bluuebunny/crossref_metadata_2025 huggingface dataset:
The Multi-Technology Footprint of the National Broadband Network in Australia: Exploring the Urban-Regional Divide and Socio-spatial Patterns for Inequality
Authors: Alizadeh Tooran , Helderop Edward , Grubesic Tony H. , Ferrers Richard
Published: April 2023

The recent global pandemic renewed the importance of telecommunication infrastructure, as many COVID responses (e.g., working from home, home-schooling, e-commerce) were challenged by the inequity of access to broadband services and its underlying network. This paper examines the geospatial footprint of the National Broadband Network (NBN) in relation to the demographics of Australia’s cities and regions. Through data made available by the NBN, which describes the technologies used in its multi-technology mix platform, and published demographic data available via the Australian Bureau of Statistics (ABS), we explore the equity of access to broadband technologies across the nation. The results show a persistent urban-regional divide in the NBN. The paper also offers a brief assessment of the complex and contradictory ways policy responses attempt to mitigate the digital divide, including updates to the national infrastructure project plans.
Detour and Dao: Benjamin, with Jullien, contra the Ontology of the Event
Authors: Fenves Peter
Published: April 2023

Taking its point of departure from Jullien’s primary claim in The Silent Transformations that ancient Greek ontology propels European thought into ‘the vertigo of the event,’ the article turns toward a European thinker whom Jullien does not mention in this context, namely Walter Benjamin, and asks whether his work, too, succumbs to this vertigo. The choice of Benjamin as a ‘test case’ is governed by two factors: while his work is widely associated with notions of the event, there is little recognition of the degree to which he was engaged with the Daodejing (in translation) from the early 1910s to the late 1930s. Divided into four chronologically ordered sections, each of which is prefaced by a claim advanced in The Silent Transformations, the article shows how Benjamin’s concepts of transition, effective non-action (under the term ‘proletarian general strike’), mimesis, ‘the second technology,’ and Jetztzeit (‘now-time’) are all traversed by a mediated conception of the Dao. The primary question around this re-evaluation of his work, guided by the idea of ‘the silent transformations’ that Jullien adopts from Wang Fuzhi, is whether the theory of revolution Benjamin developed in the 1930s can be characterized as Daoist or, better yet, Marxist-Daoist.
Predicting literacy development and risk in Spanish-English bilingual first graders
Authors: Bedore Lisa M , Peña Elizabeth D , Collins Penelope , Fiestas Christine , Lugo-Neris Mirza , Barquin Elisa
Published: April 2023

Purpose: There are well-established links between oral language and reading development in monolingual English-speaking children that are associated with literacy outcomes. Oral language, defined relative to lexical quality, provides key support for developing early reading skills. For bilingual children, the connection between oral language and reading development and risk for identification of having language or reading difficulties is assumed but has been less systematically studied. Our goal was to document the relationship between knowledge of semantics and morphosyntax and children's performance on letter and word identification in first grade in each of their languages so as to evaluate the risk for poor reading outcomes in the Spanish and English of bilingual first graders. Method: We examined data from 111 Spanish-English bilingual first graders on measures of Spanish and English semantics and morphosyntax in relation to letter-word identification, which indexes early reading development. We evaluated the within- and across-language relationships between skills and also whether the same children who performed in the at-risk range on the oral language tasks showed risk for future reading difficulties based on their letter-word performance. Results: Oral language skills and early reading skills were strongly related within languages, and cross-language relationships were also evident, though not for all domains. There were significant associations between risk for developmental language disorder (DLD) based on semantics performance and reading risk. Conclusions: We observe cross-linguistic relationships between letter-word identification and morphosyntactic and semantic skills in young Spanish-English bilinguals with and without risk for language and reading development. These findings indicate that connections between oral language and reading hold across differing levels of language and reading risk.
Vestibular dysfunction in people who fall: A systematic review and meta-analysis of prevalence and associated factors
Authors: Donovan Jacquelin , De Silva Luckshica , Cox Hayley , Palmer Gretta , Semciw Adam Ivan
Published: April 2023

Objectives

To evaluate the prevalence and factors associated with vestibular dysfunction in people who fall.

Data Sources

All electronic records from MEDLINE, CINAHL, Embase and psycINFO databases were searched to 9 December 2022.

Review Methods

Participants were adults with at least one fall within the previous year who were exposed to at least one vestibular function test. Any published peer reviewed trial designs were accepted. Included studies were assessed for risk of bias using a modified Epidemiological Appraisal Instrument. The quality of each meta-analysis was assessed using modified Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

Ten trials (468 participants) were identified, six of which had high methodological quality. Vestibular dysfunction was found in 61% (48.01–72.32) I2 =  78% of participants. The most prevalent type of dysfunction was from tests of vestibulo-ocular reflex at 61% (49.79 to 70.49) I2 =  68%, followed by benign paroxysmal positional vertigo at 22% (10.30–40.32) I2  =  87% and central dysfunction at 11% (2.24–37.76) I2  =  50%. People who fall with vestibular dysfunction had reduced walking function compared to those without dysfunction −0.51 (−0.85 to −0.16) I2  =  11%. Dizziness was not related to vestibular dysfunction in people who fall 0.25 (−0.10 to 0.60), I2  =  0%. The quality of the body of evidence ranged from very low to high.

Conclusion

More than one in two people who fall have vestibular dysfunction. Clinicians cannot rely on dizziness report to indicate need for vestibular screening in those who fall. A vestibular screen should be incorporated into a comprehensive falls assessment.
Existential experiences and perceptions of death among children with terminal cancer: An interpretative qualitative study
Authors: Lin Nan , Lv Danni , Hu Yan , Zhu Jihua , Xu Hongzhen , Lai Dengming
Published: April 2023

Background:

Exploring the experience and understanding of death in children with terminal cancer is important to provide them with appropriate care. However, most studies have focused on the perspectives of parents and healthcare professionals, and few have focused on the end-of-life experiences of children.

Aim:

To advance the understanding of end-of-life experiences and perceptions of death in children with cancer.

Design:

Interpretative qualitative study using semi-structured interviews. Data were analyzed using reflexive thematic analysis.

Setting/participants:

The study was conducted at the department of oncological surgery, Children’s Hospital, Zhejiang University School of Medicine. Ten children aged 8–17 with terminal cancer were included in the study.

Results:

Four major themes (and eight sub-themes) were identified from the findings: (1) helplessness in the face of death (loneliness, loss of control); (2) desire to connect with the world they left (reluctantly to be forgotten, sense of self-worth); (3) perceptions and attitudes toward death (separating from loved ones, embracing death); (4) expectations of future life (promoting comfort, fulfilling wishes).

Conclusions:

Children with terminal cancer have a strong sense of loneliness and a desire to connect with the world they have left behind. Differences in children’s perceptions and attitudes about death suggest that healthcare professionals should focus on their experiences and needs and provide personalized palliative care services to children and their families to improve their quality of life.
Identifying Patterns in Preoperative Communication about High-Risk Surgical Intervention: A Secondary Analysis of a Randomized Clinical Trial
Authors: Stalter Lily N. , Baggett Nathan D. , Hanlon Bret M. , Buffington Anne , Kalbfell Elle L. , Zelenski Amy B. , Arnold Robert M. , Clapp Justin T. , Schwarze Margaret L.
Published: April 2023

Introduction

Surgeons are entrusted with providing patients with information necessary for deliberation about surgical intervention. Ideally, surgical consultations generate a shared understanding of the treatment experience and determine whether surgery aligns with a patient’s overall health goals. In-depth assessment of communication patterns might reveal opportunities to better achieve these objectives.

Methods

We performed a secondary analysis of audio-recorded consultations between surgeons and patients considering high-risk surgery. For 43 surgeons, we randomly selected 4 transcripts each of consultations with patients aged ≥60 y with at least 1 comorbidity. We developed a coding taxonomy, based on principles of informed consent and shared decision making, to categorize surgeon speech. We grouped transcripts by treatment plan and recorded the treatment goal. We used box plots, Sankey diagrams, and flow diagrams to characterize communication patterns.

Results

We included 169 transcripts, of which 136 discussed an oncologic problem and 33 considered a vascular (including cardiac and neurovascular) problem. At the median, surgeons devoted an estimated 8 min (interquartile range 5–13 min) to content specifically about intervention including surgery. In 85.5% of conversations, more than 40% of surgeon speech was consumed by technical descriptions of the disease or treatment. “Fix-it” language was used in 91.7% of conversations. In 79.9% of conversations, no overall goal of treatment was established or only a desire to cure or control cancer was expressed. Most conversations (68.6%) began with an explanation of the disease, followed by explanation of the treatment in 53.3%, and then options in 16.6%.

Conclusions

Explanation of disease and treatment dominate surgical consultations, with limited time spent on patient goals. Changing the focus of these conversations may better support patients’ deliberation about the value of surgery. Trial registration: ClinicalTrials.gov Identifier: NCT02623335.

Highlights

In decision-making conversations about high-risk surgical intervention, surgeons emphasize description of the patient’s disease and potential treatment, and the use of “fix-it” language is common. Surgeons dedicated limited time to eliciting patient preferences and goals, and 79.9% of conversations resulted in no explicit goal of treatment. Current communication practices may be inadequate to support deliberation about the value of surgery for individual patients and their families.
Quantification of cardiac iron in patients with thalassemia with 3-T MRI calibrated by 1.5-T MRI
Authors: Xu Fengming , Luo Chaotian , Li Meicheng , Guan Kaiming , Peng Fei , Yang Gaohui , Peng Peng
Published: April 2023

Background

Due to the small sample size of many studies, it remained unclear what standardized reference range the T2* cutoff at 3 T would be used to assess the severity of cardiac iron load. In addition, the number of patients with moderate to severe cardiac iron load was small in some studies, especially the sample of patients with severe cardiac iron load.

Purpose

To explore the feasibility, reproducibility, and reliability of using T2* values in quantifying cardiac iron load in patients with thalassemia at 3 T.

Material and Methods

A total of 122 patients with thalassemia underwent cardiac T2* imaging at both 1.5 T and 3 T. Cardiac R2* (1000/T2*) values of the 100 patients at 3 T were fitted against the values at 1.5 T using linear regression and the prediction equation was derived. The remaining 22 cases were used to test the prediction accuracy of the equation.

Results

The combined R2* values exhibited a strong linear relationship between 1.5 T and 3 T ( r = 0.830， P<0.001). At the center, it had a slope of 1.348 and an intercept of 37.279. According to the equation, the truncated T2* values of cardiac iron overload and cardiac heavy iron overload at 3 T were <10 ms and <6 ms, respectively. The two truncated T2* values were used to diagnose different levels of cardiac iron overloaded of 22 patients at 3 T; the accuracy rates were 95.5% and 100.0%, respectively.

Conclusion

T2* quantification of cardiac iron load at 3 T MRI resulted to be feasible, reproducible, and reliable.
Spontaneous hepatic haemorrhage after caesarean section in a patient with uraemia and superimposed preeclampsia: a case report
Authors: Chen Yuanyuan , Liu Kai , Song Kangjie , Fang Changtai , Zhu Lianghua , Wu Gaofei , Zha Junjing , Zha Jiaan
Published: April 2023

Perinatal spontaneous hepatic haemorrhage is a very rare disease affecting pregnant women, particularly those on long-term dialysis, that has a high maternal and infant mortality rate. Most patients experience preeclampsia with haemolysis, elevated liver enzymes and low platelets syndrome. Here, the case of a 35-year-old multigravida patient with known chronic kidney disease and chronic hypertension with uraemia, who developed spontaneous hepatic haemorrhage after caesarean section, is described. The patient experienced sudden massive circulatory failure, but hemodynamics were temporarily stabilized after emergency surgery. Following transfer to the intensive care unit for continued treatment, her blood pressure and haemoglobin level continued to drop. Selective hepatic artery embolization was performed on day 2 after delivery, and her vital signs gradually stabilized. On day 30 after delivery, the patient was discharged in a stable condition. The newborn recovered after therapy in neonatal intensive care for 2 months. The present case suggests that, for perinatal spontaneous hepatic haemorrhage, timely and accurate diagnosis, multidisciplinary management and determining the therapeutic approach according to clinical symptoms are essential.
Impact of Inpatient Initiation of SGLT2 Inhibitors on Diuretic Requirements in Patients With Heart Failure
Authors: Cavagnini Megan E. , Best Emily E. , Skersick Preston T. , Truitt Kelsey P. , Musick Kaitlin L. , Mangum Blake R. , Hollis Ian B. , Rodgers Jo E.
Published: April 2023

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve outcomes in patients with heart failure (HF) and are now included in guideline-directed medical therapy. Trials reporting the change in loop diuretic dose following SGLT2i initiation have indicated conflicting results. There is no clear guidance on whether reducing loop diuretic doses following SGLT2i initiation is appropriate. Objective: The purpose of this study is to assess the impact of SGLT2i initiation on diuretic adjustment in hospitalized patients with known or new HF. Methods: This was a retrospective, single health-system study assessing the change in loop diuretic dose in the 60 days following discharge for patients with HF initiated on SGLT2i therapy during a hospital admission or upon discharge. Secondary outcomes assessed effect on renal function and discontinuation of SGLT2i within the 60 day follow up period. Results: Forty percent of patients required loop diuretic dose adjustment, with 29% requiring a dose reduction within the 60 days following discharge. There was minimal change in serum creatinine or blood urea nitrogen. The SGLT2i was discontinued in 6 patients. Conclusions: After inpatient initiation of SGLT2is, approximately one-third of patients required a reduction in loop diuretic dose within 60 days following hospital discharge. Further study is recommended to confirm if empiric diuretic dose adjustments are appropriate in this HF population.
Relational and decision-making skills development in South African accounting students
Authors: Kotze Ruhan , Miller Taryn
Published: April 2023

Employers of accounting graduates have criticised graduates’ ability to work well with others and think critically. This study investigates aspirant Chartered Accountants in South Africa (‘aspirant CA(SA)s’) perceptions of the extent to which universities should and are developing relational and decision-making (RDM) skills in accounting students. Questionnaire data from 44 aspirant CA(SA)s, employed at three offices of a large audit firm in South Africa, were obtained. The majority of participants perceive that virtually all RDM skills are developed to an intermediate or advanced level during the academic programme. However, participants also perceive that the academic programme should develop all RDM skills to a greater extent; in particular, skills relating to managing others, teamwork, relationship-building, professional scepticism, emotional intelligence and leadership, to maximise performance during the training programme. Academics may benefit from this study’s findings of perceived RDM skills deficits, and suggestions for their development, which includes collaborating with training offices.
Facing fragmented labour markets: Individual variables and the decision-making ability of humanities students
Authors: Eimer Andreas , Bohndick Carla
Published: April 2023

While humanities graduates can aspire to many fields of work, these labour markets are mostly fragmented and relatively small. In order to be able to enter one of these potential professional fields in a targeted and successful manner, students in the humanities need to develop an individual professional profile. This profile comprises individual characteristics and competencies which include but also go beyond the qualifications from the study programme. Therefore, the authors postulate that specifically students in the humanities have to make many decisions in the course of their studies to prepare for a targeted career entry. From this background, it is important to know what factors are connected with their decision-making ability. This exploratory study examines the relationship of various individual factors with career decision-making adaptability (CDA) and thus on the decision-making competence on a sample of 872 humanities students from German and Swiss universities. A significant relationship with self-efficacy, conscientiousness, perseverance and professional information on CDA was found. The decision-making competence of teacher-training and non-teacher training students did not vary significantly. This study is based on the situation in German-speaking countries, but is also intended to be a stimulus for international comparison.
Research advances in preparation, mechanism and application of thermally conductive and electrically insulating polymer composites in thermal management materials: A review
Authors: Wang Qian , Li Ying
Published: April 2023

Today, electronic components are gradually developing towards miniaturization and multi-function. During the use of electronic components, a large amount of heat will be generated, which seriously limits the performance and service life of electronic components. Therefore, the preparation of thermal management material (TMMs) with high thermal conductivity (λ) can effectively solve the problem of thermal accumulation in electronic components. Compared with the preparation of intrinsic thermal conductive polymer composite, the method of filling thermal conductive filler in polymer matrix can better improve the λ of polymer composite. This review discusses the heat conduction mechanism of polymer and the factors affecting λ of polymer composites, including the type of filler, the shape and distribution of filler, and the functional surface treatment of filler. Then, the different methods of preparing thermally conductive and electrically insulating polymer composites (TCEIPCs) are introduced in detail. The application of polymer composites in thermal management is also introduced.
Synthesis and characterisation of magnesium-based nano-composite – A review
Authors: Mitra Anirban , Mandal Suman Kumar , Rai Ram Naresh
Published: April 2023

In the recent decades, the need for light weight and high specific strength has been the hot issue in many engineering field and also biomedical sectors. Magnesium and its alloys are considered as a light weight material due to its low density that can replaced aluminium, steel and titanium. However, at room temperature, magnesium alloys have closely packed hexagonal crystalline structure with restricted number of freely actuated independent slip system that suffers from poor ductility by 5%–8% approximately. Therefore, Magnesium alloy creates some challenges for the application of many industrial sectors. One technique that can improve strength properties without significant reduction of ductility is to add reinforcing nanoparticles within the magnesium matrix and making them an attractive choice for light weight structural application. The performance of magnesium matrix-based composites to a current stage depends upon the proper selection of composition and combination of reinforcement particles within the matrix materials. In light of the writing overview, the inclusion of reinforcing particles, for example, TiC, SiC, B4C, Al2O3, hybrid reinforcement and so forth is the way to betterment of the tribological behaviour and the mechanical properties of magnesium matrix composites. This paper presents a brief overview based on the available literature survey that the effect of different geometries and percentage contribution of reinforcement particles in various processing techniques on the mechanical properties, microstructure and wear behaviour of magnesium-based metal composites.
Radiation synthesis and modification of biopolymers and polymeric composites for biomedical applications
Authors: Abdel-Ghaffar Ashraf Maher
Published: April 2023

Recently the replacing of the petrochemical origin polymers with biopolymers and biocomposites which are environmental biodegradable polymers became a growing interest. The use of gamma radiation for synthesis and produce further modification of the biopolymers and biocomposites found to be suitable for biomedical application due to none using of toxic additives. Moreover, the radiation technique is the combining of preparation and sterilization in a one technological step thus, reducing time of the production and lower the costs. The use of gamma radiation technique in biomedical application is growing rapidly in controlled drug delivery, injectable materials, wound dressing, tissue engineering, immobilized enzymes and biosensors.
Contesting the integration narrative: Shifting perceptions of EUrope
Authors: Bachmann Veit
Published: April 2023

The European Union (EU) has long projected the vision of an integrating Europe, centred on successful regional integration, as a better geopolitical model in comparison to ‘others’, such as the Cold War superpowers, US neoconservativism or diverse autocratic regimes. The purported superiority of the ‘European model’ is thereby linked to credibly advancing the story of successful regional integration – internally as well as externally. This article suggests a narrative continuum between EU-optimism and EU-scepticism and argues that perceptions about the ‘success’ of the EU as a model for regional integration have changed between the first and the second decade of the new millennium. As part of this shift, EU-scepticism has gained in prominence over EU-optimism. This is related to a series of geopolitical ruptures since the late 2000s, in particular, the financial crisis, disputes on human mobility and border management, rising nationalism, Brexit and other right-wing populist movements across the continent. Focussing on the divisions within the EU as regards financial and migration policy, this article highlights three interrelated simultaneities. It argues (a) that process and discourse of (b) integration and disintegration have (c) internal and external dimensions. Empirically, it builds on interviews with African and European geopolitical elites that have been conducted as part of two research projects on external perceptions of the EU in East Africa between 2010 and 2018. It thus offers a snapshot on the shift of both ‘internal’ and ‘external’ perceptions of the EU against the context of wider geopolitical transformations over the course of this decisive decade.
Place and immigrant labour market integration: A sequence analysis approach
Authors: Klaesson Johan , Wixe Sofia
Published: April 2023

Although the process of integrating immigrants into the labor market unfolds over many years, it is often modeled as outcomes (e.g. employment) at specific points in time. We contribute to the literature by providing empirical evidence of the sequence of events leading to active labor market participation of East African and EU15 immigrants to Sweden, whom we follow for up to 28 years. By combining the method of sequence analysis with binomial logit estimation, we can explain why individuals are sorted into different representative labor market sequences. A further contribution is that along the usual initial conditions (individual and geographic), we employ longitudinal micro data to find (1) representative sequences of movements between various types of neighborhoods and (2) an empirical estimate of individual ability, which turns out to be a strong predictor for immigrants entering an active labor market trajectory. Our results show that East Africans tend to reside in neighborhoods with a high degree of socioeconomic and ethnic segregation. Despite this, their labor market activity seems to be less influenced by neighborhood trajectories than EU15 immigrants. The labor market activity of EU15 immigrants and female East African immigrants is positively related to residing in less ethnically segregated and socioeconomically stronger neighborhoods. Our results are relevant to policy development since they point to the importance of the initial location of immigrants and their subsequent residential mobility.
Characterising variability in youth mental health service populations: A detailed and scalable approach using digital technology
Authors: Capon William , Hickie Ian B , McKenna Sarah , Varidel Mathew , Richards Matthew , LaMonica Haley M , Rock Daniel , Scott Elizabeth M , Iorfino Frank
Published: April 2023

Objective

This study utilised digital technology to assess the clinical needs of young people presenting for care at headspace centres across Australia.

Method

1490 young people (12–25 years) who presented to one of 11 headspace services from four geographical locations (urban New South Wales, urban South Australia, regional New South Wales, and regional Queensland) completed a digital multidimensional assessment at initial presentation. Characteristics were compared between services and geographical locations.

Results

We identified major variation in the demographics, and the type and severity of needs across different services. Individuals from regional services were more likely to be younger, of Aboriginal and Torres Strait Islander origin, and present with psychotic-like symptoms and suicidality, while those in urban areas were more likely to have previously sought help and have problematic alcohol use. Further differences in age, distress, depressive symptoms, psychotic-like experiences, trauma, family history, alcohol use, education/employment engagement, and days out of role were identified between different urban sites.

Conclusions

The variability between services provides insight into the heterogeneity of youth mental health populations which has implications for appropriate early intervention and prevention service provisions. We propose that integrating digital technologies has the potential to provide insights for smarter service planning and evaluation.
Benign Vascular Lesions of the Breast: A Clinical, Radiographic, and Pathologic Review
Authors: Braun Ankica , Solari Mariana , Gattuso Paolo , Agarwal Indu
Published: April 2023

Vascular lesions of the breast are uncommon, however, these are increasingly encountered now due to more frequent use of magnetic resonance imaging. They comprise a spectrum of lesions including benign, atypical, and malignant tumors. The prototype is a hemangioma, which is most often nonpalpable and is detected on routine screening. Different histopathologic subtypes of hemangioma have been described, including perilobular, venous, cavernous, and capillary hemangioma. Other benign vascular lesions include anastomosing hemangioma, a well-circumscribed proliferation of anastomosing blood vessels with lobular or diffuse growth pattern which affects a large segment of the breast, presenting as a painless slow enlarging palpable mass. Recent data suggest that benign vascular lesions diagnosed on core needle biopsy with concordant radiologic and pathologic findings do not require excision and have an excellent prognosis, except angiomatosis, which can be locally aggressive and may recur. The main focus of this study is to present the radiographic, gross, and histopathologic characteristics of benign vascular lesions of the breast and their differential diagnoses.
Improving Engagement in the Virtual Environment Through Culturally Relevant Expectations and Parent Collaboration for Students With Emotional and Behavioral Disorders
Authors: Marsh Robbie J. , Baltodano-Van Ness Heather M. , Mathur Sarup R.
Published: April 2023

Virtual learning is attracting more students with disabilities as it may offer unique learning opportunities in online environments. However, virtual instruction may not effectively meet the needs of students with emotional and behavioral disorders (EBD). We highlight ways that special education teachers can develop culturally relevant behavioral expectations and increase parent engagement to improve the likelihood of obtaining more positive virtual learning outcomes for students with EBD. Each component includes an explanation and accompanying examples.
Internal and Environmental Predictors of Physician Practice Use of Screening and Medications for Opioid Use Disorders
Authors: Miller-Rosales Chris , Busch Susan H. , Meara Ellen R. , King Ashleigh , D’Aunno Thomas A. , Colla Carrie H.
Published: April 2023

Medications for opioid use disorder (MOUD) remain highly inaccessible despite demonstrated effectiveness. We examine the extent of screening for opioid use and availability of MOUD in a national cross-section of multi-physician primary care and multispecialty practices. Drawing on an existing framework to characterize the internal and environmental context, we assess socio-technical, organizational-managerial, market-based, and state-regulation factors associated with the use of opioid screening and offering of MOUD in a practice. A total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Having advanced health information technology functionality was positively associated with both screening for opioid use and offering MOUD in a practice, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models. These results suggest that improving access to information and expertise may enable physician practices to respond more effectively to the nation’s ongoing opioid epidemic.
“I’m Doing Okay”: Strengths and Resilience of Children With and Without ADHD
Authors: Charabin Emma , Climie Emma A. , Miller Courtney , Jelinkova Kristina , Wilkins Jessica
Published: April 2023

Background:

The body of research directed at understanding the strengths and resilience of this population is growing. Research has indicated there are strengths for individuals with ADHD, and found factors important for promoting good outcomes. This study investigates positive qualities by examining the strengths and resilience of children with and without ADHD.

Methods:

The final sample included 56 children between the ages of 10 and 17 years (ADHD: n = 38; without ADHD: n = 18).

Results:

Children in both groups tended to report average levels of strengths and resilience except for school functioning, where significant differences were found between groups. Significant correlations between strengths and resilience for both groups were found. Only family involvement was not significantly correlated with resilience for the without ADHD group.

Conclusions:

Results from this study emphasize the importance of taking a strength-based perspective when working with children diagnosed with ADHD.
Effects of Trainer Continuity and Experience on Neurofeedback Treatment of ADHD in Children
Authors: Cash Shelby , Rogge Carson , Schrader Constance , deBeus Roger , Kerson Cynthia , Arnold Lawrence Eugene
Published: April 2023

Objective:

To examine whether trainer continuity and experience impacted the significantly improved inattention scores (pre-post d = 1.44–1.53) seen in both the control and active treatment groups of “Double-Blind Placebo-Controlled Randomized Clinical Trial of Neurofeedback for Attention-Deficit/Hyperactivity Disorder” (2021).

Methods:

The primary trainer was the one who coached the most treatment sessions with a participant. A trainer was considered experienced after coaching 100 sessions. The percentage of sessions each participant had with their primary trainer and percentage with an experienced trainer were entered as independent variables into linear mixed models in SASv.9.4 with improvement in inattention ratings by parents and teachers (primary outcome) as dependent variable.

Results:

Effect of trainer continuity on primary outcome was not significant ( B = −0.016, SE = 0.153, t(123) = −0.11, p = .916). However, percent of sessions with an experienced trainer correlated with increased improvement ( B = 0.238, SE = 0.095, t(123) = 2.51, p = .013).

Conclusion:

Neurofeedback trainer continuity does not appear important, while trainer experience with at least 100 sessions correlates with better outcomes.
Using Body Worn Camera Footage to Investigate Predictors of Officer Behavior and the Outcomes of Police–Community Interactions
Authors: James Lois , James Stephen
Published: April 2023

The objective of this study was to use interval-level metrics to code a random sample of body worn camera footage from a large ( N ∼ 700) municipal police department in 2019. Just over 1,100 videos were coded for (1) community member factors; (2) officer behaviors—including an overall “performance” score; and (3) encounter outcomes. Our goal was to answer the following: Do police receive higher overall performance scores when interacting with some types of community members compared to others? Which community member factors significantly predict specific officer behaviors? Which community member factors significantly predict encounter outcomes? We found that officers received higher performance scores when interacting with women, and with community members with mental illness. We found that socio-economic-status and gender were the most common predictors of officer behaviors, while race and ethnicity, socio-economic-status, gender, and armed status predicted encounter outcomes. The policy implications of these findings are discussed.
Teleneurocritical care is associated with equivalent billable charges to in-person neurocritical care for patients with acute stroke
Authors: Murray Nick M , Thomas Katherine , Roller Dean , Marshall Scott , Martinez Julie , Hoesch Robert , Hobbs Kyle , Smith Shawn , Meier Kevin , Puttgen Adrian
Published: April 2023

Introduction

Teleneurocritical care (TNCC) provides virtual care for hospitals who do not have continuous neurointensivist coverage. It is not known if TNCC is cost effective nor which variables impact the total billed charges per patient encounter. We characterize cost, defined by charge characteristics of TNCC compared to in-person neurocritical care (NCC), for patients with acute ischemic or hemorrhagic stroke requiring ICU care.

Methods

We performed a retrospective review from 2018 to 2021 of prospectively collected multinstitutional databases from a large, integrated, not-for-profit health system with an in-person NCC and spoke TNCC sites. The primary outcome was the total billable charge per TNCC patient with acute ischemic or hemorrhagic stroke compared to in-person NCC. Secondary outcomes were functional outcome, transfer rate, and length of stay (LOS).

Results

A total of 1779 patients met inclusion criteria, 1062 at the hub in-person NCC hospital and 717 at spoke TNCC hospitals. Total billed patient charges of TNCC were similar to in-person NCC (median 104% of the cost per in-person NCC patient, 95% CI: 99%–108%). From 2018 to 2021, the charge difference between TNCC and NCC was not different ( r2  =  0.71, p  =  0.16). Both age and length stay were independently predictive of charges: for every year older the charge increased by US $6.3, and every day greater LOS the charge increased by $2084.3 ( p < 0.001, both). TNCC transfer rates were low, and TNCC had shorter LOS and greater favorable functional outcome.

Discussion

TNCC was associated with similar patient financial charges as compared to in-person NCC. Standardization of care and the integrated hub-spoke value-focused operational procedures of TNCC may be applicable to other healthcare systems, however, further prospective study is needed.
A review of questionnaires used for the assessment of telemedicine
Authors: Agbali Raphael A , Balas E Andrew , Beltrame Francesco , Heboyan Vahe , De Leo Gianluca
Published: April 2023

Introduction

Telemedicine is the exchange of medical information from one site to another via electronic communications with the goal of improving a patient's clinical health status. Prior studies have identified the absence of a standardized assessment tool for evaluating telemedicine encounters. This study aims to collect and to analyze questionnaires used for the assessment of audiovisual telemedicine encounters from a patient perspective and aims to identify reasons driving the use of self-developed questionnaires.

Methods

We conducted a systematic search in PubMed for studies that used survey questionnaires to assess synchronous audiovisual telemedicine encounters from 2016 to 2021. We categorized questionnaires used into validated and non-validated types, and for each of them, collected questions, response format, author, year, specialty, and country of publication.

Results and Discussion

We analyzed a total of 71 articles. We found that only 16 studies used three validated questionnaires. The remaining 55 studies used non-validated questionnaires. Non-validated questionnaires had a high variability in length and used Likert scales, binary responses, multiple choice, and open-ended answers. We found only eight studies in which the authors gave a reason for resorting to designing their own questionnaires. This review reveals insufficient standardized survey questionnaires to be used for the assessment of audiovisual telemedicine encounters. Future research initiatives should focus on developing a standardized and validated instrument well accepted by researchers.
What and How are we Measuring When we Research Gendered Divisions of Domestic Labor? Remaking the Household Portrait Method into a Care/Work Portrait
Authors: Doucet Andrea , Klostermann Janna
Published: April 2023

The porous and shifting boundaries within and between care and work concepts, and practices and their related measurement complexities call for innovative conceptual and methodological approaches to research on work and care. This article details how we reconfigured the Household Portrait – a qualitative, participatory, visual, creative method that engages couples in mapping and discussing their household and care tasks and responsibilities – into a Care/Work Portrait. Informed by conceptual shifts in care theories, the Care/Work Portrait offers theoretical and methodological advantages for studying gendered divisions and relations of household work and care. It attends to unpaid care work/paid work/paid care work intra-connections, moves outside the household to include community-based work, deepens distinctions between tasks and responsibilities, and considers wider forms and contexts of care. This method goes beyond who does what tallies to bring forth relational, temporal, spatial stories about people’s complex care/work configurations and the specific contexts, constraints, supports, and structuring conditions of their lives.
Early orthognathic surgery with postsurgical bone-anchored retention in unilateral cleft lip and palate: A case report
Authors: Resende Leal Claudia , Bastos José Carlos da Cunha , Turri de Castro Ribeiro Tiago , de Clerck Hugo , Garib Daniela Gamba
Published: April 2023

We present a case report of early Le Fort I osteotomy with maxillary advancement retained postoperatively by Class III elastics anchored on miniplates in a growing patient with complete unilateral cleft lip and palate (UCLP). A 14-year-old boy who underwent orthognathic surgery at the pubertal growth spurt was presented. During surgery, Bollard miniplates were installed in the posterior region of the maxilla and in the anterior region of the mandible. Class III elastics anchored on miniplates were used at night (8–10 h) starting 60 days after surgery. The force of the elastics progressively increased from 100 g to 250 g. The elastics were replaced daily. The positive overjet remained stable over 15 months of postoperative follow-up. Maxillary advancement was adequately retained using Bollard miniplates and the facial profile remained stable until the end of facial growth.
Understanding dementia care pathways for policy development and service planning in Kenya
Authors: Musyimi Christine W , Muyela Levi A , Mutiso Victoria N , Mutunga Elizabeth , Ndetei David M
Published: April 2023

Background

In Kenya, there is lack of evidence on existing dementia care pathways, with minimal or no presentation for dementia-related symptoms in health care settings. Understanding the services available for people with dementia as well as how communities access the services could offer a practical pattern for policy makers to identify strategies that encourage early detection, care and support for people with dementia and their families.

Objectives

To elucidate initial responses of individuals and their families to dementia and challenges encountered in help seeking through care pathways to inform dementia care-related policies and practice.

Methods

The Strengthening Responses to dementia in Developing Countries (STRiDE) Kenya team adapted case vignettes (brief hypothetical stories meant to elicit responses on how the characters would behave) developed by the entire STRiDE team. A total of 29 stakeholders were then asked to provide feedback on the completed vignettes and summarize a common pathway to dementia care in Kenya while using the proposed case vignettes.

Findings

We found four initial responses to dementia suspicion in Kenya where individuals:(i) Perceive symptoms as normal part of ageing, (ii) Consult a spiritual or traditional healer, (iii) Visit a private clinic or primary health care facilities, or (iv) No action taken. These were the first points within the care pathways which determined the care trajectory the person with dementia would follow.

Conclusions

Identification of dementia care pathways could form a basis for improving the way communities perceive dementia etiology and establish standard pathways to care whilst ensuring that some pathways do not further pose an impediment to care and treatment for dementia.
Child Maltreatment as a Risk Factor for Rejection Sensitivity: A Three-Level Meta-Analytic Review
Authors: Gao Shuling , Assink Mark , Bi Chongzeng , Chan Ko Ling
Published: April 2023

Theoretical and empirical evidence has suggested that child maltreatment victimization is associated with rejection sensitivity. However, empirical evidence on this association is inconsistent. Therefore, this meta-analysis aimed to examine the overall association between child maltreatment and rejection sensitivity, and to investigate variables that may affect the strength of this association. Studies eligible for inclusion were searched in the databases: Web of Science, Science Direct, PubMed, MEDLINE, and China National Knowledge Infrastructure after which relevant studies were coded. Studies were synthesized in advanced three-level meta-analytic models in R. A total of 16 studies ( N = 5,335 participants) yielding 41 effect sizes were included. Results showed that child maltreatment is significantly and positively related to rejection sensitivity (mean r = 0.230; p < .001), and to a small extent. Furthermore, this association is stronger for emotional abuse ( r = 0.275) than for physical abuse ( r = 0.157). It is not affected by the mean age and gender distribution of primary study samples nor by sample type (community sample versus clinical sample). It is concluded that child maltreatment is a risk factor for developing rejection sensitivity later in life. Therefore, interventions for rejection sensitivity should consider potential trauma resulting from prior child maltreatment experiences.
Learning How to Drive: Rites of Passage in Being and Becoming (A Collaborative Autoethnography Not Just About Driving)
Authors: Alexander Bryant Keith , Carroll Joanna , Perez William , Melendrez Maria , Flaherty John Kennith , Espinoza Roberta , DeSilva Chris , Axtell John
Published: April 2023

This collaborative autoethnography uses the prompt of “learning to drive” as a pivot point of critically remembering aspects of the authors being and becoming; from the earned autonomy of operating a vehicle to a broader sense of self-determination, social responsibility, and determined directionality as literal and figurative metaphor for life choices. The authors from diverse backgrounds working in the same academic institution engage the processes of reflectivity, reflexivity, and refractivity in autoethnography to theorize through lived experience. In the process, they bridge the gap between past, present, and beyond. The piece ends with prompts for others to tell critical stories of lived experience.
A New Frontier: No Working Port for Robotic Mitral Valve Repair
Authors: Rosen Jake L. , Yost Colin C. , Prochno Kyle W. , Komlo Caroline M. , Mandel Jenna L. , Wu Meagan , Guy T. Sloane
Published: April 2023

A 61-year-old male presented via referral for mitral regurgitation and was deemed an appropriate robotic surgery candidate for complex mitral valve repair with the maze procedure and patent foramen ovale and left atrial appendage closures, using all percutaneous cannulation. We report upon the first case in the literature that describes the use of only 4 robotic ports, with no working port used.