bluuebunny/crossref_metadata_2025 huggingface dataset:
Social workers’ approaches to ethical dilemmas
Authors: Gómez-García Rogelio , Lucas-García Jezabel , Bayón-Calvo Siro
Published: July 2021

The study objective was the identification of social workers’ ethic profiles in their professional interventions. To conduct this pilot study, we used data from a national survey ( N = 1071) carried out in Spain. The information was collected through an online questionnaire.

Findings

Results show that social workers face a variety of ethical dilemmas in their professional practice. Through exploratory factor analysis, it was revealed that the underlying structure of the questionnaire consisted of three categories: direct service to individuals and families, design and implementation of social welfare policy and programmes and relationships among professional colleagues. Through latent class analysis, four unique social workers’ ethical profiles were identified: professionals with minimum incidence of experiencing ethical dilemmas, professionals with low incidence of experiencing ethical dilemmas, professionals with a notable incidence of experiencing ethical dilemmas and, finally, professionals with high incidence of experiencing ethical dilemmas. A third of the social workers in the sample showed a very low probability to be conflicted by ethical dilemmas.

Applications

The pilot study is expected to serve as a catalyst for discussion of social workers’ ethical conduct and professional practice, to promote professional ethics training and education and to support the development of professional guidelines.
Components of Hostile Masculinity and Their Associations With Male-Perpetrated Sexual Aggression Toward Women: A Systematic Review
Authors: Ray Travis N. , Parkhill Michele R.
Published: July 2021

Hostile masculinity and its components (i.e., sexual dominance, hostility toward women, adversarial sexual beliefs, rape myth acceptance, and acceptance of interpersonal violence) have received considerable research attention as predictors of male-perpetrated sexual aggression toward women. The current systematic review sought to synthesize and organize the extant literature. Studies were included in the systematic review if they were published in a peer-reviewed journal between the years 1990 and 2020, contained a male sample within the United States, analyzed quantitative data, and examined at least one component of hostile masculinity and its association with sexual aggression. Literature searches were conducted in three academic databases, and additional records were identified through references sections from known hostile masculinity research. A total of 95 articles met inclusion criteria and were integrated into the overview of results. The reviewed literature provided broad support for the association between hostile masculinity and sexual aggression, including evidence for the theoretical framework posited by the confluence model of sexual aggression. Prevention efforts are likely to find success by modifying hostile masculine characteristics among men, particularly within problematic environmental contexts. However, the review also highlighted the need for a uniform conceptualization and operational definition of hostile masculinity. Additionally, empirical work with diverse samples is necessary to determine the scope of generalizability and potential subcultural distinctions. Future research that addresses these limitations will contribute to the understanding and prevention of sexual aggression beyond what is provided by the extant literature.
COVID-19 global pandemic planning: Presence of SARS-CoV-2 fomites in a university hospital setting
Authors: Bartlett Christopher , Langsjoen Jens , Cheng Qiuying , Yingling Alexandra V , Weiss Myissa , Bradfute Steven , Perkins Douglas J , Hurwitz Ivy
Published: July 2021

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has surged across the globe, great effort has been expended to understand mechanisms of transmission and spread. From a hospital perspective, this topic is critical to limit and prevent SARS-CoV-2 iatrogenic transmission within the healthcare environment. Currently, the virus is believed to be transmitted primarily through respiratory droplets, but a growing body of evidence suggests that spread is also possible through aerosolized particles and fomites. Amidst a growing volume of patients with coronavirus disease 2019 (COVID-19), the purpose of this study was to evaluate the potential for SARS-CoV-2 transmission through fomites. Samples collected from the exposed skin of clinicians (n = 42) and high-touch surfaces (n = 40) were collected before and after encounters with COVID-19 patients. Samples were analyzed using two assays: the CDC 2019-nCoV Real-Time Reverse Transcription polymerase chain reaction (RT-qPCR) assay, and a SYBR Green assay that targeted a 121 bp region within the S-gene of SARS-CoV-2. None of the samples tested positive with the CDC assay, while two high-touch surface areas tested positive for SARS-CoV-2 using the Spike assay. However, viral culture did not reveal viable SARS-CoV-2 from the positive samples. Overall, the results from this study suggest that SARS-CoV-2 RNA were not widely present either on exposed skin flora or high-touch surface areas in the hospital locations tested. The inability to recover viable virus from samples that tested positive by the molecular assays, however, does not rule out the possibility of SARS-CoV-2 transmission through fomites.
Revealing Meaning From Story: The Application of Narrative Inquiry to Explore the Factors That Influence Decision Making in Relation to the Withdrawal of Life-Sustaining Treatment in The Intensive Care Unit
Authors: Foxall Fiona , Sundin Deborah , Towell-Barnard Amanda , Ewens Beverly , Kemp Vivien , Porock Davina
Published: July 2021

This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive sample of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story; the focus of analysis is the story, with the story becoming the object of investigation. Initially, participants’ stories were restoried to produce narratives that were co-constructed between researcher and participant. Narrative analysis, employing McCormack’s lenses and the interconnected analytical lenses, facilitated vertical analysis of each narrative. Horizontal analysis through thematic analysis facilitated the derivation of themes that were consistent within or across narratives. We detail here how narrative inquiry methodology was effective in revealing the meaning participants gave to their decision-making experiences through story, offering a broader understanding of the factors that impact on decision-making regarding the withdrawal of life-sustaining treatment. The study’s findings were powerful, derived from narratives rich and thick in description, depicting a multi-dimensional interpretation of the participants’ perceptions of their decision-making experiences. Participants experienced transformative learning through the narrative process, which led to changes in ways of working in the study setting. Recommendations arose to enhance clinical practice and education in this vital area of practice as a result of this study. The application of narrative inquiry enabled the discovery of significant findings as an avenue to challenge legislation and current opinion regarding the autonomy and role of the family in decision-making.
Trauma and cervical cancer screening among women experiencing homelessness: A call for trauma-informed care
Authors: Kohler Racquel E , Roncarati Jill S , Aguiar Anastasia , Chatterjee Pritha , Gaeta Jessie , Viswanath Kasisomayajula , Henry Cassis
Published: July 2021

Objective:

Women experiencing homelessness are at increased risk of cervical cancer and have disproportionately low Pap screening behaviors compared to the general population. Prevalence of Pap refusals and multiple kinds of trauma, specifically sexual trauma, are high among homeless women. This qualitative study explored how trauma affects Pap screening experiences, behaviors, and provider practices in the context of homelessness.

Methods:

We conducted 29 in-depth interviews with patients and providers from multiple sites of a Federally Qualified Health Center as part of a study on barriers and facilitators to cervical cancer screening among urban women experiencing homelessness. The Health Belief Model and trauma-informed frameworks guided the analysis.

Results:

Trauma histories were common among the 18 patients we interviewed. Many women also had strong physical and psychological reactions to screening, which influenced current behaviors and future intentions. Although most women had screened at least once in their lifetime, many patients experienced anticipated anxiety and retraumatization which pushed them to delay or refuse Paps. We recruited 11 providers who identified strategies they used to encourage screening, including emphasizing safety and shared decision-making before and during the exam, building strong patient–provider trust and communication, and individually tailoring education and counseling to patients’ needs. We outlined suggestions and implications from these findings as trauma-informed cervical cancer screening.

Conclusion:

Discomfort with Pap screening was common among women experiencing homelessness, especially those with histories of sexual trauma. Applying a trauma-informed approach to cervical cancer screening may help address complex barriers among women experiencing homelessness, with histories of sexual trauma, or others who avoid, delay, or refuse the exam.
Family history of obesity and the influence on physical activity and dietary adherence after bariatric surgery
Authors: Fipps David C , Holder Sharon M , Schmalz Dorothy L , Scott John
Published: July 2021

Background

The causes of obesity are multifactorial, with genetic, environmental, behavioural and societal contributions. These factors also affect adherence to diet and exercise after bariatric surgery. The objective of this study was to evaluate changes in perceived obesity-related stigma, exercise and dietary adherence perioperatively as well as what demographic factors most influence the magnitude of these changes.

Methods

Validated questionnaires regarding perception of stigma and adherence to diet and exercise regimens were administered to 104 bariatric surgery patients preoperatively and postoperatively at three, six and 12 months. Scoring was compared for improvement, and concomitant factors were analysed for effect on magnitude of improvement.

Results

Our study found overall improvement in perception of stigma as well as adherence to diet and exercise regimens. Those with a family history of obesity had less robust improvement compared to those without a family history of obesity. Those who were Caucasian also did not have as robust of an improvement in their scores.

Conclusions

Patient perception of obesity-related stigma and adherence to diet and exercise regimens improve after bariatric surgery. However, a patient with a family history of obesity and/or a Caucasian ethnicity may have a less robust improvement in these facets.
Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
Authors: Wang Shanshan , Shen Lei , Luo Hesheng
Published: July 2021

Introduction:

Minimally invasive endoscopic resection is often effective in the management of early gastrointestinal tumors. However, advanced and more effective methods of endoscopic examination are required to improve the rate of diagnosing early gastrointestinal tumors.

Discussion:

The development of dye-based image-enhanced endoscopy (d-IEE) and equipment-based image-enhanced endoscopy (e-IEE) has helped improve the diagnostic rate of early gastrointestinal tumor using endoscopy. In some special cases, these methods are still not accurate in diagnosing lesions. On the basis of these e-IEEs, a new endoscopic technique, linked color imaging (LCI), that combines a specific short wavelength narrow band of light with white light, has been developed.

Conclusion:

In this article, we summarized the characteristics of LCI and the development of research regarding digestive tract examination.

Plain language summary

Application of linked color imaging in early gastrointestinal neoplasms At present, the complete diagnosis of early gastrointestinal tumors and precancerous lesions can be made by gastrointestinal endoscopy. With the improvement of therapeutic instruments and operators’ experience, endoscopic therapy can often achieve significant effect in the treatment of early gastrointestinal tumors. The development and spread of equipment-based image-enhanced endoscopy (e-IEE) mode has helped improve the diagnosis rate of early gastrointestinal tumors under endoscopy. However, in some special cases, these methods are still not accurate for the diagnosis of lesions. On the basis of these E-IEEs, a new endoscopic technique, linked color imaging (LCI), has been developed, which combines a specific short wavelength narrow band of light with white light. LCI can significantly improve the diagnostic rate of all types of gastrointestinal mucosal lesions. Tumor lesions and inflammatory lesions can be distinguished by observing the mucosal microvascular structure and color difference. LCI helps detect early gastrointestinal mucosal lesions by taking advantage of the differences in light absorption of different wavelengths and contrast of enhanced colors in the later stage.
Hiding in the classroom: How neo-Nazi leaders prepare their children for schooling
Authors: Mattsson Christer
Published: July 2021

As part of the general curricular ambitions of contributing to the development of a democratic society, Swedish schools are mandated to actively combat racism and extremism. This causes particular challenges when teachers encounter students who have been brought up in environments where racist and extremist worldviews dominate. This study analyses four Swedish neo-Nazi leaders’ experiences of schooling and how they have utilised these experiences when establishing an approach for their children’s schooling. The focal point of the analysis is the ideological dilemmas that arise from clashes of conviction among neo-Nazi leaders, their children and the teachers. The results show how neo-Nazi leaders use their own negative experiences of schooling to prepare their children on how to escape both democratic education and prevent social stigmatisation.
A Glucose-Only Model to Extract Physiological Information from Postprandial Glucose Profiles in Subjects with Normal Glucose Tolerance
Authors: Eichenlaub Manuel M. , Khovanova Natasha A. , Gannon Mary C. , Nuttall Frank Q. , Hattersley John G.
Published: July 2021

Background:

Current mathematical models of postprandial glucose metabolism in people with normal and impaired glucose tolerance rely on insulin measurements and are therefore not applicable in clinical practice. This research aims to develop a model that only requires glucose data for parameter estimation while also providing useful information on insulin sensitivity, insulin dynamics and the meal-related glucose appearance (GA).

Methods:

The proposed glucose-only model (GOM) is based on the oral minimal model (OMM) of glucose dynamics and substitutes the insulin dynamics with a novel function dependant on glucose levels and GA. A Bayesian method and glucose data from 22 subjects with normal glucose tolerance are utilised for parameter estimation. To validate the results of the GOM, a comparison to the results of the OMM, obtained by using glucose and insulin data from the same subjects is carried out.

Results:

The proposed GOM describes the glucose dynamics with comparable precision to the OMM with an RMSE of 5.1 ± 2.3 mg/dL and 5.3 ± 2.4 mg/dL, respectively and contains a parameter that is significantly correlated to the insulin sensitivity estimated by the OMM ( r = 0.7) Furthermore, the dynamic properties of the time profiles of GA and insulin dynamics inferred by the GOM show high similarity to the corresponding results of the OMM.

Conclusions:

The proposed GOM can be used to extract useful physiological information on glucose metabolism in subjects with normal glucose tolerance. The model can be further developed for clinical applications to patients with impaired glucose tolerance under the use of continuous glucose monitoring data.
Human-Elephant Conflict Around Moukalaba-Doudou National Park in Gabon: Socioeconomic Changes and Effects of Conservation Projects on Local Tolerance
Authors: Terada Saeko , Yobo Christian Mikolo , Moussavou Guy-Max , Matsuura Naoki
Published: July 2021

Human-elephant conflict (HEC) poses a serious problem in Africa for both local livelihoods and elephant conservation. Elephant damage is the price local people pay for coexisting with this species, and is assumed to reduce tolerance for elephants. However, conservation-related projects, through the benefits they offer may enhance local tolerance toward elephants. This study aimed to examine how crop damage by elephants and the benefits gained from conservation activities affect local people’s tolerance toward elephants around Moukalaba-Doudou National Park in southwest Gabon based on long-term ethnographic research and interview surveys in two periods (2010 and 2019). Based on the results, crop damage by elephants had a significant negative impact on the local social economy, leading to a decrease in human population in the area and making local people highly resentful of elephants. However, in one of the villages where employment from research and conservation activities was concentrated, many acknowledged the benefits associated with wildlife and expressed high tolerance for elephants. These findings suggest that benefits from conservation activities can increase tolerance toward elephants, which is negatively affected by the crop damage they cause. However, it should also be noted that externally generated projects have limitations and drawbacks. It is important to establish a system in which the benefits of conservation are shared widely and distributed appropriately, and wherein income resources are diversified. Multisectoral interventions focusing on local socio-ecological vulnerability are needed to mitigate human-elephant conflict and advance the conservation of African elephants.
Afterword: Reprise and reflection*
Authors: Carver Terrell
Published: July 2021

The bicentenary of Engels’s birth in 1820 is an occasion for assessing his works as received by geographers. This Afterword to the special issue draws on Terrell Carver’s recent researches into Engels’s political activities and associations, beginning with his schooldays in Wuppertal, focusing on his Anglo-German journalism, continuing through his political partnership with Marx, and extending after the latter’s death into later life in London. The article demonstrates the value of close contextual attention to the precise character of the political regimes which Engels struggled to change. This approach also reveals the Marx-centric terms through which Engels has been understood, thus undervaluing many of his achievements. Concluding speculatively, it is possible to glimpse in Engels’s thought a geography of space-time, where capitalism is an Einsteinian warp.
The use of tafasitamab in diffuse large B-cell lymphoma
Authors: Düll Johannes , Topp Max , Salles Gilles
Published: July 2021

Patients who relapse or are refractory after first-line therapy for diffuse large B-cell lymphoma (DLBCL) frequently have poor prognoses, especially when they are not candidates for autologous stem cell transplant (ASCT). Tafasitamab is a humanized monoclonal anti-CD19 antibody that has recently been approved by the FDA in combination with lenalidomide for the treatment of relapsed/refractory (R/R) DLBCL in patients who are not eligible for ASCT. Tafasitamab has an Fc region which has been modified to have an increased affinity for Fcγ receptors, to potentiate antibody-dependent cellular cytotoxicity and antibody-dependent cell-mediated phagocytosis. Here, we review the development, mode of action and clinical data for tafasitamab in combination with lenalidomide in R/R DLBCL, and discuss the various ways in which this novel antibody could be utilized in the treatment sequence to improve clinical outcomes for patients with DLBCL.
The limits of territory and terrain
Authors: Elden Stuart
Published: July 2021

This response outlines the intention of thinking critically about terrain as a way to think about the political materiality of territory. It responds to the interlocutors particularly around the themes of place, geology, depth, Eurocentrism, and the relation between human and physical geography.
Hong Kong as special cultural zone: Confucian geopolitics in practice
Authors: Bennett Mia M
Published: July 2021

Responding to An, Sharp, and Shaw’s article, ‘Towards Confucian Geopolitics’, I consider how strategies and interpretations of Chinese geopolitics are playing out in Hong Kong with attention to their cultural dimensions. First, I reflect upon the reactions of individuals and the media in the West—specifically Britain—to the protests and street violence that rocked its former colony in the summer of 2019. Second, to reckon with An, Sharp, and Shaw’s contention that the hybridized nature of Chinese geopolitics emerges from its ‘strategic adaptability’, thereby enabling the integration of foreign ideas into Chinese cultural traditions, I offer a brief critique of cultural and infrastructural developments in Hong Kong relating to the West Kowloon Cultural District. Initially intended to showcase local culture and link it into the art world’s global circuits, the megaproject is increasingly being made in China’s image. Third, as a counterpoint to the supposed flexibility of the Chinese geopolitical imagination, I address the ossification of Western geopolitical thought and practice. In order for geographers to build more pluralistic critical geopolitics, engaging with a diversity of geopolitical approaches and their cultural underpinnings is key. For Western nation-states, failing to practice a more hybridized geopolitics may represent a more existential risk.
Herding on Fundamental/Nonfundamental Information During the COVID-19 Outbreak and Cyber-Attacks: Evidence From the Cryptocurrency Market
Authors: Yousaf Imran , Ali Shoaib , Bouri Elie , Dutta Anupam
Published: July 2021

We provide an empirical analysis of herding behavior in cryptocurrency markets during COVID-19 and periods of cyber-attacks, differentiating between fundamental and nonfundamental herding. The results show that herding behavior is driven by fundamental information during the full sample period and the cyber-attack days. However, herding is not prevalent during the COVID-19 outbreak, either when reacting to fundamental or nonfundamental information. This finding suggests heterogeneity in the behaviors of participants in the cryptocurrency markets during the COVID-19 period.
Convergence or Disparity? A Cross-Country Analysis of Corporate Social Responsibility Reporting for Banking Industry in Nordic Countries and China
Authors: Yang Minghui , Maresova Petra , Akbar Ahsan , Bento Paulo , Liu Weixi
Published: July 2021

This research investigates the corporate social responsibility (CSR) reporting for banking industry in Nordic countries and China, and compares the convergence and disparity of disclosed CSR information across these two regimes. The study encompasses a sample of eight largest commercial banks by total assets in Nordic countries and China over a 5-year period of 2013–2017. We employ a disclosure index approach to assess the contents of CSR reporting based on eight categories and a total of 60 CSR indicators. The results indicate that Nordic banks have a higher overall disclosure level of CSR information than Chinese banks, and significantly ahead of their counterparts with respect to the international commitment, and a wider coverage of addressing stakeholders’ needs. In contrast, CSR reporting in Chinese banks put greater emphasis on national public policy and philanthropic activities. Nevertheless, all sample countries share a convergence on underlining the importance of complying with applicable laws and regulations. The study findings assert that the convergence and disparity of CSR reporting across countries is relevant to pre-existing socio-political institutions the firms can rely on. This research probes into an unexplored research territory by comparing the CSR reporting between banks from a so-called Nordic business-society model and a Confucian-tradition model. Hence, it entails some important policy prescriptions for the concerned administrators and corporate practitioners in the sample countries.
Effects of Data-Driven Learning on College Students of Different Grammar Proficiencies: A Preliminary Empirical Assessment in EFL Classes
Authors: Lin Ming Huei
Published: July 2021

This article reports a pre–post comparative study investigating whether the data-driven learning (DDL) approach has different pedagogical effects on grammar students of English as a foreign language (EFL) with different levels of English proficiency. The study entailed a treatment group (TG) of 95 first-year undergraduates who learned grammar using DDL and a control group (CG) of 84 students who received no grammar treatment. Most of the participants were 18 or 19 years old, with only a few outliers, aged 17 or 20. The grammar performance and learning attitudes in both groups (their motivation and self-efficacy) were quantitatively examined through grammar achievement tests and a questionnaire. The data obtained from the groups were then compared at three proficiency levels: high, intermediate, and low. The results of an analysis of covariance show that in grammar performance, the proficiency levels in all the TG students rose significantly and in the posttest they outperformed their counterparts in the CG. However, neither the members of the TG nor those of the CG made any statistically significant improvement in their learning attitudes; no significant differences were found between the groups at any proficiency level. The mixed findings make an important contribution to the field, confirming that DDL is pedagogically suitable for enhancing the linguistic knowledge of university-level grammar learners, regardless of their proficiency, but warning that practitioners who treat the development of learner attitudes (e.g., motivation and self-efficacy) as important should be cautious with this approach.
A Study of Cloud Computing Adoption in Universities as a Guideline to Cloud Migration
Authors: Aydin Hakan
Published: July 2021

Universities face many challenges such as budget costs, licensing, and software and hardware management in their activities related to information and communications technology (ICT). Through overcoming these challenges, universities may deliver smart, secure, and fluent services for their instructors, students, researchers, information technologies (IT) staff, and administrators. Cloud computing can be a solution to these challenges. The transition to cloud computing in universities is an important step in terms of online education, economic crisis, globalization, and high and constantly changing requirements, especially in the COVID-19 period. Cloud computing can play a very important role in quickly solving the problems faced by universities during this coronavirus period. The purpose of this research was to determine the position of universities in Turkey within the context of cloud computing and to present an abstract hybrid cloud framework for these universities. Descriptive method and survey technique were used in the research. SPSS program was used to analyze the data. Percentage, frequency, and chi-square statistics were used in the analysis process. As a result of the research, the existing conditions and problems in the use of the cloud service model in universities were tried to be identified and a road map for solving these problems was drawn up. In this context, a hybrid framework for adopting cloud computing in universities for them to overcome their identified challenges was proposed. The results are primarily intended to provide a guideline to universities in cloud computing adoption.
The Cultural Adaptation of the Everyday Problems Test—Greek Version: An Instrument to Examine Everyday Functioning
Authors: Pavlidis George , Hatzifilalithis Stephanie , Marwan Zawaher Nikolaos , Papaioannou Georgia , Giagkousiklidou Eleni , Vivas Ana B.
Published: July 2021

Assessing cognitive decline and everyday functioning (EvF) in older age is valuable in detecting age-related neurological disorders. In Greece, there is a lack of sensitive instruments that capture fluctuations in EvF among older persons who are cognitively healthy or have subtle cognitive impairments. The EPT 28-items test, a widely used paper-and-pencil EvF measure, was translated in Greek and adapted to the Greek culture in this study. A multi-step methodology using a sample of 139 older Greek persons was employed. The results indicate that the Greek version of the EPT 28-items (i.e., the EPT-G) was well adapted, representing everyday tasks in Greece within a good range of task difficulty. The psychometric properties of the EPT-G replicate those of the original instrument, capturing EvF fluctuations among older persons with mild cognitive impairments. It was concluded that the EPT-G is a useful measure of EvF among Greek older persons.
Publishing and Parenting in Academic Science: A Study of Different National Contexts
Authors: Di Di , Thomson Robert A. , Howard Ecklund Elaine
Published: July 2021

In the first cross-national, mixed-methods study on gender, family, and science, the authors examined the relationship between research productivity and family life for male and female physicists and biologists in four countries: India, Taiwan, the United States, and the United Kingdom. Drawing on surveys of 5,756 respondents and follow-up interviews with 369 participants, the authors found that the relationship between family responsibilities and publishing operates differently for men and women. Additionally, this relationship is conditioned by the national context in which the scientists work. The interviews indicate that family responsibilities constrain women’s publication productivity according to context. Cross-contextual differences are partially explained by the macro-level gender norms transmitted to academic scientists and how women navigate their scientific research productivity and family responsibilities. The findings have implications for the broader literature on the dialectical relationship between macro-level gender norms and responses by scientists in India, Taiwan, the United States, and the United Kingdom.
The Racially Disparate Effects of Drug Arrest on High School Dropout
Authors: Ashtiani Mariam
Published: July 2021

Racial biases in law enforcement over the past three decades have been linked to the racialized policies of the war on drugs. The author examines the educational consequences of the war on drugs on the lives of youth by analyzing racial differences in the impact of a juvenile drug arrest on high school dropout. Using data from the National Longitudinal Study of Adolescent and Adult Health, the author finds that juvenile drug arrests are more consequential for Black and darker phenotype Latinx youth, who are less likely to be involved in delinquent and criminal behaviors than white youth with drug arrests. The author suggests that racial disparities in drug enforcement may be creating a racialized selection bias among drug arrestees, leading to racially disparate consequences for drug arrests, but not for other types of arrest. The results hold important implications for how drug arrests can produce and sustain racial disadvantages in educational attainment.
The Future Is Open and Shapable: Using Solar Speculative Fiction to Foster Learner Agency
Authors: Jordan Michelle , Bernier Jeremy , Zuiker Steven
Published: July 2021

Speculative fiction is a powerful medium to explore possible futures, inviting literacy researchers and educators to consider the value of futures thinking as a tool for eliciting learners’ hopeful narratives about equitable, sustainable futures for their communities. Yet, when asked to imagine the future, adults and youth alike often envision dystopian stories and fail to consider the interdependencies between technological innovations and the social, economic, and environmental contexts they shape. Moreover, current pedagogic strategies for thinking about the future encourage globalized perspectives rather than stories localized in learners’ lived contexts. Using design-based research methods and informed by ecological theories that assume learners exercise agency through their actions that bring together past, present, and future, our team developed conjectures about how futures thinking might support learners’ agency in relation to sustainability activism and environmental justice. Data analyzed to test our conjectures were 18 solar futures narratives written by adult and youth participants in a solar energy research program. Findings show promise for writing practices that foster sustainability and climate change learning.
Total Joint Replacement of Ankle, Knee, and Hip: How Do Patients Perceive Their Operative Outcomes at 10 Years?
Authors: Ramaskandhan Jayasree , Smith Karen , Kometa Simon , Chockalingam Nachiappan , Siddique Malik
Published: July 2021

Background:

Patient-reported outcomes (PROMs) are an integral part of national joint registers in measuring outcomes of operative procedures and improving quality of care. There is lack of literature comparing outcomes of total ankle replacement (TAR) to total knee replacement (TKR) and total hip replacement (THR). The aim of this study was to compare PROMs between TAR, TKR, and THR patient groups at 1, 5, and 10 years.

Methods:

Prospective PROMs from patients who underwent a TAR, TKR, or THR procedure between 2003 and 2010 were studied. Patients were divided into 3 groups based on their index joint replacement (hip, knee, or ankle). Patient demographics (age, gender, body mass index), patient-reported outcome scores (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], 36-Item Short Form Health Survey [SF-36]) and patient satisfaction scores (4-point Likert scale) at follow-up were compared between the 3 groups.

Results:

Data was available on 1797 THR, 2475 TKR, and 146 TAR patients. TAR patients were younger and reported fewer number of comorbidities. All 3 groups improved significantly from preoperative to 10 years for WOMAC scores ( P < .001). For SF-36 scores at 10 years, the THR group (32.2% follow-up) scored the highest for 3 domains ( P = .031) when compared to the TKR group (29.1% follow-up). All 3 groups had similar outcomes for 5 of 8 domains; P < .05). For patient satisfaction, the THR group reported overall 95.1% satisfaction followed by 89.8% for the TKR group and 83.9% in the TAR group (42.4% follow-up).

Conclusion:

In this cohort with diminishing numbers over the decade of time the patients were followed up we found that patients are equally happy with functional and general health outcomes from total ankle replacement vs other major lower extremity joint replacement. TAR surgery should be considered as a viable treatment option in this patient group.

Level of Evidence:

Level III, retrospective case series.
Heavy metals in urinary stones in the Democratic Republic of Congo
Authors: Diangienda Pablo Kuntima Diasiama , Moningo Dieudonné Molamba , Mayindu Alain Ngoma , Haymann Jean-Philippe , Daudon Michel
Published: July 2021

Background

The Democratic Republic of Congo has been a country of intensive mining activities for centuries, but the data on the presence of heavy metals in stones are lacking. This study aimed to identify different heavy metals in urinary tract stones and to investigate their association with the main components of urinary stones.

Methods

Thirty-six stones from urolithiasis patients (n = 36) followed in 10 hospitals in the Democratic Republic of Congo between January 2016 and September 2019 were analyzed by Fourier transform infrared spectrophotometry. Further analysis using X-ray fluorescence was conducted at the Laboratory of Solids Physics.

Results

Eight heavy metals were detected in all the stones analyzed. The average (SD) number of heavy metals detected by stone was 5 (1.2). Iron and strontium were detected in all the stones analyzed. Other heavy metals detected included zinc, copper, bromine, rubidium, lead and nickel. Rubidium had the highest concentration in the stones regardless of the sampling site. There was no statistically significant association between the content of heavy metals at the center level and at the crown level of the stones. Rubidium had more affinity with phosphates and purines (p ˂ 0.001). Iron and strontium exhibited a high affinity with weddellite than with whewellite.

Conclusion

Iron and Strontium were present in all stones analyzed. The presence of heavy metals in stones analyzed might suggest environmental pollution rather than crystalline induction factors.
Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai
Authors: Jibhakate Nikhilesh A. , Patwardhan Sujata K. , Sawant Ajit S. , Pathak Hemant R. , Patil Bhushan P. , Kamal Hitesh
Published: July 2021

Background

To evaluate the impact of COVID-19 lockdown on non-COVID urological patient’s management in tertiary care urology centres.

Methods

This is an observational study in which data of patients visiting the urology department of all the MCGM run tertiary care hospitals were recorded for the duration of 1 April 2020 to 31 July 2020 and were compared to data of pre-COVID-19 period of similar duration.

Results

There was a decrease of 93.86% in indoor admissions of urology patients during the COVID-19 lockdown. Indoor admissions for stone disease, haematuria, malignancy accounted for 53.65%, 15.85%, 9.75%, respectively. Elective surgeries had the highest percentage decrease followed by emergency and semi-emergency procedures. There was a reduction of more than 80% in patients attending outpatient clinics. Stone disease and its consequences were the main reasons for visiting outdoor clinics (39%). A substantial number of patients presented with flank and abdominal pain (14.8%) and benign enlargement of the prostate (10.23%). Malignancy accounted for a very small number of patients visiting outdoor clinics (1.58%).

Conclusions

COVID-19 pandemic has a profound impact on patient care and education in Urology. There was more than ninety percent reduction in indoor admissions, operative procedures, and outpatient clinics attendance. Once the pandemic is controlled, there will be a large number of patients seeking consultation and management for urological conditions and we should be prepared for it. Surgical training of urology residents needs to be compensated in near future. Long-term impact on urological patient outcome remains to be defined.
Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study
Authors: Al Hasan Dalal , Yaseen Ameen , Al Roudan Mohammad , Wallis Lee
Published: July 2021

Background

The objective of this study was to describe the epidemiology of severe hypoglycaemia in Kuwait, aiming to provide a preliminary background to update the current guidelines and improve patient management.

Method

This was a prospective analysis of severe hypoglycaemia cases retrieved from emergency medical services (EMS) archived data between 1 January and 30 June 2020. The severe hypoglycaemia cases were then sub-grouped based on EMS personal initial management and compared in terms of scene time, transportation rate, complications and outcomes. The primary outcomes were GCS within 10–30 min and normal random blood glucose (RBS) within 10–30 min.

Results

A total of 167 cases met the inclusion criteria. The incidence of severe hypoglycaemia in the national EMS was 11 per 100,000. Intramuscular glucagon was used on scene in 89% of the hypoglycaemic events. Most of the severe hypoglycaemia patients regained normal GCS on scene (76.5%). When we compared the two scene management strategies for severe hypoglycaemia cases, parenteral glucose administration prolonged the on-scene time (P = .002) but was associated with more favourable scene outcomes than intramuscular glucagon, with normal GCS within 10–30 min (P = .05) and normal RBS within 10–30 min (P = .006). Conclusion: Severe hypoglycaemia is not uncommon during EMS calls. Appropriate management by EMS personals is fruitful, resulting in favourable scene outcomes and reducing the hospital transportation rate. More research should be invested in improving and structuring the prehospital management of severe hypoglycaemia. One goal is to clarify the superiority of parenteral glucose over intramuscular glucagon in the prehospital setting.
Prehospital time and mortality in polytrauma patients: a retrospective analysis
Authors: Berkeveld E. , Popal Z. , Schober P. , Zuidema W. P. , Bloemers F. W. , Giannakopoulos G. F.
Published: July 2021

Background

The time from injury to treatment is considered as one of the major determinants for patient outcome after trauma. Previous studies already attempted to investigate the correlation between prehospital time and trauma patient outcome. However, the outcome for severely injured patients is not clear yet, as little data is available from prehospital systems with both Emergency Medical Services (EMS) and physician staffed Helicopter Emergency Medical Services (HEMS). Therefore, the aim was to investigate the association between prehospital time and mortality in polytrauma patients in a Dutch level I trauma center.

Methods

A retrospective study was performed using data derived from the Dutch trauma registry of the National Network for Acute Care from Amsterdam UMC location VUmc over a 2-year period. Severely injured polytrauma patients (Injury Severity Score (ISS) ≥ 16), who were treated on-scene by EMS or both EMS and HEMS and transported to our level I trauma center, were included. Patient characteristics, prehospital time, comorbidity, mechanism of injury, type of injury, HEMS assistance, prehospital Glasgow Coma Score and ISS were analyzed using logistic regression analysis. The outcome measure was in-hospital mortality.

Results

In total, 342 polytrauma patients were included in the analysis. The total mortality rate was 25.7% (n = 88). Similar mean prehospital times were found between the surviving and non-surviving patient groups, 45.3 min (SD 14.4) and 44.9 min (SD 13.2) respectively (p = 0.819). The confounder-adjusted analysis revealed no significant association between prehospital time and mortality (p = 0.156).

Conclusion

This analysis found no association between prehospital time and mortality in polytrauma patients. Future research is recommended to explore factors of influence on prehospital time and mortality.
Challenges to implementing electronic trial data collection in primary care: a qualitative study
Authors: Cabral Christie , Curtis Kathryn , Curcin Vasa , Domínguez Jesús , Prasad Vibhore , Schilder Anne , Turner Nicholas , Wilkes Scott , Taylor Jodi , Gallagher Sarah , Little Paul , Delaney Brendan , Moore Michael , Hay Alastair D. , Horwood Jeremy
Published: July 2021

Background

Within-consultation recruitment to primary care trials is challenging. Ensuring procedures are efficient and self-explanatory is the key to optimising recruitment. Trial recruitment software that integrates with the electronic health record to support and partially automate procedures is becoming more common. If it works well, such software can support greater participation and more efficient trial designs. An innovative electronic trial recruitment and outcomes software was designed to support recruitment to the Runny Ear randomised controlled trial, comparing topical, oral and delayed antibiotic treatment for acute otitis media with discharge in children. A qualitative evaluation investigated the views and experiences of primary care staff using this trial software.

Methods

Staff were purposively sampled in relation to site, role and whether the practice successfully recruited patients. In-depth interviews were conducted using a flexible topic guide, audio recorded and transcribed. Data were analysed thematically.

Results

Sixteen staff were interviewed, including GPs, practice managers, information technology (IT) leads and research staff. GPs wanted trial software that automatically captures patient data. However, the experience of getting the software to work within the limited and complex IT infrastructure of primary care was frustrating and time consuming. Installation was reliant on practice level IT expertise, which varied between practices. Although most had external IT support, this rarely included supported for research IT. Arrangements for approving new software varied across practices and often, but not always, required authorisation from Clinical Commissioning Groups.

Conclusions

Primary care IT systems are not solely under the control of individual practices or CCGs or the National Health Service. Rather they are part of a complex system that spans all three and is influenced by semi-autonomous stakeholders operating at different levels. This led to time consuming and sometimes insurmountable barriers to installation at the practice level. These need to be addressed if software supporting efficient research in primary care is to become a reality.
An extremely rare case of a gastric accessory spleen: case report and review of the literature
Authors: Chen Guiqin , Nie Lei , Zhang Tijiang
Published: July 2021

Background

The accessory spleen has no anatomical or vascular relationship with the normal spleen, The tissue structure and physiological function of the accessory spleen are the same as those of the normal spleen, which usually locate in the splenic hilum and the tail of the pancreas. The aims of this manuscript are to present a rare case of the gastric accessory spleen and a review of the literature.

Case presentation

A 19-year-old male patient was sent to the emergency department with stomach bleeding after drinking alcohol. The computed tomographic scan showed a 1.2 cm × 1.7 cm mass at the lesser curvature of the gastric fundus. Gastrointestinal endoscopy displayed a submucosal elevated lesion on the gastric fundus, and gastrectomy was performed. Postoperative pathological examination proved an accessory spleen in the stomach. The postoperative course was uneventful, and the patient was discharged on the 6th day after the surgery.

Conclusions

The accessory spleen at the fundus of stomach is extremely rare, especially in this case, which is accompanied by acute gastric bleeding, and it is difficult to diagnosis before operation. Many literatures reported that it was misdiagnosis as tumor, so it is necessary to diagnose accessory spleen correctly.