bluuebunny/crossref_metadata_2025 huggingface dataset:
The Lived Experience of Siblings of Children With Cancer Who Attended a Peer Support Camp in the United States
Authors: Gregory Donna , Van Puymbroeck Marieke , Crowe Brandi , Garst Barry , Amylon Michael
Published: May 2022

Childhood cancer has a profound and negative impact on siblings, yet there are limited studies exploring lived experiences from their perspective. This qualitative study examined the perceptions and experiences of siblings of children with cancer who attended a peer support camp. Semi-structured interviews were conducted three to six weeks after the weeklong peer support camp with a stratified random sample of 10 siblings (six non-bereaved and four bereaved) ages 8 to 16 years. The qualitative data were analyzed using conventional content analysis and an inductive data-driven approach. Four themes emerged: social connection (subthemes: support/feeling of belonging, mentorship, and expressing feelings), personal growth, identity, and freedom to have fun and relax. These findings add to the scant body of research by providing enhanced understanding of the siblings’ experiences and new insights into their perceptions of meaning and outcomes associated with participation in a peer support camp. These findings have implications for peer support camp programs and the well-being of siblings of children with cancer.
Treatment Experiences Among People Who Use Opioids: A Social Ecological Approach
Authors: Kahn Linda S. , Wozniak Monika L. , Doscher Tildabeth , Moore Cheryll , Vest Bonnie M.
Published: May 2022

The prevalence of opioid use disorder (OUD) and surge in overdose deaths remain key public health concerns. Despite evidence supporting the efficaciousness of medications for opioid use disorder, most people with OUD do not receive treatment. In this qualitative study, semi-structured interviews were conducted with 35 adults in a northeastern city to learn about their experiences with substance use treatment. Qualitative data were analyzed using an inductive thematic content analysis approach, and a social ecological model was applied to examine contextual factors affecting participants’ experiences accessing and engaging in treatment. While we organized our findings following the individual, interpersonal, community, and society levels of the socio-ecological model, we also observed overlap and interconnectedness between and across these levels. Our findings suggest that retention in treatment often depends upon personal motivation, treatment availability, the match of the treatment modality to an individual’s needs, and social support. A person-centered approach is needed to promote individualized care and tailor treatment components to the patient’s needs.
Singing for Wellbeing: Formulating a Model for Community Group Singing Interventions
Authors: Hendry Natasha , Lynam Dr Siobhan , Lafarge Caroline
Published: May 2022

Research into the benefits of community-based group singing, pertaining to positive wellbeing and Quality of Life is lacking. Additionally, no preferred theoretical framework exists for community singing-based interventions. For the present study, six members of a UK community choir were interviewed using a semi-structured interview approach. Interpretative phenomenological analysis (IPA) was employed. Analysis produced superordinate themes of: Social Factors with key elements such as social bonds and group identity; Psychological Factors, highlighting self-efficacy, self-identity and positive emotions and Psychological Motivations for Joining the Group, including autonomy, change of life circumstance and seeking a new challenge. The style/method of the group, teaching, music and group leader, were shown to have an influence on perceived benefits of the singing group. A key product of this study beyond the evidenced benefits of group singing is the development of an intervention model that optimises wellbeing outcomes in community singing groups underpinned by psychological theory, findings from the wider literature and the results of this study.
Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden
Authors: Starr Lauren T. , Washington Karla , McPhillips Miranda V. , Pitzer Kyle , Demiris George , Oliver Debra Parker
Published: May 2022

Background

Poor sleep exacerbates mental health problems and reduces quality-of-life (QOL) but prevalence of insomnia symptoms among hospice family caregivers and associations of poor sleep with caregiver health and QOL outcomes are not known.

Objective

To describe prevalence of insomnia symptoms among hospice family caregivers and compare anxiety, depression, self-rated health, QOL, and caregiver burden between hospice family caregivers with and without insomnia symptoms.

Methods

Descriptive sub-study using data collected during baseline interviews of hospice family caregivers involved in a randomized clinical trial in Midwestern United States (xxxxxxxx). Caregivers were dichotomized based on Insomnia Severity Index (ISI) scores (8+ indicated insomnia symptoms).

Results

Among 57 hospice family caregivers, the mean ISI score was 8.2; nearly half (49.1%) experienced insomnia symptoms. Compared to caregivers without insomnia symptoms, caregivers with insomnia symptoms reported 2.4 times greater mean anxiety scores (4.7 vs 11.4); 3.5 times greater mean depression scores (3.1 vs 10.7); 2.1 times greater caregiver burden scores (5.6 vs 11.8); and 1.3 times lower self-rated health (3.5 vs 2.8); 1.3 times lower total QOL scores (29.3 vs 22.6); including differences in emotional QOL (7.9 vs 2.2), social QOL (7.2 vs 3.0), and physical QOL (7.4 vs 5.3).

Conclusions

Hospice family caregivers experience high prevalence of insomnia symptoms; caregivers with insomnia symptoms report worse anxiety, depression, caregiver burden, QOL, self-rated health. Clinicians must screen hospice caregivers for poor sleep and mental health and offer supportive interventions that improve their sleep and health. Policy makers must expand hospice benefits to better support family caregivers.
Elastic wave attenuation in a metaplate with periodic hollow shapes for vibration suppression
Authors: Tomita Sunao , Nishigaki Hidekazu , Omote Ryuji
Published: May 2022

Low noise and vibrations are requirements for engineering structures to realize comfort and ensure systems are environmental friendly. Periodic structures such as phononic crystals have been investigated to suppress noise and vibrations because they inhibit elastic wave propagation in the frequency ranges referred to as the band gap. This study led to the proposal of a metaplate (MP) with periodic hollow structures to form band gaps by changing the surface shapes of the thin plates. MPs such as this can be beneficial from the viewpoints of manufacturing cost and structural reliability when applied to engineering structures. To evaluate the potential ability of the proposed MP to suppress vibrations, we obtained the band gap frequency of out-of-plane deformation waves using the wave finite element method. To efficiently evaluate the band gaps, the internal degrees of freedom in a unit cell are reduced based on the modal analysis technique. Furthermore, the out-of-plane and in-plane deformation waves are separated using kinematic energy to extract the band gap related to the out-of-plane deformation waves. Based on this numerical framework, we demonstrate that periodic hollow shapes can form a band gap in the frequency range of interest in engineering problems. Moreover, the potential of the MP was investigated using hollow shape design and material selection, and the results indicate that the proposed MP is beneficial for tuning the band gap frequency in a unit cell of which the size is acceptable for engineering structures. Finally, vibration suppression caused by band gap is experimentally demonstrated via impact testing of an MP fabricated using additive manufacturing.
Observer-based adaptive neural network control design for projective synchronization of uncertain chaotic systems
Authors: Boubakir Ahsene , Labiod Salim
Published: May 2022

This paper addresses the design of an observer-based adaptive neural network chaos synchronization scheme for a general class of uncertain chaotic systems. The controller consists of an adaptive neural network control law and an extended state observer. The parameterization of the designed extended observer and the sufficient stability conditions are derived in the light of the singular perturbation theory. The extended observer is incorporated into the controller to reconstruct the synchronization error vector as well as to estimate the error between an ideal control law and the actual control. These estimated error signals are utilized in the adaptation mechanism of the neural network weight vector. In the presented chaos synchronization method, the knowledge of the models of the master–slave systems is not required and the controller only needs the projective synchronization error for its implementation. Numerical simulations are performed along with a comparative study to demonstrate the efficiency and effectiveness of the suggested chaos synchronization approach.
Mindfulness and Nondual Well-Being – What is the Evidence that We Can Stay Happy?
Authors: Jones Patrick
Published: May 2022

Research into subjective well-being (SWB) focuses on conducive life conditions, healthy cognitive-affective processes and adaptive behaviours, however, in this model, well-being fluctuates based on changing mental and physical phenomena. This inquiry explores the possibility that we can have a nondual experience of well-being that is unaffected by such movements and investigates if the literature supports this. The assertion in traditional mindfulness that the sense of self is constructed and responsible for such fluctuations is explored, along with what evidence there is that mindfulness practices deliver relevant cognitive and behavioural correlates associated with such a way of being. Proposed preconditions include (a) nondual awareness or the perception of no-self; (b) increased positive affect, decreased negative affect, and increased self-lessness; (c) increased capacity to maintain (or protect) well-being including heightened emotional self-regulation and resilience to aversive stimuli. Research findings provide some evidence that the sense of self can be both constructed and deconstructed, and that mindfulness training may target psychological dimensions that could contribute to an experience of well-being that transcends the impact of life conditions. Recommendations are made for a collaborative relationship between SWB research and mindfulness to expand the inquiry into possible causes and conditions of ‘nondual well-being’.
Hepatitis C Virus Prevalence, Medical Status Awareness and Treatment Engagement among Homeless People Who use Drugs: Results of a Street Outreach Study
Authors: Lasmanovich Rinat , Shaked Or , Sivan Ayelet , Barak Idan , Nahari Mor , Mor Orna , Katchman Helena
Published: May 2022

Background:

Hepatitis C virus (HCV) infection is a primary health concern among people who use drugs (PWUDs). Homeless PWUDs that constitute a key population for HCV transmission remain underrepresented in many surveys.

Objectives:

We performed a proactive street outreach to evaluate HCV infection prevalence among homeless PWUDs in Tel Aviv, identify risk factors associated with HCV infection, awareness of disease status and linkage to care rate.

Results:

Thirty-eight percent of approached PWUD were willing to participate in the study. Out of 53 subjects who got tested for anti HCV by rapid test, 29 (54.72%) had a positive result, 20 of 29 anti-HCV positive (69%) patients had positive HCV PCR. Risk factors were investigated using structured questionnaires. Heroin use was reported significantly more frequently in the HCV-positive group ( P =  .05, CI 95%), whereas other established risk factors did not reach significance in our cohort. While 21 of 29 (72%) HCV-positive participants were aware of their condition, only 4 of 21 (19%) received treatment in the past, and 2 of 4 (50%) failed to achieve treatment goals, as assessed by HCV PCR.

Conclusions:

Our data indicate a high prevalence of HCV infection among homeless PWUDs. Importantly, despite relatively high awareness of HCV status in this population, we found strikingly low access to care. These findings motivate novel interventional approaches targeted at improving patient access, and compliance among homeless PWUDs, in an effort to reduce HCV transmission.
Tryptophan and Biogenic Amines in the Differentiation and Quality of Honey
Authors: Borges Cristine Vanz , Nunes Aline , Costa Vladimir Eliodoro , Orsi Ricardo de Oliveira , Basilio Leticia Silva Pereira , Monteiro Gean Charles , Maraschin Marcelo , Lima Giuseppina Pace Pereira
Published: May 2022

Honey is a natural product with beneficial properties to health and has different characteristics depending on the region of production and collection, flowering, and climate. The presence of precursor amino acids of- and biogenic amines can be important in metabolomic studies of differentiation and quality of honey. We analyzed 65 honeys from 11 distinct regions of the State of Santa Catarina (Brazil) as to the profile of amino acids and biogenic amines by HPLC. The highest L-tryptophan (Trp), 5-hydroxytryptophan (5-OH-Trp), and tryptamine (Tryp) levels were detected in Cfb climate and harvested in 2019. Although we have found high content of serotonin, dopamine, and L-dopa in Cfb climate, the highest values occurred in honey produced during the summer 2018 and at altitudes above 900 m. Results indicate that the amino acids and biogenic amine levels in honeys are good indicators of origin. These data warrant further investigation on the honey as source of amino acids precursor of serotonin, melatonin, and dopamine, what can guide the choice of food as source of neurotransmitters.
Experimental study on shear performance of steel shell-concrete composite structure in immersed tunnel
Authors: Li Yongxuan , Song Shenyou , Jin Wenliang , Liu Yuqing
Published: May 2022

Based on local arrangement details in the top slab of Shenzhen–Zhongshan Link immersed tunnel, steel shell-concrete (SSC) composite specimens with 1:2.5 scale were prepared and tested under shear, to investigate the effects of transverse T-shape stiffeners on shear capacities, crack development, and relative slip. Finite element models were also built and verified by the experimental results. For the specimen without transverse stiffeners, the failure at the steel plate-concrete interface occurred firstly, and then top and bottom steel plates were separated from the compression concrete core. While for the specimen with transverse T-shape stiffeners, the concrete cracks developed diagonally from the flange edge of T stiffeners near the bottom steel plate in sequence, and the corresponding tension field in the steel web enlarged gradually until full web yielding, as the shear force increased. Compared to specimens without transverse stiffeners, when transverse T stiffeners were placed in SSC composite specimens, the shear force at initial cracking was much smaller, but the yielding and ultimate shear capacities were increased by 12.2% and 14.6%, respectively. Although earlier cracking induced, the transverse T stiffeners were beneficial to improve shear capacities of SSC composite structures. The maximum relative slip at steel plate-concrete interface of specimens with and without transverse T stiffeners were 0.28 mm and 0.62 mm before the structure reaching the yielding stage, respectively, indicating that transverse T stiffeners could reduce the relative slip and separation between steel plates and concrete core, ensuring the effective composite action of steel plates and filled concrete. T stiffeners could improve the compressive behavior of concrete. With transverse T stiffeners placed in SSC composite structure, and the shear force could be resisted by both the diagonal compressive core in concrete and the arch system formed with the T stiffeners.
Parenting coordination, a new role for social workers
Authors: Blanco Marta , Ferreira Jorge Manuel Leitao , Arias Astray Andrés
Published: May 2022

• Summary. The main aim of this article is to assess the attention paid in social work to the role of parenting coordinator (PC). These professionals offer individualised support to high-conflict families in their implementation of parenting plans, normalising the relationship between parents and safeguarding the protection of minors. This form of alternative dispute resolution is being incorporated into the judicial system of various countries in a highly heterogeneous manner, with some countries such as Spain and Portugal experiencing uncertain times. A systematic literature review was performed, incorporating existing international studies in English, Spanish and Portuguese as well as court rulings in Spain, to identify the presence of social work as a discipline in this new professional role. • Findings. The findings show that despite the suitable training background of social workers, the involvement of their professional associations and their contributions to the function performed by PCs, there is no specific social work research focused on this area of knowledge. • Applications. The main contribution of this study is the commitment to a new professional niche for social work, traditionally occupied by psychologists. The emphasis should be placed not so much on the original training of the professional, but rather on his or her complementary training and accredited experience in highly conflictive situations.
A Machine learning-based approach to determining stress in rails
Authors: Belding Matthew , Enshaeian Alireza , Rizzo Piervincenzo
Published: May 2022

Recent advancements in both software and hardware have sparked the use of machine learning (ML) in structural health monitoring (SHM) applications. This paper delves into the use of ML to determine axial stress in continuous welded rails (CWR). The overall proposed SHM strategy consists of monitoring the vibration of CWR and associating their modal characteristics to the rail longitudinal stress using a ML algorithm trained with data generated with a finite element model. In the present study, the feasibility of the proposed strategy was tested on a simple rail segment subjected to mechanical compression. Two algorithms were developed using hyperparameter search optimization techniques to infer the stress from the frequencies of vibration of a few modes of the rail. The training data were generated with a finite element model of a rail segment under varying axial stresses, rail lengths, and boundary conditions at the two ends of the segment. The algorithms were then tested with a second set of data generated numerically and the results of an experiment in which a 2.4-m-long rail was subjected to compressive load and excited with an instrumented hammer. Both tests demonstrated that ML is a viable tool to estimate axial stress in the rail segment provided a sufficient number of modes of vibrations are presented to the learning algorithm. For the future, more experiments are warranted to test the ML against data from real CWR.
Locating of acoustic emission source for stiffened plates based on stepwise time-reversal processing with time-domain spectral finite element simulation
Authors: Yu Zexing , Sun Jiaying , Xu Chao , Du Fei
Published: May 2022

Stiffened thin-walled structures are widely utilized in aerospace engineering as critical load-bearing components. These structures are prone to be damaged from external impact or corrosion, and fatigue cracks. Acoustic emission (AE) is a key phenomenon accompanying damage and can be used as an efficient indicator to locate the damage in stiffened structures. In this paper, a novel AE source locating approach is proposed, which is based on combining the concepts of the time-reversal (T-R) guided wave and time-domain spectral finite element method (T-D SFEM), in which an improved T-R strategy named stepwise T-R is developed to overcome the defocus issue, and the T-D SFEM is utilized to simulate the re-emitted wavefield. Benefit from the improvement and virtual simulation, the focused wavefield can be rapidly obtained without high-cost and large bulk wavefield imagine devices. The approach is validated experimentally. In addition, the effects of the signal length, mesh size, and noise levels on locating are studied in different scenarios. The results show that the proposed approach can locate the AE source in the stiffened plate efficiently and accurately. The optimal signal length and suggested mesh size are also decided. Besides, the robustness of the proposed method is demonstrated and the results are effective in the case of the measured signals with 30% white noise.
Mature Students’ Experience: A Community of Inquiry Study during a COVID-19 Pandemic
Authors: Homer Damien
Published: May 2022

The COVID-19 pandemic has had a profound effect on university students across the world. In a short period of time from 2020 to 2022, Higher Education Institutions (HEIs) had to pivot their modes of delivery to ensure they could meet the needs of their students. The move to digital platforms has been challenging for students from all ages, but particularly mature students. This study sought to explore mature students’ experiences of university during the COVID-19 pandemic through the lens of the Community of Inquiry (CoI) model. Utilising a qualitative approach, twenty semi-structured interviews were conducted with students from across the University of Warwick. The interviews were conducted by a staff member and a mature student during the pandemic and four themes were identified: Adapting to online learning, relationships, external factors and response of the university. This research study has identified that some participants responded well to the emergency situation, others had caring responsibilities which impacted on their studies but that peer relationships and collaborative learning is key to their success.
Investigation of moisture transfer properties of double-face weft knitted fabrics for sports clothing
Authors: Thangamuthu Suganthi , Pandurangan Senthilkumar
Published: May 2022

Thermo-physiological comfort of the fabric is achieved through the ability to manage heat and transmit sensible and insensible perspiration through the fabric. Ergonomic comfort aspects of sports clothing can be improved by enhancing the moisture management properties of knitted fabrics. Double-face knitted structures were developed by selecting the right type of material for the top and bottom layer. In this paper, the moisture management properties of four double-face knitted fabrics with hydrophobic fibre in the top layer (Polypropylene and micro-fibre polyester) and hydrophilic fibre in the bottom layer (Bamboo) were studied to find out the suitability for sportswear. The subjective perception was carried out using thermal state parameters and was correlated with Overall Moisture Management Capacity (OMMC). Double-face fabric knitted with micro-fibre polyester in the top layer and bamboo in the bottom layer has excellent moisture management properties which seem suitable for next-to-skin application. However, micro-fibre polyester (20%)/polypropylene (20%) yarns in the top layer on account of polypropylene due to its dry feel shows good OMMC followed by micro-fibre polyester in the top layer. Univariate analysis of variance with a confidence level of 95% showed that all the moisture management indices are statistically significant.
Visual imagery imitation skills and cognitive functions in patients with Schizophrenia
Authors: Tanaka Makoto , Osanai Takao , Kato Takuhiko , Ogasawara Hisako , Wada Kazumaru
Published: May 2022

Background/Objectives

Visual demonstration by occupational therapists is very common in psychiatric treatment, however, some patients with schizophrenia could not imitate the actions despite the absence of any physical impairments. Therefore, the purpose of this study was to identify how cognitive functions such as attention and cognitive processes in the imitation process is necessary and how these processes were related to the ability to convert this into action (imitation) in patients with schizophrenia.

Method

The participants were patients with schizophrenia with mean age 59.2 (± 11.3) years, 23 were men and 10 were women. The participants were tested for imitation ability and cognitive function, working memory, and motor imagery.

Results

Three subjects achieved full scores in the visual imitation test. However, the median of the total score was 10.0, with many subjects failing to imitate multiple tasks. Imitation learning is associated with duration of illness(t = −4.09, p = .000), mental health(t = −2.30, p = .029), and cognitive function such as the ability to retain visual information(t = −2.97, p = .006), and that these factors are interrelated.

Conclusion

To effectively promote imitation learning in patients with schizophrenia, occupational therapists need to establish teaching methods that make it easier for learners to retain visual information from the early stages of their illness.
Perspectives of Adults without Disabilities on their Friendships with Individuals with Intellectual and Developmental Disabilities
Authors: Josol Cynde Katherine , Fisher Marisa H. , Athamanah Lindsay S.
Published: May 2022

Friendships contribute to positive social outcomes such as the promotion of prosocial behaviors and social well-being and can lead to an overall healthy quality of life. Despite the importance of friendships, little is known about how individuals without disabilities develop and maintain friendships with individuals with intellectual and developmental disabilities. Using a phenomenological research design, the current study explored the lived experiences of 17 adults without disabilities who discussed the development and maintenance of their friendship with an individual with intellectual and developmental disabilities. Semi-structured interviews were conducted and subsequently collaborative, open coding was used to identify codes and themes across participants. Three main themes emerged related to 1) factors that facilitated friendship development; 2) factors that contributed to friendship maintenance; and 3) impacts of the friendship for both individuals with and without intellectual and developmental disabilities. Implications of the results are discussed as well as future directions for research.
Nasointestinal tube placement: Techniques that increase success
Authors: Taylor Stephen J , Sayer Kaylee , White Paul
Published: May 2022

Background

Delayed gastric emptying (DGE) is a major cause of undernutrition that can be overcome using nasointestinal (NI) feeding, but tube placement often fails. We analyse which techniques enable successful NI tube placement.

Methods

Efficacy of tube technique was determined at each of six anatomical points: Nose, nasopharynx-oesophagus, stomach-upper and -lower, duodenum part-1 and intestine.

Results

In 913 first NI tube placements, significant associations with tube advancement were found in the pharynx (head tilt, jaw thrust, laryngoscopy), stomach_upper (air insufflation, 10 cm or 20–30 cm flexible tube tip ± reverse Seldinger manoeuvre), stomach_lower (air insufflation, possibly flexible tip and wire stiffener) and duodenum part-1 and beyond part-2 (flexible tip and combinations of micro-advance, slack removal, wire stiffener or prokinetic drugs).

Conclusion

This is the first study to show what techniques are associated with tube advancement and the alimentary tract level they are specific to.
Neurology of Acute Viral Infections
Authors: Krett Jonathan D , Beckham J David , Tyler Kenneth L , Piquet Amanda L , Chauhan Lakshmi , Wallace Carla J , Pastula Daniel M , Kapadia Ronak K
Published: May 2022

As specialists in acute neurology, neurohospitalists are often called upon to diagnose and manage acute viral infections affecting the nervous system. In this broad review covering the neurology of several acute viral infections, our aim is to provide key diagnostic and therapeutic pearls of practical use to the busy neurohospitalist. We will review acute presentations, diagnosis, and treatment of human herpesviruses, arboviruses, enteroviruses, and some vaccine-preventable viruses. The neurological effects of coronaviruses, including COVID-19, are not covered in this review.
Remembering Phil O’Keefe
Authors: McCusker Brent
Published: May 2022

In this brief note, I summarize some of Phil O’Keefe's contributions to the discipline of geography. I focus on there specific interventions and show his lasting impact.
Anatomical Patterns of the Nasopalatine Canal and Incisive Foramen in an African Setting: A Cross-Sectional Study
Authors: Sarna Krishan , Estreed Merna A. , Sonigra Khushboo J. , Amuti Thomas , Opondo Florence , Kamau Martin , Ngeow Wei C.
Published: May 2022

Study Design: Descriptive cross-sectional.

Objective: To determine the morphology and morphometry of the nasopalatine canal (NPC) and incisive foramen (IF) in an African population.

Methods: Measurements of the NPC and the IF were carried out on 150 Cone-Beam computed tomography (CBCT) scans. The maxillary bone thickness anterior to the NPC was measured at 3 levels. Independent t-test and Chi-square test were performed to determine the presence of sexual dimorphism.

Results: The presence of one Stenson’s foramen was most prevalent. The mean length of NPC was 13.21 ± 3.25 mm with significantly longer canals in males. The most prevalent shape of NPC was cylindrical in sagittal view and a single canal in coronal view. The mean angulation of NPC was 118.42° to the horizontal plane. The average dimensions of the IF were 3.53 mm and 3.07 mm in the anteroposterior and mediolateral diameter, respectively, while the most common shape was round. The anterior maxillary bone was thicker in males and generally reduced in thickness from the anterior nasal spine superiorly towards the alveolar crest inferiorly.

Conclusion: This study highlights the anatomical characteristics of the NPC and IF, with significant sexual dimorphism observed regarding the number of Stenson’s foramina, length of NPC, shapes of the NPC and IF, as well as alveolar bone thickness anterior to NPC.
Bone health in transgender people: a narrative review
Authors: Giacomelli Giulia , Meriggiola Maria Cristina
Published: May 2022

Bone health in transmen and transwomen is an important issue that needs to be evaluated by clinicians. Prior to gender-affirming hormone treatment (GAHT), transwomen have lower bone mineral density (BMD) and a higher prevalence of osteopenia than cismen probably related to external factors, such as hypovitaminosis D and less physical activities. Gonadotropin-releasing hormone (GnRH) analogues in transgender youth may cause bone loss; however, the addition of GAHT restores or at least improves BMD in both transboys and transgirls. The maintenance or increase in BMD shown in short-term longitudinal studies emphasizes that GAHT does not have a negative effect on BMD in adult transwomen and transmen. Gonadectomy is not a risk factor if GAHT is taken correctly. The prevalence of fractures in the transgender population seems to be the same as in the general population but more studies are required on this aspect. To evaluate the risk of osteoporosis, it is mandatory to define the most appropriate reference group not only taking into consideration the medical aspects but also in respect of the selected gender identity of each person.
Investigating EFL Learners’ Perceptions of Critical Thinking Learning Affordances: Voices From Chinese University English Majors
Authors: Du Xiaoshuang , Zhang Lian
Published: May 2022

Affordances are action possibilities provided by the environment. This study investigated university EFL learners’ perceptions of the critical thinking learning affordances in their course learning environment. The participants were a cohort of 156 fourth-year English majors from a Chinese university where the English department was under a curriculum reform to promote students’ language learning and critical thinking development. The instrument of this study was the Learning Environment Affordance Survey_Critical Thinking (LEAS_CT) with a set of multiple-choice questions. The data analysis methods used in the study included descriptive statistical analysis, factor analysis, and MANOVA tests. The results showed that the English majors had strongly positive perceptions of the critical thinking learning affordances, which included four types: Rich Resources, Interactive Negotiation, Quality Task, and Community Culture. The results also revealed that high-achieving students had significantly better perceptions of the critical thinking learning affordances than lower-achieving students. Responses to the multiple-choice questions indicated that the English majors considered content-rich materials, teacher-facilitation, and small-group/peer learning benefited them most in terms of critical thinking development. Factors that influenced their perceptions of learning affordances and implications concerning integrating critical thinking into the tertiary EFL curriculum were discussed.
Theater of Public Punishment in Pakistan: A Discourse Analysis of Demand for Public Hanging
Authors: Jan Faizullah , Malik Tasleem
Published: May 2022

This paper investigates the discourse of public hanging of rapists on the social media space, that is, Twitter in Pakistan. It also examines how this discourse is interdiscursively related to the power relations particularly implicated in the discourses on religion and gender and the possible effects of this discursive struggle on society. By employing Critical Discourse Analysis (CDA) for analysis, this research uses Laclau and Mouffe’s Discourse Theory as theoretical framework. We conclude that the discourse approving death by hanging for the rapists is a device to propagate the power and the fear of the State. It has a “repetition induced effect” and implies sovereign’s exception; and women are silenced in their demands for justice against the patriarchal social structures which are responsible for crime against women’s body. It also reifies the patriarchal structures and controls societies through vengeance rather than reformative justice.
Mental Wellbeing and Boosting Resilience to Mitigate the Adverse Consequences of the COVID-19 Pandemic: A Critical Narrative Review
Authors: Beckstein Amoneeta , Chollier Marie , Kaur Sangeeta , Ghimire Ananta Raj
Published: May 2022

The COVID-19 pandemic has wreaked havoc globally. Besides devastating physical health consequences, the mental health consequences are dire as well and are predicted to have a long-term impact for some individuals and communities and society as a whole. Specific keywords were entered into various popular databases at three points in time (June 2020, April 2021, and February 2022). Articles about COVID-19 that focused on mental health and/or discussed improving resilience/coping were reviewed by the authors. A total of 119 publications were included. The pandemic is certainly a chronic stressor for many people, and some may be traumatized in the aftermath which may lead to stress-related disorders. The psychological impacts of this stress and trauma are reported and findings presented around three key themes: mental health impact, impact in the workplace, and improving resilience. In addition, particularly vulnerable populations are discussed and some of the violence and inequities they might face. Resilience literature offers keys to promoting positive mental wellbeing during and after the pandemic. Being able to effectively respond to the heterogeneity of specific situations while building resilience is addressed. Prevention, preparedness, Psychological First Aid training, and trauma informed practice can all contribute to building resilience and promoting peri/post-traumatic growth at all levels of society. This narrative review provides an overview of the literature on mental health and resilience in the context of the COVID-19 pandemic. The authors propose that, through the use of the accumulated empirical knowledge on resilience, we can mitigate many of the most damaging outcomes. Implications for mental health professionals, policy suggestions, and future research directions are explored.
Paper 06: The Effect of Anterior Glenoid Cartilage Defects on Anterior Glenohumeral Instability: A Biomechanical Study
Authors: Kawakami Jun , Henninger Heath , Knighton Tyler , Yamamoto Nobuyuki , Tashjian Robert , Itoi Eiji , Chalmers Peter
Published: May 2022

Objectives:

While it is well-known that a glenoid osseous defect of >25% glenoid width or 20% of the glenoid length critically destabilizes the shoulder, it is unclear whether glenoid cartilage defects contribute to the shoulder stability, and if so at what size defect the shoulder is critically destabilized. The purpose of this study was to determine the effect of incremental cartilage defect sizes on the anterior shoulder stability. We hypothesized that cartilage defects of equal to or greater than 25% of the glenoid width or 20% of the glenoid length will significantly the decrease the anterior shoulder stability ratio.

Methods:

This was a controlled laboratory study testing 12 fresh-frozen shoulders. Specimens were attached to a custom testing device in abduction and neutral rotation with 50N compression applied to the glenoid. The humeral head was translated 10 mm anteriorly, anteroinferiorly, and anterosuperiorly with conditions of intact cartilage and labrum and anterior cartilage defects of 3, 6, and 9 mm width. Translation force was measured continuously. Peak translation force divided by 50 N compression force was defined as the stability ratio. Data were analyzed using ANOVA tests.

Results:

In the anterior direction, the stability ratio decreased between intact cartilage (36±7%) and all defects 3-mm or larger (32±8%, p=0.023.) In the anteroinferior direction, the stability ratio decreased between intact cartilage (52±7%) and all defects 3-mm or larger (47±7%, P=0.006). In the anterosuperior direction, the stability ratio decreased between intact cartilage (36±4%) and all defects larger than 6-mm (32.6±4%, P = 0.006.) A 3-mm cartilage defect was equivalent to 10% of the glenoid width and 7% of the glenoid length. There were strong negative correlations between the glenoid cartilage defect size and the stability ratio in the anterior direction, the anteroinferior direction and the anterosuperior direction (r= -0.79, -0.63, and -0.58, respectively, P≤0.001). There were strong negative correlations between the ratio of glenoid cartilage defect size to the glenoid width and the stability ratio in all directions (r= -0.81, -0.63, and -0.61, respectively, P≤0.001.)

Conclusions:

An anterior cartilage defect of >3 mm or >10% of the glenoid width or 7% of the glenoid length significantly decreases anterior and anteroinferior stability and may require further treatment to restore stability. Cartilage defect size negatively correlates with stability.
Paper 18: Treatment of Lateral Meniscus Tears Influences OA Rate following ACL Reconstruction at 9-year Follow-Up
Authors: Briggs Karen , Petterson Stephanie , Plancher Kevin
Published: May 2022

Objectives:

Recent studies have described an increased risk of osteoarthritis (OA) following ACL reconstruction (ACLR). Systematic reviews have suggested that meniscal pathology, which occurs in up to 60% of patients with ACL injury, increases this risk. The purpose of this study was to determine the influence of lateral meniscus tears and repair versus partial lateral meniscectomy on the risk of OA in patients following ACLR.

Methods:

All patients who underwent primary autograft or allograft bone-patellar tendon-bone (BPTB) transtibial ACLR by a single surgeon between 1999-2019, were identified. Revision ACLR, multi-ligamentous reconstructions, and patients with less than 2-year imaging follow-up were excluded. Patients with lateral meniscus pathology at the time of ACLR were identified and treatment (e.g. lateral meniscectomy or lateral meniscus tear) was extracted. OA was defined at follow-up as Kellgren-Lawrence (KL) grade III-IV on plain radiographs. Chi-square tests assessed differences in incidence rates (p<0.05).

Results:

A consecutive series of 113 patients (57 males, 56 females; age 35.7±11.9 years) with BPTB ACLR were included. The mean follow-up was 9±5 years. The prevalence of lateral meniscus tears was 60.2% (68/113) and the prevalence of lateral compartment OA at follow-up was 14% (16/113) Patients with a lateral meniscus tear were 4.7 times more likely to develop OA compared to patients with no lateral meniscus tear. 20.6% of patients (14/68) with lateral meniscus tear developed lateral OA compared to 4.4% of patients (2/45) without lateral meniscus tear (p=0.0158). Patients who underwent lateral meniscal repair (n=16) had significantly lower prevalence of OA (0/16) compared to patients who underwent lateral meniscectomy (14/52) (p=0.0196).

Conclusions:

At nine-year follow-up, patients with a lateral meniscus tear at time of ACLR were more likely to develop OA compared to patients with no lateral meniscus tear and patients treated with partial meniscectomy had higher prevalence of OA compared to those treated with meniscus repair. In patients who require ACLR, care should be taken in evaluating and treating the lateral meniscus to decrease the likelihood of the development of OA. We believe lateral meniscal repair is essential for lateral meniscus tears at the time ACL reconstruction to help avoid development of OA. [Figure: see text]
Paper 23: Long Term Outcomes After Arthroscopic Treatment of Femoroacetabular Impingement for Patients with Borderline Dysplasia
Authors: Day Molly , Olsen Reena , Buza Stephanie , Kelly Bryan , Ranawat Anil , Nawabi Danyal , Selley Ryan
Published: May 2022

Objectives:

Outcomes following isolated hip arthroscopy for patients with dysplasia have been unfavorable, results have included iatrogenic instability and conversion to total hip arthroplasty (THA) at a young age. However, patients with borderline dysplasia have portended more favorable results at short and medium term follow-up. The purpose of this study was to assess long term outcomes after hip arthroscopy for femoroacetabular impingement (FAI) in borderline dysplasia (BD) patients (LCEA, 18°-25°) compared to a control cohort of nondysplastic patients (LCEA, 25°-40°).

Methods:

Between March 2009 and July 2012, a BD group of 33 patients (38 hips) was identified. An age- and sex-matched control group of 83 patients (96 hips) was also identified. Patient-reported outcome scores, including the modified Harris Hip Score (mHHS), the Hip Outcome Score–Activities of Daily Living (HOS-ADL) and Sport-Specific Subscale (HOS-SSS), and the International Hip Outcome Tool (iHOT-33), were collected preoperatively and subsequently at an average of 9.6 years post-operatively.

Results:

The mean LCEA and Tönnis angle was 22.4° ± 2.02° and 6.2° ± 3.23° in the BD group and 31.7° ± 3.52° and 2.42° ± 3.02° in the control group, respectively ( P <0.001). A labral repair was performed in 78.9% and 76% of the BD and control groups, respectively, all patients underwent capsular closure as part of routine hip arthroscopy. A cam decompression was performed in 97.4% of the BD patients and 99.0% of the control patients. At mean follow-up of 9.6 years (range, 8.2-11.6 years) on average there was significant improvement in all patient-reported outcomes scores in both groups (P<0.001). There were no significant differences between pre and post-operative scores between BD and control groups. Two hips (5.2%) underwent revision surgery in the BD group and 10 hips (10.4%) in the control group, of these one patient in the BD group underwent THA and one patient who underwent bilateral hip arthroscopies in the control group underwent bilateral hip resurfacing.

Conclusions:

Durable outcomes (>9 years) with low revision rates can be expected after isolated hip arthroscopy that includes cam resection, labral refixation and capsular closure in BD patients with equivalent outcomes to a nondysplastic cohort.
Paper 26: Defining Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome at 1-Year Follow-Up
Authors: Clapp Ian , DeFroda Steven , Newhouse Alexander , Alter Thomas , Nwachukwu Ben , Nho Shane , Bodendorfer Blake
Published: May 2022

Objectives:

While minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) have been defined for hip-specific legacy patient reported outcome measures, they have not been defined for the Patient-Reported Outcomes Measurement Information System (PROMIS) instruments for patients undergoing hip arthroscopy. The purpose of the study was to define the MCID, PASS, and SCB thresholds for the PROMIS Physical Function (PF) computerized adaptive test (CAT) and PROMIS Pain Interference (PI) instruments in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Methods:

Patients undergoing primary hip arthroscopy between August 2018 and January 2019 for the treatment of FAIS were retrospectively analyzed. Patients received PROMIS-PF, PROMIS-PI, Hip Outcome Score Activities of Daily Living, Hip Outcome Score Sport Subscale, modified Harris Hip Score, and international Hip Outcome Tool-12 preoperatively and at 1 year postoperatively. MCID was calculated using the distribution method, while PASS and SCB were calculated using an anchor-based method. Patients achieving clinically significant outcomes (CSOs) were compared to those who failed to achieve via chi-square and independent sample t-tests, and a multivariate logistic regression was conducted to determine predictors of CSO achievement.

Results:

124 patients with an average age of 32.7±12.3 were included in the analysis. The threshold scores required to achieve MCID, PASS, and SCB, respectively, were as follows: PROMIS-PI (-3.1, 53.7, 51.9) and PROMIS-PF (3.3, 47.0, 49.9). Patients achieved any MCID, PASS, and SCB for PROMIS scores at a rate of 89.0%, 71.8%, and 62.1%, respectively compared to 87.1%, 76.6%, and 71.8% for legacy PROMs. For PROMIS-PF, higher preoperative PROMIS-PF score was a positive predictor of CSO achievement, and patients achieving SCB were significantly younger (30.3±12 vs 35.6±12, p=0.017) with significantly lower BMIs (24.7±6.4 vs. 27.9±7, p=0.009). Preoperative chronic pain and past history of orthopaedic surgery were negative predictors of PROMIS-PI CSO achievement while higher (worse) preoperative PROMIS-PI scores were a positive predictor.

Conclusions:

Our study defined the MCID, PASS, and SCB for the PROMIS PF and PI CAT at 1-year postoperatively. CSO is achieved via PROMIS at a rate comparable, but slightly less than legacy hip PROMs. In addition, patients with higher preoperative PROMIS scores, younger age, and lower BMIs were more likely to achieve a CSO while preoperative chronic pain and past history of orthopaedic surgery were negative predictors of CSO achievement.
Like Any Other Trap: The Circuitous Path of Student Loan Repayment
Authors: Furquim Fernando , Deane KC , McCall Brian P. , DesJardins Stephen L.
Published: May 2022

This paper studies the patterns of individuals’ student loan repayment for up to 12 years, tracking borrowers through the formative ages of the early 20s to the late 30s. Using social sequence and cluster analysis to understand these longitudinal repayment histories, we identify five archetypes of loan repayment that describe borrowers’ experiences: persistent defaulters, perpetual payers, rapid full payers, late full payers, and consolidators. We find significant stratification by race/ethnicity, social class, and institutional sector into repayment clusters, with minoritized borrowers and those attending for-profit institutions more likely to experience adverse borrowing outcomes and to experience them for longer.