bluuebunny/crossref_metadata_2025 huggingface dataset:
Rousseau e as manifestações populares
Authors: Souza Maria das Graças de
Published: November 2024

This article examines the criteria that determine the legitimacy of popular demonstrations in Rousseau's political thought. It can be said that, from the point of view of the law, in a legitimately constituted republic, demonstrations by the people are lawful when they are provided for in the constitution and formally convened by the government, both in the case of periodic and ordinary meetings, as well as extraordinary ones. In other words, spontaneous demonstrations and popular initiatives are excluded. However, at the end of the first chapter of Book IV of the Contract, Rousseau refers to the right of every citizen, which cannot be taken away, to express an opinion, to oppose, to discuss, to propose, a right that the members of the government want to keep to themselves. Here I intend to explore the question of the possibilities of popular expression in books 3 and 4 of the Contract and in letters 7 and 8 of the Written Letters from the Mountain.
Merleau-Ponty nos arquivos Husserl: uma entrevista com Emmanuel de Saint Aubert
Authors: Saint Aubert Emmanuel de , Santos Junior Iracy Ferreira dos , Oliva Luís César , Ramos Silvana de Souza
Published: November 2024

Silvana de Souza Ramos and Iracy Ferreira dos Santos Junior’s interview with Emmanuel de Saint Aubert explores the history and role of the Husserl Archives (Paris) in fostering multidisciplinary research in phenomenology. Saint Aubert clarifies Merleau-Ponty’s engagement with Husserl’s manuscripts, describing the situated and complex reading he undertook not only of these manuscripts but also of Husserl’s work as a whole. This aspect is particularly significant for contemporary French philosophical studies, as Merleau-Ponty played a pivotal role in introducing Husserl’s ideas into French thought. This clarification allows us to show the originality of Merleau-Ponty’s philosophy, as it reveals that he was not merely an exegete of Husserl, but a restless and multifaceted thinker, deeply involved in the intellectual and political debates of his time. If he cannot be reduced to a mere reader of Husserl, neither can his later ontology be simply attributed to Heidegger’s influence. Once engaged in a meticulous study of the unfinished manuscripts that Merleau-Ponty left behind due to his premature death, which were drafts for a new book, Saint Aubert conducted a thorough investigation of Merleau-Ponty’s use of key terms in his ontology – chair, Leib, empiétement, chiasmi – showing that these terms do not literally translate or express concepts derived from Husserl or Heidegger. On the contrary, these terms acquire a multifaceted range of meanings in Merleau-Ponty’s writings, nourished by his philosophical readings and meditations, by his scientific and literary refinement, as well as his ethical and political concerns. Saint Aubert’s research, dedicated to the interpretation of Merleau-Ponty’s so-called “unpublished” works, resulted in the publication of five books by Vrin, all guided by a transversal genetic reading of Merleau-Ponty’s work. Additionally, with the help of other researchers, Saint Aubert carefully edited and published several volumes of Merleau-Ponty’s manuscripts. This material, made available in an organized and contextualized manner, is of incomparable richness, allowing for a more precise understanding of Merleau-Ponty’s role in contemporary thought, while also illuminating the meaning of his ontological project.
Device-Measured 24-Hour Movement Behaviors and Blood Pressure: A 6-Part Compositional Individual Participant Data Analysis in the ProPASS Consortium
Authors: Blodgett Joanna M. , Ahmadi Matthew N. , Atkin Andrew J. , Pulsford Richard M. , Rangul Vegar , Chastin Sebastien , Chan Hsiu-Wen , Suorsa Kristin , Bakker Esmée A. , Gupta Nidhi , Hettiarachchi Pasan , Johansson Peter J. , Sherar Lauren B. , del Pozo Cruz Borja , Koemel Nicholas A. , Mishra Gita D. , Eijsvogels Thijs M.H. , Stenholm Sari , Hughes Alun D. , Teixeira-Pinto Armando , Ekelund Ulf , Lee I-Min , Holtermann Andreas , Koster Annemarie , Stamatakis Emmanuel , Hamer Mark , Savelberg Hans , de Galan Bastiaan , van de Kallen Carla , Thijssen Dick H.J.
Published: November 2024

BACKGROUND:

Blood pressure (BP)–lowering effects of structured exercise are well-established. Effects of 24-hour movement behaviors captured in free-living settings have received less attention. This cross-sectional study investigated associations between a 24-hour behavior composition comprising 6 parts (sleeping, sedentary behavior, standing, slow walking, fast walking, and combined exercise-like activity [eg, running and cycling]) and systolic BP (SBP) and diastolic BP (DBP).

METHODS:

Data from thigh-worn accelerometers and BP measurements were collected from 6 cohorts in the Prospective Physical Activity, Sitting and Sleep consortium (ProPASS) (n=14 761; mean±SD, 54.2±9.6 years). Individual participant analysis using compositional data analysis was conducted with adjustments for relevant harmonized covariates. Based on the average sample composition, reallocation plots examined estimated BP reductions through behavioral replacement; the theoretical benefits of optimal (ie, clinically meaningful improvement in SBP [2 mm Hg] or DBP [1 mm Hg]) and minimal (ie, 5-minute reallocation) behavioral replacements were identified.

RESULTS:

The average 24-hour composition consisted of sleeping (7.13±1.19 hours), sedentary behavior (10.7±1.9 hours), standing (3.2±1.1 hours), slow walking (1.6±0.6 hours), fast walking (1.1±0.5 hours), and exercise-like activity (16.0±16.3 minutes). More time spent exercising or sleeping, relative to other behaviors, was associated with lower BP. An additional 5 minutes of exercise-like activity was associated with estimated reductions of –0.68 mm Hg (95% CI, –0.15, –1.21) SBP and –0.54 mm Hg (95% CI, –0.19, 0.89) DBP. Clinically meaningful improvements in SBP and DBP were estimated after 20 to 27 minutes and 10 to 15 minutes of reallocation of time in other behaviors into additional exercise. Although more time spent being sedentary was adversely associated with SBP and DBP, there was minimal impact of standing or walking.

CONCLUSIONS:

Study findings reiterate the importance of exercise for BP control, suggesting that small additional amounts of exercise are associated with lower BP in a free-living setting.
Reservation Wages and the Wage Flexibility Puzzle
Authors: Koenig Felix , Manning Alan , Petrongolo Barbara
Published: November 2024

Using micro data for the UK and Germany, we provide novel evidence on the cyclical properties of reservation wages and estimate that wages and reservation wages are characterised by moderate and very similar degrees of cyclicality. Several job search models that quantitatively match the cyclicality of wages tend to overpredict the cyclicality in reservation wages. We show that this puzzle can be addressed when reservation wages display backward-looking reference dependence. Model calibrations that allow for reference dependence match the empirically observed cyclicality of wages and reservation wages for plausible value of all other model parameters.
The Long-Run Effects of Monetary Policy
Authors: Jordà Òscar , Singh Sanjay R. , Taylor Alan M.
Published: November 2024

We document that the real effects of monetary shocks last for over a decade. Our approach relies on (1) identification of exogenous and non-systematic monetary shocks using the trilemma of international finance; (2) merged data from two new international historical cross-country databases; and (3) econometric methods robust to long-horizon inconsistent estimates. Notably, the capital stock and total factor productivity (TFP) exhibit greater hysteresis than labor. When we allow for asymmetry, we find these effects with tightening shocks, but not with loosening shocks. When extending the horizon of the responses reported in several recent studies that use alternative monetary shocks, we find similarly persistent real effects, thus supporting our main findings.
Ein Einheitliches Prozessrecht?
Authors: Hess Burkhard
Published: November 2024

This contribution investigates the perspectives for further harmonisation of the law of civil procedure at the national, European, and international levels. The analysis is not limited to the potential for uniform or coordinated national and supranational law-making. It also focuses on other catalysts for uniformity, such as the increasing control of the law of civil procedure by the European Court of Human Rights and the ECJ on the basis of uniform, supranational standards of human rights. The contribution begins with a look at the relevant factors influencing the law of procedure in Europe, such as the separation of different avenues of conflict resolution and the increasing focus on timely and inexpensive litigation. After a brief overview of the current norms applicable to litigation procedure at the domestic and international level, the contribution then considers the possible forms of regulation for unifying the law in this area. On this basis, the contribution suggests perspectives for further harmonisation and coordination of civil procedure in Europe and investigates the specific methodological and practical challenges of these efforts at harmonisation. The article concludes with summarising theses.
Culture and Predictability of the Law
Authors: Marinoni Luiz Guilherme
Published: November 2024

This paper shows the link between the irrationality and unpredictability of Brazilian law and underlying values in the formation of Brazilian culture. Based on Max Weber’s ideas, it is suggested that the current lack of respect for the Supreme Courts’ precedents is compatible with a culture characterised by personalism and patrimonialism. The aversion to impersonality and rationality, which is characteristic of an agent seeking to turn the public sphere into the private sphere and to run away from legislation’s general and abstract character, through which everyone should be treated as equals, results in a culture that does not adequately value the predictability of the law and equality before judicial decisions.
Begonia laxiflora (Begoniaceae), a new species in sect. Petermannia from Central Vietnam
Authors: BUI VAN THANH , NGUYEN KHANG SINH , LE MANH TUAN , NGHIEM DUC TRONG , UONG SY HUNG , TRUONG QUANG TRUNG , LE ANH TU , LIN CHE WEI
Published: November 2024

Begonis laxiflora is described as a new species endemic to Vietnam from granite boulder habitats in the Dakrong district. It is most similar to B. abbreviata in its creeping habit, broadly ovate leaves, persistent bracts, and the number of tepals in both staminate and pistillate flowers. The new species is different in its inflorescence having internodes much longer than the bracts (vs. internodes are hidden by the bracts), the outer tepals glabrous in both staminate and pistillate flowers (vs. sparsely scabrescent on the abaxial surface), ovary covered with minutely glandular trichomes (vs. hirsute) and the wings of the capsule distally pointed (vs. rounded).
Microlicia ferricola (Lavoisiereae), a new species of Melastomataceae from the Iron Quadrangle, Minas Gerais, Brazil
Authors: VERSIANE ANA FLÁVIA ALVES , ROCHA MARIA JOSÉ REIS DA , SANTOS AMANDA ALVES , ROMERO ROSANA
Published: November 2024

Here, we describe Microlicia ferricola, a newly discovered species exclusive to the Iron Quadrangle, Minas Gerais state. Additionally, we provide an illustration plate, field images, occurrence map, and comparisons with its morphological relatives such as M. longicalycina, M. woodgyeriana, and M. trichocalycina. This new species is characterized by its green-reddish to reddish branches, leaves, hypanthia, and sepals covered with glandular trichomes, lanceolate to elliptic-lanceolate leaves, setose at the apices, campanulate-oblong hypanthia, long-triangular sepals, dimorphic and bicolorous androecium with tetrasporangiate anthers. Microlicia ferricola is found in the Serra do Rola-Moça State Park and is considered a Least Concern (LC) taxon since it is within a conservation unit, ensuring its preservation.
Enchanted realism: Representations of self-fulfilment among Italian youth after the pandemic
Authors: Colombo Enzo , Rebughini Paola , Demirsu Ipek
Published: November 2024

Our aim in this article is to analyse youth aspirations for self-fulfilment through work in the interplay between individualization and self-entrepreneurship. Theoretically, we discuss the main approaches of individualization and self-government in contemporary youth studies. Empirically, we focus on urban youth in the post-pandemic context, in the Italian city of Milan, paying specific attention to the transformation of their aspirations and social relations after the experience of the lockdown. We highlight the rise of a new form of self-narration that we define ‘enchanted realism’. Such self-narration tries not to completely give up hopes of self-fulfilment in the face of the challenges of the neoliberalist socio-economic environment, but at the same time, it resizes the myth of the entrepreneurial self by unveiled doubts and fears of inadequacy, paving the way to less self-referential attitudes.
Impact of intracranial hypertension and cerebral perfusion pressure on spreading depolarization
Authors: Nishimoto Takuma , Oka Fumiaki , Inoue Takao , Moriyama Hiroshi , Kawano Reo , Suzuki Michiyasu , Chung David Y , Ayata Cenk , Ishihara Hideyuki
Published: November 2024

Spreading depolarization (SD) develops after stroke and traumatic brain injury and may contribute to secondary brain damage. These diseases are often accompanied by intracranial hypertension, but little is known about the effects of intracranial pressure (ICP) on SD. Here, we study the effect of increased ICP on hemodynamic and metabolic response to SD in rats. SDs were triggered at different ICPs and cerebral perfusion pressures (CPP). The regional cerebral blood flow (rCBF), partial pressure of brain tissue oxygen (PbtO2), cerebral extracellular glucose and lactate concentrations were recorded. Fluoro-Jade staining was used to quantify neuronal injury in cortex. At high ICP (50 mmHg) with low CPP (30 mmHg), rCBF and PbtO2 were monophasically decreased in contrast to a monophasically increased pattern under normal conditions. Neuronal death increased in both hemispheres but much more on the side where SDs were triggered. At high ICP (50 mmHg) with normal CPP (70 mmHg), CBF and metabolism during SD did not differ from baseline, and neuronal death did not increase even on the side of SD induction. These data suggest that maintaining CPP at 70 mmHg, even when the ICP is as high as 50 mmHg, preserves normal blood flow and metabolism during SD events and prevents neuronal degeneration.
Are Family Caregiving Programs Appropriate for Minority Caregivers? A Systematic Review of 37 Caregiving Programs
Authors: Meinertz Naomi R. , Lee Jeongeun , Kim Yulri
Published: November 2024

The extent to which dementia caregiving programs are effective among racially or ethnically diverse caregivers is unknown. Limited information about program effectiveness for minority caregivers may further exacerbate health disparities and contribute to unmet needs. Guided by the PRISMA guidelines, this systematic review aimed to determine whether 37 evidence-based dementia caregiving programs were efficacious with racially and ethnically diverse caregiving populations. Using six databases (APA PsycINFO, APA PsycArticles, Academic Search Elite, Academic Search Premier, CINAHL, and Scopus), 140 empirical studies were identified as program evaluation studies of the 37 programs with diverse populations. After reviewing these articles, 24 empirical studies supported 11 programs as efficacious with racially/ethnically diverse populations. The 24 studies form three categories: no program alterations; targeted recruitment efforts; and program adaptations that address culturally specific needs. The findings of this review underscore the gaps in current family caregiving programs and identify the need for culturally appropriate programs.
Relationship between personality and music preference: Psychometric adaptation of the music preference scales in a Chinese sample
Authors: Wang Yifan , Qu Weina , Ge Yan
Published: November 2024

Individuals evidently have different tastes in and preferences for music. The purpose of this study was to develop two scales for measuring music preference based on genres (text-based) and excerpts (clip-based), using a Chinese sample to explore the relationship between music preference and personality. Specifically, we collected measures of people’s self-reported preferences for a wide range of music genres for further analysis in Study 1. In Study 2, we developed two music preference scales based on the genres identified in Study 1, one text- and the other clip-based. The results of two principal component analyses suggest three-dimensional psychological structures of music preference using both versions of the scale: (1) Traditional and Retro, (2) Exotic and Complex, and (3) Intense and Rebellious. Correlation and regression analyses of music preferences and personality also indicated that music preference is a relatively stable construct that reflects personality traits. Moreover, the three factors identified from the results of studying music preferences in a Chinese sample differ from those identified in studies of music preference in Western countries, suggesting that music preference is influenced by culture. The two scales yielded similar but slightly different outcomes reflecting their discrete emphases and characteristics; they can be used separately or together, depending on the research topic and question. In this study we verified the structure of music preference among a Chinese sample. It provides a reference point for theoretical research on music preference and personality and has practical applications.
Public Opinion on the Minimum Age of Criminal Responsibility: The Role of Cognition and Emotions
Authors: Hulmáková Jana , Tomášek Jan , Krulichová Eva
Published: November 2024

Given that young people have a limited capacity to recognize the unlawfulness of their actions, the minimum age of criminal responsibility (MACR) presents an important subject of professional and political inquiry. In addition to the natural and legal sciences, public opinion is confirmed to influence the decision-making of legislators in the matter of criminal policy. Research on determinants of public opinion on the MACR is relatively scarce; however, some studies focusing on punitiveness in general suggest that it is influenced by both cognitive assessments as well as emotions and beliefs. Using a representative sample of Czech citizens, this study finds public support for a lower MACR to be particularly driven by their perception of children crime trend, mediated through people's negative attitude toward the behaviour of today's children.
‘All naked at the gyno’: Psychosocial approach to the gynaecological examination from digital media in a French context
Authors: Roussel Sarah , Restivo Léa , Apostolidis Thémistoklis
Published: November 2024

The gynaecological examination (GE) is a major public health issue, with bad experiences of this examination widely reported as a disincentive to cervical cancer screening. In France, a movement to denounce gynaecological and obstetrical violence is expressed through a massive publication of testimonies on social networks. Via a socio-representational approach and from a critical gender perspective, this article aims to explore how people use digital media to communicate about the GE, and to analyse the experiences related to the GE and the representation systems underlying them. Using an inductive strategy, a corpus of discussion from the Doctissimo forum, and testimonies and comments from the PayeTonGynéco Facebook pages and Tumblr was created and submitted to lexicographical analysis. Our results suggest that the GE is indicative of a broader social function. People seem to use digital media to cope with a form of social ignorance of women’s experience in gynaecology with a certain ambivalence regarding their liberating potential.
David Greenberg on prison abolition, an interview by John Clegg
Authors: Clegg John
Published: November 2024

David Greenberg, who passed away in July 2024, was a pioneer of radical criminology as well as polymath who excelled in several disciplines, including physics, history, and mathematical sociology. In November 2022, I spoke with David about some research I was doing into the history of prison abolitionism in the United States. David had been the author of “The Problem of Prisons,” a pamphlet written in 1969 which was one of the first sustained arguments for prison abolition to have been published in the post-war United States. He also edited and was a main contributor to The Struggle For Justice, a coauthored book published in 1971 by the American Friends Service Committee (AFSC). This book would become a key reference in the emerging field of radical criminology and would influence early Quaker prison abolitionists like Fay Honey Knopp and Ruth Rittenhouse Morris, as well as later abolitionist groups like Critical Resistance. In his later writings, however, David was critical of prison abolitionism. 1 I was curious about how and why his views changed, so I sat down with him in a Greenwich village cafe and recorded our conversation. The following is an edited transcript of that recording.
Culturally Tailored Lifestyle Modification Strategies for Hypertension Management: A Narrative Review
Authors: Miezah Dennis , Hayman Laura L.
Published: November 2024

Hypertension (HTN) is a significant global health challenge affecting billions of individuals worldwide. The prevalence of HTN varies considerably across the globe due to diverse factors, such as lifestyle influenced by culture, genetics, health care access, and socioeconomic conditions. Lifestyle modification has a substantial impact on blood pressure management; however, some cultural practices and behaviors affect recommended lifestyle modification strategies for HTN management. The purpose of this review was to explore lifestyle modification strategies for HTN management from a cultural perspective. Lifestyle modification, including physical activity, stress reduction, changes in dietary patterns (adopting a low-sodium diet and intake of fruit and vegetables), and weight management, provide an effective non-pharmacologic intervention for the management of hypertension. Individual’s cultural practices have the potential to determine their diet, physical activity levels, knowledge, and perception about HTN, adherence to treatment and medications, and the use of local herbal preparations for HTN management. Culture focuses on individuals’ belief, practices and how these beliefs and practices influence their lifestyle behaviors for HTN management. It is important to consider patients’ cultural beliefs before recommending lifestyle behaviors for HTN management.
Teaching agile: A case study approach with an optional game
Authors: Chavarría Juan A. , Flores Javier , Lakshmikanth Geethalakshmi S. , Paz Ignacio
Published: November 2024

Learning Agile philosophy is essential for system analysis and design or software development courses. Organizations operate in highly dynamic environments, constantly needing to adapt, change, or create innovative Information Systems. Agile provides guiding values and principles that enable systems analysts to support organizations in responding to change and developing, modifying, or updating information systems. By learning Scrum, an Agile-inspired framework, students can assume the role of systems analyst, organizing activities and working in teams iteratively to solve complex problems using Agile principles. This hands-on approach helps students understand the importance of stakeholder involvement, constant scrutiny, and adjustment to achieve frequent system updates. Hence, this case study immerses students in a scenario where they apply the Scrum framework, with an optional puzzle game to introduce students to agile philosophy through its manifesto. Learning by doing has proven effective for complex or dry topics, with students responding positively to this method. Interview data collected at the end of the activity showed high student satisfaction and a strong sense of knowledge acquisition while enjoying the class. Additionally, integrating a game to internalize agile concepts with a teaching case to apply concepts presents a rich educational approach that can be adapted to other Information Systems topics.
Suspected clopidogrel-associated hepatitis in a cat
Authors: Kamp Astrid L , Yousofzai Washma , Kooistra Hans S , Santarelli Giorgia , van Geijlswijk Ingeborg M
Published: November 2024

Case summary

Acute hepatitis and liver damage are rare adverse effects of clopidogrel in humans. In veterinary medicine, clopidogrel is mainly prescribed in the treatment of feline patients with cardiomyopathies. Little is known regarding the safety and adverse effects of clopidogrel in this group of patients. The limited number of studies scarcely report adverse effects. In this case report, a 6-year-old male castrated crossbred cat with the hypertrophic cardiomyopathy phenotype had signs of acute hepatitis after 5 weeks of clopidogrel treatment.

Relevance and novel information

Evaluation of the case and review of the literature indicate that acute hepatitis might be a potential adverse effect of clopidogrel in feline patients. Therefore, hepatotoxicity should be taken into consideration when a feline patient shows clinical deterioration after the use of clopidogrel.
No Conflicting Loyalties in Parents When Their Healthy Child Donates Stem Cells to a Severely Ill Sibling: An Interview Study
Authors: Rinaldo Carina , Stenmarker Margaretha , Øra Ingrid , Pergert Pernilla
Published: November 2024

Background: When a potential stem cell donor to a seriously ill child is a healthy sibling below 18 years, Swedish parents have the legal right and obligation to decide on behalf of the donor child. However, there are potentially conflicting loyalties when parents have one severely ill child in need for a cure and one healthy child who will be subjected to medical procedures. This study explored parents’ experiences related to their decision on stem cell donation, as well as ethical considerations in the donation process where outcomes are uncertain. Method: Individual interviews were performed with 18 parents of 13 minor donors after successful hematopoietic stem cell transplantations. Interviews were analyzed using inductive Reflexive Thematic Analysis. Results: The parents were living with the threat of losing a child, and in this context, the main theme No conflicting loyalties was found and included four subthemes; Focus on the ill child, Sibling as the preferred donor, Obvious that the healthy child should donate, and Keep on keeping on. Conclusion: When a healthy child is a potential donor to an ill sibling, their parents’ main focus is on the cure for the ill child. The lack of obvious conflicting loyalties among parents highlights the need to secure an ethical process for healthy minor donors and the importance of a separate donor advocate for these minor donors.
Epidemiology and outcomes of critically ill patients in the emergency department of a tertiary teaching hospital in Rwanda
Authors: Kamunga B. Laurent Gamy , Bearnot Courtney J. , Martin Kyle D. , Uwamahoro Doris L. , Cattermole Giles N.
Published: November 2024

Background

The introduction of Emergency Medicine in Rwanda in 2015 has been associated with a mortality reduction in patients presenting to Kigali University Teaching Hospital (KUTH). In the context of increasing numbers of critically ill patients presenting to Emergency Departments (ED) globally, the aim of this study was to describe the characteristics of critically ill patients, the critical care interventions performed, and the outcomes of critically ill patients presenting to the KUTH ED with the goal of informing future research into the root causes of mortality of critically ill ED patients and of identifying high yield topics for didactic and procedural training.

Methods

A descriptive observational prospective cohort pilot study analyzed all patients ≥15 years who presented to KUTH between April and June 2022 with modified South African Triage Scores of Red with alarm, Red without alarm, and Orange.

Results

Of 320 patients, 66.9% were male and median age was 40 years. Patients were triaged as Orange (65.3%), Red without alarm (22.8%), and Red with alarm (11.9%). Presentations were categorized as: medical emergencies (48.0%), traumatic injury (44.5%), and surgical emergencies (7.6%). Median length of stay was 31 h (IQR 28, 56) and boarding was 23 h (IQR 8, 48). Overall mortality was 12.2% and highest among medical emergencies (16.5%, p = 0.048) and increased significantly with triage color: Red with alarm (47.4%), Red without alarm (16.4%), and Orange (4.3%, p < 0.0001). Cardiopulmonary resuscitation (CPR) (10.3%), endotracheal intubation (8.8%), and vasopressor administration (3.1%) were the most frequent critical interventions performed. Survival after cardiac arrest was 9.1% and 32.1% after intubation. Mortality was associated with the following interventions: CPR, intubation, and use of vasopressors (p < 0.05).

Conclusions

This pilot study identified the most common critical care interventions performed and a high mortality among patients who required these interventions in the ED of a tertiary teaching hospital in Rwanda. These findings will inform didactics and procedural training for emergency care providers. Future research should focus on the root causes of mortality in these specific patient populations and identify areas of system strengthening to reduce mortality.
Relative-to-resident abuse in Norwegian nursing homes: a cross-sectional exploratory study
Authors: Botngård Anja , Eide Arne Henning , Mosqueda Laura , Blekken Lene , Malmedal Wenche
Published: November 2024

Background

In community settings, relatives often provide care to their older family members, which is sometimes perceived as a high burden, overwhelming and stressful, contributing to an increased risk of elder abuse. In most countries, relatives have no legal obligation to provide care when family members are admitted to nursing homes; nevertheless, studies have shown that relatives continue to provide emotional, instrumental, and personal care after admission, often related to the understaffing and high workload of nursing staff. Despite the growing interest in elder abuse in nursing homes, most studies have concentrated on the abuse perpetrated by nursing staff or co-residents, but few studies have explored the abuse that relatives may perpetrate.

Methods

This study was a cross-sectional survey of 3,693 nursing staff members recruited from 100 nursing homes in Norway, to examine the extent of relative-to-resident abuse in Norwegian nursing homes, as observed by nursing staff.

Results

The findings indicate that 45.6% of the nursing staff had observed one or more episodes of relative-to-resident abuse during the past year. Among the subtypes of abuse, 44.8% of the nursing staff had observed psychological abuse, 8.4% had observed physical abuse, 2.7% had observed financial/material abuse, and 0.7% had observed sexual abuse at least once during the past year.

Conclusions

This is the first large study exploring the extent of relative-to-resident abuse in nursing homes, which is a phenomenon that is significantly less addressed than abuse committed by staff and co-residents. The findings in our study illustrate that abuse committed by relatives needs more awareness and attention to improve the well-being of nursing home residents. Further research is recommended to enhance our understanding of such abuse and should include other approaches measuring the proportion of relative-to-resident abuse, as relying solely on staff observations is insufficient for determining the prevalence in this case. Future studies should also examine the cumulative impact of victimization in nursing homes and should include an analysis of how cases of abuse are reported and handled.
Pain and depressive symptoms among adolescents: prevalence and associations with achievement pressure and coping in the Norwegian Ungdata study
Authors: Jahre Henriette , Grotle Margreth , Smedbråten Kaja , Richardsen Kåre Rønn , Øiestad Britt Elin
Published: November 2024

Background

This study investigated the prevalence of pain, depressive symptoms, and their co-occurrence in Norwegian adolescents. Additionally, we investigated if perceived achievement pressure and coping with pressure were associated with pain, depressive symptoms and co-occurrent pain and depressive symptoms.

Methods

Cross-sectional data from the Norwegian Ungdata Survey (2017–2019) were analysed. Adolescents from across Norway completed an electronic questionnaire including questions on perceived achievement pressure, coping with pressure, pain, and depressive symptoms. Descriptive statistics presented prevalence rates, and multinominal regression reported in relative risk ratios (RR) was employed to estimate associations, adjusted for gender (boys/girls), school level, and socioeconomic status.

Results

The analyses included 209,826 adolescents. The prevalence of pain was 33%, 3% for depressive symptoms, and 14% reported co-occurring pain and depressive symptoms. The prevalence of co-occurring symptoms was higher in girls (22%) than boys (6%). Significant associations were found between perceived achievement pressure and pain (RR 1.11, 95% CI 1.10–1.11), depressive symptoms (RR 1.27, 95% CI 1.27–1.28), and co-occurring symptoms (RR 1.34, 95% CI 1.33–1.34). Struggling to cope with pressure was associated with pain (RR 2.67 95% CI 2.53–2.81), depressive symptoms (RR 16.68, 95% CI 15.60-17.83), and co-occurring symptoms (RR 27.95, 95% CI 26.64–29.33).

Conclusion

The prevalence of co-occurring pain and depressive symptoms is high among Norwegian adolescents. Perceived achievement pressure and struggling to cope with pressure were associated with isolated and, more strongly, co-occurring pain and depressive symptoms. Enhancing adolescents’ ability to cope with pressure could be a crucial target in treating pain and depressive symptoms.
Preoperative abductor muscle strength on the healthy side affects the Timed Up and Go test after total hip arthroplasty in women
Authors: Kawakami Takehiro , Imagama Takashi , Matsuki Yuta , Okazaki Tomoya , Kaneoka Takehiro , Yamazaki Kazuhiro , Ueda Masaya , Sakai Takashi
Published: November 2024

Background

The risk of falls causing periprosthetic fracture has become an issue with the increase in the number of patients undergoing long-term follow-up after total hip arthroplasty (THA) and the aging of patients. The Timed Up and Go test (TUG) is utilized to evaluate fall risk. This study investigated muscle volume around the hip joint based on computed tomography (CT), CT value, and muscle strength to investigate contributing factors to poor TUG 1 year post-THA.

Methods

This study retrospectively investigated 124 patients with unilateral hip osteoarthritis who underwent THA and classified them based on TUG results at 1 year postoperatively into TUG of < 10 s (fast group [103 patients]) and ≥ 10 s (slow group [21 patients]). Body mass index, the volume and CT density of the psoas major and gluteus medius muscles on CT images, pre- and postoperative hip flexion muscle strength, and hip abductor muscle strength were compared in each group.

Results

Age was significantly older and preoperative abductor (fast Group: 1.0 ± 0.3 and slow Group: 0.7 ± 0.3, P = 0.003) and flexion muscle strengths (0.9 ± 0.3 and 0.7 ± 0.3, respectively, P = 0.02) on the healthy side were significantly lower in the slow group. The gluteus medius muscle demonstrated significantly lower CT density in the slow group on both sides. Nominal logistic regression analysis revealed that age and preoperative healthy abductor muscle strength, which are poor factors for TUG 1 year post-THA, were significantly associated with TUG of ≥ 10 s at 1 year post-THA.

Conclusions

The poor factors for TUG 1 year after THA were age and preoperative abductor muscle strength on the healthy side.
Linking theory and practice to advance sustainable healthcare: the development of maturity model version 1.0
Authors: Sijm-Eeken Marieke , Ossebaard Hans C. , Čaluković Aleksandra , Temme Bram , Peute Linda W. , Jaspers Monique W.
Published: November 2024

Background

Climate change and increased awareness of planetary health have made reducing ecological footprints a priority for healthcare organizations. However, improving healthcare’s environmental impact remains difficult. Numerous researchers argue these difficulties are caused by healthcare’s environmental impact being multidimensional, influenced throughout the healthcare chain, and often has downstream consequences that are hard to identify or to measure. Even though existing research describes many successful approaches to reduce healthcare’s environmental impact, a robust multidimensional framework to assess this impact is lacking. This research aims at developing a maturity model for sustainable healthcare that could be used for self-assessment by healthcare professionals to identify improvement actions and for sharing best practices in environmental sustainability.

Methods

A design-oriented approach for maturity model development was combined with an expert panel and six case studies to develop, refine and expand the maturity model for environmentally sustainable healthcare.

Results

A maturity model was developed containing four domains: ‘Governance’, ‘Organization Structures’, ‘Processes’, and ‘Outcomes and Control’. Applying the model in real-world environments demonstrated the model’s understandability, ease of use, usefulness, practicality and ability to identify improvement actions for environmental sustainability in healthcare organizations.

Conclusions

This study found that healthcare practitioners could apply the maturity model developed and tested in this study in several hours without training to help them gain valuable insights into the environment footprint of the healthcare setting they worked in.

Systematically implementing the model developed in this study could help address the urgent need to mitigate the substantial environmental impact of healthcare. These implementations can help evaluate and improve the maturity model.
Quality of family planning counseling and associated factors among reproductive age women who are current contraceptive users at Dessie town health facilities east Amhara, 2023
Authors: Abebaw Nigusie , Haile Berihun , Workie Amare , Mebratu Wondwosen , Getie Molla
Published: November 2024

Background

The role of counseling in Family Planning is to care a woman in navigating the process of choosing a contraceptive method that will allow her to fulfill her family planning goals and exercise her reproductive health rights. The effectiveness and appropriateness of family planning counselling play a crucial role in a client’s decision-making process regarding contraception. The decision for a client to use contraception with effectively and properly it should be ultimately achieved the quality of family planning counclling.

The aim of this research is to assess quality of family planning counseling and associated factors among reproductive age women at Dessie town health facilities, east Amhara, Ethiopia, and 2023.

Methods

A facility based cross-sectional study was conducted from December 1, 2022- January 30, 2023. Study subjects were selected by using systematic random sampling method. Data was be collected by exit interview of the women and analyzed by SPSS version 26.  Bivariable and Multi variable logistic regression were executed to identify associated factors with quality of family planning counseling and the P- Value <0.05 on Multi variable analysis was considered as significantly associated with the dependent variable.

Result

The proportion of women receiving good quality family planning counselling in this study was 36.5%.  Contraceptive source [AOR=2.03, 95%CI (1.09, 3.75)], Contraceptive currently used [AOR=0.43, 95%CI (0.26, 0.73)], separate room for family planning counseling [AOR=3.38, 95%CI (1.09, 3.75)] and availability of all methods [AOR=3.10, 95%CI (1.85, 5.21)]were significantly associated with quality of family planning counselling.

Conclusion

The proportion of women obtaining good quality FP counseling in this study low. Type of contraceptives currently used, source of contraceptives, separate room for providing family planning counseling and availability of all methods of family planning in the facility are significantly associated with quality of family planning counseling. Therefore, all health profession could be given proper counseling to increase the quality of family planning.
The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study
Authors: Ugaz Maria Elena , Meyer Christina L. , Jackson-Morris Angela M. , Wu Daphne , Jimenez M. Michelle , Rojas-Davila Carlos , Zegarra Zamalloa Carlos Orlando , Ludwig-Borycz Elizabeth F. , Williams D’Arcy , Jewell Jo
Published: November 2024

Background

Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5–19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.

Methods

A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.

Results

Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.

Conclusions

The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study’s findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.
Evaluating ATP testing for distribution system monitoring: comparison to HPC, impact of chlorine quenching, and hold time dependency
Authors: Chen William S. , Abkar Leili , Mohseni Madjid
Published: November 2024

Adenosine triphosphate (ATP) assays have a faster turnaround time and higher sensitivity than traditional cultivation methods for microbial monitoring. Challenges implementing ATP testing include incompatibility with chlorine quenching agents and hold time sensitivity, which are not well-studied. Chlorinated distribution system samples were collected from two Canadian utilities, Metro Vancouver (n = 40 samples) and Halifax Water (n = 283). No significant correlations were observed between heterotrophic cell count (HPC) and cellular ATP, suggesting these do not correlate well in waters with low biological activity (median HPC < 2 CFU/mL). However, interpretation of HPC and cATP results (based on the HPC guideline of 100 CFU/mL and cATP of 10 pg/mL) yielded the same conclusion for 95% of samples, suggesting a potential decision-making framework to replace HPC with cATP. Moreover, cATP correlates better with free chlorine (p < 0.04) compared with HPC for one of the studied systems. Importantly, adding chlorine quench (10% sodium thiosulfate) did not produce significantly different cATP results, nor did analyzing at various hold times of 4-, 6-, and 24-h. This study supports the integration of ATP testing into existing sampling procedures for water utilities, as a sensitive, fast, and reliable monitoring method.

Graphical Abstract
Effect of high-flow nasal therapy on patient-centred outcomes in patients at high risk of postoperative pulmonary complications after cardiac surgery: update to the statistical analysis plan for NOTACS, a multicentre adaptive randomised controlled trial
Authors: Dawson Sarah N. , Chiu Yi-Da , Klein Andrew A. , Earwaker Melissa , Villar Sofia S. ,   on behalf of the NOTACS study team, Duckworth Melissa , Temple Ellen , Affandi Jacquita , Shetty Siddesh , Devine Thomas , Steel Jo
Published: November 2024

Background

The NOTACS trial will assess the efficacy, safety and cost-effectiveness of high-flow nasal therapy (HFNT) compared to standard oxygen therapy (SOT) on the outcomes of patients after cardiac surgery.

Methods/design

NOTACS is an adaptive, international, multicentre, parallel group, randomised controlled trial, with a pre-planned interim sample size re-estimation (SSR). A minimum of 850 patients will be randomised 1:1 to receive either HFNT or SOT. The primary outcome is days alive and at home in the first 90 days after the planned surgery (DAH90), with a number of secondary analyses and cost-effectiveness analyses also planned. The interim SSR will take place after a minimum of 300 patients have been followed up for 90 days and will allow for the sample size to increase up to a maximum of 1280 patients.

Results

This manuscript provides detailed descriptions of the design of the NOTACS trial and the analyses to be undertaken at the interim and final analyses. The main purpose of the interim analysis is to assess safety and to perform a sample size re-estimation. The main purpose of the final analysis is to examine the safety, efficacy and cost-effectiveness of HFNT compared to SOT on the outcomes of patients after cardiac surgery.

Discussion

This manuscript outlines the key features of the NOTACS statistical analysis plan and was submitted to the journal before the final analysis in order to preserve scientific integrity under an adaptive design framework. A previous version of this SAP was published prior to the interim analysis (Dawson, 2022). The NOTACS SAP closely follows published guidelines for the content of SAPs in clinical trials (Gamble, 2017).

Trial registration

ISRCTN14092678. (13 May 2020).