals and collaboratively plan actions oriented to each patient’s priorities, alongside biomedical concerns. Little is known about how the shift to remote consulting initiated with COVID-19 restrictions has impacted PCSP.

Aim

To investigate HCPs’ experiences of conducting PCSP conversations remotely and consider implications for the fulfilment of PCSP ambitions as remote consulting continues beyond COVID-19 restrictions.

Methods

19 semi-structured interviews with HCPs in England and Scotland; interpretive analysis.

Results

HCPs’ accounts made clear that COVID-19 restrictions impacted multiple aspects of PCSP delivery, not just the mode of conversation. Broader disruption to general practice systems for gathering and sharing information ahead of PCSP conversations, and moves to ‘wide window’ appointment times, made it harder for patients to be prepared for PCSP conversations. This constrained scope to achieve PCSP ambitions even with the best professional communication skills. Most remote PCSP conversations were conducted by telephone. In the absence of visual communication with patients, it was sometimes harder to achieve the ambitions of PCSP conversations, including to balance patient and professional agendas, fulfil key planning activities, and foster a relational ethos of equal, collaborative partnership. The challenges were particularly severe when working with new patients and people with complex clinical and social problems. Although options for telephone appointments now offer valued flexibility, sustained experience of struggling to achieve PCSP ambitions via remote consulting led some HCPs to lower their standards for judging a “good” PCSP conversation, and to diminished professional satisfaction.

Conclusions

There are significant challenges to fulfilling the ambitions of PCSP via telephone, especially when preparatory support is limited. This study provides grounds for scepticism about how compatible telephone appointments can be with this person-centred model of working, especially for people who are socially disadvantaged and live with complex health conditions. These threats to the provision of person-centred support for people with long-term conditions warrant careful attention going forward if the PCSP model and its benefits are to be sustained.
Household air pollution and urinary incontinence symptoms among older adults in LASI: a large-scale population-based study
Authors: Liu Xiaoyang , Ma Kai , Liu Shengzhuo , Song Pan , Yang Luchen , Liu Zhenghuan , Zhou Jing , Wang Linchun , Yan Xin , Yu Yunfei , Dong Qiang
Published: May 2024

Background

The effects of household air pollution on urinary incontinence (UI) symptoms and stress urinary incontinence (SUI) symptoms have not been studied. This study seeks to investigate the correlation between household air pollution and UI/SUI symptoms among middle-aged and elderly adults in India.

Methods

We employed data derived from individuals aged 45 years and older who participated in the inaugural wave (2017–2018) of the Longitudinal Aging Study in India (LASI). The assessment of household air pollution exposure and the occurrence of UI/SUI symptoms relied on self-reported data. The analytical approach adopted was cross-sectional in nature and encompassed a cohort of 64,398 participants. To explore relationships, we utilized multivariate logistic regression analysis, incorporating subgroup analysis and interaction tests.

Results

1,671 (2.59%) participants reported UI symptoms and 4,862 (7.55%) participants reported SUI symptoms. Also, the prevalence of UI/SUI symptoms is much higher among middle-aged and elderly adults who use solid polluting fuels (UI: 51.23% vs. 48.77%; SUI: 54.50% vs. 45.50%). The results revealed a noteworthy correlation between household air pollution and the probability of experiencing UI/SUI symptoms, persisting even after adjusting for all conceivable confounding variables (UI: OR = 1.552, 95% CI: 1.377–1.749, p < 0.00001; SUI: OR: 1.459, 95% CI: 1.357–1.568, p < 0.00001). Moreover, significant interaction effects were discerned for age, education level, tobacco consumption, alcohol consumption, and physical activity (p for interaction < 0.05).

Conclusions

The results of our study indicate that the utilization of solid fuels in the home increases the likelihood of developing urinary incontinence and stress urinary incontinence. As a result, we argue that there is an immediate need to reform the composition of cooking fuel and raise public awareness about the adverse effects of air pollution in the home.
Integrating Syrian refugees into Lebanon’s healthcare system 2011–2022: a mixed-method study
Authors: Honein-AbouHaidar Gladys , Bou-Karroum Lama , Parkinson Sarah E. , Majed Rima , Salameh Sabine , Daher Najla , Hemadi Nour , Fouad Fouad M. , El-Jardali Fadi
Published: May 2024

Introduction

The Lebanese government estimates the number of Syrian refugees to be 1.5 million, representing 25% of the population. Refugee healthcare services have been integrated into the existing Lebanese health system. This study aims to describe the integration of Syrian refugee health services into the Lebanese national health system from 2011 to 2022, amid an ongoing economic crisis since 2019 and the COVID-19 pandemic.

Methods

This paper employs a mixed-methods approach drawing upon different data sources including: 1- document review (policies, legislation, laws, etc.); 2- semi-structured interviews with policymakers, stakeholders, and health workers; 3- focus group discussions with patients from both host and refugee populations; and 4- health systems and care seeking indicators.

Results

Although the demand for primary health care increased due to the Syrian refugee crisis, the provision of primary health care services was maintained. The infusion of international funding over time allowed primary health care centers to expand their resources to accommodate increased demand. The oversupply of physicians in Lebanon allowed the system to maintain a relatively high density of physicians even after the massive influx of refugees. The highly privatized, fragmented and expensive healthcare system has impeded Syrian refugees’ access to secondary and tertiary healthcare services. The economic crisis further exacerbated limits on access for both the host and refugee populations and caused tension between the two populations. Our findings showed that the funds are not channeled through the government, fragmentation across multiple financing sources and reliance on international funding. Common medications and vaccines were available in the public system for both refugee and host communities and were reported to be affordable. The economic crisis hindered both communities’ access to medications due to shortages and dramatic price increases.

Conclusion

Integrating refugees in national health systems is essential to achieve sustainable development goals, in particular universal health coverage. Although it can strengthen the capacity of national health systems, the integration of refugees in low-resource settings can be challenging due to existing health system arrangements (e.g., heavily privatized care, curative-oriented, high out-of-pocket, fragmentation across multiple financing sources, and system vulnerability to economic shocks).
What is the optimal number of embryos to transfer for POSEIDON group 1 and group 2? A retrospective study
Authors: Liu Rang , Zhang Qiuju , Geng Lan , He Huiqing , Xu Chang , Feng Jiali , Song Miaoling , Cao Yanpei , Wang Tianren , Xia Xi
Published: May 2024

Background

The 2016 Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria redefined the poor responders as low prognosis patients. The embryo transfer strategy for POSEIDON patients remained to be addressed. This study aimed to investigate the optimized number of embryos to transfer for unexpected low-prognosis patients (POSEIDON Group 1 and Group 2) with blastocyst transfer in their first frozen cycle.

Methods

A retrospective cohort study of 2970 patients who underwent frozen-thawed embryo transfer (FET) between January 2018 and December 2021. Patients from POSEIDON Group 1 (N = 219) and Group 2 (N = 135) who underwent blastocyst transfer in their first FET cycles were included and divided into the elective single embryo transfer (eSET) group and the double embryo transfer (DET) group.

Results

For POSEIDON Group 1, the live birth rate per embryo transfer of the DET group was slightly higher than the eSET group (52.17% vs 46.15%, OR 0.786, 95% CI 0.462–1.337, P = 0.374; adjusted OR (aOR) 0.622, 95% CI 0.340–1.140, P = 0.124), while a significant increase of 20.00% in the multiple birth rate was shown. For Group 2, higher live birth rates were observed in the DET group compared to the eSET group (38.46% vs 20.48%, OR 0.412, 95% CI 0.190–0.892, P = 0.024; aOR 0.358, 95% CI 0.155–0.828, P = 0.016). The difference in the multiple birth rate was 20.00% without statistical significance. Univariate and multivariate analyses revealed that age (OR 0.759, 95% CI .624–0.922, P = 0.006 and OR 0.751, 95% CI 0.605–0.932, P = 0.009) and the number of transferred embryos (OR 0.412, 95% CI 0.190–0.892, P = 0.024 and OR 0.367, 95% CI 0.161–0.840, P = 0.018) were significant variables for the live birth rate in POSEIDON Group 2.

Conclusions

The findings in the present study showed that eSET was preferred in the first frozen cycle for POSEIDON Group 1 to avoid unnecessary risks. Double embryo transfer strategy could be considered to improve the success rate for POSEIDON Group 2 with caution. Further stratification by age is needed for a more scientific discussion about the embryo transfer strategy for POSEIDON patients.
Triggers of intensive care patients with palliative care needs from nurses’ perspective: a mixed methods study
Authors: Schallenburger Manuela , Schwartz Jacqueline , Icks Andrea , in der Schmitten Jürgen , Batzler Yann-Nicolas , Meier Stefan , Mendez-Delgado Miguel , Tenge Theresa , Neukirchen Martin
Published: May 2024

Purpose

Triggers have been developed internationally to identify intensive care patients with palliative care needs. Due to their work, nurses are close to the patient and their perspective should therefore be included. In this study, potential triggers were first identified and then a questionnaire was developed to analyse their acceptance among German intensive care nurses.

Methods

For the qualitative part of this mixed methods study, focus groups were conducted with intensive care nurses from different disciplines (surgery, neurosurgery, internal medicine), which were selected by convenience. Data were analysed using the “content-structuring content analysis” according to Kuckartz. For the quantitative study part, the thus identified triggers formed the basis for questionnaire items. The questionnaire was tested for comprehensibility in cognitive pretests and for feasibility in a pilot survey.

Results

In the qualitative part six focus groups were conducted at four university hospitals. From the data four main categories (prognosis, interprofessional cooperation, relatives, patients) with three to 15 subcategories each could be identified. The nurses described situations requiring palliative care consults that related to the severity of the disease, the therapeutic course, communication within the team and between team and patient/relatives, and typical characteristics of patients and relatives. In addition, a professional conflict between nurses and physicians emerged. The questionnaire, which was developed after six cognitive interviews, consists of 32 items plus one open question. The pilot had a response rate of 76.7% (23/30), whereby 30 triggers were accepted with an agreement of ≥ 50%.

Conclusion

Intensive care nurses see various triggers, with interprofessional collaboration and the patient's prognosis playing a major role. The questionnaire can be used for further surveys, e.g. interprofessional triggers could be developed.
Locus coeruleus integrity and left frontoparietal connectivity provide resilience against attentional decline in preclinical alzheimer’s disease
Authors: Pahl Jennifer , Prokopiou Prokopis C. , Bueichekú Elisenda , Schultz Aaron P. , Papp Kathryn V. , Farrell Michelle E. , Rentz Dorene M. , Sperling Reisa A. , Johnson Keith A. , Jacobs Heidi I.L.
Published: May 2024

Background

Autopsy work reported that neuronal density in the locus coeruleus (LC) provides neural reserve against cognitive decline in dementia. Recent neuroimaging and pharmacological studies reported that left frontoparietal network functional connectivity (LFPN-FC) confers resilience against beta-amyloid (Aβ)-related cognitive decline in preclinical sporadic and autosomal dominant Alzheimer’s disease (AD), as well as against LC-related cognitive changes. Given that the LFPN and the LC play important roles in attention, and attention deficits have been observed early in the disease process, we examined whether LFPN-FC and LC structural health attenuate attentional decline in the context of AD pathology.

Methods

142 participants from the Harvard Aging Brain Study who underwent resting-state functional MRI, LC structural imaging, PiB(Aβ)-PET, and up to 5 years of cognitive follow-ups were included (mean age = 74.5 ± 9.9 years, 89 women). Cross-sectional robust linear regression associated LC integrity (measured as the average of five continuous voxels with the highest intensities in the structural LC images) or LFPN-FC with Digit Symbol Substitution Test (DSST) performance at baseline. Longitudinal robust mixed effect analyses examined associations between DSST decline and (i) two-way interactions of baseline LC integrity (or LFPN-FC) and PiB or (ii) the three-way interaction of baseline LC integrity, LFPN-FC, and PiB. Baseline age, sex, and years of education were included as covariates.

Results

At baseline, lower LFPN-FC, but not LC integrity, was related to worse DSST performance. Longitudinally, lower baseline LC integrity was associated with a faster DSST decline, especially at PiB > 10.38 CL. Lower baseline LFPN-FC was associated with a steeper decline on the DSST but independent of PiB. At elevated PiB levels (> 46 CL), higher baseline LFPN-FC was associated with an attenuated decline on the DSST, despite the presence of lower LC integrity.

Conclusions

Our findings demonstrate that the LC can provide resilience against Aβ-related attention decline. However, when Aβ accumulates and the LC’s resources may be depleted, the functioning of cortical target regions of the LC, such as the LFPN-FC, can provide additional resilience to sustain attentional performance in preclinical AD. These results provide critical insights into the neural correlates contributing to individual variability at risk versus resilience against Aβ-related cognitive decline.
How to report perinatal and paediatric postmortem CT
Authors: Shelmerdine Susan C. , Arthurs Owen J.
Published: May 2024

Postmortem CT (PMCT) has become increasingly accepted alongside skeletal surveys as a critical part of investigation in childhood deaths, either as part of a suite of non-invasive investigations through parental choice, or comprehensive evaluation in a forensic setting. Whilst CT image acquisition and protocols have been published and are relatively standardised, CT imaging reporting remains highly variable, largely dependent upon reporter experience and expertise. The main “risk” in PMCT is the over-interpretation of normal physiological changes on imaging as pathological, potentially leading to misdiagnosis or overdiagnosis of the disease. In this article, we present a pragmatic standardised reporting framework, developed over a decade of PMCT reporting in children in our institution, with examples of positive and negative findings, so that it may aid in the interpretation of PMCT images with those less experienced in paediatric findings and postmortem imaging.

Critical relevance statement

Standardised reporting using a common framework with a sound understanding of normal postmortem changes that occur in children are crucial in avoiding common reporting errors at postmortem CT.

Key Points

Familiarity with postmortem imaging is required for useful image reporting, and reporting standards vary.

Understanding normal postmortem change from significant abnormalities requires training and experience.

Following a template may remind reporters what to include and help improve performance.

Graphical Abstract
Correlation between imaging and histology in benign solitary retroperitoneal nerve sheath tumors: a pictorial review
Authors: Carone Luisa , Messana Gaia , Vanoli Alessandro , Pugliese Luigi , Gallotti Anna , Preda Lorenzo
Published: May 2024

Background

Benign nerve sheath tumors presenting as solitary retroperitoneal masses (RBNSTs) pose a complex diagnostic challenge for multidisciplinary teams regarding differential diagnosis, staging, and treatment planning. This article reviews the role played by different imaging techniques in assessing RBNSTs and elucidates their typical pathological features with a particular emphasis on the correlation between imaging and histological findings. Furthermore, some examples of retroperitoneal tumors that merit consideration in the process of differential diagnosis based on cross-sectional investigations (CSIs) are reported. The correlation between tissue architecture and appearance on imaging can help increase the accuracy of differential diagnosis with other retroperitoneal neoplasms at CSIs.

Critical relevance statement

This educational review critically examines the correlation between imaging and histological features in solitary retroperitoneal benign nerve sheath tumors, offering valuable insights for improving the accuracy of differential diagnosis in clinical radiology.

Key Points

RBNSTs are challenging to diagnose because they lack specific radiological features.

Differential diagnosis of RBNSTs from other retroperitoneal neoplasms on imaging is complex.

Surgical removal of RBNSTs is recommended for an accurate diagnosis.

Graphical Abstract