bluuebunny/crossref_metadata_2025 huggingface dataset:
Programmatic Mentoring for LGBTQ+ Youth as Early Prevention for Juvenile Detention
Authors: Tankersley Amelia P. , George Brianna A.
Published: May 2024

While juvenile arrests have markedly declined over the last decade, LGBTQ+ youth (and particularly those of color) continue to be overrepresented in the juvenile justice system due to a cascade of environmental stressors and systemic factors, including trauma exposure, familial rejection, increased surveillance, disproportionate school suspension, and housing instability. The deleterious effects and economic costs of juvenile detention are well documented. Once detained, sexual and gender diverse (SGD) youth face heightened risk of sexual, physical, and emotional abuse. Decades of research have demonstrated that community mentoring programs help prevent juvenile delinquency and incarceration. Although the Office of Juvenile Justice and Delinquency Prevention (OJJDP) provides funding to mentoring programs, LGBTQ+ youth continue to report a dearth of mentors. This policy brief provides recommendations for mentoring programs to better recruit, include, retain, and serve LGBTQ+ youth.
Minding the Gap: Tools for Trust Engineering of Artificial Intelligence
Authors: Dorton Stephen L. , Stanley Jeff C.
Published: May 2024

There is growing consensus and appreciation for the importance of trust in the development of Artificial Intelligence (AI) technologies; however, there is a reliance on principles-based frameworks. Recent research has highlighted the principles/practice gap, where principles alone are not actionable, and may not be wholly effective in developing more trustworthy AI. We argue for complementary, evidence-based tools to close the principles/practice gap, and present ELATE (Evidence-Based List of Exploratory Questions for AI Trust Engineering) as one such resource. We discuss several tools or approaches for making ELATE actionable within the context of systems development.
Improving Outcomes for Vulnerable Children and Families: Applying what We Learned About the COVID-19 Pandemic and Child Maltreatment
Authors: Quas Jodi A.
Published: May 2024

In this special issue, innovative research teams expanded work on the effects of the COVID-19 pandemic and lockdowns on child maltreatment by assessing these effects on treatment and service delivery following maltreatment, on the professionals responsible for identification and treatment, and on the systems responsible for oversight and instruction. One theme that emerged across these studies concerned challenges faced by professionals as they attempted to evaluate families and provide service and support. Organizational leadership was crucial in helping these professionals navigate challenges in a positive and productive manner. A second theme concerned remote service delivery. Findings suggested that remote maltreatment assessments, treatment, and court procedures all worked to some degree. Thus, despite the massive social disruption caused by the pandemic and lockdowns, parents, professionals, and systems were able to adapt and address core needs of children and families. In future work, it may be important to consider how these findings and their implications vary depending on the type of maltreatment children experienced. Doing so would allow for more nuanced understanding of the consequences of significant national and global crises on child maltreatment and would enable clearer recommendations regarding how best to protect children and support families during such events.
Propofol alleviates spinal cord ischemia-reperfusion injury by preserving PI3K/AKT/GIT1 axis
Authors: Zhou Yilin , Bai Yuyan , Zhang Peisen , Weng Peiqing , Xie Wenxi
Published: May 2024

Spinal cord ischemia-reperfusion injury (SCIRI) is a major contributor to neurological damage and mortality associated with spinal cord dysfunction. This study aims to explore the possible mechanism of Propofol and G-protein-coupled receptor-interacting protein 1 (GIT1) in regulating SCIRI in rat models. SCIRI rat models were established and injected with Propofol, over expression of GIT1 (OE-GIT1), or PI3K inhibitor (LY294002). The neurological function was assessed using Tarlov scoring system, and Hematoxylin & Eosin (H&E) staining was applied to observe morphology changes in spinal cord tissues. Cell apoptosis, blood-spinal cord barriers (BSCB) permeability, and inflammatory cytokines were determined by TdT-mediated dUTP Nick-End Labeling (TUNEL) staining, evans blue (EB) staining, and enzyme-linked immuno sorbent assay (ELISA), respectively. Reverse transcription-quantitative polymerase chain reaction and western blot were used to detect the expression levels of GIT1, endothelial nitric oxide synthase (eNOS), PI3K/AKT signal pathway and apoptosis-related proteins. SCIRI rats had decreased expressions of GIT1 and PI3K/AKT-related proteins, whose expressions can be elevated in response to Propofol treatment. LY294002 can also decrease GIT1 expression levels in SCIRI rats. Propofol can attenuate neurological dysfunction induced by SCIRI, decrease spinal cord tissue injury and BSCB permeability in addition to suppressing cell apoptosis and inflammatory cytokines, whereas further treatment by LY294002 can partially reverse the protective effect of Propofol on SCIRI. Propofol can activate PI3K/AKT signal pathway to increase GIT1 expression level, thus attenuating SCIRI in rat models.
Barriers, Benefits, and Enablers of Acute Home-Based Care (Hospital In The Home) in Australia for Older People: A Systematic Review
Authors: Bransgrove Natalie J. , Porter Joanne E. , Peck Blake , Bishop Jaclyn
Published: May 2024

To determine the barriers, benefits, and enablers of acute home-based care in Australia for older people (aged 65 and over). A systematic review for people aged 65 and over receiving acute home-based care in Australia was conducted using various databases (CINAHL, Medline, PsycINFO, SCOPUS, Web of Science, PubMed, Informit) and citation searching in September 2023. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the evidence and a thematic analysis approach was utilized to narratively synthesize results. Ten studies were included, consisting mostly of cohort studies in metropolitan areas. Barriers included inefficacy, patient demographics, and carers. Benefits included efficacy, high satisfaction, and medical management. Enablers included education, holistic assessments, and support interventions. Within the literature there was a significant research gap regarding HITH for older people in rural areas of Australia. Patient outcomes were closely aligned with admission pathways.
Use of orally administered dexmedetomidine to induce emesis in cats
Authors: Maxwell Kathleen M , Odunayo Adesola , Wissel Charlotte
Published: May 2024

Case series summary

This case series describes the use of orally administered dexmedetomidine at a dose of 20 µg/kg to induce emesis in six cats. Emesis was successfully induced in 5/6 cats, with each of the cats vomiting once. The reasons for inducing vomiting included known or suspected ingestion of lilies, onions, acetaminophen (paracetamol) or acetylsalicylic acid. Four of the five cats in which emesis induction was successful did not develop any clinical signs of toxicity associated with the toxin ingested; the fifth cat developed clinicopathological changes consistent with acetaminophen toxicity. All six cats exhibited moderate to profound sedation, as expected, but no other adverse effects were documented.

Relevance and novel information

Induction of emesis in cats is notoriously difficult. This case series describes a novel route of administration of dexmedetomidine, a commonly available medication, with a high success rate observed for inducing emesis in this group of cats.
Aboriginal youth mentoring: a pathway to leadership
Authors: McMahon Mishel , Chisholm Michael , Vogels Werner , Modderman Corina
Published: May 2024

This article shares findings from evaluating a mentoring programme for Aboriginal youth on Yorta Yorta (an Aboriginal Tribal nation, north-eastern Victoria and Southern New South Wales, Australia) Country. This work is positioned in First Nations worldviews that are relational and require deep listening to youth, mentors, Elders, Country, and Ancestors. Applying a qualitative participatory action research design, methods involved attending camps on Country and research Yarning Circles. The findings demonstrate that Aboriginal mentoring programmes need to be led in their delivery and evaluation by First Nations peoples. This ensures that the programmes are culturally embedded in First Nations worldviews and that important interpretations of meanings are not overlooked. On Country experiences are a place for healing and learning. Country is a stakeholder in Aboriginal mentoring programmes. A trusting mentoring relationship creates a space where youth become part of an Aboriginal community, and where they feel strong in their identity.
Creating the beta-infrastructure: Facial recognition terminals and social management during and after COVID-19 in China
Authors: Cao Xiyu , Sun Ping
Published: May 2024

Taking facial recognition access control (FRAC) as an example, this article examines the changing and fluctuant infrastructuralization process of facial recognition technology (FRT) in China. Drawing on ethnographic interviews, observations, and qualitative content analysis, we provide empirical accounts of how local governments, commercial entities, and community residents perceive FRT in different logics and how FRAC terminals become a key site for social negotiations unfolding through combinations of relation, power, and capital. The article outlines a new framework “beta-infrastructure” to capture the semi-material and semi-social characters of technology artifacts in nowadays digital society. The concept emphasizes both the material functionalities of FRT and the role of local citizens in negotiating what it means to be a good smart city.
Vertical displacement of a non-Newtonian Bingham plastic by a Newtonian phase in an axially composite reservoir
Authors: Constantino Lucas , Rodríguez-Bermudez Panters , Francisco Alexandre Santos , Nunes Araujo Isamara Landim , Durán Jorge A Rodríguez
Published: May 2024

In general, oil reservoirs may consist of composite sedimentary structures composed of materials such as sand, clay, or limestone, which exhibit varying lithology due to sedimentary processes. A comprehensive knowledge of this lithology is essential for accurately assessing their hydrocarbon storage and production capacity. Additionally, this information is indispensable for the implementation of various recovery techniques such as waterflooding, gas injection, surfactant injection, polymer injection, alkaline water solution injection, and others. Highly viscous oil can exhibit non-Newtonian behavior during water injection in certain cases. The use of surfactants, alkaline, or polymer solutions in enhanced oil recovery also introduces non-Newtonian behavior. Recovery methods face challenges when non-Newtonian phases, gravity, and reservoir heterogeneity are combined. Against this backdrop, this work presents a mathematical model for immiscible two-phase flow in an axially composite reservoir with a periodic-layered structure. The model considers a non-Newtonian plastic Bingham-type phase extension of the Buckley-Leverett model. To address the porous medium’s heterogeneity with discontinuous flux functions, the numerical solutions were obtained using the Lax-Friedrichs and Lagrangian-Eulerian schemes. The numerical solutions were compared to analytical solutions obtained using an extended version of Oleinik’s geometric construction for discontinuous flux functions. The outcomes display shock and rarefaction waves, as well as a fixed shock due to the porous medium heterogeneity. The numerical results closely correspond with the analytical solutions, seen particularly in the greater accuracy of the Lagrangian-Eulerian method compared to the Lax-Friedrichs method.
Information-seeking behaviour in patients exploring orthognathic surgery: A qualitative study
Authors: Wade Nicola , Paul Ninu , Nagar Nathan , Rolland Sarah , Germain Sarah
Published: May 2024

Objective:

To explore how orthognathic patients seek information during decision-making.

Design:

Qualitative, cross-sectional study.

Setting:

A hospital in Cumbria, UK.

Participants:

Prospective orthognathic patients.

Methods:

Participants were purposively recruited from joint orthognathic clinics after the original consultation. Semi-structured interviews were conducted via remote video call with nine participants aged 18–30 years. Data collection and reflexive thematic analysis occurred in parallel until thematic saturation was achieved.

Results:

The central finding of this research was that patients were making informed decisions about orthognathic surgery. Four themes were identified to support this central finding including the following: (1) selective engagement with orthognathic information sources; (2) the central role of patient-specific information from professionals and peers; (3) Internet use to supplement standard information resources; and (4) concerns over information found online. The preferred source of information was verbal from the clinical team as it was trusted and person-specific. Past patients were identified as valued sources of information and establishing contact through digital social media networks was found to be a convenient alternative to face-to-face. Online information found was valued but concerns included information overload, problems establishing applicability and concerns over its credibility.

Conclusion:

Orthognathic patients were making informed decisions about their treatment. This study highlights the central role of the patient–clinician interaction in decision-making, especially in providing patient-specific information. Insight into the nuances of information-seeking behaviours will better inform clinical care. Since patients frequently access online information that is decision-relevant, encouraging patients to discuss online searches will support the shared decision-making process and alleviate any concerns with information found. During consultation, explaining the purpose of an information aid rather than expecting patients to read them separately, may further enhance its usefulness in decision-making. This study identified an unmet need for visual aids, such as real-time images of postoperative recovery. These findings can inform the design of future information resources.
Welfare at the Statehouse Democracies: Assessing the Impact of Public Opinion on Welfare Policies at the State Level
Authors: Molina Rafael
Published: May 2024

A frequent question in discussions about democracy is whether input from the public is ever considered and to what extent by politicians. This influence of public opinion on the realm of welfare policies has not been extensively explored, and most analyses are less precise for being conducted before the passage of the national welfare reform in 1996, better known as the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). Bringing the analysis to a period after the reform to account for contextual changes since its passage, this study uses the multilevel and poststratification (MRP) model considered superior in analysis of subnational opinion using national survey data to assess the influence of public opinion on welfare policies at the state level. Collecting data from the 2014 CCES and a new developed welfare generosity index, I find that public opinion does not have any influence on how generous welfare programs turn out in their states, unless it is interacted with state government ideology. It seems that the ideology of the state government and the state poverty rate are the major determinants on welfare policies outcomes in the states, although the latter had different effects for TANF and SNAP.
Improvement in Nutritional Knowledge Confidence and Food-Agency: Outcomes of the First French-Speaking Culinary Medicine Courses Among Medical Students
Authors: Dodin Sylvie , Bégin Catherine , Lucas Michel
Published: May 2024

Background

Medical students often lack sufficient nutrition education, leading to confidence gaps and an inability to address this healthcare aspect. Culinary Medicine (CM) courses offer an innovative solution.

Methods

We tested the first French-speaking CM courses among 2 groups of second-third year medical students, compared to a control group (CG). The objectives were to assess if an optional CM course could enhance their confidence in both nutritional knowledge and providing nutritional advice, and improve their food agency (CAFPAS: Cooking and Food Provisioning Action Scale). The analysis examines changes in scores by comparing post-session to pre-session questionnaire measurements.

Results

Of the 22 CM students and 6 in CG, predominantly aged 20-25 years, Caucasian, and female, the majority (CG = 100%, CM = 86.4%) reported <5 hours of nutrition education. Almost all expressed dissatisfaction with nutrition education provided in medicine, both quantitatively and qualitatively. CM students reported significantly increased confidence in their knowledge and ability to advise about nutrition during the sessions. We also observed improvements in their CAFPAS scores, which measure food agency, while the control group exhibited no change in confidence or CAFPAS scores.

Conclusion

The findings highlight CM as practical strategy for integrating nutrition education into medical curricula, offering insights for enhancing future physicians’ knowledge.
Spontaneous thrombosis with a conservative approach to posterior spinal artery pseudoaneurysm management: A case series
Authors: Pirahanchi Yasaman , Atchie Benjamin , Flynn Michael , Kaminsky Ian
Published: May 2024

In this study, we address the rarity and management challenges associated with ruptured spinal artery pseudoaneurysms, which comprise < 1% of subarachnoid hemorrhage cases. With our limited understanding of their natural history, the prevailing consensus leans towards surgical clipping, contrasting with the typically benign symptoms of sudden back pain and lower extremity weakness. Despite reported low morbidity and mortality, fatal re-ruptures underscore the need for effective management strategies. In this context, we present the largest case series to date, featuring five patients with spinal subarachnoid hemorrhage from isolated posterior spinal artery pseudoaneurysms. All cases achieved spontaneous thrombosis and resolution through conservative management, challenging the prevailing surgical emphasis. The patients, aged 58–81, exhibited varied symptoms, including back pain, paresthesia, confusion, and seizures, with hypertension as a common comorbidity. The results of these cases lead us to tender a “hybrid” management strategy, combining conservative measures with short-term follow-up angiograms, fostering a paradigm shift and warranting further investigation into individualized patient care within larger clinical cohorts.
Grape seed-derived procyanidins decreases neuropathic pain and nerve regeneration by suppression of toll-like receptor 4-myeloid differentiation factor-88 signaling
Authors: Hu Li , An Erdan , Zhu ZhiPeng , Cai Ying , Ye Xiaoyan , Zhou Hongmei , Ge Hejia
Published: May 2024

Background: Recent studies have shown that peripheral nerve regeneration process is closely related to neuropathic pain. Toll-like receptor 4 (TLR4) signaling was involved in different types of pain and nerve regeneration. TLR4 induced the recruitment of myeloid differentiation factor-88 adaptor protein (MyD88) and NF-κB-depended transcriptional process in sensory neurons and glial cells, which produced multiple cytokines and promoted the induction and persistence of pain. Our study aimed to investigate procyanidins’s effect on pain and nerve regeneration via TLR4-Myd88 signaling. Methods: Spinal nerve ligation (SNL) model was established to measure the analgesic effect of procyanidins. Anatomical measurement of peripheral nerve regeneration was measured by microscopy and growth associated protein 43 (GAP43) staining. Western blotting and/or immunofluorescent staining were utilized to detect TLR4, myeloid differentiation factor-88 adaptor protein (MyD88), ionized calcium-binding adapter molecule 1 (IBA1) and nuclear factor kappa-B-p65 (NF-κB-p65) expression, as well as the activation of astrocyte and microglia. The antagonist of TLR4 (LPS-RS-Ultra, LRU) were intrathecally administrated to assess the behavioral effects of blocking TLR4 signaling on pain and nerve regeneration. Result: Procyanidins reduced mechanical allodynia, thermal hyperalgesia and significantly suppressed the number of nerve fibers regenerated and the degree of myelination in SNL model. Compared with sham group, TLR4, MyD88, IBA1 and phosphorylation of NF-κB-p65 were upregulated in SNL rats which were reversed by procyanidins administration. Additionally, procyanidins also suppressed activation of spinal astrocytes and glial cells. Conclusion: Suppression of TLR4-MyD88 signaling contributes to the alleviation of neuropathic pain and reduction of nerve regeneration by procyanidins.
Locating a queer regional imaginary through media framing of male same-sex criminalisation in Newcastle, Australia, post WWII to 1989
Authors: Ellis Justin R , Barham Grace
Published: May 2024

Media framing of the political, professional, and personal dynamics of criminal law in regional areas can illuminate the reach of arbitrary moral arguments used to criminalise marginalised populations. Drawing on analysis of media articles from post-Second World War up to 1989, this case study contextualises criminalisation processes of male same-sex offences in the regional New South Wales city of Newcastle. The cases and issues documented provide insight into the legal and social symbiosis between the regions and the metropole, and the role of place in defining regional identity. At the same time, they show a diversity of male same-sex sexual and gender expression often considered incongruous in an industrial centre that has signified the ‘raw masculinity’ of the Australian male. The case study emphasises the risks of cross-sectional analyses that can sever processes of criminalisation from stigma that persists beyond decriminalisation, and the integral role of social movements in achieving law reform.
How to make EU enlargement work? A grass-roots approach to strategic preparations
Authors: Lavrelashvili Teona
Published: May 2024

Enlargement is back on the EU agenda. Leaders have broken long-established foreign policy taboos by green-lighting accession talks with Ukraine and the Republic of Moldova, and by awarding EU candidate country status to Georgia. This bold step has elevated the expectations of the existing candidate countries, instilling renewed optimism in the Western Balkans Six. At the same time, the EU has recognised the need to carry out its own reforms to be prepared to integrate potentially 10 new member states.

However, given the complexities of EU institutional reform, coupled with the uncertain political context, expectations of EU enlargement may lead to disillusionment. This article argues that the EU should not tie its progress on institutional reform too closely to its enlargement policy and that it needs to take a grass-roots approach to enlargement. It should focus on strengthening horizontal cooperation, enhancing efficiency and increasing public involvement in the EU enlargement process.
Changing the narrative: The future we want to see. Insights from older generations
Authors: Gheno Ilenia
Published: May 2024

Demographic change, a prominent trend in our societies, impacts the labour market, pensions, and the health and care sectors, among others. Concurrently, ageing brings opportunities, as older people actively contribute to society through work, caregiving and knowledge sharing. When looking at demographic change, it is important to consider its intersections with other global trends, such as inequality, climate change and technological advancements, and how this interconnectedness impacts people's daily lives across their lifespan.

This article delves into recent European policy approaches and research on demographic change, pinpointing shortcomings and suggesting initiatives to reshape perceptions of ageing and revise the current narrative of old age. Drawing on insights from AGE Platform Europe, the European advocacy organisation of and for older people, this article highlights the collective advocacy efforts at the European and international levels. These efforts aim to truly embody the European motto ‘United in Diversity’ and to foster fairer and more resilient societies.
Carotid artery calcium score: Definition, classification, application, and limits
Authors: Saba Luca , Benson John C , Scicolone Roberta , Paraskevas Kosmas I , Gupta Ajay , Cau Riccardo , Suri Jasjit S , Schindler Andreas , Balestrieri Antonella , Nardi Valentina , Song Jae W , Wintermark Max , Lanzino Giuseppe
Published: May 2024

Introduction

In the current paper, the “carotid artery calcium score” method is presented with the target to offer a metric method to quantify the amount of calcification in the carotid artery.

Model and Definition

The Volume of Interest (VOI) should be extracted and those voxels, with a Hounsfield Unit (HU) value ≥130, should be considered. The total weight value is determined by calculating the sum of the HU attenuation values of all voxels with values ≥130 HU. This value should be multiplied by the conversion factor (“or voxel size”) and divided by a weighting factor, the attenuation threshold to consider a voxel as calcified (and therefore 130 HU): this equation determines the Carotid Artery Calcium Score (CACS).

Results

In order to provide the demonstration of the potential feasibility of the model, the CACS was calculated in 131 subjects (94 males; mean age 72.7 years) for 235 carotid arteries (in 27 subjects, unilateral plaque was present) considered. The CACS value ranged from 0.67 to 11716. A statistically significant correlation was found (rho value = 0.663, p value = .0001) between the CACS in the right and left carotid plaques. Moreover, a statistically significant correlation between the age and the total CACS was present (rho value = 0.244, p value = .005), whereas no statistically significant difference was found in the distribution of CACS by gender ( p = .148). The CACS was also tested at baseline and after contrast and no statistically significant difference was found.

Conclusion

In conclusion, this method is of easy application, and it weights at the same time the volume and the degree of calcification in a unique parameter. This method needs to be tested to verify its potential utility, similar to the coronary artery calcium score, for the risk stratification of the occurrence of cerebrovascular events of the anterior circulation. Further studies using this new diagnostic tool to determine the prognostic value of carotid calcium quantification are needed.
Modeling of solar UV-induced photodamage on the hair follicles in human skin organoids
Authors: Kim Min-Ji , Ahn Hee-Jin , Kong Dasom , Lee Seunghee , Kim Da-Hyun , Kang Kyung-Sun
Published: May 2024

Solar ultraviolet (sUV) exposure is known to cause skin damage. However, the pathological mechanisms of sUV on hair follicles have not been extensively explored. Here, we established a model of sUV-exposed skin and its appendages using human induced pluripotent stem cell-derived skin organoids with planar morphology containing hair follicles. Our model closely recapitulated several symptoms of photodamage, including skin barrier disruption, extracellular matrix degradation, and inflammatory response. Specifically, sUV induced structural damage and catagenic transition in hair follicles. As a potential therapeutic agent for hair follicles, we applied exosomes isolated from human umbilical cord blood-derived mesenchymal stem cells to sUV-exposed organoids. As a result, exosomes effectively alleviated inflammatory responses by inhibiting NF-κB activation, thereby suppressing structural damage and promoting hair follicle regeneration. Ultimately, our model provided a valuable platform to mimic skin diseases, particularly those involving hair follicles, and to evaluate the efficacy and underlying mechanisms of potential therapeutics.
Selection of criteria for a telemedicine framework for designing, implementing, monitoring and evaluating telemedicine interventions: Validation using a modified Delphi process
Authors: Katz Che , Robles Noemí , Novillo-Ortiz David , Saigí-Rubió Francesc
Published: May 2024

Objectives

The call to scale up telemedicine services globally as part of the digital health transformation lacks an agreed-upon set of constructs to guide the implementation process. A lack of guidance hinders the development, consolidation, sustainability and optimisation of telemedicine services. The study aims to reach consensus among telemedicine experts on a set of implementation constructs to be developed into an evidence-based support tool.

Methods

A modified Delphi study was conducted to evaluate a set of evidence-informed telemedicine implementation constructs comprising cores, domains and items. The study evaluated the constructs consisting of five cores: Assessment of the Current Situation, Development of a Telemedicine Strategy, Development of Organisational Changes, Development of a Telemedicine Service, and Monitoring, Evaluation and Optimisation of Telemedicine Implementation; seven domains: Individual Readiness, Organisational Readiness, Clinical, Economic, Technological and Infrastructure, Regulation, and Monitoring, Evaluation and Optimisation; divided into 53 items. Global telemedicine specialists ( n = 247) were invited to participate and evaluate 58 questions. Consensus was set at ≥70%.

Results

Forty-five experts completed the survey. Consensus was reached on 78% of the constructs evaluated. Regarding the core constructs, Monitoring, Evaluation and Optimisation of Telemedicine Implementation was determined to be the most important one, and Development of a Telemedicine Strategy the least. As for the domains, the Clinical one had the highest level of consensus, and the Economic one had the lowest.

Conclusions

This research advances the field of telemedicine, providing expert consensus on a set of implementation constructs. The findings also highlight considerable divergence in expert opinion on the constructs of reimbursement and incentive mechanisms, resistance to change, and telemedicine champions. The lack of agreement on these constructs warrants attention and may partly explain the barriers that telemedicine services continue to face in the implementation process.
“My Mind Varied Its Focus Quite a Bit”: A Thematic Analysis of the Attentional Focus of Aspiring Professional Violinists and Violists During Performance
Authors: Lubert Veronika J. , Chełkowska-Zacharewicz Maria E. , Gröpel Peter
Published: May 2024

Knowledge about musicians’ attentional focus may shed more light on why some succeed in demonstrating their optimal performance under pressure while others fail to do so. In previous research, attentional focus has not been investigated directly after performance. The aim of this study was to extend and deepen our understanding of the “what” and “how” of musicians’ attentional focus during performance under pressure. Qualitative data provided by 46 violinists and violists in open-format questionnaires immediately after they performed audition excerpts under low- and high-pressure conditions were analyzed using thematic analysis within a constructivist framework. Findings revealed that the focus of upper string players during “real-life” performance may be more dynamic and multifaceted than previous research might suggest. In particular, when participants reported a music-related focus, they referred to the level of formal and technical elements and to the level of interpretation and character, but also to prioritizing between the two levels. They focused on the navigation of these music-related aspects, their physical and emotional performance experience, critical thoughts and attempts at control, and the quality and dynamic of their focus. Furthermore, they described ways of managing their focus in a positive and adaptive sense but also reported negative thoughts, feelings, and sensations. Staying in the present moment and enjoying the music was thus a desirable focus. Approaches based on mindfulness and acceptance may be particularly suited to supporting musicians in maintaining a beneficial attentional focus during performance.
Risk of Cephalic Vein Injury During the Creation of an Anterior Portal in Shoulder Arthroscopy
Authors: Inoue Jumpei , Tawada Kaneaki , Yamada Kunio , Takenaga Tetsuya , Tsuchiya Atsushi , Takeuchi Satoshi , Isobe Yuki , Hanaki Shunta , Murakami Hideki , Yoshida Masahito
Published: May 2024

Background:

There is a risk of cephalic vein injury during shoulder arthroscopy. However, limited data regarding its anatomic course are available.

Purpose:

To analyze the positional relationship and factors affecting the distance between the coracoid tip and cephalic veins.

Study design:

Case series; Level of evidence, 4.

Methods:

A total of 80 contrast‐enhanced computed tomography images from 80 patients (mean age, 49.6 ± 20.3 years; 61 men) were retrospectively analyzed. The distance between the center of the coracoid tip and the vertical line through the cephalic vein was measured in the axial (D1) and sagittal (D2) planes. The distance between 1 cm lateral to the center of the coracoid tip and the vertical line through the cephalic vein was measured in the sagittal plane (D3). Each distance was compared according to patient sex and laterality. Associations between each distance and the patient's age, height, weight, and body mass index were investigated.

Results:

The mean D1 was 18.4 ± 7.3 mm in 59 patients. The mean D2 was 23.4 ± 11.6 mm, and it was within 10 mm in 10 patients (12.5%). The mean D3 was 33.7 ± 12.2 mm. There was no significant difference in D1, D2, and D3 according to patient sex or laterality. A positive correlation was observed only between D3 and patient height ( r = 0.320; P = .034).

Conclusion:

The cephalic vein was found to travel a mean of 23.4 mm distal and 33.7 mm distal to 1 cm lateral to the coracoid tip. Therefore, Care should be taken to avoid cephalic vein injury when creating an anterior inferior portal or 5-o’clock portal around these areas.
Practice What You Preach: Complicating the Relationship among Christian Religious Identity, Abortion Attitudes, and Reported Abortion Experiences among Canadians
Authors: Milmine Lexie , Fetner Tina
Published: May 2024

Abortion providers often report having patients who describe abortion as immoral, even while accessing abortion care. According to these anecdotes, antiabortion identities, frequently depicted as tied to religious identities, are not necessarily reflected in individuals’ lived experiences. Yet social science research and political rhetoric tend to suggest a straightforward connection between religion and antiabortion beliefs and practices. The authors ask, does religion have a greater impact on attitudes toward abortion than on personal decisions to terminate one’s own pregnancy? Using an original survey of Canadian women ( n = 1,181), the authors examine religious affiliation and attendance, abortion attitudes, and self-reported abortion experience. Religious affiliation and attendance predict abortion attitudes to a greater extent than they predict abortion behavior. The authors use Burke’s concept of polysemic categories to argue that personal meanings of religious affiliation may be more salient for attitudes toward abortion than for the personal decision to access abortion care.
Practical Tips for Undergraduate Medical Education Advisors in Residency Application Signaling
Authors: Spatz Christin , Olaf Mark , Ellison Halle
Published: May 2024

Objectives

The residency application process has become increasingly complex for medical students and advisors to navigate. Program signaling was piloted to improve applicants’ abilities to obtain interview offers at programs they were strongly interested in. The initial positive results led to expansion of signaling to additional specialties over the next two application cycles. Despite the benefits of program signaling, the variation in signaling practices among specialties has presented challenges for both advisors and students when determining how to best allocate signals. The aim of this study is to identify students’ perceptions of the signaling process, how this may impact outcomes, and to guide future educational programming.

Methods

This is an exploratory original survey study of students in a US allopathic medical school applying in ERAS for the 2023 residency cycle. The survey was developed to determine students’ understanding of how programs would use signals in the application process and assess strategies students used to allocate signals. We compared program signals to student interview offers and match outcomes using descriptive statistics.

Results

57 of 96 eligible students completed the survey. 51% signaled a range of programs based on their perceived competitiveness for the program while 40% signaled programs of interest regardless of perceived competitiveness. 53% of students thought sending a signal would increase their chance of an interview, while 42% were unsure how the signal would be used by residency programs. Students received interviews at 49% of the programs signaled, which increased to 56.5% when specialties offering more than 7 signals were excluded. 35% of students matched at a signaled program.

Conclusions

Students’ perceptions and strategies related to the signaling process are varied and may impact interview offers. Advisors should monitor and review internal institutional trends to help inform future educational programming to optimize signal allocation for their students.
Gendered Harm and Social Abandonment: Stories of the Dooars Women Tea Garden Workers
Authors: Bhattacharya Priyadarshini
Published: May 2024

The Tea Tribes of the Dooars in West Bengal are of the numerically preponderant culturally and socially dispossessed Adivasi population of Chota Nagpur and make up 80% of the tea plantation labour force. These tribes especially its women who form around 60% of the labour pool in the Dooars, serve as crucial social capital for the sustenance and burgeoning of the plantation industry. The tribes exhibit localised and hybridised social customs that have historically been in a dialectic relationship with the culture of commerce that predominates a capitalist bureaucratic organisation. This acculturation and an unfortunate reign of neglect have given birth to distinctive social arrangements, with the article examining the curious social currents of lone motherhood and abandonment of women shaping the household and thereby the social reproduction cycle of the tea industry. By invoking a feminist methodology, qualitative in-depth interpretive interviews of lone mothers and deserted women have been conducted to understand their renditions of gendered neglect and subliminal violence, while attempting to discover their position in the communitas of the tea industry. The study was conducted in the district of Jalpaiguri, with a heavy concentration of the Scheduled Tribe (62%) of the Adivasi subgroup found in its 89 registered tea gardens. The ‘thick’ descriptions of women’s narratives reveal nuanced notions of gender and intimate partner abuse, that shine light on violence characterised by its distinctive low intensity and its latent and subliminal nature evinced in the breach of a social compact. The nature of mistreatment and abuse that they describe opens up conceptual chinks in existing feminist literature on violence while providing further avenues to deliberate upon them. Imperfect, yet partial access to education, social media and government outreach as tools of modernity are however stoking aspirations for social justice, ineffectively handled by poorly trained and gender unresponsive socio-legal and bureaucratic agents.
Exploring social media influences on vaccine decision-making in parents: a netnography
Authors: Smith Susan E. , Sivertsen Nina , Lines Lauren , De Bellis Anita
Published: May 2024

Background:

Immunization is one of the most significant health initiatives of recent times. Despite this, vaccine hesitancy is increasing and was listed as one of the top 10 threats to global health by the World Health Organization in 2019. A major factor associated with vaccine hesitancy is thought to be the viral spread of misinformation by a small but active anti-vaccination movement.

Objectives:

The purpose of this study was to explore the influences of social media on vaccine decision-making in parents.

Design:

This study is part of a larger body of research that explored vaccine decision-making in parents. Other methods included were an online survey and semi-structured interviews. This study investigated the influence of cyberculture on parents in an online environment.

Method:

This study employed netnography, a form of qualitative inquiry with its roots in ethnography as methodology and a purpose-designed Facebook page as the means of exploring a purpose-designed online community with a particular focus on the culture, belief systems and influences present. Both manual and computer-assisted thematic analyses were used to analyse the data obtained.

Results:

Three key themes were identified in this study. These included vaccine safety concerns, the emotional debate and COVID-19-specific issues. The results indicated the presence of strong anti-vaccination sentiment combined with an ‘infodemic’ of conspiracy theories, misinformation and vitriol with the potential to negatively impact parents seeking immunization information.

Conclusion:

Given the popularity and accessibility of social media and the ready access to misinformation present online, it is evident that parental vaccine decision-making may be impacted adversely. Therefore, it is important that healthcare professionals are aware of this and provide adequate and timely education prior to parents seeking information on social media.
Association of Opioid and Concurrent Benzodiazepine, Skeletal Muscle Relaxant, and Gabapentinoid Usage on Healthcare Expenditure and Resource Utilization: A Serial Cross-Sectional Study, 2009 to 2019
Authors: Sepassi Aryana , Li Meng , Suh Kangho , Stottlemyer Britney , Bounthavong Mark
Published: May 2024

Background:

Healthcare providers may be utilizing central nervous system (CNS) depressants to reduce opioid use due to recent changes in public policy. Combination use of these agents with opioids increases the risk of respiratory depression and death. Healthcare expenditures by individuals using these drug combinations have not been previously quantified. We sought to characterize healthcare costs and expenditures associated with a population reporting concurrent CNS depressants and opioid use compared with nonopioid analgesics in the United States from 2009 to 2019.

Methods:

A serial cross-sectional design was used to compare the healthcare expenditures of adult Medical Expenditure Panel Survey respondents who were prescribed nonopioid analgesics, opioids only, opioids/benzodiazepines (BZD), opioids/BZD/skeletal muscle relaxants (SMR), or opioids/gabapentin (gaba) using pooled data from 2009 to 2019. Expenditure (cost and resource utilization) categories included inpatient, outpatient, office-based, and prescription medicine. Average marginal effects were used to compare survey-weighted annual costs and resource utilizations across the groups as compared to nonopioid analgesic respondents, adjusted for covariates.

Results:

A weighted total of 34 241 838 individuals were identified. Most were opioid-only respondents (46.5%), followed by nonopioid analgesic (43.4%), opioid/BZD (5.3%), opioid-gaba (3.5%), and opioid/BZD/SMR respondents (1.3%). In comparison to the study groups with nonopioid analgesics, opioid-gaba users had the highest significant incremental cost difference among the different pairings (+$11 684, P < .001). Opioid-gaba, opioid/BZD, and opioid/BZD/SMR respondents had significantly higher inpatient, emergency department, and prescription drug costs and use compared to nonopioid analgesic respondents. Opioid-only respondents had higher outpatient and office-based costs and visits compared to nonopioid analgesic respondents.

Conclusions:

As healthcare providers seek to utilize fewer opioids for pain management, attention must be paid to ensuring safe and effective use of concurrent CNS depressants to mitigate high healthcare costs and burden.
Stress Exposure and PTSD in a Cross-Sectional Residential Substance Use Treatment Sample
Authors: Schacht Rebecca L. , Meyer Laurel E. , Wenzel Kevin R. , Mette Meghan E. , Berg Samantha K. , Lewis Christa R. , Carrano Jennifer L. , Fishman Marc
Published: May 2024

Background:

Aim 1 of this cross-sectional, observational study with people in residential treatment for substance use disorders (SUDs) was to document stress exposure. Aim 2 was to assess potential sociodemographic and health differences based on probable posttraumatic stress disorder (PTSD) status. Aim 3 was to assess relative contributions of Diagnostic and Statistical Manual (DSM)-congruent versus DSM-incongruent stressors (Criterion A vs non-Criterion A) to mental and physical health. We hypothesized that both types of stressors would significantly contribute to impairment across indicators and that DSM-congruent stressor exposure would be more strongly associated with impairment than DSM-incongruent exposure.

Methods:

We assessed exposure to DSM-congruent traumatic stressors and DSM-incongruent life stressors, PTSD and depressive symptoms, emotion regulation difficulties, substance use recovery capital, and physical/mental health-related quality of life among 136 people in residential SUD treatment who were 64% men, 36% women; 49% white, 41% Black, 11% multiracial/another race; 18% lesbian, gay, or bisexual (LGB+); mean age = 39.82 (standard deviation = 12.24) years.

Results:

Participants reported experiencing a mean of 9.76 (SD = 6.11) DSM-congruent events. Those with probable PTSD were younger and more likely to be LGB+ than those without probable PTSD ( P < .05). Experiencing higher numbers of DSM-congruent events was associated with more severe PTSD and depressive symptoms, emotion regulation difficulties, and lower physical health-related quality of life ( P < .05). DSM-incongruent stressor exposure was not independently associated with any indicators. Recovery capital was not associated with either type of stress exposure.

Conclusions:

Stressful event exposure among people in residential SUD treatment is very high. Those who are younger or LGB+ in residential SUD treatment may be at greater risk of developing PTSD. DSM-congruent stressors are more consistently associated with mental health indicators than are DSM-incongruent stressors. Prioritizing treatment targets and identifying implementable treatment strategies can be challenging with this complex population.