bluuebunny/crossref_metadata_2025 huggingface dataset:
Competing with Urban Verticality: Cinematic Landscapes in Seediq Bale and Beyond Beauty: Taiwan from Above
Authors: Hsiung Yuwen
Published: March 2021

While buildings strive to reach higher and higher, cities are obsessed with a visible expression of verticality. Seediq Bale (2011) and Beyond Beauty: Taiwan from Above (2013) represent a new development in Taiwan’s cinematic use of landscape that challenges the dominance of urban verticalism. Seediq Bale sets up an alternative vertical dimension of mountainous areas that puts into dialogical relationship the dichotomies of civilised/barbarous, advanced/primitive, and vertical/horizontal. Audiences no longer experience space in a traditional manner, as eventually Mona Rudao’s graveyard is undiscovered/undefined. Beyond Beauty, on the other, asks viewers to ‘go higher’, encouraging a break with ordinary experience for a more spiritual quest like aerial shots. As both offer a sense of disorientation and alienation, what does the spatial metaphor address to aesthetics, ecocriticism, politics of identity, and sovereignty in geography? What are the implications as cinematic landscapes extend into a real-life environment that is ready to be consumed?
Anemia Is Associated With Poor Clinical Outcomes in Hospitalized Patients With Takotsubo Cardiomyopathy
Authors: Lu Xiaojia , Li Pengyang , Teng Catherine , Cai Peng , Wang Bin
Published: March 2021

The association between anemia and Takotsubo cardiomyopathy (TCM) has not been well studied. To assess the effect of anemia on patients hospitalized with TCM, we identified 4733 patients with a primary diagnosis of TCM from the 2016 to 2018 National Inpatient Sample (NIS) database (the United States) using the International Classification of Diseases, 10th edition, Clinical Modification ( ICD-10-CM) code. Of these, 603 (12.7%) patients had a comorbidity of anemia and 4130 did not. After propensity score matching, we compared the in-hospital outcomes between the 2 groups (anemia vs nonanemia, n = 594 vs 1137). Patients with TCM with anemia had significantly higher rates of in-hospital complications, including cardiogenic shock (11.4% vs 4.0%, P < .001), ventricular arrhythmia (6.6% vs 3.6%, P = .008), acute kidney injury (22.7% vs 13.1%, P < .001), acute respiratory failure (22.6% vs 13.1%, P < .001), longer length of hospital stay (5.6 ± 5.8 days vs 3.6 ± 3.6 days, P < .001), and higher total charges (US$79 586 ± 10 2436 vs US$50 711 ± 42 639, P < .001). In conclusion, patients with anemia who were admitted for TCM were associated with a higher incidence of in-hospital complications compared with those without anemia.
Robustness of Latent Profile Analysis to Measurement Noninvariance Between Profiles
Authors: Wang Yan , Kim Eunsook , Yi Zhiyao
Published: March 2021

Latent profile analysis (LPA) identifies heterogeneous subgroups based on continuous indicators that represent different dimensions. It is a common practice to measure each dimension using items, create composite or factor scores for each dimension, and use these scores as indicators of profiles in LPA. In this case, measurement models for dimensions are not included and potential noninvariance across latent profiles is not modeled in LPA. This simulation study examined the robustness of LPA in terms of class enumeration and parameter recovery when the noninvariance was unmodeled by using composite or factor scores as profile indicators. Results showed that correct class enumeration rates of LPA were relatively high with small degree of noninvariance, large class separation, large sample size, and equal proportions. Severe bias in profile indicator mean difference was observed with intercept and loading noninvariance, respectively. Implications for applied researchers are discussed.
Physical activity counselling among junior doctors in the UK: A qualitative study
Authors: Osinaike Jimisayo , Hartley Sandra Elaine
Published: March 2021

Background:

Evidence supporting physical activity (PA) as an effective modality in the prevention and management of non-communicable diseases is robust. Medical doctors are ideally placed to translate this into practice; however, realising this has proved challenging. To ensure doctors are well prepared, the training of medical students to be proficient in PA counselling seems essential. This study aimed to explore the PA counselling practice of junior doctors, to gain insight into how undergraduate training might influence their future practice.

Methods:

Interviews were conducted with 11 junior doctors recruited by purposive sampling from across seven different medical schools. All junior doctors were currently undertaking their post-graduate training in North-West England. Interviews were digitally recorded, transcribed verbatim and analysed using thematic analysis.

Results:

Themes developed from the data were PA attitudes and practices, and barriers and facilitators to PA counselling in clinical practice.

Conclusion:

The PA counselling practice of junior doctors was found to be inadequate, and attitudes towards PA promotion were particularly discouraging while in the hospital setting. Lack of training in PA counselling at both the undergraduate and postgraduate level and lack of support from consultants were major hindrances. However, unexplored opportunities exist for junior doctors to incorporate PA counselling into primary and secondary care and thus transform the practice of the next generation of doctors.
Externalizing Faith: Countering Individualism Through an Embodied Emphasis
Authors: Aždajić Dejan
Published: March 2021

While the importance of an embodied theology has been recognized, in light of recent literature that sees a growing modern-day shift from emancipated individuality to ideological individualism, the aim of this article is to deepen the theological reflection on the urgent need for a more intentional embodied emphasis. This strategic approach is particularly significant, since in spite of the current challenge there remains a tendency toward a disembodied, anti-liturgical orientation that prioritizes words and cognition, locating theological truth on the inside of the autonomous individual thinking subject, who remains free to either accept or reject its propositional content. Drawing from relevant literature that provides a conceptual framework, this article argues that especially in today’s context, an overt emphasis on the externalization of faith and the embodiment of theological normatives performed together in community offers more promising pedagogical effectiveness. A bodily focus is principally important since it provides an experiential platform for the communal enactment and consequent appropriation of religious knowledge, thus potentially circumventing the present challenge of increasingly rigid individualism.
What Do We Mean By a “Hard-to-reach” Population? Legitimacy Versus Precarity as Barriers to Access
Authors: Ellis Rachel
Published: March 2021

Numerous articles and textbooks advise qualitative researchers on accessing “hard-to-reach” or “hidden” populations. In this article, I compare two studies that I conducted with justice-involved women in the United States: a yearlong ethnography inside a state women’s prison and an interview study with formerly incarcerated women. Although these two populations are interconnected—and both are widely deemed hard-to-reach—the barriers to access differed. In the prison study, hard-to-reach reflected an issue of institutional legitimacy, in which researchers must demonstrate themselves and their proposed study as legible, appropriate, and worthy to organizational gatekeepers. In the reentry study, hard-to-reach reflected an issue of structural precarity, in which researchers must navigate the everyday vulnerabilities of research participants’ social position to ensure the study is inclusive and feasible. Juxtaposing these two experiences, I propose greater nuance to the term hard-to-reach such that researchers may proactively address institutional and structural barriers to access.
The Double Darkness of Digitalization: Shaping Digital-ready Legislation to Reshape the Conditions for Public-sector Digitalization
Authors: Plesner Ursula , Justesen Lise
Published: March 2021

In recent years, policymakers have begun to problematize how legislation stands in the way of the digitalization of the public sector. We are witnessing the emergence of a new phenomenon, digital-ready legislation, which implies that, whenever possible, new legislation should build on simple rules and unambiguous terminology to reduce the need for professional (human) discretion and allow for the extended use of automated case processing in public-sector organizations. Digital-ready legislation has potentially wide-ranging consequences because it creates the conditions for how public organizations are digitalized. The processes, practices, choices, and responsibilities for drafting digital-ready legislation, however, are not well-described or debated. Digital-ready legislation is a dormant issue. This paper develops the notion of the “double darkness” of digitalization to account for this. Based on a qualitative study, the paper investigates how digital-ready legislation as a sociotechnical arrangement is shaped by policy tools and by a complex, collaborative process where responsibility for legislation is fragmented. It argues that although the policy tools are aimed at making actors responsible for digitalization and creating clarity about the process, actors seem to be reluctant to take on the responsibility for making political decisions related to digitalization.
Examining the language of solitude versus loneliness in tweets
Authors: Hipson Will E. , Kiritchenko Svetlana , Mohammad Saif M. , Coplan Robert J.
Published: March 2021

People have widely different experiences of being alone. Sometimes being alone is relaxing and restorative other times it gives way to feelings of loneliness. Researchers conceptually distinguish between solitude, which tends to be viewed more positively, and loneliness, which is more negative. However, it is unclear whether these terms are used differently in everyday language. We sought to compare the emotional content of over 19 million tweets containing the terms solitude and lonely/loneliness. Using a computational linguistics approach, we found that solitude tends to be used in more positive and less emotionally activated (i.e., lower arousal) contexts compared to lonely. We also found that the word alone tends to be used somewhat differently from solitude and lonely. These results have implications both for how we understand different experiences of time alone in general and for what kind of language we should use when discussing these experiences.
Investigating the effectiveness of parent-implemented shared book reading intervention for preschoolers with ASD
Authors: Westerveld Marleen F. , Wicks Rachelle , Paynter Jessica
Published: March 2021

Children diagnosed with autism spectrum disorder (ASD) are at increased risk of persistent language and literacy difficulties. This study investigated the effectiveness of an 8-week parent-implemented shared book reading intervention designed to change parent and child book reading behaviours. Sixteen parents and their preschoolers on the autism spectrum participated. Nine parents were randomly allocated to receive the shared book reading intervention first. The intervention used a coaching model and comprised a training session, four home visits, and four follow-up phone calls. Parents completed a shared book reading video with their child prior to the intervention, immediately post-intervention and eight weeks after the intervention was completed. Following intervention, there was a significant increase in the intervention group parents’ use of book-related vocabulary and their explicit teaching of story structure, compared to the waitlist control group. Compared to the control group, there was a significant increase in children’s verbal participation (number of utterances and number of different words). However, these effects disappeared when the significant increase in reading duration following the intervention was taken into account. All improvements were maintained over time. Our results highlight the feasibility of a parent-implemented shared book reading intervention for encouraging early language skills in children on the spectrum in a naturalistic setting that is part of many family routines.
Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors – the randomized phase II Motivate AYA – MAYA trial
Authors: Salchow Jannike , Koch Barbara , Mann Julia , von Grundherr Julia , Elmers Simon , Dwinger Sarah , Escherich Gabriele , Vettorazzi Eik , Reer Rüdiger , Sinn Marianne , Baumann Freerk , Bokemeyer Carsten , Stein Alexander , Jensen Wiebke
Published: March 2021

Objective:

To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors.

Design:

Randomized controlled phase II trial.

Setting:

University Cancer Center Hamburg, Germany.

Subjects:

Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control ( n = 44) or intervention group ( n = 45).

Interventions:

The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0).

Main measures:

The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up).

Results:

Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly ( P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0).

Conclusions:

A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.
The ideal victim: A critical race theory (CRT) approach
Authors: Long Lisa J
Published: March 2021

Using a critical race theory (CRT) framework, this paper analyses Black and Black mixed- race people’s experiences of reporting crime. It is based on qualitative interviews with 20 participants. The analysis finds that the process of becoming the (un)victim is mediated through the intersection of race with gender and masculinity, class and migrant status. Ultimately, Black and Black mixed-race men are the ‘ideal offender’ rather than the ‘ideal victim’ (Christie, 1986). The research finds that the (un)victim experiences racial re-victimization and develops an altered perception of the police as a trusted body. The racialized affect of being the (un)victim is greater than the effects of minor crime on the victim. The challenges that this poses to the relationship between Black communities and the police are explored and the implications for future practice discussed.
The role of perioperative intravenous low-dose dexamethasone in rapid recovery after total knee arthroplasty: a meta-analysis
Authors: Zhuo Youguang , Yu Rongguo , Wu Chunling , Huang Yuting , Ye Jie , Zhang Yiyuan
Published: March 2021

Purpose

The purpose of this meta-analysis was to evaluate the overall safety and effectiveness of perioperative intravenous dexamethasone to facilitate postoperative rehabilitation in patients after total knee arthroplasty (TKA).

Methods

A comprehensive literature search was performed using the Embase, PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases for relevant randomized controlled trials (RCTs) from inception to 2020. Methodological quality of the trials was assessed using the Cochrane Risk of Bias Tool, and the relevant data were extracted using a predefined data extraction form.

Results

Ten RCTs with 1100 knees were included. Our study showed a significant reduction in pain using a postoperative pain visual analog scale (VAS) at 24 hours and 48 hours, total opioid consumption at 24 hours and 48 hours, postoperative nausea and vomiting (PONV), active range of motion (ROM) limitation, and passive ROM limitation at 72 hours in dexamethasone-treated groups compared with controls.

Conclusion

Intravenous low-dose dexamethasone is potentially useful in the perioperative setting for reducing postsurgical immediate ROM limitations, pain, opioid consumption, and PONV. There are no data that directly attribute an increase in postoperative complications to intravenous dexamethasone. More high-quality studies are necessary to draw these conclusions.
Review on Canine Oral Melanoma: An Undervalued Authentic Genetic Model of Human Oral Melanoma?
Authors: Palma Stefano Di , McConnell Ashleigh , Verganti Sara , Starkey Mike
Published: March 2021

Oral melanoma (OM) is a highly aggressive tumor of the oral cavity in humans and dogs. Here we review the phenotypic similarities between the disease in these 2 species as the basis for the view that canine OM is a good model for the corresponding human disease. Utility of the “canine model” has likely been hindered by a paucity of information about the extent of the molecular genetic similarities between human and canine OMs. Current knowledge of the somatic alterations that underpin human tumorigenesis and metastatic progression is relatively limited, primarily due to the rarity of the disease in humans and consequent lack of opportunity for large-scale molecular analysis. The molecular genetic comparisons between human and canine OMs that have been completed indicate some overlap between the somatic mutation profiles of canine OMs and a subset of human OMs. However, further comparative studies featuring, in particular, larger numbers of human OMs are required to provide substantive evidence that canine OMs share mechanisms of tumorigenesis with at least a subset of human OMs. Future molecular genetic investigations of both human and canine OMs should investigate how primary tumors develop a metastatic gene expression signature and the genetic and epigenetic alterations specific to metastatic sites. Such studies may identify genetic alterations and pathways specific to the metastatic disease which could be targetable by new drugs.
Are you listening? Echoing the voices of looked after children about their transition to secondary school
Authors: Francis Yvonne J , Rowland Laura , Humrich Sarah , Taylor Sally
Published: March 2021

Transition to secondary school is a significant childhood event, especially for the most vulnerable children. Many looked after children experience multiple episodes of instability, loss and change which can affect this move. Research shows that school belonging promotes acceptance, inclusion and respect, and impacts positively on school transfer and participation. Asking children for their views on matters that affect them can ease the process and increase their belonging and well-being. This article seeks to echo the voices of 36 children aged 10 to 12 who participated in a therapeutic primary to secondary transition initiative for looked after children. Informed by a participatory action research approach, its focus was to facilitate the child’s voice. Child-friendly, multi-method techniques and activities were used to elicit their views about the transition. Social connections, relationships, feeling safe and belonging within the school environment emerged as key themes. Children specifically highlighted the importance of friendships as a mechanism for supporting their belonging during this time. They also voiced the need for their social connections and belonging to be promoted. This unique intervention provides a framework for facilitating the voices of looked after children and underlines the need for practitioners to listen and understand moves from primary to secondary schools from the child’s perspective.
Sediment yield over glacial cycles: A conceptual model
Authors: Antoniazza Gilles , Lane Stuart N
Published: March 2021

The temporal variability in sediment export yield from glaciers over a timescale of multiple glacial cycles (e.g. 1 × 102 − 1 × 106 years) is of interest for a wide range of applications in glaciology, sedimentology, geomorphology, climatology and environmental engineering. However, the time required for the products of glacial erosion to be transferred through glaciated catchments and the extent to which glacially-conditioned sediment can be transiently stored within them are still poorly constrained and a matter of debate within the community. We propose a conceptual model of the variability in sediment exported from glaciers over multiple glacial cycles based on a literature review. Sediment yield is likely to be highly variable through a glacial cycle, notably between phases of glacier advance, retreat and re-advance due to changes in ice velocity and erosion rates, ice and meltwater transport capacity, and in glacially-conditioned sediment accessibility at the bed. Typically, early phases of glacier retreat and re-advance are expected to lead to the highest increase in sediment yield due to the ease with which the products of bedrock erosion can be accessed and reworked. In contrast, later phases of glacial (re)advance, once glacially-conditioned sedimentary sources become exhausted, may be characterized by intermediate rates of sediment export yield maintained through bedrock erosion. The latest phases of deglaciation, once glacially-conditioned sedimentary sources are either exhausted, stabilized or disconnected from active processes of sediment transfer, are likely to have the lowest rate of export. The conceptual model proposed in this paper fills a gap in the literature by developing a continuous pattern of sediment yield rate variability over the course of multiple glacial cycles, with wider implications for future research. However, its systematic applicability to various glacier settings and glaciations needs more field and modeling data to validate it.
Mainstreaming natural flood management: A proposed research framework derived from a critical evaluation of current knowledge
Authors: Ellis Nicola , Anderson Karen , Brazier Richard
Published: March 2021

Natural flood management (NFM), or working with natural processes, is a growing flood risk management method in the UK, Europe and worldwide. However, unlike the current dominant technical flood management, it lacks an established evidence base of flood risk parameters. This lack of evidence base can limit the uptake of NFM as a flood management method. This paper critically evaluates examples of NFM and wider relevant literature in order to identify NFM knowledge gaps and suggest how to overcome these. The UK is used as a microcosm of different environments for diverse examples. The sections include: land cover, land management, landscape interactions and trade-offs, evaluating the wider benefits of NFM and, finally, scaling from plot to catchment. This concludes in a suggested framework for a new approach to NFM research, which encompasses spatial scales, interactions and trade-offs of NFM and consistency of reporting results. Widening the NFM empirical evidence base should be seen as an opportunity for a new approach to flood research through exploring new habitats and new flood resilience methods.
Critical Station Practical Capacity on a Bus Rapid Transit Line with Nonstopping Buses
Authors: Bunker Jonathan M. , Hisham Faheema
Published: March 2021

Bus rapid transit (BRT) can offer transit mobility to meet growing travel demands by cost-effectively providing high capacity and quality of service. It is adaptable to a wide range of operating conditions and technological advancements. Stations are elements that typically control BRT line capacity, so it is essential to understand the operation of any potentially critical station to understand and manage the facility. The Transit Capacity and Quality of Service Manual (TCQSM) provides the standard methodology for capacity estimation. However, that model does not account for important operational aspects including the stochastic nature of many parameters beyond dwell time, along with nonstopping buses’ capacity, the degrees of saturation of the stopping and nonstopping bus streams, and the upstream average waiting time and queue length of stopping buses. We adapted the theory developed by Hisham et al. for an onstreet bus stop, to reflect the operational conditions of a BRT station and to account for these aspects. This new reliability-based capacity model tailored to BRT facilities provided superior insight into station bus capacity and quality of service to the TCQSM model.
Swimming in the waters of a sinking National Health Service (NHS): A group analytic perspective
Authors: Malda-Castillo Javier , Anderson Daniel
Published: March 2021

This article examines the psychological effects of the reorganization of the NHS. Through a combination of theoretical and clinical perspectives, the authors describe the psychological effects of the neoliberal and privatizing policies that have changed the landmark of the NHS in England. The article uses Foulkes’ main theoretical viewpoints as well as some Bionian ideas in an attempt to illustrate the losses, challenges, tensions and opportunities that the NHS has experienced in the face of change and pressure. The ultimate aim is to describe how group analytic theory and technique could aid understanding of, and thereby alleviate, some of the pain that the organization has endured through this process.
What Is in a Plan? Using Natural Language Processing to Read 461 California City General Plans
Authors: Brinkley Catherine , Stahmer Carl
Published: March 2021

Land-use control is local and highly varied. State agencies struggle to assess plan contents. Similarly, advocacy groups and planning researchers wrestle with the length of planning documents and ability to compare across plans. The goal of this research is to (1) introduce Natural Language Processing techniques that can automate qualitative coding in planning research and (2) provide policy-relevant exploratory findings. We assembled a database of 461 California city-level General Plans, extracted the text, and used topic modeling to identify areas of emphasis (clusters of co-occurring words). We find that California city general plans address more than sixty topics, including greenhouse gas mitigation and Climate Action Planning. Through spatializing results, we find that a quarter of the topics in plans are regionally specific. We also quantify the rift and convergence of planning topics. The topics focused on housing have very little overlap with other planning topics. This is likely a factor of state requirements to update and evolve the Housing Elements every five years, but not other aspects of General Plans. This finding has policy implications as housing topics evolve away from other emphasis areas such as transportation and economic development. Furthermore, the topic modeling approach reveals that many cities have had a focus on environmental justice through Health and Wellness Elements well before the state mandate in 2019. Our searchable state-level database of general plans is the first for California—and nationally. We provide a model for others that wish to comprehensively assess and compare plan contents using machine learning.
The Role of Obesity in Motor Vehicle Injuries and Fatalities in the Pediatric Population: A Systematic Review
Authors: Alattar Zana , Hoebee Shelby , Ron Eyal , Kang Paul , vanSonnenberg Eric
Published: March 2021

Purpose:

A systematic review done to evaluate obesity as a risk factor for injuries and mortality in motor vehicle accidents (MVAs) in the pediatric population, as there has not been a systematic review done in over 10 years. This study aims to update the literature regarding obesity as a risk factor for injuries in MVAs in the pediatric population.

Materials and Methods:

A systematic review was conducted according to the PRISMA guidelines with strict inclusion and exclusion criteria, resulting in the use of 3 total articles to analyze obesity as a risk factor for overall injury and mortality in the pediatric population.

Results:

Zaveri et al demonstrated a statistically significant, but weak, decrease in the odds of extremity injury in overweight patients ages 2 to 17 years old (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.4-1.0, P ≤ 0.05). On the other hand, Pollack et al and Haricharan et al found an increase in extremity injury in the obese population, in ages 9 to 15 years (OR = 2.54, 95% CI = 1.15-5.59, P ≤ 0.05), and 10 to 17 years (Age 10-13: OR = 6.06, 95% CI = 2.23-16.44, P ≤ 0.05, Age 14-17 OR = 1.44, 95% CI = 1.04-2.00, P ≤ 0.05), respectively. Haricharan et al also found an increase in thoracic injuries in obese children, ages 2 to 13 and increased risk of head/face/neck injury in obese children ages 2 to 5 (OR = 3.67, 95% CI = 1.03-13.08, P ≤ 0.05), but a decreased risk of head injury in obese children ages 14 to 17 (OR = 0.33, 95% CI = 0.18-0.60, P ≤ 0.05).

Conclusions:

There are sparse data that are conflicting, regarding the effect of obesity on extremity injuries in the pediatric population. Obesity is not protective against thoracic, head, or abdominal injuries. However, it was found to be a risk factor for trunk injuries in ages 2 to 13, as well as head/face/neck injuries for ages 2 to 5. Since the literature is so sparse, further research is warranted in these areas.
Longitudinal Link Between Bullying Victimization and Bullying Perpetration: A Multilevel Moderation Analysis of Perceived School Climate
Authors: Nie Qian , Yang Chunyan , Stomski Meg , Zhao Zhanfeng , Teng Zhaojun , Guo Cheng
Published: March 2021

Existing theories and empirical studies have evidenced the association between bullying victimization and bullying perpetration. However, it is still unclear what factors mitigate or alter this risk linkage between bullying victimization and bullying perpetration to reduce bullying incidents. Guided by the social-ecological theory, this study used a longitudinal design to examine the moderating role of school climate in the association between bullying victimization and bullying perpetration at both the within-person and between-person levels among Chinese adolescents across a 1-year period. Participants included 2,997 Chinese adolescents ( Mage = 14.9, 49.7% male) from 5 secondary schools. Results suggested that students who experienced high levels of bullying victimization were also involved in high levels of bullying perpetration over time (i.e., the positive within-person effect of bullying victimization on bullying perpetration). Results also showed that the between-person level of perceived school climate interacted with the within-person level of bullying victimization to predict the within-person level of bullying perpetration (i.e., cross-level effects). More specifically, the magnitude of the positive association between bullying victimization and bullying perpetration at the within-person level was mitigated among students with higher perceptions of school climate at the between-person level. Findings of the study highlighted the causal effect of bullying victimization on bullying perpetration and the buffering role of perceived school climate in the longitudinal association between bullying victimization and perpetration, which was consistent with the risk-buffering model but not the healthy context paradox hypothesis. Furthermore, the findings provided implications for bullying prevention and intervention services by using multitiered systems of support in bullying prevention efforts and highlights the need for promoting positive school climate.
Emerging Adult Report of Childhood Maltreatment and Related Facets of Impulsivity
Authors: Rogers Mary Moussa , Szkody Erica , McKinney Cliff
Published: March 2021

Childhood maltreatment is related to a host of outcomes, many of which may be partially explained by the transdiagnostic factor of impulsivity. The research linking maltreatment to impulsivity is well supported. However, research differentiating between emotional and physical maltreatment and impulsivity is lacking, particularly with regard to facets of trait impulsivity. Thus, the current study examined the links between childhood emotional and physical maltreatment and current impulsivity traits of positive and negative urgency, lack of perseverance, lack of premeditation, and sensation seeking in emerging adults. Furthermore, effects of maltreatment are known to differ by the gender of the parent and the gender of the child. Thus, differences between parent-emerging adult child gender dyads were also examined. Results suggested both physical and emotional maltreatment were associated with negative urgency across the parent–child gender dyads. Emotional maltreatment and physical maltreatment differed in relation to impulsivity facet across parent and child gender. Results contribute to a knowledge base to use in future exploration of emotional and physical maltreatment outcomes and targets of intervention.
Social Reproduction as Language Policy: The Neoliberal Co-option of English in Global Japan
Authors: Smith Michael D.
Published: March 2021

In Japan, neoliberal discourses rationalize English language proficiency as a pathway to meritocratic reward and success in the global knowledge economy. With this ideology in mind, this review engages the market orientation of English domestically and the causative implications of class-distinguished capital. Specifically, Bourdieu’s theory of social reproduction is employed to foster comprehension of Japanese foreign language policies in which English substantiates itself as a valuable source of cultural investment. Notwithstanding the supposedly meritocratic intention of the Japanese state, this study concludes that credentialism, hierarchization, and marketization function in concert with a survival of the fittest corollary that, per globalized ideological-discursive assumptions, constrains agency through the justification of ELL as a vocational and civic moral worth. This conflation of internationalization and Englishization is better understood as an instrument of dominance, with the agency to participate in ELL interlocking with an incontrovertible doxa that rationalizes the economic, social, and political hierarchy.
Medication Regimen Complexity Score as an Indicator of Fluid Balance in Critically Ill Patients
Authors: Olney William J. , Chase Aaron M. , Hannah Sarah A. , Smith Susan E. , Newsome Andrea Sikora
Published: March 2021

Background:

Critically ill patients are at increased risk for fluid overload, but objective prediction tools to guide clinical decision-making are lacking. The MRC-ICU scoring tool is an objective tool for measuring medication regimen complexity.

Objective:

To evaluate the relationship between MRC-ICU score and fluid overload in critically ill patients.

Methods:

In this multi-center, retrospective, observational study, the relationship between MRC-ICU and the risk of fluid overload was examined. Patient demographics, fluid balance at day 3 of ICU admission, MRC-ICU score at 24 hours, and clinical outcomes were collected from the medical record. The primary outcome was relationship between MRC-ICU and fluid overload. To analyze this, MRC-ICU scores were divided into tertiles (low, moderate, high), and binary logistic regression was performed. Linear regression was performed to determine variables associated with positive fluid balance.

Results:

A total of 125 patients were included. The median MRC-ICU score at 24 hours of ICU admission for low, moderate, and high tertiles were 9, 15, and 21, respectively. For each point increase in MRC-ICU, a 13% increase in the likelihood of fluid overload was observed (OR 1.128, 95% CI 1.028-1.238, p = 0.011). The MRC-ICU score was positively associated with fluid balance at day 3 (β-coefficient 218.455, 95% CI 94.693-342.217, p = 0.001) when controlling for age, gender, and SOFA score.

Conclusions:

Medication regimen complexity demonstrated a weakly positive correlation with fluid overload in critically ill patients. Future studies are necessary to establish the MRC-ICU as a predictor to identify patients at risk of fluid overload.
Self-Reported Fatigue in Chinese Children and Adolescents During Cancer Treatment
Authors: Cheng Lei , Wang Yingwen , Duan Mingxia , Wang Jiashu , Wang Yanqing , Huang Haiying , Yuan Changrong
Published: March 2021

Background: Fatigue is a prevalent and distressing symptom in children and adolescents with cancer. Objectives: This study aimed to (1) investigate the current fatigue status reported by Chinese children and adolescents with cancer during active cancer treatment and (2) examine whether sociodemographic information, disease and treatment information, co-occurring symptoms, function and related clinical data are significantly associated with fatigue according to the biopsychosocial model. Methods: Participants were children aged 8–17 years, who had undergone treatment for cancer at four hospitals in China. Children completed the Chinese version of the Pediatric Patient-Reported Outcomes Measurement Information System short forms. Results: In total, 187 children (33.16% female, mean age 10.28 years) participated. The mean T-score for child-reported fatigue was 48.52 (34–72). Multiple linear regression analysis showed that fatigue in pediatric active cancer treatment could be significantly predicted by greater child-reported pain interference ( β = 0.391, p < .001), greater depressive symptoms ( β = 0.443, p < .001), and reduced mobility ( β = −0.226, p = .004) (adjusted R2 = 0.613, F = 16.476, p < .001). Conclusions: Children and adolescents with cancer experience multiple, intersecting troubling symptoms during their treatment. There is a need to attend to the biopsychosocial aspects of care for children and adolescents during active cancer treatment. To reduce pediatric oncology patients’ fatigue level, clinicians could develop culturally sensitive interventions to alleviate children’s pain interference, treat depressive symptoms, and maximize their physical mobility.
Terminal Delirium in Hospice: The Experiences and Perspectives of Caregivers Providing Care to Terminally Ill Patients in Home Settings
Authors: Soroka Jacek T. , Fling Krista J. , Heibel Jennifer M. , Kutcher Gregory R. , Ward Sarah J.
Published: March 2021

Objectives:

Little is known about the experiences of caregivers who provide care to persons with terminal delirium (TD) in home settings. This scarcity of information is suggestive that further research is needed about care for hospice patients with delirium in the home and community.

Aim:

To elicit views, feelings, and end-of-life care experiences of primary caregivers assisting dying persons with TD in hospice at home.

Design:

Qualitative, exploratory, cross-sectional study design was chosen. In-depth semistructured interviews explored caregiver experiences in caring for persons with TD. Qualitative thematic framework analysis was used.

Participants:

Fifteen bereaved adult primary caregivers who received services from a hospice care program affiliated with a large nonprofit health system in the US Midwest.

Results:

Caregiver experiences were broad and reflected 4 major themes: symptomology, coping, effective and noneffective interventions, and support. The most distressing factors for caregivers were behaviors and symptomology of TD. They did not know what to say, how to respond, and how best to behave with someone who had delirium. Many caregivers had the impression that medication does not lessen delirium symptoms and that nonpharmacologic interventions are effective and beneficial only when they were important and meaningful to patients before delirium onset.

Conclusions:

This study added new knowledge from direct and personal perspectives of caregivers providing end-of-life care to patients at home. Understanding developed about provision of care to someone with TD in home hospice. Improved comprehension of caregiver experiences can help professional hospice and palliative care staff better prepare caregivers for when patients have TD.
Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection
Authors: Rao Anirudh , Zaaqoq Akram M. , Kang In Guk , Vaughan Erin M. , Flores Jose , Avila-Quintero Victor J. , Alnababteh Muhtadi H. , Kelemen Anne M. , Groninger Hunter
Published: March 2021

Background:

Critically ill patients with COVID-19 infection on extracorporeal membrane oxygenation (ECMO) face high morbidity and mortality. Palliative care consultation may benefit these patients and their families. Prior to the pandemic, our institution implemented a policy of automatic palliative care consultation for all patients on ECMO due to the high mortality, medical complexity, and psychosocial distress associated with these cases.

Objectives:

The main objective was to describe the role of the palliative care team for patients on ECMO for COVID-19 infection. The secondary objective was to describe the clinical outcomes for this cohort.

Design:

Case series.

Settings/Subjects:

All patients age 18 or older infected by the novel coronavirus who required cannulation on ECMO from March through July of 2020, at an urban, academic medical center in the United States. Inter-disciplinary palliative care consultation occurred for all patients.

Results:

Twenty-three patients (median age 43 years [range 28-64], mean body mass index 34.9 kg/m2 [SD 9.2], 65% Hispanic ethnicity) were cannulated on ECMO. Eleven patients died during the hospitalization (48%). Patients older than 50 years of age demonstrated a trend toward increased odds of death compared to those younger than 50 years of age (OR 9.1, P = 0.07). Patients received an average of 6.8 (SD 3.7) palliative clinical encounters across all disciplines. The actions provided by the palliative care team included psychosocial support and counseling, determination of surrogate decision maker (for 100% of patients), pain management (83%), and non-pain symptom management (83%).

Conclusions:

Here, we present one of the first studies describing the patient characteristics, outcomes, and palliative care actions for critically ill patients with COVID-19 on ECMO. Almost half of the patients in this cohort died during their hospitalization. Given the high morbidity and mortality of this condition, we recommend involvement of palliative care for patients/families with COVID-19 infection who are on ECMO. The impact of palliative care on patient and family outcomes, such as symptom control, satisfaction with communication, rates of anxiety, and grief experience merits further investigation.
Frailty Recognition by Clinicians and its Impact on Advance Care Planning
Authors: Queisi Munther M. , Atallah-Yunes Suheil Albert , Adamali Farah , Jonnalagadda Nageshwar , Rastegar Vida , Brennan Maura J. , Kapoor Alok , Stefan Mihaela S.
Published: March 2021

Background:

Frailty has important implications for the care of the elderly and how their needs are met.

Objective:

To assess clinicians’ acknowledgement of frailty in the electronic medical records (EMR) and the impact of frailty recognition on advance care planning (ACP).

Methods:

We performed a retrospective study on 119 patients 65 years or older with moderate or severe frailty assessed using a validated frailty scale. We reviewed notes to determine if primary team identified frailty and obtained data regarding ACP planning. We present the characteristics and outcomes of patients who were identified as frail and compared them with patients whose frailty was unrecognized in EMR.

Results:

Among the 119 frail patients, one third were ≥85 years and one-year mortality was 25.4%. Most patients were taking ≥5 medications and only 14.3% rated their health as excellent or good prior to hospitalization. Only 15 patients (12.6%) were identified as frail in the EMR. The only significant differences between those recognized versus unrecognized frail were body mass index (23.4 vs 28.6, p = 0.02) and reported weight loss in the 3 months prior to admission (93.3% vs 59.6%, p = 0.009). Geriatric or palliative care consults, and changes in code status to do-not resuscitate were more frequent among those recognized vs not. (33.3% vs 11.5%; 13.3% vs 1.9% respectively).

Conclusion:

Documentation of frailty in the EMR was rare and it was associated with a lower likelihood of providing advance care planning. These findings suggest a need for consistent frailty assessment, which might promote patient-centered care.
Whispers of the Soul; Autohistoria-Teoría as Decolonial Knowledge Production
Authors: Arfuso Chimine N.
Published: March 2021

The imperative for decolonial research methodology has been long discoursed in academia. However, there remains a rift between dominant colonial research practices in the academy and the needs of researchers of color. In this article, I explore autohistoria-teoría as a decolonial research methodology by weaving between personal narrative, magical thinking, and contemporary academic discourse on autoethnographical research methods. I will exemplify both the uniqueness and importance of spirit in Anzaldúa’s iteration of autohistoria-teoría. Finally, I will challenge the academy’s perception of autoethnographical research methods as navel gazing and reframe autohistoria-teoría as decolonial praxis, and as such does not need adhere to the validity paradigm of western hegemonic knowledge production.
World-Making in the Academy: Transnational Scholars Seeking “Home” in Women’s, Gender, and Sexuality Studies
Authors: Duncan Patti , Driskill Qwo-Li , Mize Ronald L. , Osei-Kofi Nana , Shirazi Mehra
Published: March 2021

In this roundtable discussion, faculty of color associated with a Women’s, Gender, and Sexuality Studies program reflect on our experiences within the academy. As faculty of color connected to the notion of the transnational through our various identities, experiences, family histories, and places of origin, we discuss the various ways we navigate academic spaces. Through an autoethnographic method, we consider our distinct yet overlapping experiences of seeking “home” in the academy.