bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the Moderating Effect of Job Stress on the Relationship between Job Performance and Job Satisfaction of Elementary School Sports Instructors
Authors:   Gyeongin National University of Education, Kim Tae-Hwan , Kim Chae-Woon , Hwang Sun-Hwan
Published: January 2024

This study validates the moderating effect of job stress on the relationship between job satisfaction and performance of elementary school sports instructors. Furthermore, it investigates the influence of job characteristics on job stress. To this end, a survey was conducted among 289 sports instructors currently employed in elementary schools in the Gyeonggi region. The analysis was performed using PROCESS Macro model 1 to validate the moderating effect of stress on the relationship between job satisfaction and performance. Moreover, a multiple regression analysis was conducted to clarify the factors affecting job stress. The results revealed that although job satisfaction significantly influenced job performance, it did not significantly impact job stress. However, job stress was found to significantly interact with job satisfaction to influence job performance. Specifically, when the job stress level was below a certain point, job satisfaction had a significant positive effect on job performance, implying that to enhance job performance through increased job satisfaction, managing and preventing excessive job stress levels is essential. Job characteristics that influenced sports instructors’ job stress were identified as “feedback” and “task diversity.” In conclusion, for improving job performance through increased job satisfaction for elementary school sports instructors, maintaining the job stress levels below a certain threshold is crucial. Improving factors such as feedback and task diversity, which impact sports instructors’ job stress, can positively affect job performance. Efforts are needed to foster a collaborative relationship between teachers and sports instructors, capitalizing on their unique expertise to encourage positive feedback exchange.
Exploring Elementary School Teachers’ Selection Process for Social Studies Textbooks: A Contradiction between Standards and Reality
Authors:   Gyeongin National University of Education, Kim Ki-Hwan , Lee Dong-won
Published: January 2024

This study sought to understand the gap between the ideal selection criteria and the reality of selection by exploring the selection process of elementary school teachers and to seek alternatives to the realistic selection criteria. The following research results could be derived through questionnaires and FGI interviews with 62 students from 90 elementary schools in Incheon. First, the standard for selecting certified textbooks for elementary school teachers was almost the same as the example standard presented in the manual of the Ministry of Education. Second, apart from the standard proposal for selecting certified textbooks, there was a tendency to prioritize adopted textbooks based on individual teachers’ subjective standards. Third, the Textbook Selection Committee was hurt by receiving negative feedback from fellow teachers about their choices during the textbook selection process. The task became more difficult and stressful, offering fewer rewards in the process of selecting textbooks. Fourth, the proposal for an alternative test textbook standard was presented, encompassing a total of eight questions in three areas: appropriateness, diversity, and usefulness.
Endothelin-1 indices in patients with leptospirosis of various severity degrees and their changes under the influence of seven-day treatment
Authors:   Danylo Halytsky Lviv National Medical University, Telehina T. , Zinchuk O. ,   Danylo Halytsky Lviv National Medical University
Published: January 2024

Introduction. Leptospirosis is one of the most common zoonoses in the world, pathogenesis of which is based on the damage of vascular endothelium. Violation of endothelial functions leads to damage of these cells plasma membranes, loss of vascular integrity, ischemia, necrosis, and, finally, the development of organ dysfunction. In current literature there is sparce information concerning endothelial dysfunction in patients with leptospirosis, therefore the development and standardization of methods for the assessment of vascular endothelium imbalance in patients with leptospirosis of different severity degrees is an urgent task. Detection of endothelin-1 (ET-1) one of the best markers of endothelial dysfunction, can become an important tool for predicting the severity of the disease. The aim of the study. To investigate ET-1 indices in patients with leptospirosis of different severity degrees and to estimate their changes after the seven-day treatment. Materials and methods. ET-1 content in the blood serum of patients with diagnosed leptospirosis was detected by ELISA method. Absolute values were compared using Mann-Whitney test (U-test); the results were statistically processed using Fisher’s bilateral test (F-test). Correlation analysis was carried out according to Spearman’s method. The difference was considered statistically significant with p less than 0.05. Results. ET-1 content was detected at time of hospitalization and after 7 days of leptospirosis treatment. Patients (n = 43) were divided into two groups depending on the severity of leptospirosis course: the first group with a moderate course included 21 patients; second group with a severe course included 22 patients; the control group consisted of 20 healthy individuals. Both groups of leptospirosis affected patients demonstrated significantly higher ET-1 concentration in comparison with the control group (p less than 0.01). Moreover, the proportion of patients with high (more than 5.5 pg/ml) concentration of ET-1 in the blood post the 7 days treatment was documented in 13.3% patients of the first group, and 43.8 % patients of the second group (p less than 0.05). It was also estimated that in both groups patients 7 days treatment of leptospirosis induced a credible increase in the concentration of ET-1 (p less than 0.05). Conclusions. Our results claim that at time of hospitalization and after 7 days treatment both groups of leptospirosis affected patients demonstrated significantly higher level of ET-1 in comparison to control group individuals (p less than 0.01). 7 days of leptospirosis treatment caused a credible enhancement of ET-1 content (p less than 0.05). Patients with a severe course of leptospirosis after 7 days treatment exposed significantly higher ET-1 concentration compared to patients with moderate course (p less than 0.05).
Wybrane zagadnienia związane z promocją zdrowia w okresie pandemii
Authors: Jarząbek-Bielecka Grażyna , Luwański Dawid , Plagens-Rotman Katarzyna , Mizgier Małgorzata , Bielecki Marek , Jarząbek Antoni
Published: January 2024

Health promotion during a pandemic is also one of the special tasks not only in the practice of a family doctor, which also results from changes in the lifestyle of patients. Since the start of coronavirus pandemic working from home, called home-office gained popularity not only amongst big corporations. Unfortunately not all the occupations has an option to do their job related responsibilities at their own personal desk. It would sound difficult to keep self-discipline while being able to watch TV without sudden consequences, but the results show that home workers do very well. The most important thing for the employer, which is productivity, increased in COVID-19 times. It can be caused by lack of disturbing noises and uncomfortable surroundings that could lead to stress. Allowing employees to do their jobs from home reduced the time spent every day on getting ready to work. For example for many people morning commute has become the thing of the past. Another positive aspect of home-office is workers time flexibility. While at home some people can plan their day in their own way. Some jobs in this situation have no arranged daily working hours, the only obligation is to do the task until the deadline. Maybe there are more advantages than disadvantages of working from home, but the negative sites can overcome the positives and have negative health effects. After some time one can get bored with their own four walls, or even feel alone and abandoned, which can lead to lowered well-being. In such a new time everybody should keep the balance between social and job-related life, as well as a proper diet and physical activity, for example through gymnastics at home. Communicating this knowledge to patients is important in both medical, in pharmacy counseling and nursing practice.
Synbiotyczne działanie produktów pszczelich wytwarzanych ze źródeł roślinnych
Authors: Hołderna-Kędzia Elżbieta , Kędzia Bogdan
Published: January 2024

The publication discusses the new use of natural products produced by bees from plant sources (honey, pollen and bee bread) as synbiotics, because they have both prebiotic and probiotic activity. The basis for classification to these groups are the carbohydrates present in them: disaccharides, trisaccharides, other oligosaccharides, polysaccharides and fructooligosaccharides known for their beneficial effects on the body (prebiotic effect), as well as live microorganisms typical of fresh products (probiotic effect). On this basis, bee products (honey, pollen and bee bread) can significantly supplement the level of prebiotics in the body, and honey can additionally be a source of probiotic microorganisms. In the group of oligosaccharides, the most important prebiotic substances are: 1-kestosis and panosis, and among polysaccharides, amylose, cellulose, pectins and dextrins. During processing in the hive, both the honey, pollen and bee bread are enriched with lactic acid bacteria of the Lactobacillus genus. However, during storage, their number especially in pollen and bee bread gradually decreases, as a result of which they lose their probiotic properties. On this basis, it can be assumed that bee products (honey, pollen and bee bread) can significantly supplement the level of prebiotics in the body, and fresh honey can additionally be a source of probiotic microorganisms.
Diosmina i hesperydyna – obecny stan wiedzy
Authors: Szymański Marcin , Wrzesińska Anna , Młynarek Daria , Szymański Arkadiusz
Published: January 2024

Diosmin is the 7-rutinoside of 3 ‘, 5,7-trihydroxy-4’-methoxyflavone (7-O-rutinoside of diosmetin), and hespheridine is the 7-rutinoside of 3’, 5,7-trihydroxy-4’-methoxyflavanone (7 -O-rutinoside hesperetin). Diosmin, is a gray-yellow or pale-yellow, hygroscopic powder, whereas hesperidine is in the form of light-yellow spherocrystals. Diosmin was isolated from fruits of the Citrus genus (C. sinensis, C. limonia), now it is obtained semi-synthetically from natural hesperidin. These flavonoids have, among others: antimicrobial, anti-inflammatory, anti-diabetic, anti-cancer, analgesic, antioxidant and possibly anti-virus activity, that cause COVID-19. The metabolism of diosmin takes place initially in the small intestine and involves demethoxylation and hydrolysis. In contrast, oxidation and conjugation take place in the liver. There is no presence of diosmin and diosmetin in the urine, which are mainly eliminated in the form of glucuronic acid conjugates. The dominant metabolite detected in urine samples is m-hydroxy-phenylpropionic acid, excreted in conjugated form. Diosmin may reduce the aggregation of Red Blood Cells, and thus it is able to reduce blood viscosity. The LD50 of the mixture of 90% diosmin and 10% hesperidin for rats is over 3 g/kg. The tests did not reveal any mutagenic effects or effects on reproductive functions. It also does not pose a significant threat during breast feeding, as it poorly passes into breast milk.
Patch Antenna Dielectrics Reduction by Topology Optimization and Radio Wave Characteristics
Authors: Torisaka Ayako
Published: January 2024

This research is aimed at exploring the potential for reducing the overall mass of large space structures on which space systems are supported. A key component of these systems comprises microwave arrayed antennas, which are distributed across the surface of the structure. Given that dielectric materials constitute a significant portion of the antenna mass, this study is primarily concerned with minimizing the mass of these antenna dielectrics. It is crucial to note that while reducing mass is a priority, the stiffness of the antenna system must be preserved, as it needs to adhere securely to the structure’s surface. To achieve this objective, we embark on a process of optimizing the topological distribution of the dielectric material. We investigate how this optimized configuration impacts the microwave characteristics of a patch antenna. Our approach involves conducting topological optimization while concurrently ensuring structural stiffness. Subsequently, we assess the influence of this optimized distribution on the antenna’s patterns and gains using different materials.
Onboard Cryogenic Liquid-Propellant Subcooler Based on Thermodynamic Vent for Upper-Stage Propulsion System
Authors: Banno Yuya , Kinefuchi Kiyoshi
Published: January 2024

Subcooling of cryogenic liquid propellants offers significant advantages for launch vehicles. Liquid subcooling can reduce the extent of cavitation generation in turbopumps, which provides advantages for upper-stage engine reignition in orbit. Additionally, liquid-propellant subcooling densifies the liquid, which can reduce the propellant tank volume and increase launch capability when it is applied during the propellant-filling phase on the ground. Here, a cryogenic propellant subcooling system derived from thermodynamic vent system (TVS) concepts is proposed. In contrast to prior approaches with TVS, the proposed method only focuses on the liquid subcooling and only requires the installation of a heat exchanger at the tank bottom, making it easily applicable to conventional upper stages and enhancing launch capability. First, ground tests were conducted using liquid nitrogen. We introduced energy efficiency to evaluate the subcooler performance, and an optimum point was found for the coolant supply pressure and Joule–Thomson orifice diameter. To investigate the advantages of the proposed method, a theoretical model for the subcooling process before engine reignition in orbit was developed based on experimental observation. The model assuming liquid hydrogen demonstrated an improved weight penalty in the proposed method compared to the conventional vent/pressurization method. A study that quantitatively addresses the enhancement of launch capability through TVS-induced liquid subcooling is unprecedented, paving the way for a new cryogenic propulsion system.
Ballistic Capture Analysis Using the Energy Transition Domain
Authors: Anoè Lorenzo , Bombardelli Claudio , Armellin Roberto
Published: January 2024

In the framework of the planar Circular Restricted Three-Body Problem (CR3BP) and for a given value of the Jacobi constant, a necessary condition for a ballistic capture is a passage through zero two-body energy, which defines a region in the synodic plane called energy transition domain (ETD). The latter is the locus of points where the zero-energy condition and selected Jacobi constant are simultaneously fulfilled. This paper shows how an ETD can be described analytically and exploited for the efficient computation and insightful classification of the complete set of ballistic capture trajectories in the planar problem. The new methodology is applied to different three-body systems and highlights the influence of the three-body energy on key aspects of the capture mechanism, such as prograde to retrograde transition. Other interesting results concern three-body energy limits, collisions, long-duration captures, altitude range throughout the capture process, and the origin of ballistic capture orbits.
Comparative Study of Using Superhydrophobic and Icephobic Surface Coatings for Aircraft Icing Mitigation
Authors: Hu Haiyang , Tian Linchuan , Eluchie Chukwudum , Sista Harsha , Hu Hui
Published: January 2024

We report a comparative study to evaluate the effects of surface coatings with different hydrophobicities and icephobicities on the performance of a hybrid anti-/de-icing system that integrates surface heating with hydro-/ice-phobic coating for aircraft icing mitigation. While a flexible electric film heater wrapped around the leading edge of an airfoil/wing model was used to heat the airfoil frontal surface to prevent ice accretion near the airfoil leading edge, three different kinds of coatings were applied to coat the airfoil model at three distinct spanwise locations, which included an icephobic coating with an outstanding icephobicity but a weak hydrophobicity; a superhydrophobic surface (SHS) coating with outstanding water repellency but a moderate icephobicity; and a commonly used hydrophilic coating with poor hydrophobicity and poor icephobicity. Surface wettability was found to play a more important role than icephobicity in affecting the performance of the hybrid anti-/de-icing systems. In comparison to the approach of forceful heating the hydrophilic airfoil surface, the hybrid approach with the SHS coating was found to be able to achieve about 90% energy savings in keeping the entire airfoil surface ice-free; the corresponding energy savings for the hybrid system with the icephobic coating was only about 10%.
Three-Dimensional Accurate Geometric Modeling and Mechanical Analysis of Wire Mesh for Deployable Antennas
Authors: Li Zhuolin , Zhang Han , Li Yusheng , Wu Xiaofei , Tan Zhilong , Qin Qingyan , Zhang Yiqun
Published: January 2024

Wire meshes are widely used in deployable antennas, and the structure of the wire mesh directly affects the structural and electrical properties of the antenna. This study proposes a set of automated geometric modeling and mechanical analysis processes to realize the automated mechanical analysis and design of complex wire mesh structures. First, considering the tilt in the wire mesh structure owing to the traction of the underlap on the loop, a three-dimensional (3D) geometric model of the repeating unit of the wire mesh structure was established using periodic cubic spline curves. Subsequently, a method using sensitivity matrix adjustment is proposed to eliminate the interstructure inlay phenomenon, and an optimization model is established. The vector superposition method established a 3D geometric model of the overall wire mesh structure without an inlay problem. Finally, a finite element model of the wire mesh considering the contact problem was established by the adaptive matching method for contact pairs of the finite element model of the wire mesh. Mechanical simulation experiments were carried out on the model, comparing the theoretical analysis with the experimental results and verifying its reasonableness.
The God Shed at Amarna
Authors:   Universidad Católica de Argentina (Argentina), GESTOSO SINGER Graciela
Published: January 2024

During the Amarna Period (fourteenth century BCE), Akkadian and Hittite texts attest a lethal epidemic that spread from Egypt to Syria and the land of Hatti. DNA studies conducted on the mummies of Tutankhamun and two other members of the royal family (Thuya and Yuya) confirmed that they had been infected with malaria. Excavations at the Southern and Northern Tombs reveal evidence of traces of dietary deficiency, diseases, and heavy workloads. The discovery of stelae and chapels in the workmen’s village that were dedicated to the worship of ancestors and of the gods Amun, Aten, Shed, and Isis permit an analysis of the different forms of materialization of the ancestral memory of a population during hard times. The last days of Amarna witnessed the cult of the god Shed, the “Savior,” who sought to save the Egyptians from disease and misfortune. The presence of several diseases that were easily spread in the poor living conditions of the tomb workers could explain the short period of activity of the new capital (ca. 1350–1330 BCE). New archaeological evidence allows us to interpret the practices of private worship of ancestors and gods as evidence of a complex economic-social and political phenomenon that arose during a time of changes and marked a transition towards the restoration of traditional cults.
A review on hazards and risks to pipeline operation under transporting hydrogen energy and hydrogen-mixed natural gas
Authors: Li Ji , Song Fumei , Zhang Xiaoqian
Published: January 2024

As an efficient and clean fuel, hydrogen energy plays an important role in relieving the energy crisis and achieving the orientation of zero carbon emissions. Transportation is the key link in the construction of hydrogen energy infrastructure. For large-scale and long-distance transportation of hydrogen, pipeline transportation has the advantages of high efficiency and cost saving. While using the existing natural gas pipeline to transport hydrogen, it would economize the economic cost, time cost and labor cost. However, the transportation of hydrogen may bring more hazards and risks. Based on the investigation of a large number of literatures, the research advance in hydrogen embrittlement, leakage, combustion and explosion risk of hydrogen and hydrogen-mixed natural gas pipelines was reviewed. The mechanism, research means and evaluation methods of hydrogen embrittlement, as well as the experimental and numerical simulation research results of leakage, combustion and explosion were discussed in detail. The definite and important conclusions include: (1) For buried hydrogen-mixed natural gas transportation pipeline, the leakage rate of hydrogen and methane is the same, the formation of the leakage crater is foreign to the nature of leakage gas. (2) When adding less than 25 volume percentage of hydrogen into the natural gas pipelines, the explosion risk would not be increased. Future research should focus on the risk prediction, quantitative risk assessment, intelligent monitoring, and explosion-suppression technical measures of hydrogen and hydrogen-mixed natural gas transportation pipelines, so as to establish comprehensive and multi-level pipeline safety protection barriers.
A Study on the Korean Drug Policy through U.S. Drug Integration Management System
Authors:   The Korean Association of Criminal Psychology, Shin Jae Woo , Lee Wan Hee
Published: January 2024

New Psychoactive Substances (NPS) are spreading like a trend around the world, and the number of drug crimes is increasing more than ever as distribution methods evolve day by day. Recently, as the drug problem has become increasingly serious, it has become an unbearable reality with the functions and roles of existing drug-related institutions. Most countries use a combination of criminal justice punishment models that control and deter drug supply to make the drug-free society and medical & treatment models that rehabilitate addicts. In other words, supply control policies rely mainly on thorough crackdowns and strong punishment, and demand control policies pursue balanced strategies by focusing on prevention in advance through treatment and rehabilitation. However, countries that have implemented most drug policies have experienced many side effects from unbalanced policies and are making great efforts to make balanced policies to solve them. However, the results vary widely depending on the efforts and budgets of each government, also the structure of the organization that manages drugs is diverse. Current study will examine the current status of Korean drug-related institutions and review the U.S. drug integration management system(IMS). And mainly discuss the direction of Korea's drug policy through the background and historical changes of the Drug Enforcement Administration (DEA). It is meaningful in preparing a specific and practical balanced drug policy that can create a drug-free society through the advantages and disadvantages of the U.S. drug IMS . At the conclusion this study establishes a practical national system to efficiently deal with drugs and in turn protect citizen from drugs.
Species Selection for Automatic Chemical Kinetic Mechanism Generation
Authors: Johnson Matthew S. , Pang Hao-Wei , Liu Mengjie , Green William H.
Published: January 2024

Many important chemical kinetic systems require detailed chemical kinetic models to resolve. These detailed kinetic models can involve thousands of species and hundreds of thousands of chemical reactions, making them difficult to construct by hand. Modern automatic mechanism generation algorithms can mostly be divided into two classes: rule and rate based. Rule-based generators choose species based on user defined constraints on species and reaction classes. Rate-based generators generate a much larger set of potentially important species and reactions and then choose which ones to add based on running simulations of species and reactions deemed important and calculating the flux to potentially important species. In principle, the latter is preferable, as it requires the user to make far fewer assumptions about what is important in the system. However, while the effectiveness of the rate-based approach has been demonstrated in a wide variety of systems, it has also been demonstrated to have difficulty picking up important low-flux chemistries. Here we present a discussion of the challenges associated with rate-based mechanism generation and new algorithms that are able to efficiently mitigate these challenges in a set of case studies.
Insights into the Mechanochemical Glass Formation of Zeolitic Imidazolate Frameworks
Authors: Xue Wen-Long , Das Chinmoy , Weiß Jan-Benedikt , Henke Sebastian
Published: January 2024

Metal-organic framework (MOF) glasses, known for their potential in gas separation, optics, and solid-state electrolytes, benefit from the processability of their (supercooled) liquid state. Traditionally, MOF glasses are produced by heating MOF crystals to their melting point and then cooling the liquid MOF to room temperature under an inert atmosphere. While effective, this melt-quenching technique requires high energy due to the high temperatures involved. It also limits the scope of new material development by restricting the compositional range to only those combinations of metal ions and linkers that are highly thermally stable. An alternative, mechanical milling at room temperature, has demonstrated its capability to transform MOF crystals into amorphous phases. However, the specific conditions under which these amorphous phases exhibit glass-like behavior remain uncharted. In this study, we explore the mechanochemical amorphization and vitrification of a variety of zeolitic imidazolate frameworks (ZIFs) at room temperature. These ZIFs feature diverse functionalized linkers and different metal ions (Zn2+, Co2+ and Cu2+). Through comprehensive analyses, including X-ray diffraction, calorimetry, and gas sorption studies, we gain valuable insights into the chemical and structural prerequisites and constraints for the mechanochemical vitrification of ZIFs. Our findings demonstrate that ZIFs capable of melting can be successfully converted into glasses through ball-milling. Remarkably, some non-meltable ZIFs can also be vitrified using the ball-milling technique, as highlighted by the preparation of the first Cu2+-based ZIF glass. This research significantly contributes to expanding the currently limited compositional range of MOF glasses. Moreover, it paves the way for integrating thermally sensitive substances into MOF glasses by room temperature mechanochemical vitrification, thus offering new possibilities for innovative applications.
Generation of Protocells by Spontaneous Reaction of Cysteine with Short Chain Thioesters
Authors: Cho Christy J. , An Taeyang , Lai Yei-Chen , Vázquez-Salazar Alberto , Fracassi Alessandro , Chen Irene A. , Devaraj Neal K.
Published: January 2024

It is unknown how the earliest forms of life were compartmentalized. Several models have suggested a role for single-chain lipids such as fatty acids, but the membranes formed are often unstable, particularly when made from shorter alkyl chains (≤C8) that were likely more prevalent on the prebiotic Earth. We show that the amino acid cysteine can spontaneously react with two short-chain (C8) thioesters to form diacyl lipids, generating protocell-like membrane vesicles. The three-component reaction takes place rapidly in water using low concentrations of reactants. Silica can catalyze the formation of protocells through a simple electrostatic mechanism. Several simple aminothiols react to form diacyl lipids, including short peptides. The protocells formed are compatible with functional ribozymes, suggesting that coupling of multiple short-chain precursors may have provided membrane building blocks during the early evolution of cells.
Turning Lignin into Aliphatic Organic Chemicals in Gamma- Valerolactone: Advances into a Bioelectrorefinery
Authors: Lindenbeck Lucie , Dahlhaus Sira , Wende Luca , Beele Björn , Schebb Nils , Lehmann Christian , Bornhorst Julia , Slabon Adam , Rodrigues Bruno
Published: January 2024

This investigation reports on the reductive electrochemical depolymerization and dearomatization of lignin using water/γ-valerolactone (GVL) as solvent system combined with sodium carbonate as electrolyte. GVL, derived from biomass, has often served as a solvent for biomass treatment, such as in the Organosolv process. Consequently, various strategies for biorefineries have emerged, utilizing GVL as a green platform, with a primary focus on its potential for the delignification of lignocellulosic biomass when combined with water and dilute acid. This investigation proposes the electrochemical depolymerization of lignin in GVL as a step toward the concept of a bioelectrorefinery, valorizing lignin conversion into aliphatic organic chemicals. Applying a current of −100 mA over 8 h resulted in the formation of sodium levulinate, sodium 4-hydroxyvalerate, sodium acetate, and sodium formate, as confirmed by liquid chromatography electrospray ionization high resolution mass spectrometry (LC-ESI-HRMS), nuclear magnetic resonance (NMR), and infrared (IR) spectroscopy. These findings enhance the understanding of GVL as a biomass-based platform, showcasing its potential as a medium in the conversion of lignin into valuable aliphatic organic chemicals. This study contributes to advancing the bioelectrorefinery concept and opens new avenues for utilizing renewable resources, envisioning the feasible future replacement of crude oil as the primary industrial source of carbon-based chemicals.
Using the serious illness conversation guide to improve the quality of life of hematology-oncology patients: a pilot study
Authors: Korsos Victoria , Ahmed Saima , Heslip Sheena , Cassis Chantal , Bitzas Vasiliki , Assouline Sarit
Published: January 2024

Introduction:

Hematology-oncology patients are more likely to receive high intensity care (HIC), including ICU admission and active cancer treatment, than solid cancer patients near end of life (EOL). This prevents patients and their families from realistically planning for the future, and diminishes quality of life (QOL). We previously conducted a retrospective study to understand factors influencing HIC outcomes at EOL in hematology patients at McGill-affiliated hospitals. While non-curative goals, early level of intervention (LOI) discussions and palliative care (PC) involvement lowered the likelihood of HIC at EOL, the median time of LOI discussion and PC involvement to death was 22 and 9 days respectively. We hypothesize that a timely discussion aligning patient perspectives and goals with their treating team could improve QOL at EOL.

Methods:

We are conducting a pilot study looking at the impact of using the Serious Illness Conversation Guide (SICG), a validated conversation tool in the general oncology population, on the QOL of hematology patients. Participants are identified by their treating doctor or nurse practitioner to be at risk of dying in the next year. The primary aim is to decrease death in acute care. Secondary aims include reporting other HIC outcomes, time from LOI discussion and PC consult to death, and the short term benefit to QOL. In addition, qualitative analysis will explore participant perspectives on benefits of the SICG and areas to improve, and explore EOL QOL topics relevant to hematology patients. We have currently enrolled 2 patients. Interim analysis is projected for September 2023.
Simulating a situation of homelessness: nursing students' perceptions of learning through virtual embodiment
Authors: Soilis Niki , Kinsella Elizabeth Anne , Filion Francoise , Harley Jason , Bhanji Farhan , Claudio Fernanda , Roy Laurence , Thambinathan Vivetha , Benmohamed Nadja
Published: January 2024

Individuals experiencing homelessness encounter unique challenges in accessing and receiving care in our health systems[1,2,3,4]  Preparing emerging health professionals to respond to their complex health needs will require innovative educational approaches that promote person-centered care, and stimulate critical reflection and action towards the personal, interpersonal and structural factors that shape health care delivery.[5,6,7]

This presentation reports on preliminary findings of phase 1 of a critical qualitative case study of nursing student’s perceptions of learning about the experience of homelessness, through a virtual reality educational experience.  The study design was informed by critical transformative learning theories and theories of embodiment.  Twenty nursing students were engaged in a virtual reality experience of 12 minutes, followed by a 1:1 debrief interview. The debrief interview used an adapted version of the Promoting Excellence and Reflective Learning in Simulation (PEARLS) framework to elicit students’ reflections on the experience. The interviews were audio recorded and transcribed verbatim.

Data analysis involved a process of reading all of the transcripts for a sense of the whole, mindmapping each of the transcripts, identifying themes that permeated the data set, and coding data in Quirkos software. Six preliminary themes include: a) seeing the person through story, b) destabilizing assumptions and questioning stereotypes, c) embodied emotional awareness, d) challenges to care, e) recognizing vulnerability of people experiencing homelessness, and f) quality of the immersive experience in learning.

The findings contribute to our knowledge about virtual reality simulation as an innovative approach to fostering learning about homelessness in health professions education.
“He told me my pain was in my head”: Testimonial injustice in patient-physician relationships
Authors: Vigouroux Marie , Morck Angela , Hovey Richard B.
Published: January 2024

Women living with chronic pain are more likely than men to experience pain dismissal, receive nonspecific diagnostics, receive fewer follow-ups, have their condition undertreated, and be told that it results from a psychological condition. This is particularly concerning for adolescent girls living with scoliosis, who, given the progressive nature of their condition, require timely diagnosis to allow for less invasive treatment options to be explored. This population is also significantly more likely to have their condition progress to a curve angle where treatment such as bracing or spinal fusion surgery is required, both of which are associated with chronic pain. However, timely diagnosis depends on clinicians taking patients’ testimony regarding their health concerns seriously and investigating their claims.

This presentation will dive into the gender gap in care for adolescent girls living with chronic pain caused by scoliosis, focusing on their experiences of pain dismissal and its negative short and long-term effects. Leveraging the concept of intersectionality, the authors argue that adolescent girls may suffer a testimonial injustice when their pain is dismissed by clinicians.

This presentation will also explore gender-specific peer support groups as a possible mitigating factor to testimonial injustice and other negative outcomes from chronic pain and pain dismissal. The researchers interviewed members from scoliosis peer support group Curvy Girls using open-ended questions, gathering narrative data about their experiences that was subsequently analyzed using an applied philosophical hermeneutics approach, along with intersectionality and testimonial injustice as part of their framework.
Ethical challenges for children undergoing surgery: Evaluation of graduate nursing students' learning
Authors: Gautrin Ariane , Tsimicalis Argerie , Wang Yi Wen , Passos dos Santos Raissa , Carnevale Franco A. , Cervantes Amanda , Logue Katherine
Published: January 2024

Background

Multiple barriers can impede the holistic care of children and their meaningful involvement in their healthcare in the context of surgery. These include lack of clinician knowledge of the ethical concerns impacting children and scarce educational resources. Our team created an open-access training module (https://childsxethics.net) to enhance clinicians’ understanding of ethical challenges for children undergoing surgery.  Objective

To evaluate the level of Bloom’s Taxonomy cognitive, affective, and psychomotor learning reached by graduate nursing students after completing the module.  Methods

A qualitative descriptive study was conducted. Data sources comprised of participants’ course assignments. Data were analysed inductively and deductively using Bloom’s Taxonomy and the Childhood Ethics Framework. Results

Nineteen participants wrote online reflections and peer responses. Two subgroups completed group assignments. The module and associated class assignments successfully promoted high levels of cognitive and affective learning of ethical challenges impacting children undergoing surgery. The type of assignment influenced participants’ level of learning and achievement of learning objectives. Cognitive and affective learning processes were enhanced when integrating reflections and fostering dialogue/interaction among peer learners.  Implications

Study findings will be used to improve the module. Future iterations will include collaborations with international clinicians to enhance the global relevance of the module contents, which will be evaluated with other clinicians/trainees. Providing educational resources for clinicians on ethical challenges in children’s surgery will help facilitate the recognition of children as active moral agents and improve their surgical experiences by promoting holistic patient care.
Reframing perceptions: A phenomenological inquiry into students’ written reflections on learning about mindfulness
Authors: Kinsella Elizabeth Anne , Chrestensen Allison , Smith Kirsten Sarah
Published: January 2024

Introduction

Mindfulness practices offer approaches to reflection that have been argued to contribute to positive outcomes for students in the health professions. Despite calls for more phenomenological investigations in the field, few studies examine the lived experience of learning about mindfulness in professional schools.  Objective

The objective of this study was to inquire into first-hand written accounts of students’ experiences of learning about mindfulness.  Methods

This study reports on occupational therapy health professions students’ phenomenological reflections written during and following a 5 week, 15 hour, mindfulness elective course offered at a Canadian University. The study adopts a hermeneutic phenomenological methodology and is informed by theoretical frameworks of embodiment and practice theories. An indepth thematic analysis of twenty-one students' written reflections on the experience of integrating mindfulness practices into their lives was undertaken.  Results

Predominant themes identified in students’ written reflections include: reframing perceptions, ‘being’ while ‘doing’, witnessing the struggle, and compassion for self and others.  Conclusions

This research contributes richly textured accounts that advance understandings about the affordances of mindfulness education in the lives of future health care practitioners. The results also hold implications for educational design in higher education professional school contexts, considerations of mindfulness practices in future professional practitioners’ everyday and workplace occupations, and identification of promising avenues for future research. This study is funded by the Social Science and Humanities Research Council of Canada (SSHRC).
Survey on the current status of undergraduate education on self-care in university medical schools and medical colleges in Japan
Authors: Takamiya Yusuke
Published: January 2024

A survey on the current status of undergraduate education on self-care was conducted in university medical schools and medical colleges in Japan. This survey was planned and conducted by the Professionalism Subcommittee of the Japan Society for Medical Education. Prior approval was given by the Ethics Committee of Showa University.

Self-care education was defined as education to enhance the well-being (physical and mental health) of medical students. Of the 82 universities invited to participate, 65 universities responded to the survey, giving a response rate of 79.3%. Of these 65 universities, 32 universities (49.2%) indicated that they were implementing self-care education programs. Stress management, mindfulness, self-awareness, resilience, and improvement of self-affirmation were the most common topics, and many of the faculty in charge of the topics were psychiatrists, psychologists, and medical education faculty members. Although about half of the universities implemented self-care education programs, the educational content has not yet been standardized, suggesting the need for standardization of self-care education in the future.

The survey was conducted in all medical year levels, and the results showed that self-care education is given to first- and second-year medical students. It was suggested that it is necessary to provide more education to upper-year medical students who undergo clinical practice and experience increased stress. The need for self-care education for medical students has become even more important since 2020 and onwards, partly because of the impact of the COVID-19 pandemic.
Medical students as whole persons – tending to the elephants in clinical practice training
Authors: Boudreau J. Donald , Schei Edvin , Valestrand Eivind , Gillespie Hannah , Whelan Beth , Kinsella Elizabeth Anne , Grimstad Hilde , Kvernenes Monika , Stenfors Terese
Published: January 2024

BackgroundFor years, we have known that many medical students lose empathy and experience burn out during the last part of their undergraduate education, despite starting with high motivation and above average mental health. The most powerful learning environment is the clinic, where students in the final stages of their program interact with real patients and practice doctor’s skills in authentic environments. We wondered how students at this stage are cared for as learners and novice professionals. We tried to identify explicit and hidden professional norms and competence goals that students are measured by, and sanctioned for not conforming with, in daily practice. We asked: Is there a mismatch between what medical students need to manage in their professional lives and the affordances inherent to the workplace environment where learning takes place?  Can we intervene to mitigate any gaps?

MethodInspired by the Consolidated Framework for Implementation Research (CFIR), we engaged leaders, physicians, residents, and medical students at a small Norwegian hospital in a three-year project aiming to improve students’ motivation, participation, and clinical learning, by strengthening pedagogical and affective support during an 8-week practice period.

ResultsMedical students and residents identified needs for preparation and orientation, continuity, and secure relationships where learners are acknowledged as unique individuals. A simple model of learning needs was developed, where educational goals can be arranged on three levels: 1) social survival, 2) medical knowledge and skills, and 3) clinical wisdom.
Challenges and opportunities of relationship centred care in health care settings. My journey and the evolution of my approach
Authors: Hurley Maeve
Published: January 2024

Understanding the complexities of relating in a health care context invites practitioners to anticipate and identify challenges and opportunities as they arise in their practice. This experiential paper will attempt to explore and illustrate some of the complexities of adopting a relationship centred  approach in healthcare settings, from the perspective of one practitioner. 

This paper will consider how the organisational culture can impact on the practitioners ability to interact with patients. In this context the  influence of the organisational culture with its emphasis on task, diagnosis and treatment of disease, functioned to undermine this practitioners capacity to relate and take up a relationship centred approach.

This paper, with reference to clinical material, will highlight the tension that exists between task and relationship  in healthcare settings. Special reference will be made  to how in some situations the wish to relate interrupted the task focused work, causing co  nfusion and great challenge for the practitioner . The invitation to adopt  relationship centred practice , while  still attending  to the task in hand  restored the practitioners belief in the medical consultation’s potential to create  a receptive , responsive  and relationship centred space .

Finally, this paper will conclude by considering how to navigate this complex context and to achieve a balance which includes relationship centred care , using these  opportunities as they arise to  ensure  optimum health care outcomes for both practitioner and patients.
The early encounter: shallow looking and the manifest presence in medical education
Authors: Schwartz Ezra
Published: January 2024

If the pressure of patient flow limits a doctor’s visit to fifteen minutes, the importance of the early encounter is increasing. My proposal is dedicated to the first moment of the intersubjective encounter (with art or otherwise), that defined by the unconscious assessment a priori to conscious interpretation, its authority in the clinical encounter, and how to address this moment in medical education.The dynamics between observer and artwork occur in two stages. First, the observer’s senses are attacked, indeed overwhelmed, by the work. Our adaptive unconscious uses reflexive techniques (e.g. thin-slicing) to triage and resolve this information to a more manageable load. Because pattern collection, discovery, and comparison are under unconscious control, the question arises concerning accountability for snap judgments. By studying the patterns that thin-slicing utilizes and our immediate reaction given these patterns, the conscious self can predict—or at least become more accountable—for these judgments.Second, uncomfortable as the victim of a sensory attack, the observer dominates the artwork through the act of interpretation. The observer’s intellect and desire to interpret (both under conscious control) dissolve the uncertainty of the encounter by categorizing it into a comfortable system. Once attuned to this conscious power reversal, we can restrain the unconscious desire prompting the reversal and maintain space in the intersubjective encounter.As visual art is a strong vehicle to discuss the theory behind the dynamics of the early encounter, it is also the appropriate method by which to coach medical students through the early medical encounter.