bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovative entrepreneurial market trend prediction model based on deep learning: Case study and performance evaluation
Authors: Huang Kongyao , Zhou Yongjun , Yu Xiehua , Su Xiaohong
Published: August 2024

In the current economic landscape, the growing importance of innovation and entrepreneurship underscores an urgent need for accurate market trend prediction. Addressing this challenge, our study introduces an innovative entrepreneurial market trend prediction model based on deep learning principles. Through detailed case studies and performance evaluations, this paper demonstrates the model's effectiveness and its potential to enhance decision-making capabilities in a competitive business environment. Accurate market trend prediction is crucial in the fields of innovation and entrepreneurship, and our approach meets this demand. Our model leverages the power of deep learning technology, combining historical market data with diverse market indicators, including sentiment analysis derived from social media, to create an advanced predictive model that surpasses traditional methods. By analyzing data from multiple channels, our model exhibits exceptional accuracy in forecasting future market trends. The case study provides strong evidence of our model's performance and precision, showcasing its significant support for innovators and entrepreneurs navigating complex market trends. Furthermore, this study highlights the vast potential of deep learning technology in the economic sector. We emphasize the importance of developing innovative entrepreneurial market trend prediction models and foresee an increase in project success rates for innovators and entrepreneurs by enhancing decision quality through the adoption of deep learning.
Neural network-based robust predictive control for visual servoing of autonomous vehicles with friction compensation
Authors: Lin Yegui , Xing Kexin , He Defeng , Ni Weiqi
Published: August 2024

This paper proposes a neural network-based robust model predictive control (MPC) strategy for visual serving of autonomous vehicles (AVs) with uncertain payloads, ground friction disturbances, and air resistance effects. Based on the dynamics of visual servoing errors and driving of the AV, the quasi-min–max MPC is adopted to calculate the desired velocity of the AV subject to the constraints on the speed, control, and the visual field. The backpropagation (BP) neural network is then used to learn the ground friction disturbances of the AV, which is adopted to compensate the quasi-min–max MPC of the visual servoing system. Finally, the performance of the proposed controller is evaluated and verified by some comparison simulations.
Vocational Identity Statuses Among Hong Kong Sub-degree Students: Pattern Identification and Relationship to Career Development and Academic Performance
Authors: Cheung Raysen , Jin Qiuping , Yeung Ka Kit , Lau Hin Long , Chui Wing Hong
Published: August 2024

The process model of vocational identity was well applied in various Western countries to study the vocational identity process and statuses of college students. However, such research is limited in Hong Kong. Moreover, the relation between vocational identity development and academic performance was inconclusive in the literature, and it was also not tested among Hong Kong students. In light of these, the current study aimed to empirically identify and validate vocational identity statuses among a sample of 576 sub-degree students in Hong Kong using the vocational identity process model. Relations of vocational identity processes and statuses with perceived academic performance were also tested. Six vocational identity statuses were empirically derived in the Hong Kong Chinese context. Vocational identity statuses also differentiate perceived academic performance. Moreover, we found that career flexibility and self-doubt were significantly related to perceived academic performance. Implications of the results for theory and practice are discussed.
Social brokers in grassroots governance: The new rural gentry in China
Authors: Tsai Wen-Hsuan , Tian Gang
Published: August 2024

One important and interesting aspect of the Chinese Communist Party’s (CCP) efforts to revitalize the Chinese countryside in recent years has been the attempt to make use of prominent local people – known as xinxiangxian (新乡贤, meaning ‘new rural meritorious people’). As social brokers, xinxiangxian differ from other agents. The attributes of this new class have yet to be regularized through central government statute, which means that the CCP’s position on the xinxiangxian is still under discussion. From the example of A county, we conclude that xinxiangxian use their abundance of bridging social capital to fulfil two important political functions: lobbying their communities in favour of government policies to strengthen grassroots ruling and serving as local government supervisors to monitor village committee affairs. Compared with other brokers included into the CCP regime, xinxiangxian, as their name suggests, are renowned for their moral values and competencies, allowing them to make a significant contribution to the CCP’s governance of Chinese society.
Orthogonal cutting process in powder metallurgy green compact tools: Finite element modeling and cutting force optimization analysis
Authors: Zeng Lingxin , Yang Dayong , Wang Rui , Zhang Yuchen , Huang Shufeng , Liu Min
Published: August 2024

Powder metallurgy materials, which are widely utilized in various sectors, have led to the development of green machining. Green machining is a novel process that has attracted considerable research interest. The machining of green compacts of powder metallurgical materials presents challenges, such as low strength, high brittleness, and issues with cutting forces, fracture, and surface quality control. In previous research, experimental methodologies have primarily been considered. However, in this study, a finite element simulation model tailored for machining analysis was introduced and rigorously validated. The behavior of the material was accurately depicted through a damaged plasticity model, which was calibrated using uniaxial tensile and compression tests. Afterward, a comprehensive finite element machining model was developed. Through quantitative analysis, the simulated cutting particles were evaluated and compared with experimental data. There was a marginal error of 6.35%. Additionally, the cutting surface dimensions were meticulously compared using a 3D white light interferometer. There were errors of 7.76% in terms of width and 8.42% in terms of depth, confirming that the precision of the model was within an acceptable margin. The impacts of various cutting parameters on the cutting force and surface integrity characteristics of machined green compacts were explored in this study. The optimal parameters were identified as a cutting depth of 0.15 mm, a speed of 90 m/min, and a cutting force of 452 N, which significantly enhanced the cutting efficiency and substantiated the reliability of the model.
Comparing Nephrologists’ Self-Reported Decision-Making Skills and Treatment Attitudes With Their Patients’ Experiences of Making Kidney Therapy Decisions and Receiving Nephrology Care
Authors: Jawed Areeba , Batch Brook , Allen Rebecca , Epstein Ronald , Fiscella Kevin , Duberstein Paul , Saeed Fahad
Published: August 2024

Background

Dialysis is often initiated in the United States without exploring patients’ preferred decision-making style, and conservative kidney management (CKM) is infrequently presented. To improve kidney therapy (KT) decision-making, research on nephrologists’ comfort with various decision-making styles, attitudes towards CKM, and reports of patients’ lived experiences with KT decision-making is needed.

Methods

We surveyed 28 nephrologists and 58 of their patients aged ≥75 years. The nephrologist survey was designed to gauge their comfort levels with decision-making styles and attitudes towards CKM. The patient survey assessed experiences in making KT decisions.

Results

The average age of nephrologists was 43 years, and that of patients was 82 years. Nephrologists rated themselves as comfortable with various decision styles: paternalistic (60.7%), shared decision-making (92.8%), and patient-driven decision-making (67.8%). Nearly 57% of nephrologists felt challenged or were neutral in determining CKM’s suitability, and 39% reported difficulties in discussing CKM with patients or were neutral. Only 38 % of patients recalled discussing CKM with their nephrologists, and a minority reported discussing CKM-related topics such as life expectancy (24.7%), quality of life (QOL) (45.1%), and end-of-life care (17.5%).

Conclusions

Most nephrologists displayed comfort with various decision-making styles; however, many described difficulties in guiding patients toward CKM. In contrast, patients reported gaps in vital aspects of KT decision-making and CKM choices, such as discussions of life expectancy, QOL, and end-of-life care. Raising awareness of blind spots in decision-making skills and educating nephrologists in KT decision-making to include CKM and other person-centered aspects of care are needed.
Intercultural Sensitivity Among University Students in India
Authors: Singson Kimneilam , Syiem Ibadani S. , Singson Mangkhollen
Published: August 2024

Millions of Indian students’ study at universities each year. Indian universities are diversified with students from different states and cultures. Students from different cultures communicate and interact often. However, pupils often lack intercultural awareness. The research employed Chen and Starosta's (2000) “Intercultural Sensitivity Scale” to examine Pondicherry University postgraduate students’ intercultural sensitivity. The research randomly selected 100 students from different states. No significant variations was found in intercultural sensitivity by gender, states, schedule tribes and non-schedule tribe students, Northeast students and non-Northeast students, or the subject stream. However, the study found a significant difference in intercultural sensitivity between university campus residents (hostels) and non-residents. Finally, students’ discipline had a significant influence at the multivariate level but not at the bivariate level. Residential status moderates the relationship between the subject stream and intercultural sensitivity.
A model of how hierarchical representations constructed in the hippocampus are used to navigate through space
Authors: Chalmers Eric , Bardal Matthieu , McDonald Robert , Bermudez-Contreras Edgar
Published: August 2024

Animals can navigate through complex environments with amazing flexibility and efficiency: they forage over large areas, quickly learning rewarding behavior and changing their plans when necessary. Some insights into the neural mechanisms supporting this ability can be found in the hippocampus (HPC)—a brain structure involved in navigation, learning, and memory. Neuronal activity in the HPC provides a hierarchical representation of space, representing an environment at multiple scales. In addition, it has been observed that when memory-consolidation processes in the HPC are inactivated, animals can still plan and navigate in a familiar environment but not in new environments. Findings like these suggest three useful principles: spatial learning is hierarchical, learning a hierarchical world-model is intrinsically valuable, and action planning occurs as a downstream process separate from learning. Here, we demonstrate computationally how an agent could learn hierarchical models of an environment using off-line replay of trajectories through that environment and show empirically that this allows computationally efficient planning to reach arbitrary goals within a reinforcement learning setting. Using the computational model to simulate hippocampal damage reproduces navigation behaviors observed in rodents with hippocampal inactivation. The approach presented here might help to clarify different interpretations of some spatial navigation studies in rodents and present some implications for future studies of both machine and biological intelligence.
Competing Criteria: Rethinking Congressional Redistricting and Representation
Authors: Hayes Sam D.
Published: August 2024

Congressional redistricting requires institutions to make decisions about which criteria they will use to draw new district boundaries. These decisions unavoidably prioritize certain criteria at the expense of other criteria. Further, the competitive nature of redistricting criteria also means that when institutions use certain criteria at the expense of others, they are also correlating with certain forms of group representation at the expense of others. This paper argues that the representational consequences of redistricting are best understood through an approach that accounts for this process and the full array of redistricting institutions and criteria. Using a novel research design and an extensive data set covering six decades of redistricting cycles, this paper supports these claims with empirical evidence describing the relationships of seven categories of redistricting institutions with a wide range of criteria. This paper finds that partisan legislatures, bipartisan legislatures, and political commissions facilitate partisan group representation; state courts facilitate geographic group representation; federal courts facilitate racial and ethnic group representation; and independent commissions facilitate both geographic and racial/ethnic group representation. These findings emphasize that Americans are categorized and grouped differently during congressional redistricting depending on who is drawing the lines.
How Do Exoskeletons Affect Back and Leg Muscular Demands During Repetitive Trunk Bending?
Authors: Kuber Pranav Madhav , Rashedi Ehsan
Published: August 2024

Back Support Industrial Exoskeletons (BSIEs) offer support to the wearer’s torso during trunk flexion tasks thereby alleviating low-back muscle strain and risk of injury. We conducted a controlled laboratory experiment to bridge the gap between laboratory and field assessments by simulating realistic working scenarios. Twelve participants performed 30 repetitions of trunk flexion tasks with/without BSIE and with/without ~45° left asymmetry at no fatigue and then at medium-high fatigue after performing intermittent posture maintenance tasks. Findings show reduction of 0% to 1.8% with BSIE in erector spinae and 10% to 18% in the biceps femoris muscle activity using Electromyography (EMG). Demands in low-back were higher during retraction portion ~7%, which increased even more to ~12% at medium-high fatigue when not using BSIE. General findings can contribute to the development of guidelines for design and implementation of BSIEs and may be beneficial in paving way for optimized designs that are tailored to complex industrial activities.
Navigators’ Perspective on Information Requirements for Supervisory Control of Autonomous Ships
Authors: van de Merwe Koen , Mallam Steven , Nazir Salman , Engelhardtsen Øystein
Published: August 2024

This study explores the application of agent transparency in the context of autonomous ships. Four levels of transparency were developed depicting decisions, planned actions, reasoning, and input parameters of a collision and grounding avoidance system in a realistic navigational context. Thirty-four licensed navigators were provided with Human Machine Interface concepts depicting four levels of transparency. Qualitative feedback was obtained through semi-structured interviews about which information they felt is needed to supervise autonomous ships safely and effectively. In addition, the participants’ ranked the HMIs according to their preferences. The results indicate the need for depicting the outcomes of the system’s collision risk analysis for supervisory control. Furthermore, the results illustrate the variations in supervisory strategies and the resulting dilemma for the amount and type of information required to support supervisors. Finally, this study highlights the importance of expert knowledge in the design of safety critical systems.
Pathways of Intergenerational Risk: Examining the Association Between Maternal Adverse Childhood Experiences and Child Socio-Emotional and Behavioral Concerns at 8 Years of Age
Authors: Zhu Jenney , Racine Nicole , Tough Suzanne , Madigan Sheri
Published: August 2024

Support has been found for the intergenerational transmission of risk from maternal adverse childhood experiences (ACEs) to child outcomes. Less research has focused on longitudinal psychosocial pathways that account for this transmission. In the current study, path analysis examined mediating pathways (i.e., maternal adult attachment insecurity, romantic relationship functioning, and maternal anxiety and depression symptoms) in the association between maternal ACEs and internalizing and externalizing concerns among their child at eight years of age. Participants included 1,994 mother-child dyads from a prospective longitudinal cohort sample. Maternal ACEs were significantly associated directly with child internalizing concerns (β = .06, p = .025) and indirectly via both maternal attachment anxiety and avoidance, lower romantic relationship functioning, and depression, (β = .002, p = .006; β = .003, p = .005, respectively). Maternal ACEs were directly associated with child externalizing concerns (β = .06, p = .018) and indirectly via both maternal attachment anxiety and avoidance, lower romantic relationship functioning, and depression, (β = .001, p = .008; β = .002, p = .010, respectively). This study identified several maternal risk factors that have implications for downstream internalizing and externalizing concerns among their children.
The Afghan Murat: A Queer Subject at Transnational Crossroads
Authors: Abdi Ali
Published: August 2024

This article introduces and explores the subjectivity of a queer community in Afghanistan, the self-identified murats. Murat is a subject position that emerged in Afghanistan over the past 20 years to become a viable category of personhood and a practical term of reference among a community of non-masculine dancers and sex workers living and working in the capital (and other major cities). Based on the findings of ethnographic fieldwork conducted between 2016 and 2021 in Kabul, the article shows that the transnational and transhistorical formation of Afghan murats’ gender and sexual subjectivities has been the result of the intersection of three other categories of personhood: the South Asian hijra, the Turko-Persianate bachah, and the Afghan īzak. By studying the Afghan murat subjectivity, the article further sketches out a template for imagining the sex/gender configuration in Afghanistan, suggesting that it is non-binary and cannot be comfortably divided into the two opposing poles of the male/masculine and the female/feminine.
Using big data to measure cultural tourism in Europe
Authors: Borowiecki Karol Jan , Pedersen Maja U , Mitchell Sara Beth
Published: August 2024

International tourism statistics are notorious for being overly aggregated, lacking in detailed tourist information, not timely, and often provided only on an annual basis. We suggest a unique, complementary data-driven approach relying on big data collected from Tripadvisor. We obtain a systematic, consistent, and reliable approximation for tourism flows, with high precision, frequency, and depth of information. The approach provides also a list of all tourist attractions in a country. We validate the approach pursued and present one application of the data by illuminating the patterns and changes in travel flows in selected European destinations during and after the COVID-19 pandemic. This project opens a range of new research questions and possibilities for tourism economics and cultural economics.
An Experimental Test of Jealousy's Evolved Function: Imagined Partner Infidelity Induces Jealousy, Which Predicts Positive Attitude Towards Mate Retention
Authors: Arnocky Steven , Kubinec Kayla , MacKinnon Megan , Mazmanian Dwight
Published: August 2024

Jealousy may have evolved to motivate adaptive compensatory behavior in response to threats to a valued relationship. This suggests that jealousy follows a temporal sequence: A perceived relational threat induces state feelings of jealousy which in turn motivates compensatory behavior, such as mate retention effort. Yet to date, tests of this mediation model have been limited to cross-sectional data. This study is the first to experimentally test this theoretical model. Men and women ( N = 222) who were currently in committed romantic relationships were primed with an imagined partner infidelity (versus control) scenario. Participants then completed measures of state jealousy and intended mate retention behavior. Results found that those primed with the infidelity threat scenario experienced an increase in state jealousy, which in turn predicted more intended benefit-provisioning and cost-inflicting mate retention. Findings suggest that jealousy mediated the relationship between infidelity threat and intended mate retention behavior, supporting the evolutionary account of state jealousy.
Making Hard Things Look Easy: An Interview with Richard Florida
Authors: Ghaziani Amin
Published: August 2024

Amin Ghaziani interviews urbanist Richard Florida, author of The Rise of the Creative Class, about the skills needed to communicate big ideas beyond academia.
Sentinels of the Color Line?
Authors: Skarpelis A.K.M.
Published: August 2024

A.K.M. Skarpelis on Refashioning Race.
Exploring measurement tools used to assess knowledge, attitudes, and perceptions of pregnant women toward prenatal screening: A systematic review
Authors: Sacca Lea , Zerrouki Yasmine , Burgoa Sara , Okwaraji Goodness , Li Ashlee , Arshad Shaima , Gerges Maria , Tevelev Stacey , Kelly Sophie , Knecht Michelle , Kitsantas Panagiota , Hunter Robert , Scott Laurie , Reynolds Alexis Piccoli , Colon Gabriela , Retrouvey Michele
Published: August 2024

There is a lack of standardized measurement tools globally to assess knowledge, attitudes, and perceptions of expecting women toward prenatal screening. The purpose of this systematic review was to identify reasons women pursue or decline prenatal screening and compare the strengths and limitations of available measurement tools used to assess pregnant women’s perceptions, knowledge, and attitudes toward prenatal screening. This review followed the five-step York methodology by Arksey and O’Malley and incorporated recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist for the extraction, analysis, and presentation of results. The five steps consisted of: (1) identification of the research questions; (2) searching for relevant studies; (3) selection of studies relevant to the research questions; (4) data charting; and (5) collation, summarization, and reporting of results. Four online databases (PubMed, Embase, Web of Science, and Cochrane Library) were selected after the librarian’s development of a detailed search strategy. The Rayyan platform was used between June 2023 and August 2023 to epitomize the articles produced from our search. A total of 68 eligible studies were included in the analysis. The top five major reasons for declining prenatal screening uptake included (1) being unsure of the risk of prenatal screening and harm to the baby or miscarriage ( n = 15), (2) not considering action such as termination of pregnancy for prenatal screening to be considered as necessary ( n = 14), (3) high cost ( n = 12), (4) lack of knowledge about testing procedures and being anxious about the test ( n = 10), and (5) being worried about probability of false negative or false positive results ( n = 6). Only 32 studies utilized scientifically validated instruments. Difficulties in capturing representative, adequately sized samples inclusive of diverse ethnicities and demographics were pervasive. Findings highlight the need for rigorous validation of research measurement methodologies to ensure the accuracy and applicability of resulting data regarding the assessment of prenatal screening perceptions, knowledge, and attitudes across diverse female populations.

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Women’s experiences of receiving antenatal and intrapartum care during COVID-19 at public hospitals in the Sidama region, Ethiopia: A qualitative study using the combination of three delay and social-ecological framework (hybrid framework)
Authors: Kassa Zemenu Yohannes , Scarf Vanessa , Turkmani Sabera , Fox Deborah
Published: August 2024

Background:

The COVID-19 pandemic, drought and internal conflict have worsened Ethiopia’s already weak healthcare system. Antenatal and intrapartum care are especially prone to interruption under these circumstances.

Objective:

To explore women’s experiences receiving antenatal and intrapartum care during the pandemic.

Design:

A descriptive qualitative approach was utilised.

Methods:

We conducted in-depth interviews with 17 women and held 4 focus group discussions with women who gave birth at 4 public hospitals during the pandemic. A study was conducted at four public hospitals in the Sidama region of Ethiopia, during which data were collected from 14 February to 10 May 2022. Thematic analysis was performed to generate themes.

Results:

The peak of the COVID-19 pandemic in Ethiopia presented several barriers to access and uptake of antenatal and intrapartum care at public hospitals. Four themes and 10 subthemes emerged from the thematic analysis. The themes were ‘Barriers to maternity care uptake during COVID-19’, ‘Shortage of resources during COVID-19’, ‘Delays in maternity care uptake during COVID-19’ and ‘Mistreatment of women during maternity care during COVID-19’. The subthemes included ‘Fear of contracting COVID-19’, ‘People in the hospital neglecting COVID-19 prevention’, ‘Women losing their job during COVID-19’, ‘Shortage of beds in the labour ward’, ‘Shortage of medical supplies’, ‘Delays in seeking care’, ‘Delays in receiving care’, ‘Complications during childbirth’, ‘disrespectful’ and ‘suboptimal care’.

Conclusion:

The findings of this study underscore the impact of COVID-19 on antenatal and intrapartum care, leading to delays in seeking and receiving care due to reduced rapport, resource shortages, companion restrictions, disrespectful care and suboptimal care. These factors contribute to increased obstetric complications during COVID-19. It is imperative for policymakers to prioritise essential resources for antenatal and intrapartum care in the present and future pandemics. Moreover, healthcare providers should maintain respectful and optimal care even amid challenges.
Supporting Aging-in-Place: Drivers and Desired Outcomes of a Healing Environment for Older Adults in Block Spaces of High-Density Cities
Authors: Meng Lingchao , Wen Kuo-Hsun , Xi Nannan , Zheng Tao
Published: August 2024

Aim: The objective of this study was to develop a comprehensive multidimensional framework by identifying the key drivers and components associated with the health of older people in healing environments, and to apply this framework in high-density city block spaces, creating opportunities for aging in place. Background: Effective theoretical and practical research frameworks are necessary to determine how to best support older adults in high-density city areas as they face aging-related challenges. Methods: The methodological approach involved bibliometric analysis (SciMAT) and systematic literature review of approximately 4446 articles related to rehabilitation settings and older adults. The review focused on literature that developed concepts and research frameworks and provided an empirical foundation. Results: The review identified four types of drivers for a healing environment for older individuals in high-density city blocks (HEOI-HCBs): self-environment, interpersonal, physical, and informational environments. These drivers were linked to eight desirable outcomes: initiative acquisition, shared vision, trust, empathy, integrity, systematicity, networking, and perceived usefulness. Conclusion: The drivers and outcomes formed the HEOI-HCBs framework, each representing a distinct dimension of the HEOI-HCBs concept. This study and the resulting framework facilitate the application and understanding of healing environments.
The activating podcast method: Engaging students through blended learning
Authors: Muffels Nathalie , Van Weyenberg Astrid
Published: August 2024

In university education, we aim for students to master the course materials, practice with transferable skills, have meaningful discussions, learn from each other, and be active members of the academic community. These goals are especially important for first-year students, who are new to academic education. At the same time, teaching methods should be aimed at career development and labour market opportunities. This study aims to evaluate the success of an education method that attempts to incorporate this broad range of learning goals into one course. The aim of this study is to evaluate, by means of a ‘mixed-method’ data analysis, the effectiveness, quality and sustainability of the Activating Podcast Method (APM) in student’s learning experience, a blended learning approach that uses a flipped classroom method tailored to these goals. An online survey ( N = 30) and an interview ( N = 8) measured a 2022 cohort first year BA Film and Literary Studies students’ experiences of the effectivity of the Activating Podcast Method in their academic learning and performance. After first conducting quantitative research, qualitative research was conducted to further explain the generated data. Results suggest that the Activating Podcast Method enhances and improves the students’ learning experience, efficiency and performance, by conveying theoretical knowledge and context through online independent learning in advance of on campus classes that focus primarily on in-depth discussion. The feedback of students as well as our own experiences as the lecturer of and student assistant to this course, indicate the overall benefits of APM as a learning method. Finally, this article explores how APM can be integrated into university education.
Physician advisory program at Rochester Regional Health: An exercise in participatory sociotechnical design
Authors: Hansen Sean , Bui Quang “Neo” , Phillips Matthew , Yenugadhati Vamsi , Zsenits Balazs
Published: August 2024

Electronic Health Records (EHR) systems have transformed and modernized healthcare processes. Yet, EHR systems are frequently criticized for complicating workflows and low usability. To overcome those impediments, many EHR vendors have provided tools that allow greater involvement of physicians in improving EHR workflows. However, those “physician builder” tools are often difficult for physicians to master. This case explores a participatory EHR-based business process redesign initiative at Rochester Regional Health, an integrated health system in New York State. Through close collaboration between the health system’s Health Informatics Department and its clinical care providers, the Physician Advisory (PAd) Program created standardized note templates, produced trackable data, and leveraged in-house expertise to significantly lower operational costs and empower providers. The case probes the costs and benefits of process standardization and participatory design in the dynamic environment of health information management. The experiences at Rochester Regional Health provide valuable insights for health care organizations seeking to transform EHR workflows for greater fit with their needs, highlighting the importance of data-driven workflow review, reducing process fragmentation, and measuring progress for continuous improvement.
Embracing virtual reality in rehabilitation of post-stroke aphasia
Authors: Kljajevic Vanja
Published: August 2024

About one-third of stroke survivors experience aphasia, i.e., language dysfunction caused by brain damage. Aphasia affects not only a person's ability to communicate, but it often leads to the inability to return to work, loss of close relationships, diminished quality of life, negative self-perception, and depression. Yet persons with aphasia are globally underserved due to limited access to resources, which limits their chance for recovery. Immersive virtual reality (VR) has the potential to solve this problem and deliver efficient, personalized treatments to millions of people worldwide who need access to rehabilitation services or more flexibility in treatment delivery. To reduce the global burden of stroke experts recommend taking bold, pragmatic actions across all four pillars of stroke quadrangle—surveillance, prevention, acute care, and rehabilitation. Embracing immersive VR-based rehabilitation of poststroke aphasia would be one step in that direction.
Effects of Task Complexity on Chinese EFL Learners’ Language Production in Synchronous Computer-Mediated Communication
Authors: Qian Li , Shamsudin Sarimah , Don Zuraidah Mohd
Published: August 2024

The pervasive use of synchronous computer-mediated communication (SCMC) in second language (L2) learning has generated increasing interest among researchers in integrating SCMC with task-based language teaching (TBLT). This study examined the effects of task complexity on Chinese EFL learners’ language production in SCMC modality to develop optimal tasks that facilitate the learning of English in SCMC environments. Eighty-four intermediate Chinese EFL learners completed two interactive tasks (simple and complex) in dyads via text-based or video-based SCMC. Their English productions were transcribed and coded in terms of syntactic complexity, lexical complexity and accuracy for statistical analyses. The results indicated that increasing task complexity elicited significantly lower syntactic complexity in text-based SCMC, but without significant effects on syntactic complexity in video-based SCMC. Significantly higher lexical complexity and unaffected accuracy were observed in both SCMC modes as a result of an increase in task complexity. Regarding SCMC modality, text-based SCMC resulted in significantly lower syntactic complexity, but significantly higher lexical complexity and accuracy than video-based SCMC.
Care-experienced young people’s views and experiences of accessing general practice and dental services and attending health reviews in England: a qualitative study
Authors: Herlitz Lauren , Ashford Emily , Baldwin James , Powell Claire , Woodman Jenny
Published: August 2024

Background

Children in care and care leavers have worse health outcomes than their peers without care experience. This study addresses an evidence gap in exploring care-experienced young people’s views and experiences of accessing general practice and dental services and attending health reviews in England.

Methods

We conducted a qualitative study using podcasting as a creative medium. We recruited young people from two sites: one in South England (A) and one in greater London (B). We held two paired discussions in site A and two focus groups in site B, with 14 participants in total. Participants were aged between 13 and 22 years and were diverse in gender, ethnicity, and care experiences. Data were analysed thematically using candidacy theory as a theoretical framework.

Results

Mental health was a prevailing concern for participants, but general practice was not considered a place to discuss it. Most participants reported distant relationships with primary healthcare professionals and considered opening-up to a professional to be risky, for example, it could result in an unknown/unwanted outcome. A lack of time and personal connection in appointments, and experiences of feeling judged, dismissed, or misunderstood, hindered young people’s ability to disclose mental health or relationship concerns. Participants reported variation in the timeliness and location of services, with salient examples of extensive waiting periods for braces. Participants perceived annual health reviews to be largely inconsequential.

Conclusions

Any primary care presentation by a care-experienced young person should trigger additional professional curiosity. To build rapport and trust, professionals should not underestimate the power of active listening, being reliable and honest, and small acts of thoughtfulness, for example, ensuring medical letters are provided promptly. Carers and other trusted professionals should help care-experienced young people to understand the role of primary care and support them with access. Health reviews may not be of value to all young people in care. Further research is needed to examine primary healthcare access for care-experienced young people with significant safeguarding and healthcare needs.
The experience of patients undergoing aseptic, elective revision knee joint replacement surgery: a qualitative study
Authors: Nicolson Philippa J. A. , Toye Francine , Sabah Shiraz A. , Price Andrew J. , Alvand Abtin , Barker Karen
Published: August 2024

Background

Around 6,000 revision knee replacement procedures are performed in the United Kingdom each year. Three-quarters of procedures are for aseptic, elective reasons, such as progressive osteoarthritis, prosthesis loosening/wear, or instability. Our understanding of how we can best support these patients undergoing revision knee replacement procedures is limited. This study aimed to explore patients’ experiences of having a problematic knee replacement and the impact of undergoing knee revision surgery for aseptic, elective reasons.

Methods

Qualitative semi structured interviews with 15 patients (8 women, 7 men; mean age 70 years: range 54–81) who had undergone revision knee surgery for a range of aseptic, elective indications in the last 12 months at an NHS Major Revision Knee Centre. Interviews were audio-recorded, transcribed, de-identified and analysed using reflexive thematic analysis.

Results

We developed six themes: Soldiering on; The challenge of navigating the health system; I am the expert in my own knee; Shift in what I expected from surgery; I am not the person I used to be; Lingering uncertainty.

Conclusions

Living with a problematic knee replacement and undergoing knee revision surgery has significant impact on all aspects of patients’ lives. Our findings highlight the need for patients with problematic knee replacements to be supported to access care and assessment, and for long-term psychological and rehabilitation support before and after revision surgery.
Design specifications and capabilities of a 3D simulation software for clinical education of physiotherapy students in the neurology department
Authors: Rezayi Sorayya , Ghotbi Nastaran , Shahmoradi Leila , Ardali Zakiyeh Raisi , Choobsaz Haniyeh
Published: August 2024

Introduction

In this revolutionized era, thanks to cutting-edge technological breakthroughs like 3-dimensional (3D) computerized environments, physiotherapy trainers can improve their knowledge and confidence by using such training tools. Hence, there is room for developing these technologies for training medical students to expand their skills and expertise. This study aims to identify the design requirements and key functionalities of a 3D simulation software for the clinical education of physiotherapy students in neurology departments.

Method

First, by carefully reviewing neurological books, scientific articles, curriculum, and medical records, and consulting with experts, a scenario was compiled. In the next step, a researcher-developed questionnaire was designed. Then, experts’ opinions were considered to confirm the validity and reliability of the questionnaire. The designed questionnaire was distributed among several neurological physiotherapists. Finally, the information elements, contents, and functional capabilities of the 3D software were determined by analyzing the data obtained from the questionnaire.

Findings

The main components for the design of physiotherapy educational software were identified based on the findings of the literature review, curriculum analysis, and medical record review. A survey of physiotherapy professors was conducted using a questionnaire created by the researcher in order to enhance the capabilities of simulation software and ascertain its primary functions. Following an analysis of the data from the distributed questionnaire, 37 essential features and contents have been proven to be more crucial than the rest for the creation of 3D simulation software. As a result, the essential and fundamental needs for the patient’s training in reading their medical records and performing muscle strength assessments were recognized and extracted. Based on these findings, a researcher-developed scenario for the various real cases was then established. In the patient’s medical record reading scenario, the student is required to read the patient’s record in text format. Similarly, in the section on cranial nerves, pictures are utilised to reinforce the student’s assessment skills in addition to textual content. Together with the audio and pop-up texts, the simulated 3D environment also offers training for the assessment of muscle strength.

Conclusion

As an educational tool, this software can enhance students’ learning and assist in addressing the drawbacks of conventional teaching methods like lectures and hospital visits.
Unraveling psychological burden: the interplay of socio-economic status, anxiety sensitivity, intolerance of uncertainty, and stress in first-year medical students
Authors: Gellisch Morris , Olk Bettina , Schäfer Thorsten , Brand-Saberi Beate
Published: August 2024

Background

The escalating prevalence of mental health issues among young adults, set against the backdrop of a global healthcare system under pressure, underscores the necessity for cultivating a resilient medical workforce. This study investigates the influence of socio-economic status (SES) on psychological well-being, with a particular focus on Anxiety Sensitivity (AS) and Intolerance of Uncertainty (IU) among first-year medical students. Understanding the psychological dimensions affecting medical students is crucial for fostering a future medical workforce that is both capable and mentally healthy.

Methods

This research involved 321 first-year medical students, evaluated using the Perceived Stress Questionnaire (PSQ), Anxiety Sensitivity Index (ASI), the Intolerance of Uncertainty Scale (UI-18), and the Student Self-Efficacy Scale (SSE), alongside socio-economic categorization. Employing descriptive statistics, ANOVA, and correlation analyses, the study aimed at elucidating the SES impact on AS and IU, among other psychological constructs.

Results

The analysis revealed significant SES-related differences, especially in the realms of Anxiety Sensitivity and Intolerance of Uncertainty. Notably, ASI_C (cognitive concerns) exhibited strong positive correlations with both UI_A (reduced ability to act due to IU) (Pearson’s r = 0.562, p < 0.001) and UI_B (burden due to IU) (Pearson’s r = 0.605, p < 0.001), highlighting the link between cognitive aspects of anxiety and uncertainty intolerance. Furthermore, UI_C (vigilance due to IU) was significantly associated with SES (F(4, 316) = 2.719, p = 0.030, η² = 0.033), pointing to the complex ways in which socio-economic factors modulate responses to uncertainty. Self-efficacy emerged as a significant counterbalance, showing protective associations against the adverse effects of heightened Anxiety Sensitivity and Intolerance of Uncertainty.

Conclusion

Our findings indicate that lower socio-economic status is associated with higher levels of Anxiety Sensitivity and Intolerance of Uncertainty, which contribute to increased stress among first-year medical students. Additionally, Self-Efficacy emerged as a significant protective factor, mitigating the expressions of AS and IU. Although medical faculties cannot change SES characteristics within their student body, recognizing its impact allows for the development of tailored support systems to address the unique challenges faced by students from diverse socio-economic backgrounds. This study underscores the necessity of considering social diversity, particularly regarding AS and IU characteristics, to foster a supportive and effective medical education environment with an outlook on sustainable mental health in a demanding work context.
Clinical implications of head trauma in frontotemporal dementia and primary progressive aphasia
Authors: Asken Breton M. , Bove Jessica M. , Bauer Russell M. , Tanner Jeremy A. , Casaletto Kaitlin B. , Staffaroni Adam M. , VandeVrede Lawren , Alosco Michael L. , Mez Jesse B. , Stern Robert A. , Miller Bruce L. , Grinberg Lea T. , Boxer Adam L. , Gorno-Tempini Maria Luisa , Rosen Howie J. , Rabinovici Gil D. , Kramer Joel H.
Published: August 2024

Background

Traumatic brain injury (TBI) and repetitive head impacts (RHI) have been linked to increased risk for multiple types of neurodegenerative disease, higher dementia risk, and earlier age of dementia symptom onset, suggesting transdiagnostic implications for later-life brain health. Frontotemporal dementia (FTD) and primary progressive aphasia (PPA) represent a spectrum of clinical phenotypes that are neuropathologically diverse. FTD/PPA diagnoses bring unique challenges due to complex cognitive and behavioral symptoms that disproportionately present as an early-onset dementia (before age 65). We performed a detailed characterization of lifetime head trauma exposure in individuals with FTD and PPA compared to healthy controls to examine frequency of lifetime TBI and RHI and associated clinical implications.

Methods

We studied 132 FTD/PPA (age 68.9 ± 8.1, 65% male) and 132 sex-matched healthy controls (HC; age 73.4 ± 7.6). We compared rates of prior TBI and RHI (contact/collision sports) between FTD/PPA and HC (chi-square, logistic regression, analysis of variance). Within FTD/PPA, we evaluated associations with age of symptom onset (analysis of variance). Within behavioral variant FTD, we evaluated associations with cognitive function and neuropsychiatric symptoms (linear regression controlling for age, sex, and years of education).

Results

Years of participation were greater in FTD/PPA than HC for any contact/collision sport (8.5 ± 6.7yrs vs. 5.3 ± 4.5yrs, p = .008) and for American football (6.2yrs ± 4.3yrs vs. 3.1 ± 2.4yrs; p = .003). Within FTD/PPA, there were dose-dependent associations with earlier age of symptom onset for TBI (0 TBI: 62.1 ± 8.1, 1 TBI: 59.9 ± 6.9, 2 + TBI: 57.3 ± 8.4; p = .03) and years of American football (0yrs: 62.2 ± 8.7, 1-4yrs: 59.7 ± 7.0, 5 + yrs: 55.9 ± 6.3; p = .009). Within bvFTD, those who played American football had worse memory (z-score: -2.4 ± 1.2 vs. -1.4 ± 1.6, p = .02, d = 1.1).

Conclusions

Lifetime head trauma may represent a preventable environmental risk factor for FTD/PPA. Dose-dependent exposure to TBI or RHI influences FTD/PPA symptom onset and memory function in bvFTD. Clinico-pathological studies are needed to better understand the neuropathological correlates linking RHI or TBI to FTD/PPA onset and symptoms.