bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Consciousness in Vocational Psychology: A Vision for the Next Decade and Beyond
Authors: Cadenas Germán A. , McWhirter Ellen H.
Published: April 2022

We offer a vision for a vocational psychology that places a larger focus on critical consciousness (CC) to be more responsive to marginalized communities (e.g., immigrants, low-income workers, Black, Indigenous, and other People of Color). CC describes how marginalized people analyze systems of oppression, act toward social justice, and become agentic and hopeful. In this article, we review extant theoretical frameworks that have laid a strong foundation for embedding critical consciousness in research, practice, education and training. We then offer suggestions for promoting critical consciousness within vocational psychology over the next decade. We highlight the promise of transformative, intersectional, and action research with and for marginalized communities; of career interventions that respond to oppression and liberation; and of training that prepares future vocational psychologists to engage in praxis in a complex world. We argue that a greater focus on CC is aligned with vocational psychology’s foundational social justice aspirations.
Factors Associated With Undiagnosed Obstructive Sleep Apnea in Overweight and Obese High-Tech Employees: A Multisite Cross-Sectional Study
Authors: Mei-Hsiang Lin , Ning-Hung Chen , Hsiao Ping-Ru , Hsiu-Chin Hsu
Published: April 2022

Background: Being overweight or obese is regarded as crucial risk factors for obstructive sleep apnea (OSA). Objectives: This study aimed to determine the influencing factors of overweight and obese employees with OSA in high-tech workplaces. Methods: A cross-sectional study design was employed. A total of 491 overweight and obese participants were recruited from a large-scale electronics industry. The Chinese version of Pittsburgh Sleep Quality Index, the Epworth Sleep Scale, and a portable sleep monitoring device were used for data collection. Logistic regression analysis was conducted to identify the factors affecting overweight and obese employees with OSA. This study was conducted from August 2019 to July 2020. Results: 60.5% of the overweight and obese participants were found to have OSA, of which 58.9% had mild and 18.5% had severe OSA, respectively. The results showed that age, neck circumference, snoring, and habitual drinking were the crucial factors affecting OSA. Remarkably, age and snoring times showed a significant correlation in predicting OSA of different severities. Neck circumference was an independent risk factor for moderate and severe OSA. Conclusion: More than 60% of the overweight and obese high-tech workplace employees were found to have OSA. We found that the older the age, the larger the neck circumference, a higher number of snoring instances, and drinking were important risk factors for predicting OSA in overweight high-tech employees. The healthcare providers should actively educate OSA-related information for employees in the workplace, and promote high-risk OSA groups to adopt screening based on at-home sleep apparatus.
Data-driven campaigning and democratic disruption: Evidence from six advanced democracies
Authors: Kefford Glenn , Dommett Katharine , Baldwin-Philippi Jessica , Bannerman Sara , Dobber Tom , Kruschinski Simon , Kruikemeier Sanne , Rzepecki Erica
Published: April 2022

Data-driven campaigning has become one of the key foci for academic and non-academic audiences interested in political communication. Widely seen to have transformed political practice, it is often argued that data-driven campaigning is a force of significant democratic disruption because it contributes to a fragmentation of political discourse, undermines prevailing systems of electoral accountability and subverts ‘free’ and ‘fair’ elections. In this article, we present one of the very first cross-national analyses of data-driven campaigning by political parties. Drawing on empirical research conducted by experts in six advanced democracies, we show that the data-driven campaign practices seen to threaten democracy are often not manifest in party campaigns. Instead, we see a set of practices that build on pre-existing techniques and which are far less sophisticated than is often assumed. Indeed, we present evidence that most political parties lack the capacity to execute the hyper-intensive practices often associated with data-driven campaigning. Hence, while there is reason to remain alert to the challenges data-driven campaigning produces for democratic norms, we argue that this practice is not inherently disruptive, but rather exemplifies the evolving nature of political campaigning in the 21st century.
Establishing networked misogyny as a counter movement: The analysis of the online anti-Istanbul convention presence
Authors: Eslen-Ziya Hande
Published: April 2022

We now live in an age of unhidden gender wars where direct violence occurs within online and offline spaces. These online spaces on Facebook, Twitter or Instagram become venues for attacks on gender and woman’s rights, as well as its intersection with race and ethnicity. Such online hate expressions and networked harassments channelled towards women provide clues for us, social scientists, to understand the underlying dynamics/nature of misogyny. In this paper, by studying the online misogynistic narratives developed around the Istanbul Convention as a counter movement, I aim to highpoint the conservative and polarizing discourses that frames gender-based violence as acceptable in Turkey. More specifically I show how Twitter can be used as a platform for anti-feminist and misogynistic groups, aiming violence and hostility directly at women and their rights. As these tweets illustrate, the right-wing populist and anti-gender discourses and conservative and authoritarian politics, are being implemented on many fronts and social media is one of them.
Examining organization and provider challenges with the adoption of virtual domestic violence and sexual assault interventions in Alberta, Canada, during the COVID-19 pandemic
Authors: Montesanti Stephanie , Ghidei Winta , Silverstone Peter , Wells Lana , Squires Suzanne , Bailey Allan
Published: April 2022

Objectives

In Canada, calls to domestic violence and sexual assault hotlines increased during the COVID-19 pandemic as stricter public health restrictions took effect in parts of the country. Moreover, the public health measures introduced to limit the transmission of COVID-19 saw many health providers abruptly pivot to providing services virtually, with little to no opportunity to plan for this switch. We carried out a qualitative research study to understand the resulting challenges experienced by providers of domestic violence and sexual assault support services.

Methods

Twenty-four semi-structured interviews were conducted to gather in-depth information from service providers and organizational leaders in the Canadian province of Alberta about the challenges they experienced adopting virtual and remote-based domestic violence and sexual assault interventions during the COVID-19 outbreak. Interview transcripts and field notes were analysed using a thematic analysis approach.

Results

Our findings highlighted multiple challenges organizations, service providers and clients experienced. These included: (1) systemic (macro-level) challenges pertaining to policies, legislation and funding availability, (2) organization and provider (meso-level) challenges related to adapting services and programmes online or for remote delivery and (3) provider perceptions of client (micro-level) challenges related to accessing virtual interventions.

Conclusions

Equity-focused policy and intersectional and systemic action are needed to enhance delivery and access to virtual interventions and services for domestic violence and sexual assault clients.
Why are you offline? The issue of digital consent and discrimination of Roma communities during pandemic in Slovakia
Authors: Nevická Denisa , Mesarčík Matúš
Published: April 2022

The article is focused on the issue of discrimination against Roma communities in the use of educational online platforms on account of failure to provide digital consent. The digital education model used during the COVID-19 pandemic in the Slovak Republic somehow forgot about Roma communities, thus preventing Roma students from accessing education through online platforms. This contribution is aimed to foster the discussion of discrimination against marginalized Roma communities in accessing education through online platforms and to point out the inadequacy of national legislation on the provision of digital consent.
What is ‘roadschooling’ and who does it? A data mining web content analysis
Authors: Sotomayor Sandra
Published: April 2022

Homeschooling families typically have the freedom to plan educational road trips without the constraints of a traditional school calendar. For this study, a total of 21 web pages were selected using ‘roadschool’ – a term that has recently emerged to describe such trips – as a keyword. A web content analysis revealed that this option is perceived as an opportunity for family bonding and is mostly popular among homeschooling families who own recreational vehicles and consider themselves digital nomads. Furthermore, it was observed that roadschooling parents often exhibited personality types that enhanced the overall learning outcomes and experiences of their trips. Implications and future research directions are discussed.
Expanding the conversation: A Person-centred Communication Enhancement Model
Authors: O’Rourke Deanne J , Lobchuk Michelle M , Thompson Genevieve N , Lengyel Christina
Published: April 2022

The intricacy and impact of human communication has long captured the attention of philosophers, scholars and practitioners. Within the realm of care and service provision, efforts to maximize outcomes through optimal person-provider communication have drawn research and clinical focus to this area for several decades. With the dawning of the person-centred care movement within healthcare, and in particular long-term care home and dementia care settings, improvement in care providers’ use of person-centred communication strategies and enhancement of relationships between residents, their families and care providers are desired outcomes. Thus, several person-centred care and communication theoretical perspectives have been employed to ground study in this field. However, a comprehensive theoretical position to underpin person-centred communication in dementia and older adult research does not exist to our knowledge. To offer expansion to the theoretical work in this emerging field, a Person-Centred Communication Enhancement Model for long-term care and dementia care is proposed, as well as rationale for its development. This discussion will also provide an overview and critique of the extant philosophies, theories, frameworks and models that have been utilized in the study of person-centred communication within the context of long-term care and dementia care.
Rape Crisis Victim Advocacy: A Systematic Review
Authors: Wegrzyn Annie , Tull Peggy , Greeson Megan R. , Pierre-Louis Catherine , Patton Emily , Shaw Jessica
Published: April 2022

While rape crisis center (RCC) advocacy is generally regarded as valuable, there are no prior systematic reviews of the advocacy literature. This review examined RCC advocacy service provision, perceptions and impact of advocacy, and challenges and facilitators to effective service provision. Databases related to health and social sciences were searched including Academic Search Complete, PsychINFO, PubMed, CINAHL, ProQuest, Science Direct, OAlster, WorldCat, and MEDLINE. Empirical articles written in English that examined RCC advocacy service provision and/or impact in the US were included. The researchers reviewed abstracts and titles, and then full texts. Forty-five articles met criteria, were summarized, and double checked. Findings demonstrate advocacy is multi-faceted, beneficial, and challenging. Advocates work directly with survivors and interact with other responders on behalf of survivors. Specifically, advocates provide emotional support, safety plan, support survivors in making decisions, and assist them in navigating other systems. While advocates are generally regarded positively by survivors and responders, some responders have concerns about advocates. In addition, advocates sometimes report victim-blaming and being ill-equipped to meet survivors’ needs. Finally, advocates face specific challenges in their work with survivors and responders. Future research using diverse methodological approaches is needed to understand advocacy utilization and reach; survivors’ perceptions of advocacy; marginalized survivors’ experiences; connections between specific services, implementation, and outcomes; and effective strategies for advocates’ interactions with other responders. Additional resources to help advocates serve all survivors effectively and equitably; to support evaluator-practitioner partnerships; and to share unpublished data on advocacy may help contribute to improvements in advocacy practice.
Evidencing the Need to Screen for Social Determinants of Health Among Boys Entering a Juvenile Prison: A Latent Profile Analysis
Authors: Fix Rebecca L. , Vest Noel , Thompson Kelli R.
Published: April 2022

Social determinants of health influence who ends up in the juvenile legal system and how individuals fare when entering and leaving the system. The present study utilized latent profile analysis to determine the extent to which social determinants of health were present in a sample of incarcerated youth and the patterns in which they appear. The authors then examined their relationships to racial groups, depression, substance misuse, and recidivism risk. Data were from 1288 adolescent boys sentenced to a juvenile prison in one Southeastern state for serious offending (i.e., repeat offenses, offenses involving physical or sexual violence). We ran a latent class analysis to test for patterns with which youth present with various social determinants of health. Profiles with more violence exposure and higher social support were comprised of more Black boys than the referent profile. Property and sexual offenses also differed significantly from the referent profile. Altogether, results from our examination of selected social determinants of health indicated such factors meaningfully contribute to our understanding of experiences of young people in the juvenile legal system and may be targets for mental health and substance use intervention as they may contribute to problem behaviors or negative outcomes.
Piloting attachment psychoeducation provided to parents of children with severe disabilities: Testing the feasibility of a digital micro-intervention
Authors: Vandesande Sien , Bosmans Guy , Sterkenburg Paula , Schuengel Carlo , Maes Bea
Published: April 2022

Background

A digital micro-intervention offering attachment psychoeducational videos was explored regarding its feasibility in parents of children with severe disabilities. Method: A mixed-methods study (including daily diaries and one-time questionnaires) with 16 parents (75.0% female) of children with severe disabilities (up to 10 years of age) was done during a three-week intervention. Results: Parents were positive about the video series and almost no drop-out occurred. The videos stimulated their learning and thinking and offered parents some personal meaning. Preliminary efficacy tests showed no major changes in parents’ parenting self-efficacy (PSE) or perceptions of statements on parent–child attachment. Conclusions: The study showed promising results regarding the micro-interventions’ acceptability and implementation. The limited efficacy testing did not show major changes in parents’ PSE. Further research is needed to investigate the differential relevance of the micro-intervention, based on parents’ needs, as well as its optimal embeddedness in a broader intervention trajectory.
Novel Perspectives on Adversity Exposure, Stress Responding, and Academic Retention Among First- and Continuing-Generation Students
Authors: Fletcher Anne C. , Jensen Michaeline , Vrshek-Schallhorn Suzanne
Published: April 2022

First-generation college students are less likely to complete their degrees than continuing-generation students, in part due to experiences of educational and socioeconomic adversity. Accounting for adversity and its downstream implications is likely to suggest new interventions that promote resilience and retention of these students. We propose a novel model in which the influence of adversity on long term academic outcomes acts through indicators of stress responding, then through academic avoidance behaviors. The strength of this pathway depends upon both a cognitive processing characteristic that affects stress responding—trait rumination—and levels of enacted family support during college. This perspective suggests specific targets for intervention that include decreasing levels of rumination, increasing levels of family support, and decreasing academic avoidance behaviors for all students, but might be particularly relevant to first-generation students.
An integrated framework for assessment of smart city resilience
Authors: Khatibi Hamed , Wilkinson Suzanne , Eriwata Graham , Sweya Lukuba N , Baghersad Mostafa , Dianat Heiman , Ghaedi Khaled , Javanmardi Ahad
Published: April 2022

Cities are becoming smarter in their functions; however, they are not necessarily resilient and able to survive the impact of disasters. An integrated, smart and resilient city is a quest for today and future sustainability that has been scarcely studied. Therefore, this current paper develops a comprehensive framework for re-evaluating cities’ smartness and assessing their resilience against unforeseen disruptive events. A top-down approach is adopted with an expert’s validation process and evaluated in a hypothetical city’s water supply system to demonstrate its workability. The study contributes towards a holistic framework that includes smartness re-evaluation and resilience assessment components that can be used to ensure the resiliency of smart cities from both developed and developing countries resisting disasters.
A qualitative analysis of factors influencing health-seeking behavior of people living with HIV, hypertension and diabetes in an urban area of Ghana
Authors: Abdulai Martha Ali , Marable Julian K , Wadus Awudu , Asante Kwaku Poku
Published: April 2022

Non-communicable diseases are rising globally and lower-middle-income countries are now facing a double-burden of communicable and non-communicable diseases like hypertension and diabetes. Patients with HIV/AIDS are at increased risk of developing hypertension and diabetes. Understanding how this double-burden influences persons living with HIV health-seeking behavior (HSB) is critical to identifying successful interventions and policies. To explore the factors that influence the health-seeking behavior of HIV patients with hypertension and diabetes in an urban setting of Ghana, we undertook a qualitative study consisting of sixteen in-depth interviews (five healthcare providers [HCP] and eleven patients); all recruited from Antiretroviral Therapy (ART) clinics in the Techiman South Municipality of Ghana. Interview questions were designed to explore cognitive, affective, social, and environmental factors that influence an individual’s decision-making process and behavior. All interviews were audio-recorded, transcribed, and analyzed thematically.

Participants raised unique challenges while seeking treatment services for HIV, hypertension, and diabetes. Frequent appointments, increased pill burden, food restrictions, alternate sources of care (herbalist and pastors), and negative psychological wellbeing were some of the challenges noted for seeking treatment services. Challenges with the health facility, including separate clinic days for comorbid conditions, high costs of medications and transportation, and long waiting hours were also cited as influencing health-seeking behavior.

Results indicate greater challenges for HIV patients living with hypertension and diabetes in accessing treatment services. Understanding this is critical to removing barriers and making treatment more accessible. Further integration of treatment for hypertension and diabetes into HIV care is essential to ensuring patient engagement in continuous care.
Evaluation of the combination therapy of hydroxyurea and thalidomide in β-thalassemia
Authors: Ansari Saqib H. , Ansari Iqra , Wasim Misbah , Sattar Amjad , Khawaja Shariqa , Zohaib Muhammad , Hussain Zeeshan , Adil Syed Omair , Ansari Ali H. , Ansari Usman H. , Farooq Fawad , Masqati Noor-un-Nisa
Published: April 2022

Transfusion-related complications and lack of resources in low-to-middle-income countries have led to a search for novel therapies to reduce the need for blood transfusions in patients with β-thalassemia. Hydroxyurea (HU) has demonstrated promising outcomes; additionally, thalidomide has also shown improvement in hemoglobin (Hb) levels for patients with β-thalassemia in some studies. This study presents the findings of a single-arm nonrandomized trial to evaluate the efficacy of combination therapy of HU and thalidomide in children with β-thalassemia. A total of 135 patients (median age, 6 [interquartile range, 3-10] years), 77 (57%) males and 58 (43%) females, were followed first using HU alone, for 6 months, and then using the combination of HU and thalidomide for another 6 months. The primary outcome was a response to therapy, as measured by the number of transfusions required and Hb levels, for patients while receiving HU alone and then while using the combination therapy. Study findings showed a significant decline in blood transfusion volume (P < .001) and a significant increase in median Hb levels within 3 and 6 months of the combination therapy (P < .001). Eighty-nine (65.93%) participants were good responders, 16 (11.85%) were responders, and 30 (22.22%) were nonresponders, whereas the responders had variable genetic mutations. A total of 38 adverse events were reported that resolved on supportive treatment or temporary hold of the intervention. The combination therapy demonstrated promising results and could be considered for a diverse patient population with β-thalassemia. This trial was registered at www.clinicaltrials.gov as #NCT05132270.
Remnant preservation may improve proprioception after anterior cruciate ligament reconstruction
Authors: Cho Eunshinae , Chen Jiebo , Xu Caiqi , Zhao Jinzhong
Published: April 2022

Aim

Our aim was to evaluate the literature investigating proprioception improvement after anterior cruciate ligament reconstruction (ACLR) and test the hypothesis that ACL tibial remnant-preserving reconstruction (ACLR-R) is more beneficial than standard technique (ACLR-S) in terms of postoperative proprioceptive function with various reported tests, including joint position sense (JPS) and threshold to detect passive motion (TTDPM).

Methods

An online search was performed in Embase, MEDLINE/PubMed, Cochrane, SPORTDiscus, and Web of Science databases before 5 October 2020, on the basis of the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Key terms [(‘ACLR’ or ‘ACL-R’ or ‘anterior cruciate ligament reconstruction’) AND (‘remnant’ or ‘stump’) AND (‘proprioception’ or ‘proprioceptive’)] were used. The Oxford Centre for Evidence-Based Medicine and The McMaster Critical Review Form for Quantitative Studies were used for quality assessment. In total, four articles comparing proprioceptive functions between ACLR-R and ACLR-S were included, two of which were randomized clinical trials rated as level of evidence II, and two were retrospective cohort studies rated as level of evidence III. The outcomes were then compared. Evaluation of proprioception involved joint position sense (JPS) [reproduction of active positioning (RAP) and reproduction of passive positioning (RPP)] and threshold to detect passive motion (TTDPM) tests.

Results

Only four studies were included, with a total of 234 patients (119 ACLR-R patients and 115 ACLR-S patients). High heterogeneity in characteristics and outcome measurements was observed among the studies. Three studies performed sparing technique, and one performed tensioning technique. One study tested RAP and reported better results at an average of 7 months follow-up in ACLR-R (P < 0.05). Three studies tested RPP, one of which measured RPP within 12 months after surgery and reported better results in ACLR-R than in ACLR-S (P < 0.05). The other two studies reported similar results; however, the findings of one study were statistically insignificant. TTDPM was tested in one study, with no statistically significant difference found.

Conclusion

The current literature, although limited, reported proprioception improvement after ACLR-R (compared with ACLR-S) in terms of JPS. However, owing to the heterogeneity of the relevant studies, further research is required to determine remnant preservation effect on knee proprioceptive restoration.

Level of evidence

Level III, systematic review of Level II and III studies.
Comparison of low-dose morphine intrathecal analgesia and sufentanil PCIA in elderly patients with hip fracture undergoing single spinal anesthesia — a randomized clinical trial
Authors: Xu Zhifei , Tang Zairong , Yao Juan , Liang Dongliang , Jin Feng , Liu Ying , Guo Kai , Yang Xiulu
Published: April 2022

Background

The complications of postoperative pain, such as hypertension, hypermetabolism, irritability, and postoperative cognitive dysfunction, significantly affect the postoperative rehabilitation of elderly patients. Intrathecal morphine prolongs analgesia after surgery, but has been implicated in nausea and vomiting, pruritus, postoperative respiratory depression, or apneic episodes. The present study explored the effect and safety of low-dose morphine used adjunctively with bupivacaine during single spinal anesthesia or sufentanil patient-controlled intravenous analgesia (PCIA) in elderly patients with hip fracture surgery. Since elderly patients often need anticoagulant therapy in the early postoperative period, single spinal anesthesia was involved in completing the operation in this study.

Methods

Eighty elderly patients aged 70–85 years who underwent elective hip fracture surgery with single spinal anesthesia were divided into two groups, 12.5 mg of 0.5% hyperbaric bupivacaine with 100 µg of morphine (morphine group, group M) and 12.5 mg of 0.5% hyperbaric bupivacaine with 100 µg of sufentanil PCIA (sufentanil group, group S). The analgesia scores using the visual analogue scale (VAS), the Brinell comfort scale (BCS) were evaluated at 6, 12, 24, and 48 h after operation, and adverse reactions were recorded such as nausea and vomiting, pruritus, sedation, respiratory depression, and POD (postoperative delirium) with Delirium Rating Scale-r 98.

Results

Within 24 h after operation, the analgesic and BCS scores of group M were better than those of group S (P < 0.05). Group M had higher frequency of skin pruritus than group S within 24 h, and the difference was statistically significant. The incidence of POD in group M (2 cases) was lower than that in group S (6 cases) (5.71% vs 18.18%) (P < 0.05) with the DRS-r 98 scores. No significant difference was observed in nausea and vomiting between the two groups, and the difference of severe respiratory depression was not found in both groups.

Conclusion

Compared with sufentanil PCIA, low-dose intrathecal morphine has a satisfactory analgesic effect, and little effect on the patient's cognitive function with low medical cost. Under effective respiratory monitoring, it can be used safely and effectively in elderly patients with hip fracture.

Trial registration

Registered with the Chinese Clinical Trial Registry under ChiCTR2100042706. 26/01/2021.
The ten-year risk of developing cardiovascular disease among public health workers in North-Central Nigeria using Framingham and atherogenic index of plasma risk scores
Authors: Olubiyi Olubunmi Abiola , Rotimi Bosede Folashade , Afolayan Munirat Ayoola , Alatishe-Muhammad Bilqis Wuraola , Olubiyi Olufemi Mubo , Balami Ahmed Dahiru
Published: April 2022

Background

Estimation of total cardiovascular disease (CVD) risk with the use of risk prediction charts such as the Framingham risk score and Atherogenic index of plasma score is a huge improvement on the practice of identifying and treating each of the risk factors such as high blood pressure and elevated blood cholesterol. The estimation of the total risk highlights that CVD risk factors occur together and thereby predicts who should be treated. There is scarcity of data on the risk scoring of adults in Nigeria including health workers. Therefore, this study was done to estimate the cardiovascular risks of health workers in public health services in north-central Nigeria.

Methods

A cross-sectional survey was performed using validated Framingham risk score calculator and calculation of risk based on the lipid profile of 301 randomly selected health workers in North-central Nigeria. Descriptive analysis was done using frequency counts and percentages while inferential statistics were done using chi square and correlation analyses using statistical Package for Social Sciences (SPSS) version 21.0. The confidence level was 95% and the level of significance was set at 0.05.

Results

The 10-year risk of developing CVD was generally low in the health workers. Using Framingham risk score, 98.3% of health workers have low risk, 1.0% have moderate risk and 0.7% have high risk. Among the cadres of health workers, 1.5% of the nurses have moderate risk while 2.5% of the doctors and 3.3% of the CHEWs have high risk of developing CVD in 10 years. Using Atherogenic index of plasma scoring, only 2% of the health workers have high risk, 4.7% have intermediate risk while 93.4% have low risk. Across the cadres, 6.3% of the nurses and 3.3% of the CHEWs have intermediate risk while 2.4% of the nurses and 3.3% of the CHEWs have high risk. These findings were however not statistically significant.

Conclusions

The 10-year risk of developing cardiovascular disease was low in the health workers in this study using both Framingham’s risk score and atherogenic index of plasma scores.
Internet access is a necessity: a latent class analysis of COVID-19 related challenges and the role of technology use among rural community residents
Authors: Dow-Fleisner Sarah J. , Seaton Cherisse L. , Li Eric , Plamondon Katrina , Oelke Nelly , Kurtz Donna , Jones Charlotte , Currie Leanne M. , Pesut Barb , Hasan Khalad , Rush Kathy L.
Published: April 2022

Background

Rural and remote communities faced unique access challenges to essential services such as healthcare and highspeed infrastructure pre-COVID, which have been amplified by the pandemic. This study examined patterns of COVID-related challenges and the use of technology among rural-living individuals during the first wave of the COVID-19 pandemic.

Methods

A sample of 279 rural residents completed an online survey about the impact of COVID-related challenges and the role of technology use. Latent class analysis was used to generate subgroups reflecting the patterns of COVID-related challenges. Differences in group membership were examined based on age, gender, education, race/ethnicity, and living situation. Finally, thematic analysis of open-ended qualitative responses was conducted to further contextualize the challenges experienced by rural-living residents.

Results

Four distinct COVID challenge impact subgroups were identified: 1) Social challenges (35%), 2) Social and Health challenges (31%), 3) Social and Financial challenges (14%), and 4) Social, Health, Financial, and Daily Living challenges (19%). Older adults were more likely to be in the Social challenges or Social and Health challenges groups as compared to young adults who were more likely to be in the Social, Health, Financial, and Daily Living challenges group. Additionally, although participants were using technology more frequently during the COVID-19 pandemic to address challenges, they were also reporting issues with quality and connectivity as a significant barrier.

Conclusions

These analyses found four different patterns of impact related to social, health, financial, and daily living challenges in the context of COVID. Social needs were evident across the four groups; however, we also found nearly 1 in 5 rural-living individuals were impacted by an array of challenges. Access to reliable internet and devices has the potential to support individuals to manage these challenges.
Promoting healthy eating in Latin American restaurants: a qualitative survey of views held by owners and staff
Authors: Fuster Melissa , Abreu-Runkle Rosa , Handley Margaret A. , Rose Donald , Rodriguez Michelle A. , Dimond Emily G. , Elbel Brian , Huang Terry T. K.
Published: April 2022

Background

Restaurants, particularly independently-owned ones that serve immigrant communities, are important community institutions in the promotion of dietary health. Yet, these restaurants remain under-researched, preventing meaningful collaborations with the public health sector for healthier community food environments. This research aimed to examine levels of acceptability of healthy eating promotion strategies (HEPS) in independently-owned Latin American restaurants (LARs) and identify resource needs for implementing HEPS in LARs.

Methods

We completed semi-structured, online discussions with LAR owners and staff (n = 20), predominantly from New York City (NYC), to examine current engagement, acceptability, potential barriers, and resource needs for the implementation of HEPS. Verbatim transcripts were analyzed independently by two coders using Dedoose, applying sentiment weighting to denote levels of acceptability for identified HEPS (1 = low, 2 = medium/neutral, 3 = high). Content analysis was used to examine factors associated with HEPS levels of acceptability and resource needs, including the influence of the Coronavirus pandemic (COVID-19).

Results

The most acceptable HEPS was menu highlights of healthier items (mean rating = 2.8), followed by promotion of healthier items (mean rating = 2.7), increasing healthy offerings (mean rating = 2.6), nutrition information on the menu (mean rating = 2.3), and reduced portions (mean rating = 1.7). Acceptability was associated with factors related to perceived demand, revenue, and logistical constraints. COVID-19 had a mixed influence on HEPS engagement and acceptability. Identified resource needs to engage in HEPS included nutrition knowledge, additional expertise (e.g., design, social media, culinary skills), and assistance with food suppliers and other restaurant operational logistics. Respondents also identified potential policy incentives.

Conclusions

LARs can positively influence eating behaviors but doing so requires balancing public health goals and business profitability. LARs also faced various constraints that require different levels of assistance and resources, underscoring the need for innovative engagement approaches, including incentives, to promote these changes.
Do expectations of recovery improve risk assessment for people with whiplash-associated disorders? Secondary analysis of a prospective cohort study
Authors: Griffin Alexandra R. , Sterling Michele , Ritchie Carrie , Kifley Annette , Jagnoor Jagnoor , Cameron Ian D. , Rebbeck Trudy
Published: April 2022

Background

WhipPredict, which includes prognostic factors of pain-related disability, age and hyperarousal symptoms, was developed and validated for prediction of outcome in people with whiplash associated disorders (WAD). Patient expectations of recovery was not an included factor, though is known to mediate outcomes. The aim of this study was to determine whether the addition of expectations of recovery could improve the accuracy of WhipPredict.

Methods

Two hundred twenty-eight participants with acute WAD completed questionnaires (WhipPredict and expectations of recovery) at baseline. Health outcomes (neck disability index (NDI) and Global Perceived Recovery (GPR)) were assessed at 6- and 12-months post injury. Cut-off points for expectations of recovery predictive of both full recovery (NDI ≤10 % , GPR ≥ 4) and poor outcome (NDI ≥30 % , GPR ≤  − 3) were determined, and multivariate logistic regression analyses were used to compare models with and without this variable.

Results

Expectations of recovery improved or maintained the accuracy of predictions of poor outcome (6-months: sensitivity 78 to 83%, specificity maintained at 79.5%; 12-months: sensitivity maintained at 80%, specificity 69 to 73%). The sensitivity of predictions of full recovery improved (6-months: 68 to 76%; 12-months: 57 to 81%), though specificity did not change appreciably at 6 months (80 to 81%) and declined at 12 (83 to 76%). ROC curves indicated a larger and more consistent improvement in model performance when expectations of recovery were added to the pathway predictive of full recovery.

Conclusions

The addition of expectations of recovery may improve the accuracy of WhipPredict, though further validation is required.
Predicting in-hospital length of stay: a two-stage modeling approach to account for highly skewed data
Authors: Xu Zhenhui , Zhao Congwen , Scales Charles D. , Henao Ricardo , Goldstein Benjamin A.
Published: April 2022

Background

In the early stages of the COVID-19 pandemic our institution was interested in forecasting how long surgical patients receiving elective procedures would spend in the hospital. Initial examination of our models indicated that, due to the skewed nature of the length of stay, accurate prediction was challenging and we instead opted for a simpler classification model. In this work we perform a deeper examination of predicting in-hospital length of stay.

Methods

We used electronic health record data on length of stay from 42,209 elective surgeries. We compare different loss-functions (mean squared error, mean absolute error, mean relative error), algorithms (LASSO, Random Forests, multilayer perceptron) and data transformations (log and truncation). We also assess the performance of two stage hybrid classification-regression approach.

Results

Our results show that while it is possible to accurately predict short length of stays, predicting longer length of stay is extremely challenging. As such, we opt for a two-stage model that first classifies patients into long versus short length of stays and then a second stage that fits a regresssor among those predicted to have a short length of stay.

Discussion

The results indicate both the challenges and considerations necessary to applying machine-learning methods to skewed outcomes.

Conclusions

Two-stage models allow those developing clinical decision support tools to explicitly acknowledge where they can and cannot make accurate predictions.
The value of a redesigned clinical course during COVID-19 pandemic: an explorative convergent mixed-methods study
Authors: Egilsdottir H. Ösp , Heyn Lena Günterberg , Brembo Espen Andreas , Byermoen Kirsten Røland , Moen Anne , Eide Hilde
Published: April 2022

Background

The COVID-19 lockdown in March 2020 had a significant consequence for nursing students worldwide including limited access to learning situations in clinical rotation. Therefore, this study aims to explore how an innovative redesign of a clinical course in a time of pandemic supported nursing students in learning the fundamentals of care in their first year. The redesign involved the transformation of a traditional hands-on clinical course into a technology-enhanced learning environment.

Design

This was an explorative convergent mixed-methods study using both quantitative and qualitative methods.

Methods

Twenty-four first-year nursing students responded to an online questionnaire with open-ended questions. Two nursing students and one faculty member participated in individual online interviews, and three faculty members participated in an online focus group interview. All the data were collected in June 2020. The quantitative data were analyzed using descriptive statistics and the qualitative data using content analysis. The GRAMMS guideline was applied.

Results

The students achieved the learning outcomes regarding fundamental care, basic physical assessment skills, and clinical reasoning with the help of academic assignments, multimedia learning resources, and virtual patients. Further, six central aspects of the facilitator role in the virtual simulation were identified. The aspect that was considered most valuable involved uncovering the “red thread” between different areas of knowledge in the first year of nursing education; this supported the students to better understand how to think and talk like a nurse.

Conclusion

This study offers insight into how a technology-enhanced clinical course can foster the learning of fundamental nursing care, basic physical assessment skills, and clinical reasoning skills; enhancing students’ preparedness for clinical hours. Virtual patients’ scenarios contributed to integrating different types of knowledge and skills that are important when providing nursing care for patients in clinical practice. This study also highlighted a gap in pedagogical competence among faculty members with regards to facilitating learning in a technology-enhanced learning environment. Study findings suggest promising pedagogical strategies that should be further developed post-pandemic, in response to the call for a renewal of nursing education using more technologically supported learning designs.
Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden – A cross sectional study
Authors: Andersson Ingrid , Eklund Anna Josse , Nilsson Jan , Bååth Carina
Published: April 2022

Background

With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses’ perspective.

Methods

A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question.

Results

The care activity most often missed in home care was: ‘set up or update care plans’ (41.8%), and in nursing homes: ‘scheduled group activity’ (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual.

Conclusion

Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.
Financial burden of catastrophic health expenditure on households with chronic diseases: financial ratio analysis
Authors: Jung Hyunwoo , Kwon Young Dae , Noh Jin-Won
Published: April 2022

Background

The financial status of households is vulnerable to chronic diseases which entail high medical expenses and income loss. Financial strain can be assessed by four indicators: a household surplus indicator, the liquid asset/debt ratio, a solvency indicator, and a liquidity indicator. We investigated the association between catastrophic health expenditure (CHE) and financial ratio indicators in households with chronic diseases in South Korea.

Methods

This study applied thresholds to the financial ratios to determine the financial strain. We conducted multiple logistic regression analyses to determine whether CHE is associated with financial strain. Furthermore, we analyzed the relationship between CHE and basic financial indicators, absolute finance size, using multiple linear regression.

Results

When CHE occurred, all financial ratio indicators deteriorated. However, this was not due to decreases in the absolute size of wealth and income, but rather the relative balance between finances. In particular, the loss of liquid assets was a major factor in the deterioration. In addition, all types of labor-related income deteriorated; only private transfer income increased.

Conclusions

This study revealed that CHE in households with chronic diseases negatively impacts household finances. It was found that financial coping strategies are only resource consuming.
Research capacity-building for clinicians: understanding how the research facilitator role fosters clinicians’ engagement in the research process
Authors: Flenady Tracy , Dwyer Trudy , Kahl Julie , Sobolewska Agnieszka , Reid-Searl Kerry , Signal Tania
Published: April 2022

Background

There is evidence reporting more positive outcomes from research capacity-building (RCB) programmes that include a research facilitator role. Further, it has been suggested that research facilitator roles can be a useful strategy in building the research capacity of healthcare clinicians. However, until now, little attention has been applied to identifying the characteristics of the research facilitator role and how this role contributes to clinicians’ engagement with the research process. The aim of this present study is to explore the characteristics required of the research facilitator role in the educational workshop phase of an RCB programme.

Methods

This qualitative study employed an inductive approach and utilized face-to-face interviews to gather data from a purposely selected cohort. Professionally transcribed responses were thematically analysed.

Results

The role of the research facilitator emerged as comprising two main themes: (1) facilitating the research process and (2) engaging expert clinicians as novice researchers. Pragmatically, analysis of data led to the development of a table outlining the responsibilities, skills and attributes related to each theme. Conceptually, theme 1 encapsulates the research facilitators’ skills and experience and their role as knowledge brokers and cocreators of knowledge. Theme 2 provides insight into the clinician-centric approach the research facilitators utilized to build and foster relationships and support the clinicians through their research journey.

Conclusion

This study reports on the characteristics of the research facilitator role in one phase of an RCB programme in one regional health service district in Australia and explains how the role fosters clinicians’ engagement with the research process. Findings from this study will inform the development of future RCB programmes, which is important considering that clinicians’ increased engagement with the research process is vital for developing a sound evidence base to support decision-making in practice and leads to higher levels of skills and greater ability to perform useful research.