bluuebunny/crossref_metadata_2025 huggingface dataset:
A patienthood that transcends the patient: An analysis of patient research partners’ narratives of involvement in a Canadian arthritis patient advisory board
Authors: Macdonald Graham G , Leese Jenny , Hoens Alison M , Kerr Sheila , Lum Wendy , Gulka Lianne , Nimmon Laura , Li Linda C
Published: August 2023

Objectives

Incorporating the perspectives of patients and public into the conduct of research has the potential to make scientific research more democratic. This paper explores how being a patient partner on an arthritis patient advisory board shapes the patienthood of a person living with arthritis.

Methods

An analysis was undertaken of the narratives of 22 patient research partners interviewed about their experiences on the Arthritis Patient Advisory Board (APAB), based in Vancouver, Canada.

Results

Participants’ motivations to become involved in APAB stemmed largely from their desire to change their relationship with their condition. APAB was a living collective project in which participants invested their hope, both for their own lives as patients and for others with the disease.

Conclusions

Our findings highlight how the journeys of patient partners connect and integrate seemingly disparate conceptions of what it means to be a patient. One’s experience as a clinical ‘patient’ transforms into the broader notion of civic patienthood.
Implementation and early outcomes of a telehealth visit model to deliver tecovirimat for mpox infection in New York City
Authors: Chan Justin , DiTullio David J , Pagan Pirallo Patricia , Foote Mary , Knutsen Dorothy , Kottkamp Angelica Cifuentes , McPherson Tristan D , Mukherjee Vikramjit , Pitts Robert , Wallach Andrew , Wong Marcia , Mazo Dana , Mgbako Ofole
Published: August 2023

The 2022 mpox outbreak in New York City posed challenges to rapidly scaling up treatment capacity. We describe a telehealth treatment model launched during this outbreak that facilitated healthcare provider treatment capacity, and was able to adhere to a Centers for Disease Control and Prevention (CDC)-sponsored expanded access investigational new drug (EA-IND) protocol for tecovirimat. Sixty-nine patients were evaluated and prescribed tecovirimat for mpox through telehealth visits at NYC Health + Hospitals/Bellevue and NYU Langone Health from June to August 2022. Thirty-two (46.4%) were previously diagnosed with HIV. Forty-four (63.8%) reported full recovery, with the remainder lost to follow-up. Most patients ( n = 60, 87.0%) attended at least one follow-up visit (either in person or through telehealth) after starting treatment. We observed favorable treatment outcomes, with no serious adverse events, hospitalizations, or deaths related to mpox. While equitable access to telehealth remains a limitation that needs to be addressed, this telehealth model enabled a rapid scale-up of tecovirimat prescription during the mpox outbreak, and should be considered as an important tool used to respond to future infectious disease outbreaks.
A literature review on violence and discrimination against trans people in Portugal: Are we still living in a dictatorship?
Authors: Neves Sofia , Borges Janete , Ferreira Mafalda , Correia Marta , Sousa Edgar , Rocha Helena , Silva Lourenço , Allen Paula , Vieira Cristina P
Published: August 2023

This literature review presents a characterization of violence and discrimination against trans people in Portugal, offering a critical analysis of the national efforts aiming to protect trans people’s rights. Its main objective is to highlight and frame the oppression historically suffered by trans people in family and intimate relationships, social discrimination, school, medical care, and employment. Despite legal advances in Portugal in the conquest of rights for trans people during the last two decades, violence and discrimination are still a social problem that needs urgent academic research for its effective prevention and combat.
Gendered machines in film and television: How ‘post-’ femininities and masculinities challenge the gender binary
Authors: Papakyriakopoulou Katerina
Published: August 2023

Motivated by the representation of robots in film and television, this work examines the role of emerging femininities and masculinities in revisiting the gender binary. The gendered cyborg has been a common trope in cultural texts and a favourite topic in feminist discourse, regarding how it exposes the artificiality of this binary. The case studies are the films Ex Machina and I’m Your Man, and the television series Westworld. The ‘post’-femininities and masculinities are explored through the depiction of gendered robots and their relationships with humans. By drawing on the intersection between feminist and queer theory and posthumanism, this article combines a close reading of gendered representations with an analysis of how they visualise post-gender worlds.
Science as an ‘object of love’ – affective milieus in the neoliberal university
Authors: Hokka Johanna
Published: August 2023

This study examines the affective milieus in the neoliberal university. Previous studies have demonstrated that, despite harsh neoliberal realities, academics still express a love for academic work. This study uses love as its conceptual tool to analyse the different forms of love that academics attach to science. Drawing on Sara Ahmed’s theoretisations of affect, this study shows that emotions play a crucial role in organising social order. Emotions work to divide academia into separate ingroups that have different visions of the virtues of science that represent the object of love for its proponents. While analysing higher education magazines with affective-discursive reading, the results of this study show that the neoliberal university favours the forms of love in which the individual ethos and competition are highly valued, while those forms of love that highlight collegial and emancipatory values are on trial. Overall, this study contributes to critical discussions of the neoliberal university by demonstrating the power of emotions in the construction of conflicting, intersecting and overlapping ways of othering and the complex assemblage of affective milieus that exist in today’s academia.
Machine learning-based natural language processing to extract PD-L1 expression levels from clinical notes
Authors: Lin Eric , Zwolinski Robert , Wu Julie Tsu-Yu , La Jennifer , Goryachev Sergey , Huhmann Linden , Yildrim Cenk , Tuck David P , Elbers Danne C , Brophy Mary T , Do Nhan V , Fillmore Nathanael R
Published: August 2023

Introduction: PD-L1 expression is used to determine oncology patients’ response to and eligibility for immunologic treatments; however, PD-L1 expression status often only exists in unstructured clinical notes, limiting ability to use it in population-level studies. Methods: We developed and evaluated a machine learning based natural language processing (NLP) tool to extract PD-L1 expression values from the nationwide Veterans Affairs electronic health record system. Results: The model demonstrated strong evaluation performance across multiple levels of label granularity. Mean precision of the overall PD-L1 positive label was 0.859 (sd, 0.039), recall 0.994 (sd, 0.013), and F1 0.921 (0.024). When a numeric PD-L1 value was identified, the mean absolute error of the value was 0.537 on a scale of 0 to 100. Conclusion: We presented an accurate NLP method for deriving PD-L1 status from clinical notes. By reducing the time and manual effort needed to review medical records, our work will enable future population-level studies in cancer immunotherapy.
Playbor, gamble-play, and the financialization of digital games
Authors: Zaucha Trevor , Agur Colin
Published: August 2023

This article examines non-fungible token (NFT) applications and their users through a qualitative textual analysis of NFT-based video game Axie Infinity’s Discord server. It considers NFT applications’ dual purposes as entertainment media and financial instruments and posits that the interests of capital inform users’ engagement. In an environment defined by distrust and uncertainty, predominantly Filipino digital laborers’ (“Scholars”) experiences and interactions with the game’s ownership class (“Managers”) reflect pre-existing patterns of exploitation made inexpensive by differences in currency valuations, accessible by access to digital devices, available by global financial uncertainty, possible by a lack of user protection and governance, and permissible by light government regulation. To navigate an interplay of designed systems and human behavior, users share gameplay and marketplace knowledge. The blurring of gaming, gambling, and finance discussed here risks fostering an increasingly gamified approach to work and finance and facilitates exploitation of global, stratified labor.
Beamforming with modified steering vectors for jet noise source location
Authors: Dougherty Robert P
Published: August 2023

Prof. Krish Ahuja has a longstanding interest in jet noise source location. His work in this area is grounded in the idea that if the assumed source location is correct, then the sound should obey the inverse square law relative to that point and the phase should be constant along lines originating at that point. He applied this with, conceptually, one microphone in 1985 and two microphones in 1998. In 2006 he commissioned a beamforming system, Array 48, from OptiNav, Inc. His student, Nick Breen, used this to measure subsonic jet noise source location in detail. The NASA-Glenn Research Center also purchased an Array 48. In the current work, a jet noise data set measured by Gary Podboy using Glenn’s array in 2008 is revisited with a new beamforming algorithm, Robust Functional Beamforming, to further support Tam’s two-source model and Breen’s source location. Beamforming with modified steering vectors is performed to measure the parameters of the wavepacket source model from the far field. This process suggested replacing the wavepacket spatial length parameter with a temporal lifetime parameter. Another steering vector modification aimed to measure modes with odd spinning order. It seems to have found them at an apparent location 10 jet diameters removed from the jet, laterally. This is tentatively interpreted as a Mach radius phenomenon like one observed by Csaba Horvath at NASA-Glenn, also using Array 48, to study counter-rotating propeller noise. In an observation unrelated to beamforming, the excess noise measured at 40° from the jet axis as compared with the 90° angle, is fully contained in the first few cross spectral matrix eigenvalues, or Spectral Proper Orthogonal Decomposition modes, in some cases.
Synthesis of glycine from 4-hydroxyproline in tissues of neonatal pigs
Authors: Hu Shengdi , He Wenliang , Bazer Fuller W , Johnson Gregory A , Wu Guoyao
Published: August 2023

Glycine from sow’s milk only meets 20% of the requirement of suckling piglets. However, how glycine is synthesized endogenously in neonates is not known. This study determined glycine synthesis from 4-hydroxyproline (an abundant amino acid in milk and neonatal blood) in tissues of sow-reared piglets with normal birth weights. Piglets were euthanized at 0, 7, 14 and 21 days of age, and their tissues were used to determine glycine synthesis from 0 to 5 mM 4-hydroxyproline, activities and mRNA expression of key glycine-synthetic enzymes, and their cell-specific localization. Activities of 4-hydroxyproline oxidase (OH-POX), proline oxidase (POX), serine hydroxymethyltransferase (SHMT), threonine dehydrogenase (TDH), alanine:glyoxylate transaminase (AGT), and 4-hydroxy-2-oxoglutarate aldolase (HOA) occurred in the kidneys and liver from all age groups of piglets, and in the pancreas of 7- to 21-day-old piglets. Activities of OH-POX and HOA were absent from the small intestine of newborn pigs but present in the small intestine of 7- to 21-day-old piglets and in the skeletal muscle of 14- to 21-day-old piglets. Between days 0 and 21 of age, the enzymatic activities of OH-POX, AGT, and HOA decreased in the liver and kidneys but increased in the pancreas and small intestine with age. The mRNA levels of these three enzymes changed in a manner similar to their enzymatic activities. In contrast to OH-POX, AGT, and HOA, the enzymatic activities of POX, SHMT, and TDH were present in the kidneys, liver, and intestine of all age groups of piglets. Glycine was synthesized from 0.1 to 5 mM 4-hydroxyproline in the liver and kidney from 0- to 21-day-old piglets, as well as the pancreas, small intestine, and skeletal muscle from 14- to 21-day-old piglets in a concentration-dependent manner. Collectively, our findings indicate that 4-hydroxyproline is used for the synthesis of glycine in tissues of piglets to compensate for the deficiency of glycine in milk.
The U.S. Food and Drug Administration, the mechanism of action, and other considerations for cell-based therapy candidates
Authors: Caplan Arnold I
Published: August 2023

The focus of this Commentary is to introduce cell-based therapy in the context of how I believe the U.S. Food and Drug Administration (FDA) might establish criteria for the approval of clinical trials that could eventually lead to the final marketplace approval of these medically relevant, cell-based therapeutic products. It is important to emphasize that regulatory agencies have set up practices and procedures that are based on many years of evaluating pharmaceutically provided drugs. To consider cell-based therapies as single action drugs is inappropriate given the complexity of this technology. The regulatory agencies have been slowly reevaluating the criteria by which they allow clinical trials using cell-based therapies to proceed. This commentary focuses on a few key aspects of such considerations and provides suggestions for modifying the standard criteria.
Low Posterior Internal Jugular Vein Approach for Tunnelled Haemodialysis Catheter Insertion: A Report on Outcomes at a Single Centre
Authors: Yaxley Julian , Gately Ryan , Davidson-West Shaun , Wilkinson Catherine , Mantha Murty
Published: August 2023

Aim

The impact of technical differences in cannulation technique for tunnelled haemodialysis catheter insertion is undetermined. We aimed to assess clinical outcomes of the low posterior approach for internal jugular vein tunnelled catheter placement.

Methods

A retrospective audit was undertaken on consecutive tunnelled catheter procedures performed at a single centre between January 2016 and June 2022. Only catheters specifically placed with a low posterior internal jugular approach were included. The study’s primary outcome was 12-month catheter survival, evaluated using the Kaplan-Meier survival curve and log-rank test. Secondary outcomes included catheter performance and procedure-related complications.

Results

During the study period, 391 tunnelled internal jugular haemodialysis catheters were inserted in 272 patients using the low posterior technique. The 12-month primary patency rate was 68%. Catheter insertion was successful in 96% of cases. Peri-procedural complications occurred in 4% of cases, most frequently bleeding. The most common reasons for catheter loss were dysfunction (10%) and bacteraemia (6%). The best predictors of catheter failure were advanced age (HR 1.02, 95% CI 1.00-1.04) and in-centre dialysis treatment locality (HR 2.04, 95% CI 1.19-3.45).

Conclusion

The low posterior approach for internal jugular vein tunnelled catheter insertion is effective and safe. We demonstrated a 12-month catheter survival rate of 68%. Further research comparing the low posterior approach with other internal jugular vein cannulation techniques is warranted.
The Methodological Approach to a Process Evaluation of a Community and Provider-Driven Social Accountability Intervention to Increase Contraceptive Uptake and Use
Authors: Milford Cecilia , Cordero Joanna , Nai Dela , Shamba Donat , Fuseini Kamil , Boydell Victoria , Tarimo Afiba , McMullen Heather , Steyn Petrus ,   on behalf of the CaPSAI Project Team
Published: August 2023

The community and provider-driven social accountability intervention (CAPSAI) project was a complex intervention consisting of interacting components, actors and processes, implemented in Ghana and Tanzania from 2018 to 2020. It aimed to measure the impact of a social accountability intervention implemented in family planning services, on contraceptive uptake and use. The intervention incorporated a process evaluation to identify key causal pathways and better understand factors influencing uptake and use, in the context in which the intervention was implemented. This study used a unique methodology to conduct the process evaluation, and looked at several outcomes, including service utilisation, continuation rates and attitudes and behaviours. Qualitative methods were used to evaluate the effects of the intervention – (1) context mapping, (2) a process evaluation of the different steps of the intervention, and (3) compiling cases of change. Document review, non-participant observation and in-depth interviews were conducted. Data analysis included summaries and coding of the qualitative data. Coding and thematic content analysis were conducted collaboratively across two countries and used a single codebook that was relevant to both countries, yet enabled country specific analysis. Each country team drafted reports that drew on the three data sets. Various lessons were learnt – including the importance of teamwork, development of standard operating procedures to guide practical study components, and how to prioritise study activities over a long study timeline. The study demonstrated that a process evaluation of a complex intervention across multiple countries is feasible, and was also able to yield differentiate results based on specificity in each country’s context. Based on this study, similar process evaluation activities can be replicated in future work.
The evaluation of Candida-related central line-related bloodstream infections in pediatric cancer patients: A pre- and post-intervention study
Authors: Devrim İlker , Celebi Miray Yılmaz , Karakaya Nurgul , Sahinkaya Sahika , Acar Sultan Okur , Cem Ela , Demirağ Bengü , Oruc Yeliz , Kara Aybuke Akaslan , Oymak Yesim , Karapınar Tuba Hilkay , Bayram Nuri
Published: August 2023

Aim/Objections

The purpose of this study was to assess the efficacy of a central line maintenance bundle in preventing catheter-related (implanted venous access devices, port) Candida bloodstream infections.

Methods

The study encompassed two distinct time periods, namely, pre-bundle and bundle. The number of catheter-related bloodstream infections (CRBSI) episodes per catheter days for each timeframe was determined.

Findings/Results

Upon implementation of the central line bundle, the rate of CRBSI reduced significantly from 4.27 per 1000 central line days in the pre-bundle period to 1.0 per 1000 central line days in the bundle period ( p < .001).

Discussion

Using a central line bundle to avoid CRBSIs in pediatric cancer patients with ports led to a significant decrease in Candida species-related CRBSIs.
Safety and Efficacy of a Novel Polyglycolic Acid Meniscal Scaffold for Irreparable Meniscal Tear
Authors: Otsuki Shuhei , Sezaki Shunsuke , Okamoto Yoshinori , Ishitani Takashi , Wakama Hitoshi , Neo Masashi
Published: August 2023

Objective

Meniscal tears treated with a partial meniscectomy could induce knee osteoarthritis, thereby altering or damaging knee kinetics and biomechanics. We have developed a meniscal scaffold made of polyglycolic acid (PGA) coated with polylactic acid/caprolactone (PGA scaffold), which could induce new tissue growth of meniscus-like tissue. This study aimed to evaluate the safety and efficacy of a novel meniscal scaffold for the treatment of irreparable meniscal injuries.

Design

This study describes the findings of a cyclic torque test and first clinical trial of a PGA scaffold for inducing meniscus-like tissue in humans. As the first step, biomechanical testing of the PGA scaffold was performed using a cyclic torque test. Six patients underwent arthroscopic implantation of the PGA scaffold. Furthermore, the patients underwent preoperative clinical, serological, radiographic, and magnetic resonance imaging examinations at 3, 6, and 12 months postoperatively. The patients also underwent a second-look arthroscopy 12 months after implantation.

Results

Torque increased with increasing cyclic loading. However, no structural damage to the sample was noted after 70,000 loading cycles. All patients showed improvement in pain, Lysholm scores, Tegner activity scores, International Knee Documentation Committee, and knee injury and osteoarthritis outcome. The second-look arthroscopy revealed that meniscal tissue had regenerated in 5 patients (83%). Radiography and magnetic resonance imaging confirmed no progression of degenerative joint disease.

Conclusions

The PGA scaffold could tolerate shear forces, did not produce safety concerns, and may have therapeutic potentials for irreparable meniscal tears in humans.
Vitamin D level and bone profile among 1- to 5-year-old children in Galle municipality and Bope-Poddala areas in Sri Lanka
Authors: Jayawardana Pushpika , Liyanage Gayani
Published: August 2023

Objective:

Identify the incidence and risk factors of vitamin D deficiency/vitamin D insufficiency in children aged 1–5 years.

Methods:

A cross-sectional survey was conducted among children between the ages of 1 and 5 in the Bope-Poddala and Galle municipality areas. The sample was obtained by cluster sampling method. Data on socio-demography, pregnancy, sun exposure, and diet were obtained. Serum 25(OH)D concentrations were measured and the cutoff value was determined as per the global consensus in 2016.

Results:

Among 100 children, the mean serum 25(OH)D level was 86.4 nmol/L (24.06 ng/mL). The prevalence of vitamin D deficiency and vitamin D insufficiency was 7% and 28%, respectively. Birth weight and sunlight exposure were significantly different among vitamin D deficiency/vitamin D insufficiency and sufficient groups. Both were found to be risk factors for vitamin D deficiency/vitamin D insufficiency in logistic regression.

Conclusion:

Vitamin D deficiency/vitamin D insufficiency is significant among children aged 1–5 years and decreased sun exposure and low birth weight are the main risk factors.
A private hospital’s approach to treating acute familial Mediterranean fever in Dar es Salaam
Authors: Kyejo Willbroad , Machibya Musa , Hooda Faisal , Gahhu Waziri , Mandania Shivangi , Ismail Neelam , Matillya Nancy , Mjema Kilalo , Hameed Kamran
Published: August 2023

Familial Mediterranean fever is a rare autosomal recessive autoinflammatory disorder prevalent in Middle Eastern populations, characterized by episodic abdominal pain. This case report presents a 34-year-old Egyptian man with severe lower abdominal pain, chest discomfort, and joint pain, along with a positive family history of familial Mediterranean fever but had no previous personal history of this condition. Blood work revealed leukocytosis with neutrophilia and elevated C-reactive protein and erythrocyte sedimentation rate. The patient received intravenous fluids, antiemetics, and analgesics before further evaluation. Diagnosis of familial Mediterranean fever relies on clinical symptoms, ethnic origin, and family history, supported by specific criteria. Typical familial Mediterranean fever attacks involve serositis-induced pain, recurrent episodes, short-duration fever (12 h to 3 days), and arthritis. Familial Mediterranean fever may mimic other acute abdominal conditions, warranting consideration, particularly in individuals from Mediterranean regions. Genetic testing is valuable in confirming familial Mediterranean fever diagnosis.
From masks to mismanagement: A global assessment of the rise and fall of pandemic-related protests
Authors: Hellmeier Sebastian
Published: August 2023

The Covid-19 pandemic changed contentious politics worldwide. After causing a short-lived decline in global protest activities in early 2020, it has led to the emergence of a variety of pandemic-related protests. While previous work has mostly looked at how event frequencies have changed over time, this paper focuses on changes in protest issues. It applies quantitative text analysis to protest event descriptions and makes the following contributions. First, it traces the rise and fall of pandemic-related protests globally between 2020 and mid-2022, showing that, on average, more than 15% of protest events were pandemic-related. Second, it identifies the most dominant pandemic-related protest issues—masks and vaccination, the economy, business restrictions, health care, education, mismanagement, and crime—and their salience over time. Third, the paper explores potential explanations for differences in the prevalence of pandemic-related protest issues between countries. Multivariate regression analyses suggest a global divide. Protests in developed countries and liberal democracies were more likely about government restrictions. In contrast, citizens in less developed countries took to the streets to demand better healthcare provision.
Novel method of breaking down barriers in the provision of menopause care in Ireland
Authors: Kennedy Brian , Lundy Deirdre , Mackey Rachel , Hartley Caoimhe , Soffe Karen
Published: August 2023

There is a surge in demand for menopause care and hormone replacement therapy (HRT) in Ireland on a background of neglect of a generation of healthcare professionals’ (HCPs) education in this area.

Lack of knowledge of evidence regarding the benefit/risk ratio of personalised HRT is a barrier to providing menopause care. Education of undergraduates and HCP takes investment of time and money. A more immediate solution was required.

Aim

A novel method of providing education and support to GP’s was developed. The goal was to create a rapidly accessed peer advisory community to empower GP HRT prescribing.

Method

A core group of doctors with special expertise in HRT were assembled on a GP interest group on the Telegram messaging platform. It is called ‘HRT prescribers’, an educational community with entrance by peer invitation. Most are GPs and number between 800 and 1000. Members post clinical questions and receive evidence-based responses to their dilemmas.

Results

A survey of members was overwhelmingly positive. 98% agreed the group empowered them to be confident and feel supported in their HRT prescribing. 90% agreed the group helped improve access to HRT for women who needed it in their practice.

Conclusion

This project developed, with the cooperation of specialists, a cost-effective rapid method of educating and empowering GP’s to be supported to safely treat their patients in their menopause transition. With further support and development, we believe it is the model that could be adopted in many countries.
‘I understood the texting process well’. Participant perspectives on usability and acceptability of SMS-based telehealth follow-up after voluntary medical male circumcision in South Africa
Authors: Pienaar Jacqueline , Day Sarah , Setswe Geoffrey , Wasunna Beatrice , Ncube Vuyolwethu , Ndebele Felex , Oni Femi , Waweru Evelyn , Khumalo Calsile , Tweya Hannock , Sherr Kenneth , Su Yanfang , Feldacker Caryl
Published: August 2023

Background

Voluntary medical male circumcision (MC) is a biomedical HIV prevention method that requires post-operative follow-up for healing confirmation. Recent research found that a two-way texting (2wT) app providing SMS-based telehealth for MC patients was safe and reduced provider workload. We evaluated 2wT usability among MC clients in South Africa assigned the 2wT intervention within a larger randomized controlled trial (RCT) of 2wT safety and workload.

Methods

This quantitative usability study is within an RCT where 547 men used 2wT to interact with an MC provider via SMS. The sub-study involved the first 100 men assigned to 2wT who completed a usability survey 14 days after surgery. Acceptability was assessed through 2wT response rates of the 547 men. Regression models analyzed associations between age, wage, location, potential adverse events (AEs), and 2wT responses.

Results

Men assigned to 2wT found it safe, comfortable, and convenient, reporting time and cost savings. High response rates (88%) to daily messages indicated acceptability. Age, wage, and location didn't affect text responses or potential AEs.

Conclusion

2wT for post-MC follow-up was highly usable and acceptable, suggesting its viability as an alternative to in-person visits. It enhanced confidence in wound self-management. This SMS-based telehealth can enhance MC care quality and be adapted to similar contexts for independent healing support, particularly for men.
The Christian educator as prophet, priest, and king: Nurturing moral formation in a ChatGPT era
Authors: Condrey B.J.
Published: August 2023

Educators throughout the world are deeply concerned about what ChatGPT means for education. I argue that Christian educators must avoid extreme reactions and fulfill three key roles to remain focused on students’ holistic formation: (1) casting a moral vision of truthfulness; (2) evaluating curricula, syllabi, and formal assessments while also creating a secure and explorative learning environment to learn about ChatGPT; and (3) exercising their authority through accountability measures and by paradoxically surrendering that same authority to foster dialogue. These three roles reflect the threefold office of Christ as a prophet, priest, and king and are explored using this Reformed motif.
Perceptions of Cannabis Use: A Qualitative Descriptive Study of Rheumatology Patients
Authors: Olson Joanne , Brophy Hailie , Turk Tarek , Jones Allyson , Yamamoto Shelby. S. , Yacyshyn Elaine , Sadowski Cheryl A. , Paul Pauline
Published: August 2023

Introduction/Objectives:

Some rheumatology patients use or contemplate using cannabis, however, may not be transparent about use with their providers. The objective of this qualitative descriptive study was to describe beliefs, perceptions, and learning needs of adults with rheumatic conditions regarding the use of cannabis products.

Methods:

Purposive sampling was conducted through a rheumatology clinic and sought participants who were using or thinking about using cannabis. Two online focus groups based on cannabis use patterns (non-users and users) were conducted separately. Interviews were audio recorded and transcribed. Three research team members read the transcripts independently to identify initial codes and themes. Data saturation was reached with the interviews.

Results:

We recruited 12 participants between 52 and 85 years old. The first theme was pain and desperation. Stigma was the second theme with a perception of physician opposition to cannabis, and the reluctance of many participants to discuss cannabis use with physicians. The final theme was a need for information and a general lack of trustworthy and credible sources. Users were willing to try cannabis even if they still had questions.

Conclusion:

Rheumatology patients are open to using cannabis due to the burden and suffering associated with pain. They remain silent on the topic, however, because of stigma and lack of engagement from health care professionals, particularly physicians. Patients voiced a strong need for information regarding cannabis and want healthcare providers to initiate discussion. These findings are clinically relevant to the management of rheumatic conditions and the promotion of therapeutic relationships.
Leadership Characteristics Through The Lens of Translocational Positionality Framework: Trailblazing Women in Policing
Authors: Gregory John Christopher
Published: August 2023

The purpose of this study was to explore the experiences of trailblazing women leaders in US police organizations as viewed through the lens of translocational positionality framework (TPF). The intent was to determine if as “trailblazers” their leadership strategies might have differed from other leaders in police organizations. This exploratory qualitative study used a purposive sample of 13 trailblazing leaders and conducted in-depth semi-structured interviews. Using a grounded theory methodology, the author found the women police leaders’ behaviors and leadership characteristics were fluid based on the context and circumstances of the situation. The themes of authority and presence emerged as the leaders proved to be highly capable and component caregivers, selfless servants, over-achievers, and great communicators who balanced both male and female leadership behaviors. The findings revealed that the trailblazing participants were unique, and their leadership strategies were different from their colleagues because they were willing to create their own path to leadership opportunities.
Making Network Governance Work in Forest Land-Use Policy in the Local Government
Authors: Roengtam Sataporn , Agustiyara Agustiyara , Nurmandi Achmad
Published: August 2023

Focusing on Indonesia’s Riau Province, this study examines the complexities of managing networks for forest governance, and how local governments should adopt and enforce policies in network settings based on multi-stakeholder participation. Data were collected through interviews and document analysis, and analyzed using network analysis. The finding show that network governance through regulation should be enforced through the network’s political structure, involve several local actors, and facilitate coordination and communication for mutual benefit, especially in forest land-use management. Trust and costs reflect the development of collaborative behavioral frameworks which can influence coordination capacity, including intergovernmental networks in forest land-use policy. Further, the separation of network governance from multiple linked actors, which seems more “ally” (i.e., lead-organization governed networks) than “join” (i.e., shared/participatory governance networks), is undoubtedly problematic. The network and building of trust between network stakeholders may never transform into multi-stakeholder management structures without enabling network governance.
A Struggle by Any Other Name: Coalitional Pedagogy for Antiracist Solidarity
Authors: Hikido Annie
Published: August 2023

Teaching the sociology of race often relies on discussions organized by racial groups. This approach risks foreclosing opportunities for building intergroup alliances. I develop a coalitional pedagogy that promotes a shared political commitment across racial identities. I model one application through a relational analysis of three cases. By illuminating how racism afflicts different groups in patterned ways, instructors can build interest convergence and cultivate antiracist solidarity.
Describing Racial Disparity in Hypertension Control in a Large Minnesota Outpatient Practice
Authors: Hussein Haitham M. , Chrenka Ella , Yang Mai Kau , Margolis Karen L. , Kottke Thomas E.
Published: August 2023

Introduction

This analysis is a part of ongoing quality improvement efforts aiming at improving hypertension control among various racial minority groups seen in a large outpatient practice with a special focus on two war refugee populations, the Hmong and the Somali populations.

Method

Deidentified medical records were reviewed for adult hypertensive patients who had an outpatient encounter with a hypertension diagnosis during the years 2015 through 2019. The study outcome was the rate of uncontrolled hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, and stratified by race, age, and gender.

Results

There were 752,504 patient records representing 259,824 unique patients (mean age 61 ± 13 years) with 49.1% women, 82.1% white 8.3% African American, 4% Asian, 1.6% Hispanic, Somali 0.6%, and 0.2% Hmong. Hmong men had the highest rate of uncontrolled HTN (33.6%) followed by African American (31.3%) then Somali (29.2%). Among women, African Americans had the highest rate (28.6%) followed by Hmong (28.5%) then Somali (25.7%). In all races except Somali, the rate of uncontrolled hypertension was highest in the 18–29 age group, decreased progressively over the next several decades, then increased again in the ≥70 age group.

Conclusion

Hmong, African American, and Somali groups have the highest rates of uncontrolled hypertension. Efforts to address hypertension management need to be tailored to the specific characteristics of each racial group and to target young adults.
Enhancing Cancer Pain Self-Management: A Holistic Supporting Model
Authors: Hassankhani Hadi , Orujlu Samira , Rahmani Azad , Sanaat Zohreh , Dadashzadeh Abbas , Allahbakhshian Atefeh
Published: August 2023

Introduction

Pain self-management is crucial in reducing pain intensity and improving the quality of life for cancer patients. By acquiring self-management skills, patients can actively participate in managing their pain.

Objective

The objective of this study was to develop a grounded theory-based model to assist cancer patients in enhancing their pain self-management.

Methods

This qualitative research was conducted in two stages from 2019 to 2021. The initial phase utilized a grounded theory approach to explore the process of pain self-management in cancer patients. Following Corbin and Strauss’ analytical method, a grounded theory of pain management in cancer patients was identified. Subsequently, Walker and Avant’s theory synthesis strategy was employed to construct a practical model that provides support for patients in managing their pain.

Results

Within the conceptual framework, this study developed the “Holistic Supporting from Pain Self-Management” model. This supportive model consists of three main components: (1) enhancing pain self-management skills in cancer patients and their families, (2) empowering physicians and nurses in pain management for cancer patients, and (3) improving the organizational structure for pain management in cancer patients.

Conclusion

The Holistic Supporting from Pain Self-Management model emphasizes the importance of addressing all dimensions of cancer pain, including physical, functional, psychosocial, cultural, and spiritual aspects, to effectively manage pain in cancer patients. This model addresses the needs of patients, healthcare providers, and the healthcare system, aiming to enhance and support pain self-management.
On the Profile of Intercultural Theology: A Discipline (Still) in the Making
Authors: Wrogemann Henning
Published: August 2023

This article distinguishes the discipline of Intercultural Theology from other theological disciplines (exegesis, church history, Systematic Theology) and from World Christianity and Anthropology of Christianity. The main thesis is that although Intercultural Theology has a broader methodological spectrum than Mission Studies, and although it approaches its subject matter in a far more differentiated way, the discipline will need to maintain its basis in mission theology lest it dissolve into pure cultural studies. Based on this premise, the article proceeds to discuss both methodological questions and the subject matter of the discipline. Finally, it highlights the following topics as of particular relevance at present: intercultural hermeneutics and the understanding of power, theologies of mission and the understanding of universality, and theologies of religion and the understanding of recognition.
From indoor and outdoor environment to language achievement: The chain mediating role of psychological atmosphere and curriculum implementation
Authors: Luo Lanlan
Published: August 2023

Language acquisition by children depends on the learning environment when they were in kindergarten to some extent. The goals of this study were to find out the impact of the indoor and outdoor environment on children's language development. Structural equation modeling was adopted. Children randomly selected from 270 preschool classes of five provinces in China were recruited in this study (1642 children aged between 36 and 72 months). We concluded that language achievement of children cannot be directly predicted by indoor and outdoor facilities and play materials, and an intermediate transmission pathway was needed. As an intermediary variable, the curriculum implementation partially mediated the influence of the indoor learning center on children's language achievement. The psychological atmosphere and curriculum implementation have a chain mediation effect between indoor and outdoor facilities and play material quality and childhood language achievement, and the influence effect of indoors was different from that of outdoors. In terms of the influence of indoor learning center planning and play materials, the effect on children's language achievement accounted for 61.5%, while when it came to that of outdoor learning center facilities and equipment, it was 60.7%. This indicated that the impact of the indoor and outdoor environment on children's language development could not be ignored. The indoor environment was more dependent than the outdoor environment on the chain role played by class curriculum implementation, psychological atmosphere and curriculum implementation quality. Therefore, teachers should create a positive psychological atmosphere, organically combine the curriculum implementation with environmental planning and material delivery, cultivate a prepared language environment for children and support their active learning and development.
Parents’ experiences of paediatric palliative care in the community healthcare system: a qualitative study
Authors: Rud Stine Andreassen , Skagestad Eirin , Aasebø Hauken May
Published: August 2023

Background:

Having a child with a life-limiting illness is a situation that is relatively rare and represents a multidimensional burden on the family. Paediatric palliative care (PPC) aims to maintain the quality of life for the ill child and the family. Traditionally, most PPC has been provided at a specialist healthcare level, but research indicates that most families wish to spend as much time at home as possible. However, we have limited knowledge of PPC in community healthcare, especially from the parent’s perspective. This knowledge is important to provide optimal home-based PPC.

Objectives:

To explore parents’ experiences of PPC within the community healthcare system.

Design:

Qualitative study with an interpretive descriptive design.

Methods:

In all, 11 parents of children with different life-limiting illnesses were interviewed after the child’s death using a semi-structured interview guideline. Data were analysed using systematic text condensation. Consolidated criteria for reporting qualitative research (QOREQ) was followed.

Results:

The parents’ experiences were captured in five main themes: (i) ‘Interaction with hospital and community services’, (ii) ‘Parents did not always get the help they needed’, (iii) ‘The child’s needs became increasingly complex’, (iv) ‘When the end came’ and (v) ‘The parents asked for an ordinary life in an unordinary situation’. Each main theme was further elaborated by two subthemes.

Conclusion:

Overall, the parents experienced PPC in the community as limited and fragile, and as lacking flexibility, coordination and professional competence related to the children’s complex needs. There appears to be potential for improvement in PPC through improved care coordination between the hospital and the community healthcare services, involving the community healthcare system at an early timepoint in the illness trajectory, including a family focus, and providing accessibility, flexibility and care coordination of community services.

Registration and reporting guidelines:

The study is registered in the institutional system for research project (RETTE; ID number F2082).
Reflecting on choices and responsibility in palliative care in the context of social disadvantage
Authors: French Maddy , Hansford Lorraine , Moeke-Maxwell Tess
Published: August 2023

There is a need to understand how to improve palliative care provision for people impacted by social inequity. Social inequity, such as that related to socioeconomic circumstances, has profound impacts on experiences of death and dying, posing personal and professional challenges for frontline professionals tasked to ensure that everyone receives the best standard of care at the end of their lives. Recent research has highlighted an urgent need to find ways of supporting healthcare professionals to acknowledge and unpack some of the challenges experienced when trying to deliver equitable palliative care. For example, those involved in patient or person-centred activities within health settings often feel comfortable focusing on individual choice and responsibility. This can become ethically problematic when considering that inequities experienced towards the end of life are produced and constrained by socio-structural forces beyond one individual’s control. Ideas and theories originating outside palliative care, including work on structural injustice, cultural safety and capabilities approach, offer an alternative lens through which to consider roles and responsibilities for attending to inequities experienced at the end of life. This paper draws upon these ideas to offer a new way of framing individual responsibility, agency and collective action that may help palliative care professionals to support patients nearing their end of life, and their families, in the context of socioeconomic disadvantage. In this paper, we argue that, ultimately, for action on inequity in palliative care to be effective, it must be coherent with how people understand the production of, and responsibility for, those inequities, something that there is limited understanding of within palliative care.
TAP To SKILL: Using Self-Directed Video Prompting to Promote Independence in Inclusive School Settings
Authors: Sun Xiaoning , Brock Matthew E.
Published: August 2023

Many students who have Extensive Support Needs (ESN) struggle with increasing their independence in inclusive classrooms. Federal law is clear that all students—including students with ESN—should be educated alongside their peers without disabilities in regular education classrooms to the “maximum extent appropriate.” Self-directed video prompting is an evidence-based practice that has been proven to fade adult support while building student independence. This article provides a practical how-to guide for how teachers can support their paraeducators in using self-directed video prompting. It introduces a framework for implementation called TAP To SKILL and describes what this approach looks like in action.