bluuebunny/crossref_metadata_2025 huggingface dataset:
Disturbance rejection–based robust decentralized controller design for a multivariable system
Authors: Mahapatro Soumya Ranjan , Subudhi Bidyadhar
Published: August 2022

A new robust decentralized controller based on a modified linear active disturbance rejection control structure is proposed in this article. In this work, the proposed controller is designed in a two-degree-of-freedom internal model control framework, to overcome the limitations of extended state observer in active disturbance rejection control. In the proposed controller, tuning parameters, that is, observer bandwidth and controller bandwidth are the inverse of the two-time constants, that is, set-point filter and disturbance rejection filter of internal model control (IMC). Moreover, to show the efficacy of the proposed controller, it has been compared with the linear active disturbance rejection controller (ADRC). Furthermore, to exhibit the superiority, an experimentation is conducted on a coupled tank liquid-level multivariable system. From the obtained simulation and experimental results, it is envisaged that the proposed modified linear active decentralized disturbance rejection controller exhibits superior control performance to maintain a precise desired liquid level as compared to the linear ADRC.
Deep reinforcement learning in playing Tetris with robotic arm experiment
Authors: Yan Yu , Liu Peng , Zhao Jin , Zhang Chengxi , Wang Guangwei
Published: August 2022

Tetris has been an important field for research in deep reinforcement learning (DRL). However, most studies about Tetris are focused on simulation validation, and a few attempts are conducted in the real-world environment. In this paper, the DRL algorithms are trained in the constructed Tetris simulation environment, after that they are deployed into the real-world Tetris experiments. The dynamic timesteps method is integrated into the proximal policy optimization (PPO) method to accelerate its training speed, which reaches the goal of the game within 1483 episodes. With the help of multiple recognition and segmented moving techniques, the robotic arm provides accurate and robust performance to play real-world Tetris. The effectiveness of the developed system is experimentally verified; the experimental results show that the proposed algorithm achieved superior performance compared with conventional method and Deep Q-Network (DQN) in real-world Tetris environments.
Optimized Sage–Husa filtering method for multitarget tracking with unknown detection profile
Authors: Li Bo
Published: August 2022

The Sage–Husa filter can estimate states of multitarget from available measurements. To address the imprecise estimations of the conventional Sage–Husa filter, an optimized method and its implementation are put forward in this study. Unlike previous approaches, the beta distribution for unknown detection profile is improved, and the transfer probability is applied to update the implicit probability of detection. With respect to the positive definiteness of the estimated covariance, the Cholesky decomposition is used in both prediction and update of the Sage–Husa filter. Recalling the estimated probability of detection, the track gate strategy in the proposed filtering framework is derived to distinguish clutter-generated and target-generated measurements. On the basis of updated measurements, both the state and the track of multitarget are achieved. Finally, the experiments of multitarget tracking are made to indicate the performance of the proposed Sage–Husa filtering method.
Successful treatment of pulmonary mucormycosis (Lichtheimia spp.) in a post-partum patient with COVID-19 ARDS requiring extra-corporeal membrane oxygenation using salvage therapy
Authors: Hanks Justin , Unai Shinya , Bribriesco Alejandro , Insler Steven , Yu Eileen , Banzon Jona , Mireles-Cabodevila Eduardo , Adi Ahmad , Elgharably Haytham , Yun James , Krishnan Sudhir
Published: August 2022

Case Summary: A 31-year-old female presented to a regional hospital at 27 weeks pregnant and was found to have COVID-19 ARDS. She underwent intubation and caesarian section for worsening hypoxia and non-reassuring fetal heart tones. Hypoxemia was refractory to proning requiring ECMO and transfer to a tertiary care center. Admission chest radiography showed a new right lower lobe cavitating lesion with computed tomography scan revealing a large multi-loculated cavity in the right lung and extensive bilateral ground-glass opacities. The patient was started on amphotericin and posaconazole, with final respiratory cultures growing Lichtheimia spp. Source control was discussed via possible open thoracostomy, but medical management alone was continued. Total ECMO support was 3 weeks. At the time of discharge to acute rehab, 1 month of amphotericin and posaconazole had been completed, with continuation of posaconazole. At last update, she had been discharged from rehab and was back home with her infant. Conclusion: Pulmonary mucormycosis, even in the non-ECLS population, carries a high mortality. Treatment in pulmonary disease with surgery improves mortality but is not always feasible. Salvage therapy with extended course antifungal medications may be an option for those not amendable
Whose climate intervention? Solar geoengineering, fractions of capital, and hegemonic strategy
Authors: Surprise Kevin , Sapinski JP
Published: August 2022

Proposals for slowing climate change by reflecting sunlight back to space, known as solar geoengineering (SG), are gaining traction in climate policy. Given SG’s capacity to slow warming without reducing carbon emissions, prominent criticism suggests that it will enable fossil fueled business-as-usual. This assessment is not without merit, yet the primary funders of SG research do not emanate from fossil capital. We analyze sources of funding for SG research globally, finding close ties to mostly US financial and technological capital as well as a number of billionaire philanthropists. These corporate sectors and associated philanthropies comprise part of ‘climate capital’ – the fraction of the capitalist class nominally aligned with climate action. We argue that SG is being positioned as a tactic for enabling incremental, market-driven decarbonization, explore key institutions advocating this approach in US climate policy, and conclude that SG is poised to serve as a tool for class compromise between fossil and climate capital.
Acute bilateral parotid swelling upon laryngeal mask airway insertion: A case report
Authors: Wong Nicole YE , Guise Philip A
Published: August 2022

We describe a case of bilateral parotid swelling developing shortly after laryngeal mask airway insertion. Spontaneous resolution occurred within 12 h postoperatively This unusual phenomenon has been termed ‘anaesthesia mumps’ or ‘acute sialadenosis’. Its exact relationship to anaesthesia remains unknown. It arises in a variety of patients and surgeries, making its pathogenesis difficult to determine. Its presentation can be confused with acute angioedema, but, unlike the latter, it is benign and not normally associated with airway compromise. Diagnosis is a process of exclusion, but careful airway assessment is an important component of this. Strategies to aid diagnosis and management are described.
The Duration of Thigh Tourniquet Use Associated With Anterior Cruciate Ligament Reconstruction Does Not Produce Cellular-Level Contractile Dysfunction of the Quadriceps Muscle at 3 Weeks After Surgery
Authors: Beynnon Bruce D. , Pius Alexa K. , Tourville Timothy W. , Endres Nathan K. , Failla Mathew J. , Choquette Rebecca H. , DeSarno Mike , Toth Michael J.
Published: August 2022

Background:

Anterior cruciate ligament (ACL) trauma and ACL reconstruction (ACLR) are associated with the loss of strength and function of the muscles that span the knee joint. The underlying mechanism associated with this is not completely understood.

Purpose:

To determine whether the duration of tourniquet use during ACLR has an effect on knee extensor muscle contractile function and size at the cellular (ie, fiber) level 3 weeks after surgery and at the whole-muscle level at 6 months after surgery.

Study Design:

Descriptive laboratory study and case series; Level of evidence, 4.

Methods:

Study participants sustained an acute, first-time ACL injury. All participants underwent ACLR with the use of a tourniquet placed in a standardized location on the thigh; the tourniquet was inflated (pressure range, 250-275 mm Hg), and the time of tourniquet use during surgery was documented. Participants were evaluated 1 week before surgery (to measure patient function, strength, and subjective outcome with the Knee injury and Osteoarthritis Outcome Score [KOOS] and International Knee Documentation Committee [IKDC] score), at 3 weeks after ACLR surgery (to obtain muscle biopsy specimens of the vastus lateralis and assess muscle fiber cross-sectional area, contractile function, and mitochondrial content and morphometry), and at 6 months after ACLR (to evaluate patient function, strength, and subjective outcomes via KOOS and IKDC scores). Data were acquired on both the injured/surgical limb and the contralateral, normal side to facilitate the use of a within-subjects study design. Results are based on additional analysis of data acquired from previous research that had common entry criteria, treatments, and follow-up protocols.

Results:

At 3 weeks after ACLR, the duration of tourniquet use at the time of surgery did not explain the variation in single–muscle fiber contractile function or cross-sectional area (myosin heavy chain [MHC] I and II fibers) or subsarcolemmal and intermyofibrillar mitochondrial content or morphometry. At 6 months after ACLR, the duration of tourniquet use was not associated with the peak isometric and isokinetic torque measurements, patient function, or patient-reported outcomes.

Conclusion:

The duration of tourniquet use at the time of ACLR surgery did not explain variation in muscle fiber size, contractile function, or mitochondrial content at 3 weeks after surgery or strength of the quadriceps musculature or patient-reported function or quality of life at 6-month follow-up.
Evaluating Cancer Pain Characteristics and Treatment Factors in the Emergency Department: A Retrospective Cohort Study
Authors: Gupta Rishi , Lin Lucia , Resley Vanessa , Khan Ayesha , Li David R. , Shatsky Rebecca A. , Coyne Christopher J.
Published: August 2022

Objectives: To identify patient characteristics and treatment factors of patients presenting to the emergency department (ED) with cancer-related pain that may affect patient outcomes. Methods: We conducted a retrospective cohort study to evaluate adult patients with active cancer, who presented to the ED with a chief complaint of pain between June first, 2012 and January first, 2016. We utilized multivariable logistic regression to evaluate the association of several exposure variables, including disease and demographic characteristics, primary pain site, and treatment methods, on ED disposition and revisit rate. Results: We included 483 patients with active cancer with a chief complaint of pain. Patients with severe pain on arrival tended to be younger than those who did not present with severe pain (median: 58 vs 62 respectively, OR 8.0 p < 0.01). Patients with high ECOG scores (3-4) with severe pain on arrival (≥7 out of 10) had less improvement in their pain than the rest of our cohort (OR 8.4, p < 0.01). Also, those with musculoskeletal pain had significantly less improvement in reported pain than all other pain types (delta pain −2.1 vs −3.4, OR 2.3, p = 0.025) Long delays in initial analgesic administration were associated with increased rates of subsequent admission (OR 3.4) [p = 0.014]. Although opioid analgesics led to greater decreases in pain than non-opioid analgesics, patients treated with opioids were more likely to be admitted (43% vs 34.5% AOR 1.51, p = 0.048). Conclusion: Our study showed that delays in analgesic administration, poor functional status, and the presence of musculoskeletal (MSK) pain significantly influenced outcomes for this patient cohort. These findings suggest the development of specific protocols and tools to address cancer-related pain in the ED may be necessary.
Stability and Change in Men’s Intimate Partner Violence and Substance Use in Early Adulthood
Authors: Lee Hyanghee
Published: August 2022

Despite substantial evidence of the role of substance use in intimate partner violence (IPV), little is known about the impact of substance use on stability and change in the experience of IPV as both a perpetrator and a victim. Using an ethnically diverse sample of 232 men in early adulthood (mean age = 29.1, SD = 0.91), this study defined typologies of IPV based on men’s reports of both perpetration and victimization; examined the potential impact of substance use, including alcohol and marijuana use, on IPV typologies over two measurement occasions; and quantified stability and change in these typologies over time. Patterns of IPV were characterized by three classes at each time point: no IPV, psychological aggression, and physical aggression. Men’s regular marijuana use was associated with physical aggression contemporaneously and prospectively. Partner’s problem alcohol use was associated with psychological aggression contemporaneously, suggesting that women’s problem alcohol use could be a risk factor for their own and their partner’s IPV perpetration. IPV appeared to remain somewhat stable over time with 67% of men remaining in the same IPV class. Among those who did transition from one typology to another, it was most often to a less severe IPV typology. Regular marijuana users were more likely to be in the physical aggression typology rather than the no IPV typology, with a higher probability of transitioning to a more severe IPV typology than nonusers. The present study has implications for prevention and intervention efforts by its ability to identify men who are at greatest risk for continued or increased violence and underscores that men’s marijuana use may exacerbate IPV.
Adverse Childhood Experiences and Pathways to Violent Behavior for Women and Men
Authors: Burke Catherine , Ellis Jennifer D. , Peltier MacKenzie R. , Roberts Walter , Verplaetse Terril L. , Phillips Sarah , Moore Kelly E. , Marotta Phillip L. , McKee Sherry A.
Published: August 2022

Childhood maltreatment is associated with risk for committing future violence, but the relationship between subgroups and biological sex is unknown. The relationship between adverse childhood experiences (ACEs), violence, and sex was examined using a nationally representative sample. Results from a latent class analysis suggested a four-class model (low adversity; moderate maltreatment with high household dysfunction; severe maltreatment with moderate household dysfunction; severe multi-type adversities). When compared to low adversity, all typology groups were at significantly higher risk to engage in violence (odds ratio > 2.10, ps < .013). The data supported a linear trajectory, meaning increased childhood trauma was associated with increased risk for violence. Although men endorsed more violent behavior, the relationship between ACEs and violence was significantly stronger among women. Prior findings identify that women are more negatively impacted by ACEs and the current findings newly identify that this extends to violent crime.
Evaluating the Effects of Ertapenem and Meropenem on Tacrolimus
Authors: Elledge Samantha , Klindworth Kyle , Guy Jennifer , DeZotell Lindsey , Holmes Ashley K.
Published: August 2022

Purpose: Further elucidate the potential drug interaction between tacrolimus and carbapenems in order to appropriately maintain the balance between infection treatment and therapeutic immunosuppression. Methods: This study was a retrospective evaluation of solid organ transplant recipients on a stable dose of tacrolimus who received either ertapenem or meropenem. Patients were excluded if they had acute kidney injury, acute liver failure, concomitant initiation of medications that interact with tacrolimus, or were pregnant. The primary endpoint was the change in the median daily tacrolimus dose after meropenem or ertapenem administration. The secondary endpoint was the change in serum tacrolimus levels after meropenem or ertapenem administration. Results: A total of 28 patients on tacrolimus were included in the study, 12 received ertapenem and 16 received meropenem. The median daily tacrolimus dose was 4.5 mg [IQR 3.0 mg – 8.8 mg] prior to and 3.4 mg [IQR 2.3 mg – 8.8 mg] after ertapenem administration. The median daily tacrolimus dose was 3.0 mg [IQR 1.6 mg – 5.5 mg] before and 3.0 mg [IQR 1.6 mg – 5.5 mg] after meropenem administration. No statistically significant difference in regard to the change in the median daily tacrolimus dose after ertapenem ( P =.173) or meropenem administration ( P =.755) was observed. There was no statistically significant difference found after ertapenem ( P =.583) or meropenem ( P =.317) administration when comparing pre- and post-administration median serum tacrolimus levels. Conclusion: The administration of ertapenem or meropenem did not affect serum tacrolimus levels or daily tacrolimus dose suggesting against empiric dose adjustments with co-administration.
Optimal design of step stress accelerated degradation test with multistress considering stress weight
Authors: Zhao Hongxun , Yang Zhaojun , Chen Chuanhai , Li Shizheng , Ying Jun
Published: August 2022

This paper presents a new optimization criterion considering stress weight based on Ds-optimality to solve the low estimation accuracy problem of some stress model parameters when using the existing optimization design criteria to optimize the multistress accelerated degradation test scheme. First, the accelerated degradation model and constraints are determined by analyzing the test characteristics of step-stress accelerated degradation test (SSADT) with multistress. Then, the weight of each stress is identified by fault tree analysis and potential improvement value methods. Combined with the tabu search–particle swarm optimization (TS-PSO) algorithm, the SSADT with multiple stresses of the optimization design process is given. Finally, taking the SSADT with multistress optimization design of motorized spindle as an example, the practicability of the method is verified, and the optimization results are compared with those under D-optimality and Ds-optimality to validate the effectiveness of the method.
Interstitial lung disease detection using template matching combined sparse coding and blended multi class support vector machine
Authors: Helen Sulochana C , Praylin Selva Blessy SA
Published: August 2022

Interstitial lung disease (ILD), representing a collection of disorders, is considered to be the deadliest one, which increases the mortality rate of humans. In this paper, an automated scheme for detection and classification of ILD patterns is presented, which eliminates low inter-class feature variation and high intra-class feature variation in patterns, caused by translation and illumination effects. A novel and efficient feature extraction method named Template-Matching Combined Sparse Coding (TMCSC) is proposed, which extracts features invariant to translation and illumination effects, from defined regions of interest (ROI) within lung parenchyma. The translated image patch is compared with all possible templates of the image using template matching process. The corresponding sparse matrix for the set of translated image patches and their nearest template is obtained by minimizing the objective function of the similarity matrix of translated image patch and the template. A novel Blended-Multi Class Support Vector Machine (B-MCSVM) is designed for tackling high-intra class feature variation problems, which provides improved classification accuracy. Region of interests (ROIs) of five lung tissue patterns (healthy, emphysema, ground glass, micronodule, and fibrosis) selected from an internal multimedia database that contains high-resolution computed tomography (HRCT) image series are identified and utilized in this work. Performance of the proposed scheme outperforms most of the state-of-art multi-class classification algorithms.
Hypnosis, psychoanalysis, and Morita therapy: the evolution of Kokyō Nakamura’s psychotherapeutic theories and practices
Authors: Wu Yu-Chuan
Published: August 2022

Psychotherapy had developed into a dynamic and diverse field in pre-war Japan. Apart from thousands of spiritually oriented lay psychotherapists, there were a few quasi-professional practitioners who insisted on a rational approach and experimented with a variety of psychotherapeutic methods. Among them was Kokyō Nakamura, whose quest for a viable psychotherapeutic method is intriguing and illuminating. This paper examines the evolution of Nakamura’s theories and practices by dividing it into three stages: hypnotic suggestion, psychoanalysis, and Morita therapy. His pragmatic and adaptive approach to psychotherapy provides not only an interesting example for studying the spread of psychotherapy across nations and cultures, but also valuable clues to understanding its nature as a body of knowledge and therapeutic method.
The creation of Chinese personae in Steinbeck’s fiction
Authors: Zeng Shu
Published: August 2022

This article discusses Steinbeck’s linguistic creation of Chinese personae in his fiction, which develops from the early practice of using silence in ‘Johnny Bear’ (1938) to chronologically progressive engagement with Chinese Pidgin English (CPE) in Cannery Row (1945) and East of Eden (1952). This change is evident from the increase of CPE dialogues in his later works and best exemplified in the turn to taking non-standard English as a key concern by investing style-shifting with stylistic and thematic meaning in East of Eden. Silence and implicatures are strategically employed in ‘Johnny Bear’ to keep the narrative suspense and broach the antinarratable subject of interracial romance and illegitimate pregnancy so as not to offend the reader. Steinbeck’s later experimentation with CPE demonstrates conformity and discrepancy with sociolinguistic observations, whilst in his representation of CPE the author uses metalanguage to guide readers towards a better understanding of this language variety and a sympathetic interpretation of the Chinese characters. Existing alongside real sociolinguistic systems, the ficto-linguistic system in Steinbeck’s fiction subtly critiques the supposedly ‘correct’ language expected of ethnic groups and skilfully denounces discriminatory racial distinctions. The author’s incorporation of Chinese presence and CPE into his writings serves the grander scheme of scrutinizing American identity and society.
Minimum effective concentration of ropivacaine for ultrasound-guided adductor canal + IPACK block in total knee arthroplasty
Authors: Wang Qiuru , Hu Jian , Cai Lijun , Bahete Aergen , Yang Jing , Kang Pengde
Published: August 2022

Objective

This study aimed to investigate the minimum effective concentration (MEC90, defined as effective in 90% of patients) of ropivacaine during the combined procedure of adductor canal block (ACB) and infiltration between the popliteal artery and capsule of the posterior knee (IPACK) block for patients undergoing total knee arthroplasty.

Methods

This double-blind, randomized dose-finding trial was based on a biased coin up-and-down sequential design, where the concentration of ropivacaine administered to a given patient depended on the previous patient’s response. Before surgery, the first patient received 20 mL of 0.2% ropivacaine for ACB and again for IPACK. If the block failed, the next subject received a 0.025% higher ropivacaine concentration; otherwise, the next subject received either a 0.025% smaller dose (probability of 0.11) or the same dose (probability of 0.89). The primary outcome was whether the block was successful. Block success was defined as the patient did not suffer significant pain and did not receive rescue analgesia within 6 h after surgery. MEC90 was estimated by isotonic regression, and the 95% confidence interval (CI) was calculated by bootstrapping. Secondary outcomes were numerical rating scale (NRS) pain scores at postoperative 24 h and 48 h, postoperative morphine consumption, and time to hospital discharge. Secondary outcomes were compared between patients whose blocks succeeded with those which failed.

Results

Based on analysis of 52 patients, the MEC90 was 0.247% (95% CI 0.227–0.271%), MEC95 was 0.260% (95% CI 0.244–0.282%) and MEC99 was 0.272% (95% CI 0.260–0.291%). In contrast, four of nine trials in a recent systematic review reported ropivacaine concentrations below 0.247%. Patients whose blocks succeeded ( n = 45) had significantly lower NRS pain scores, lower morphine consumption, and shorter hospitalization than patients whose blocks failed ( n = 7).

Conclusions

Our small trial suggests that 0.247% ropivacaine in 20 mL respectively can provide successful ACB + IPACK block in 90% of patients. However, given that many published trials have used lower concentrations, our findings should be verified in larger studies.
Struggles in the accounting arena: A geopolitical reading of Romanian accounting reforms
Authors: Sandu Raluca , Zelinschi Dragos , Ferry Laurence
Published: August 2022

Transition economies have undertaken an accelerated series of reforms after the collapse of communism, aiming at the (re)construction of market institutions. In this paper we build on a geopolitical perspective, and on accounting profession literature to map the accounting reforms in post-communist Romania. We find that accounting reforms are reflecting broader processes of globalisation and Europeanization. By examining the ‘territorial’ disputes over the Romanian accounting reform and the successive leadership of groups of experts from France and United Kingdom we draw attention on the drivers of accounting reforms. These are not limited to the technical aspects of accounting and the interests of the actors, but have their roots embedded in the broader geopolitical setting. In the case of Romania, the European Union accession guides the path and pace of accounting reforms, having as general background the globalisation of accounting regulation.
‘Torn in two’: Experiences of Mothers Who Are Pregnant when Their Child Is Diagnosed With Cancer
Authors: Davies Jenny , O’Connor Moira , Halkett Georgia K. B. , Kelada Lauren , Bosco Anna Maria , Gottardo Nicholas G
Published: August 2022

Mothers of children diagnosed with cancer have been shown to experience high rates of psychological distress and poor physical health. Pregnancy further increases the healthcare needs of mothers due to the marked physiological changes and psychological adaptations. Our study aimed to explore the experiences of mothers who were pregnant and/or had a baby while their older child was receiving treatment for cancer. Our study employed a qualitative description methodology using semi-structured interviews. Participants were recruited from across Australia via notices on social media sites and the distribution of flyers. The sample comprised 13 mothers who were pregnant and/or had a baby and had a child diagnosed with cancer who was under 17 years old. Thematic analysis was used to analyse the data from which six themes were identified: (1) an impossible balancing act, (2) mother’s health and well-being, (3) creating certainty: birthing plans, (4) a bit of sunshine and a time to rest, (5) challenges of caring for the baby and (6) an unenviable position: doing my best versus feeling guilty. Our study demonstrates the additional challenges faced by mothers who are pregnant while their child is receiving cancer treatment. There is a need for a comprehensive and coordinated program that provides pregnant mothers with practical and psychological support. The implementation of such a program has the potential to improve health outcomes for all family members, particularly the mother and their newborn.
Optimizing Vocabulary Instruction for Preschool Children
Authors: Madsen Keri M. , Peters-Sanders Lindsey A. , Kelley Elizabeth Spencer , Barker R. Michael , Seven Yagmur , Olsen Wendy L. , Soto-Boykin Xigrid , Goldstein Howard
Published: August 2022

A cluster randomized design was used to investigate the effects of the Story Friends vocabulary curriculum on learning of 84 preschoolers in 24 classrooms who were at risk for language difficulties. Children in the treatment condition received explicit vocabulary instruction of 36 words during small-group storybook listening centers with extended practice opportunities in the classroom and at home. Children in the comparison condition were exposed to the same words in stories without explicit instruction or extended practice. Children ( n = 16) with average or above language skills from six treatment classrooms were included to examine the impact of extended practice. Children at risk in treatment classrooms learned significantly more words (52%) than children at risk in comparison classrooms (12%). Children not at risk learned vocabulary equal to children at risk. A tiered approach to implementing Story Friends appears feasible for enhancing the vocabulary learning of preschoolers with and without language delays.
School Nurse Management of Behavioral Health, Violence, and Trauma-Related Emergencies: Findings from a Statewide Survey
Authors: Shattuck Daniel , Sebastian Rachel , Zamarin Kim , Acosta Susan , Ramos Mary M.
Published: August 2022

School nurses are critical components of school-based interdisciplinary teams supporting student behavioral health. The purpose of the present study is to understand the extent to which school nurses in New Mexico across grade levels manage emergencies related to behavioral health, violence, and trauma. The study also seeks to identify which topics the school nurses received continuing education (CE) for, and which topics they consider to be important to their practice. Analyses of 2019 statewide survey data show a considerable number of school nurses in New Mexico provide management for behavioral health, violence, and trauma-related emergencies, and nurses in secondary schools are significantly more likely than nurses in primary schools to report managing these emergencies and to have received CE on behavioral health topics. Our findings reaffirm the essential role of school nurses in addressing emergent student health issues and underscore the need for practice- and competency-based behavioral health CE opportunities.
Philosophies of Surgical Care Are Embedded in Outcome Studies: An Illustrative Reanalysis of the Cartiva MOTION Trial
Authors: Guyton Gregory P.
Published: August 2022

Background:

Subjective assumptions on the definition of surgical success are inherent to the design of clinical trials with a categorial outcome. The current study used reasonable alternative assumptions about surgical care to reassess data for the randomized controlled Cartiva trial (MOTION).

Methods:

Data from the published study were augmented by publicly accessible internal US Food and Drug Administration documents. As in the published report, 1-sided lower bound 95% CIs (LBCI95) for the difference of proportions were calculated for a series of alternative scenarios in which the assumptions underlying what constitutes surgical success were altered.

Results:

Using a noninferiority margin of −15%, the MOTION trial reported success based on a 1-sided LBCI95 of −10.9%. Each of the 3 independent alternative scenarios analyzed yielded results that altered the primary outcome of the trial: (1) eliminating failures based solely upon radiographs findings, thereby considering a painless pseudarthrosis as a success (1-sided LBCI95 of −15.9%), (2) considering only major surgical revision as a failure and discounting isolated hardware removal (1-sided LBCI95 of −15.1%), and (3) using a visual analog scale (VAS) pain threshold of <30 as the success criterion rather than a 30% reduction in VAS pain score (1-sided LBCI95 of −15.8%).

Conclusion:

In this reanalysis, applying any of 3 reasonable alternative assumptions about the definition of surgical success to the data resulted in failure to prove noninferiority of Cartiva over arthrodesis, a reversal of the reported trial result. These results highlight the effect of subjective assumptions in the design of clinical trials with a categorical outcome and illustrate how differing philosophies about what constitutes surgical success can be pivotal in determining the final result.

Level of Evidence:

Level II, prospective comparative study.
Systematic review of interventions addressing suicide among Indigenous adults and reporting Indigenous-specific content and involvement in the interventions
Authors: Moses Catherine , Brown Hilary K , Prabhakar Priya , Eltayeb Nadine , Benoit Anita C
Published: August 2022

Indigenous peoples experience high rates of suicide from historical and ongoing colonization. This systematic review examines the effectiveness, involvement of Indigenous peoples, and cultural content of interventions addressing suicide among Indigenous adults in Canada, the United States, New Zealand, and Australia. Through a systematic search of scholarly articles and grey literature, 10 articles met the inclusion criteria. In nine studies, Indigenous people made decisions at the study design level and implemented and delivered research activities, and eight studies included cultural content. There were statistically significant reductions in suicide outcomes in four studies, and in self-harm and hopelessness in two studies each. Study quality was largely weak ( n = 9) or moderate ( n = 1). There is a paucity of high-quality data on interventions addressing suicide among Indigenous adults and strengthened reporting of health research involving Indigenous peoples in interventions.
Associations Between Covid-19-Related Threat, Stress, and Smoking in UK Adults Aged Under- and Over-30
Authors: Walker Lucy , Cordero Maria I. , McChesney Gillian , Gee Ivan , Grogan Sarah
Published: August 2022

It has been suggested that smoking and age are associated with higher vulnerability to Covid-19. While threat of Covid-19 may reduce or stop smoking, increased stress due to lockdown could increase smoking behaviour. This study aimed to investigate changes in smoking behaviour in relation to age, Covid-19-related threat and subjective perceived stress during the UK lockdown. A cross-sectional study was performed. Online adverts were used to recruit UK residents who smoked combustible tobacco any time from January 2020. A questionnaire measured demographic information, smoking behaviour pre- and during-lockdown, perceived subjective stress (PSS), and Covid-19 related threat. Data were collected from a total of 145 participants (58% women, 39% men, 3% non-binary; mean age: 26 years, SD = 7.7), during UK lockdown between 22nd May and 22nd June 2020. Independent of stress and Covid-19-related threat, smoking was reduced in those aged less than 30 years. In participants aged 30 and above, increases in smoking behaviour were associated with higher PSS. The results highlight the relevance of the different stages of life on the relationship between stress, threat, and smoking behaviour. Greater emphasis should be placed on stress reduction for adult smokers aged 30 and above to enable smoking cessation.
General practice managers’ motivations for skill mix change in primary care: Results from a cross-sectional survey in England
Authors: Gibson Jon , McBride Anne , Checkland Katherine , Goff Mhorag , Hann Mark , Hodgson Damian , McDermott Imelda , Sutton Matt , Spooner Sharon
Published: August 2022

Objectives

The objectives are to determine the factors that motivated GP practice managers in England to employ non-medical roles, and to identify an ideal hypothetical GP practice workforce.

Methods

Cross-sectional survey of GP practice managers in England ( n = 1205). The survey focused on six non-medical roles: advanced nurse practitioner, specialist nurse, health care assistant, physician associate, paramedic and pharmacist.

Results

The three most commonly selected motivating factors were: (i) to achieve a better match between what patients need and what the practitioner team can deliver; (ii) to increase overall appointment availability and (iii) to release GP time. Employment of pharmacists and physician associates was most commonly supported by additional funding. Practice managers preferred accessing new non-medical roles through a primary care network or similar, while there was a clear preference for direct employment of additional GPs, advanced nurse practitioners or practice nurses. The ideal practice workforce would comprise over 70% of GPs and nurses, containing, on average, fewer GPs than the current GP practice workforce.

Conclusion

This study confirms that more diverse teams of practitioners are playing an increasing role in providing primary care in England. Managers prefer not to employ all new roles directly within the practice. A more detailed investigation of future workforce requirements is necessary to ensure that health policy supports the funding (whether practice or population based), recruitment, training, deployment and workloads associated with the mix of roles needed in an effective primary care workforce.
Narrative therapy approaches to team away days: Creating communities
Authors: McParland James , Flannery Halina , Casdagli Lucy , Portnoy Sara
Published: August 2022

‘Away Days’ in the National Health Service are a protected time away from usual tasks where a team comes together. They can have different intentions, including connecting team members and establishing team bonds. This paper describes using a Narrative Therapy approach called “The Journey of Life” to run away days. It involves thinking about the journey a team has been on and what has helped them along the way. It invites a team to think about their future directions and how they use skills they have learned when they face obstacles in the road ahead. The importance of preparing for away days, including establishing intentions, creating a feeling of safety and thinking about the role and positioning we adopt as team members ourselves is highlighted. We also outline the benefits we have observed, including a sense of community emerging through the process.
Non-affective psychosis in traditional Andean culture
Authors: Uscamayta Ayvar Marucela , Garrafa Rodolfo Sanchez , Escobar Javier I. , Gallo Carla , Vaisberg Abraham , Poletti Giovanni , de Erausquin Gabriel A.
Published: August 2022

We report a case of non-affective psychosis with a brief discussion of the phenomenology and its characterization and treatment by traditional Inka healers and eventually by Western-trained psychiatrists. Traditional Inka psychopathology provided empirical support for the transcultural stability of the Kraepelinian dichotomy.
Perspectives of children with physical disabilities, parents and physiotherapists on use of walkers and their potential to increase physical activity. A qualitative exploration
Authors: Bradbury Marilyn , Tierney Stephanie
Published: August 2022

Children with physical disabilities are less physically active than children with typical development. How children’s experiences of using walkers relates to their physical activity has not been studied previously. This study aimed to explore perspectives of walker use and their potential to increase physical activity. Four focus groups were conducted with children aged 7–10 ( n = 3; 12.5%), aged 9–12 ( n = 4; 16.7%), parents ( n = 7; 29.2%) and paediatric physiotherapists ( n = 10; 41.7%). Groups were audio recorded and transcribed. Data were analysed using framework analysis. An overarching concept of walkers needing flexibility to accommodate individual, interpersonal and environmental variability was underpinned by three themes: (a) contrasting drivers for use/non-use of walkers, (b) trade-offs, (c) acceptance of technology within walkers to increase physical activity. Participants were motivated by differing drivers: social for children, emotional for parents and professional for physiotherapists. These contrasting drivers create trade-offs, for example between quality of movement and independence. To maximise physical activity, walker prescribers and designers should prioritise drivers that motivate children and parents, ensuring goal setting is family-centred and participation orientated. Involving families in co-designing walkers is therefore important. Individual clinical assessment allows for identification of children’s specific needs and how a child’s, parent’s and physiotherapist’s goals may differ.
Online health management continuance and the moderating effect of service type and age difference: A meta-analysis
Authors: Shen Yucong , Xu Wenxian , Liang Andong , Wang Xinlu , Lu Xueqin , Lu Zhongqiu , Gao Chenchen
Published: August 2022

Numerous empirical studies have been carried out to explore factors of online health management continuance. However, results were not unified. We thus conducted a meta-analysis to identify influential factors and potential moderators. A systematic literature search was performed in nine databases (PubMed, Web of Science, the Cochrane Library, Ovid of JBI, CINAHL, Embase, CNKI, VIP, and CBM) published up to December 2020 in the English or Chinese language. Meta-analysis of combined effect size, heterogeneity, moderator analysis, publication bias assessment, and inter-rater reliability was conducted. Totally 41 studies and 12 pairwise relationships were identified. Confirmation, perceived usefulness, satisfaction, information quality, service quality, perceived ease of use, and trust were all critical predictors. Service type and age difference showed their moderating effects respectively. The perceived usefulness was more noteworthy in medical service than health and fitness service. The trust was more noteworthy in young adults. The results confirmed the validity and robustness of the Expectation Confirmation Model, Information Systems Success Model, and trust theory in online health management continuance. Moderators included but are not limited to age difference and service type. The elderly research in the healthcare context and other analytical methods such as qualitative comparative analysis should be applied in the future.
Local is now national: The Athletic as a model for online local news
Authors: Ferrucci Patrick , Perreault Gregory
Published: August 2022

Through the lens of disruptive innovation, the present study explores a potential model for local journalism—one that has proven particularly successful for sports journalism in The Athletic. The present study reports on in-depth interviews with Athletic employees across all facets of the organization ( n = 49), and argues that the key to The Athletic’s success is reflected in its emphasis on implementing a national infrastructure for local reporting, and employing journalists already embedded in local communities. The article concludes with a rudimentary rendering of how this model could be implemented for local news.
Social media and Internet-based communication in military families during separation: An international scoping review
Authors: Wood Abigail , Gray Leanne , Bowser-Angermann Joanne , Gibson Poppy , Fossey Matt , Godier-McBard Lauren
Published: August 2022

The last decade has seen the growth of social media and Internet-based communication. Recent research highlighted the need for exploration of the use of social media by military families due to the significant period of separation that they experience. On this basis, an international scoping review was undertaken to explore how military families use Internet-based communication and social media to communicate with their serving members and what the impact of this is. The review showed a paucity of research focused specifically on the use of social media by Service families. Overall, papers returned showed that social media and Internet-based communication has distinct benefits for military families, fostering connectedness, increasing potential communication, enabling Serving parents to be more involved and better accommodate their family’s routine, and potentially improving the deployment experience. However, unique practical barriers were also identified, alongside the potential exacerbation challenges associated with traditional forms of communication.
Care-full pedagogy: Conceptualizing feminist care ethics as an overarching critical framework to interrupt the dominance of developmentalism within post-secondary early childhood education programs
Authors: Richardson Brooke , Langford Rachel
Published: August 2022

This article offers a theoretical provocation through conceptualizing a pedagogy of care as a means of caring with students and each other to interrupt the dominance of developmentalism in Canadian post-secondary early childhood education programs. The authors’ conceptualization of care -full as pedagogy is rooted in the premises that education is always ethical and political, and caring about, for and with others is necessary to establish equitable, democratic spaces at the post-secondary level. In contrast to the developmental framework embraced in many Canadian post-secondary early childhood education programs, the authors describe how a critical, care -full overarching pedagogical framework provides room for educators and students to deeply and meaningfully explore developmentalism and other theoretical frameworks. They argue that a pedagogy of care rooted in feminist care ethics and Freire's critical theory can contribute to establishing a safe learning climate where developmentalism can be critiqued and alternative ways to think about children's development can be contested, explored and debated. As the authors are conceptualizing it, a care-full pedagogical framework intentionally supports the intellectual, ethical and political risk-taking necessary for critique and alternative thinking. They follow this provocation through by imagining what a care -full pedagogy might look and feel like in a post-secondary early childhood education course on child development.
Beyond Big Brother: How to Study Tech-Driven Authoritarianism With Restricted Access to State Institutions
Authors: Hou Rui
Published: August 2022

With the tremendous advancements in Internet, big data analytics, and artificial intelligence, the power and potential of digital technologies has a special appeal to political rulers. How can qualitative researchers explore tech-driven authoritarianism when they have limited access to state institutions? This article addresses this question by arguing for a wider and more nuanced understanding of tech-driven authoritarianism as a state-market complex mediating the political application of digital technologies. Based on my own research on China’s Internet surveillance, I find that the engagement of the private sector, especially technology companies, in authoritarian control creates new opportunities for qualitative researchers to study state power in non-state fields. By reflecting on my experience of field-site choice, gaining access, and informant recruitment, I discuss how thorough preparation in both theory and fieldwork approaches help qualitative investigators develop creative ways of collecting information on tech-driven authoritarianism.