bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Guid times wi the bad times’: The meanings and experiences of befriending for people living alone with dementia
Authors: Andrew Jane , Wilkinson Heather , Prior Seamus
Published: June 2021

Befriending is a service in which volunteers provide companionship and support usually to people who are lonely or isolated. Such services are promoted in Scotland’s national strategy to improve the lives of people with dementia, around a third of whom live alone. However, little is known about the perspectives of recipients. Taking a holistic qualitative case study approach, the aim of this research was to explore how people living alone with dementia experienced befriending and the contexts in which their befriending relationships were meaningful. Three people were visited on five separate occasions. Largely unstructured conversations allowed individuals to prioritise areas of importance to them within the broad topics of befriending, everyday life, social networks and biography. Participants also had the option of ‘showing’ how they spent their time with their befriender. Data were analysed using the voice-centred relational method. Three key messages emerged: befriending satisfied unmet needs and wishes for particular kinds of relationship; befriending was a facilitated friendship; and befriending was a human response to contingent and existential limitations.
Gendered Justice: Inequalities in the Minimum Age of Criminal Responsibility in Iran
Authors: Staines Jo , Aghtaie Nadia , Roy Jessica
Published: June 2021

Using the minimum age of criminal responsibility (MACR) in Iran as an illustration, this article explores the continued resistance against girls’ rights in some Islamic countries. The gendered construction of childhood in Iran has resulted in a differential MACR, which for boys is notably higher than that recommended by the United Nations Committee on the Rights of the Child, yet for girls is unacceptably low. While breaches of girls’ rights in other areas are defended on the grounds of paternalistic concerns, it is argued that the MACR is a religious-politico decision that, in Iran, upholds the rights of boys but denies the rights of girls, propagating their wider subjugation.
Education in world society: A matter of form
Authors: Vanden Broeck Pieter
Published: June 2021

In his posthumously published work on education, Niklas Luhmann (1927–1998) described his approach to the sociological observation of the educational system as a formal one. Only by refraining from more substantial definitions, based on what teachers hope to convey, he claimed, can education be understood in all its historical and geographical varieties. By rereading his oeuvre as a socio-historical account of modern school education’s morphogenesis, I inspect this so-called formal approach more closely and show how it brings together different understandings of its central notion, form. The underlying theoretical movements of Luhmann’s formal approach, composed of indication and delimitation, of generalisation and re-specification, provide useful hints for the study of those forms of education which today increasingly emerge outside of its formal institutions.
Responding to Career Development Uncertainties and Successfully Navigating Career Journeys
Authors: Hughes Claretha , Niu Yuanlu
Published: June 2021

The Problem

The COVID-19 pandemic has forced employees and organizational leaders to consider the reality of its impact on career goals. Individuals have been forced to reconsider or readjust their career goals as being achievable, deferred, or even eliminated. Organizational leaders or those in strategic positions have been forced to consider how individual career goals could impact the organization’s capacity to survive.

The Solution

Career development theories are useful for examining the role of human resource development professionals in helping employees achieve career goals as they attempt to adjust to the COVID-19 pandemic. Re-emphasizing career development as a core component of HRD highlights the significance of career development theories in adjusting to pandemics and crises that impact individual career goals and organizational strategic goals and opportunities.

The Stakeholders

HRD researchers, scholar/practitioners, professionals, and others who research and practice career development and use career development theory.
The Relationship Between a Lifetime History of Sexual Victimization and Perinatal Depression: A Systematic Review and Meta-Analysis
Authors: Lombardi Brooke N. , Jensen Todd M. , Parisi Anna B. , Jenkins Melissa , Bledsoe Sarah E.
Published: June 2021

Background:

The association between a lifetime history of sexual victimization and the well-being of women during the perinatal period has received increasing attention. However, research investigating this relationship has yet to be systematically reviewed or quantitatively synthesized.

Aim:

This systematic review and meta-analysis aims to calculate the pooled effect size estimate of the statistical association between a lifetime history of sexual victimization and perinatal depression (PND).

Method:

Four bibliographic databases were systematically searched, and reference harvesting was conducted to identify peer-reviewed articles that empirically examined associations between a lifetime history of sexual victimization and PND. A random effects model was used to ascertain an overall pooled effect size estimate in the form of an odds ratio and corresponding 95% confidence intervals (CIs). Subgroup analyses were also conducted to assess whether particular study features and sample characteristic (e.g., race and ethnicity) influenced the magnitude of effect size estimates.

Results:

This review included 36 studies, with 45 effect size estimates available for meta-analysis. Women with a lifetime history of sexual victimization had 51% greater odds of experiencing PND relative to women with no history of sexual victimization ( OR = 1.51, 95% CI [1.35, 1.67]). Effect size estimates varied considerably according to the PND instrument used in each study and the racial/ethnic composition of each sample.

Conclusion:

Findings provide compelling evidence for an association between a lifetime history of sexual victimization and PND. Future research should focus on screening practices and interventions that identify and support survivors of sexual victimization perinatally.
The Impact of Atherosclerotic Cardiovascular Risk on Graft Failure in Deceased-Donor Renal Transplantation
Authors: Hsu Grace , Sparkes Tracy M. , Reed Brent N. , Gale Stormi E. , Crossley Brian E. , Ravichandran Bharath R.
Published: June 2021

Introduction:

Pretransplant cardiovascular risk may be amplified after renal transplant, but little is known about its impact on graft outcomes.

Research question:

The purpose of this study was to determine if pretransplant cardiovascular risk was associated with graft outcomes.

Design:

This retrospective study included deceased-donor renal transplant recipients from 2010-2015. Atherosclerotic cardiovascular disease risk for patients without prior disease was calculated and patients were categorized into high (score >20%), intermediate (7.5-20%), and low risk (<7.5%). Patients with and without prior cardiovascular disease were also compared. The main endpoint was graft failure at 3-years post-transplant. Other outcomes included major adverse cardiovascular events, biopsy-proven rejection, and mortality.

Results:

In patients without prior atherosclerotic cardiovascular disease (N = 115), graft failure rates (4.5% vs 11.3% vs 12.5%; ( P = 0.64) and major adverse cardiovascular events (9.1% vs 13.2% vs 5.0%; P = 0.52) were similar in the high, intermediate, and low risk groups. In those with prior disease (N = 220), rates of primary nonfunction (6.8% vs 1.7%; P = 0.04), major adverse cardiovascular events (7.3% vs 2.6%; P = 0.01), and heart failure (10.9% vs 3.5%; P = 0.02) were higher than those without cardiovascular; rates of major adverse cardiovascular events and heart failure were insignificant after adjusting for age, gender, and race. Other outcomes were not different. Outcomes did not differ based on pretransplant cardiovascular risk.

Discussion:

Pretransplant atherosclerotic cardiovascular disease was associated with increased early graft failure but similar outcomes at 3-years, suggesting cardiac risk alone should not exclude transplantation.
Clinical use of Electroencephalography in the Assessment of Acute Thermal Pain: A Narrative Review Based on Articles From 2009 to 2019
Authors: Savignac Chloé , Ocay Don Daniel , Mahdid Yacine , Blain-Moraes Stefanie , Ferland Catherine E.
Published: June 2021

Nowadays, no practical system has successfully been able to decode and predict pain in clinical settings. The inability of some patients to verbally express their pain creates the need for a tool that could objectively assess pain in these individuals. Neuroimaging techniques combined with machine learning are seen as possible candidates for the identification of pain biomarkers. This review aimed to address the potential use of electroencephalographic features as predictors of acute experimental pain. Twenty-six studies using only thermal stimulations were identified using a PubMed and Scopus search. Combinations of the following terms were used: “EEG,” “Electroencephalography,” “Acute,” “Pain,” “Tonic,” “Noxious,” “Thermal,” “Stimulation,” “Brain,” “Activity,” “Cold,” “Subjective,” and “Perception.” Results revealed that contact-heat-evoked potentials have been widely recorded over central areas during noxious heat stimulations. Furthermore, a decrease in alpha power over central regions was revealed, as well as increased theta and gamma powers over frontal areas. Gamma and theta rhythms were associated with connectivity between sensory and affective regions involved in pain processing. A machine learning analysis revealed that the gamma band is a predominant predictor of acute thermal pain. This review also addressed the need of supplementing current spectral features with techniques that allow the investigation of network dynamics.
Minimally Invasive Plication of the Diaphragm: A Single-Center Prospective Study
Authors: Nardini Marco , Jayakumar Shruti , Migliore Marcello , Nosotti Mario , Paul Ian , Dunning Joel
Published: June 2021

Objective

Plication of the diaphragm is a life-changing procedure for patients affected by diaphragm paralysis. Traditionally, this procedure is performed through a thoracotomy. Access to the diaphragm via this incision is poor and the indications for surgery are limited to patients who can actually sustain such an invasive approach and associated morbidities. A minimally invasive approach was developed to improve the surgical management of diaphragm paralysis.

Methods

Patients underwent minimally invasive diaphragm plication either by video-assisted or robotic surgery through a 3-port technique with CO2 insufflation. Patients were followed at the routine 6-week clinic and also by telephone consultation 6 to 12 months postoperatively. Data were collected on postoperative complications, postoperative pain or numbness, symptomatic improvement, and change to quality of life following surgery.

Results

Forty-eight patients underwent 49 minimally invasive diaphragm plication. Median postoperative length of hospital stay was 4 days (range: 2 to 34 days) and there were no cases of mortality. Mean reduction in Medical Research Council dyspnea score per patient was 2.2 points (mode: 3 points). Twenty-eight patients (77.8%) reported a significant symptomatic improvement enabling improvements in quality of life, and 97.2% ( n = 35) were satisfied with the surgical outcome.

Conclusions

Minimally invasive diaphragm plication is a safe procedure associated with prompt postoperative recovery. It is effective at reducing debilitating dyspnea and improving quality of life.
Accelerating Mixed Methods Research With Natural Language Processing of Big Text Data
Authors: Chang Tammy , DeJonckheere Melissa , Vydiswaran V. G. Vinod , Li Jiazhao , Buis Lorraine R. , Guetterman Timothy C.
Published: June 2021

Situations of catastrophic social change, such as COVID-19, raise complex, interdisciplinary research questions that intersect health, education, economics, psychology, and social behavior and require mixed methods research. The pandemic has been a quickly evolving phenomenon, which pressures the time necessary to perform mixed methods research. Natural language processing (NLP) is a promising solution that leverages computational approaches to analyze textual data in “natural language.” The aim of this article is to introduce NLP as an innovative technology to assist with the rapid mixed methods analysis of textual big data in times of catastrophic change. The contribution of this article is illustrating how NLP is a type of mixed methods analysis and making recommendations for its use in mixed methods research.
A descriptive study on reading instruction provided to students with intellectual disability
Authors: Dessemontet Rachel Sermier , Linder Anne-Laure , Martinet Catherine , Martini-Willemin Britt-Marie
Published: June 2021

Little is known about the content and quality of reading instruction provided to students with intellectual disability. This study aimed to describe the reading instruction provided to students with intellectual disability who were not yet readers in self-contained elementary classrooms. The teachers of 24 classrooms participated in the study. Systematic observations of reading lessons, follow-up interviews with the teachers, review of teaching material, and content analysis of students’ individualized education plans were conducted. Findings indicate that phonics and phonological awareness were taught in most of the classrooms. However, phonics was taught systematically, as recommended in the research, in only less than half of the classes. Sight-word instruction and vocabulary instruction were observed in more than half of the classes. Comprehension instruction of texts read aloud by the teacher was observed in only about a third of the classrooms. Recommendations to support teachers in enhancing the quality of reading instruction are provided.
Capacity building for quality care and education for children with severe to profound intellectual disabilities in South Africa
Authors: Vergunst Richard , McKenzie Judith , Hansen Anthea
Published: June 2021

In the South African context, children with severe to profound intellectual disabilities are not accommodated in the compulsory education system, although steps are being taken in this direction in acknowledgement of their right to education. Critical to this development is the training of educators and caregivers. There is a paucity of studies from South Africa addressing the training of educators and caregivers. The Teacher Empowerment for Disability Inclusion (TEDI) project developed a course on the education and care of children with severe to profound intellectual disabilities to facilitate and empower teachers to provide quality education for these learners. This paper explores, through a qualitative analysis, the ways in which 30 participants attending this course developed professionally and personally. The findings show that there was personal as well as professional learning in the areas of disability approaches, collaboration, advocacy, self-care, and confidence. These findings are discussed and future implications are addressed.
Dynamic modeling, simulation, and parameter study of electric quadrotor system of Quad-Plane UAV in wind disturbance environment
Authors: Li Fan , Song Wen-Ping , Song Bi-Feng , Zhang Hang
Published: June 2021

Quad-Plane UAV(quadrotor fixed-wing hybrid vertical take-off and landing Unmanned Aerial Vehicle) is vulnerable to wind disturbance in quadrotor mode, and the performance of the electric quadrotor system directly affects its wind disturbance rejection performance. To study and optimize the wind disturbance rejection performance of the electric quadrotor system of Quad-Plane precisely and efficiently, a dynamic electric quadrotor simulation system integrating high-precision submodels of electric quadrotor system components is required. However, there are few papers on this kind of simulation system. This paper proposed a simulation system with both high computational efficiency and precision, and it can be used in optimization and flight simulation of Quad-Plane. The simulation system includes submodels of rotor, brushless direct current (BLDC) motor, electronic speed controller (ESC), and Li-ion Polymer battery. The surrogate-based rotor model is established to calculate the aerodynamic performance of the rotor in oblique flow. The BLDC motor performance calculation model considering inductance is presented and the power loss of the ESC is considered. The discharge characteristics of the battery are modeled considering the rate capacity effect. All submodels are validated and the simulation results show good agreements with test data. A flight test of Quad-Plane in quadrotor mode is conducted to validate the integrated dynamic simulation system. The results show that the simulation system has the advantages of high computational efficiency and precision. Based on the simulation system, the influence of the electric quadrotor system parameters on the performance of the electric quadrotor system, and furthermore on the wind disturbance rejection performance of the Quad-Plane are found, the conclusions are helpful to the selection and optimization of the electric quadrotor system components.
Impact of immunogenicity on clinical efficacy and toxicity profile of biologic agents used for treatment of inflammatory arthritis in children compared to adults
Authors: Parikh Chinar R. , Ponnampalam Jaya K. , Seligmann George , Coelewij Leda , Pineda-Torra Ines , Jury Elizabeth C. , Ciurtin Coziana
Published: June 2021

The treatment of inflammatory arthritis has been revolutionised by the introduction of biologic treatments. Many biologic agents are currently licensed for use in both paediatric and adult patients with inflammatory arthritis and contribute to improved disease outcomes compared with the pre-biologic era. However, immunogenicity to biologic agents, characterised by an immune reaction leading to the production of anti-drug antibodies (ADAs), can negatively impact the therapeutic efficacy of biologic drugs and induce side effects to treatment. This review explores for the first time the impact of immunogenicity against all licensed biologic treatments currently used in inflammatory arthritis across age, and will examine any significant differences between ADA prevalence, titres and timing of development, as well as ADA impact on therapeutic drug levels, clinical efficacy and side effects between paediatric and adult patients. In addition, we will investigate factors associated with differences in immunogenicity across biologic agents used in inflammatory arthritis, and their potential therapeutic implications.
Multi-criteria decision-making model for supporting manufacturing settlements location in Africa after COVID-19
Authors: Bait Stefania , Lauria Serena Marino , Schiraldi Massimiliano M.
Published: June 2021

The COVID-19 emergency is affecting manufacturing industries all over the world. Notably, it has generated several issues in the products’ supply and the global value chain in African countries. Besides this, Africa’s manufacturing value-added rate grew only 1.5 since 2018, and the foreign direct investment (FDI) from multinational enterprises (MNEs) remains very low due to high-risk factors. Most of these factors are linked to a non-optimized location selection that can adversely affect plant performance. For these reasons, supporting decision-makers in selecting the suitable country location in Africa is crucial, both for contributing to countries’ growth and companies’ performance. This research aims at presenting a comprehensive multi-criteria decision-making model (MCDM) to be used by MNEs to evaluate the best countries to develop new manufacturing settlements, highlighting the criteria that COVID-19 has impacted. Thus, it has affected countries’ performance, impacting the plant location selection choices. A combination of the Analytic Hierarchy Process (AHP) and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) methods have also been used for comparative analysis. The criteria used in the proposed approach have been validated with a panel of MNEs experts.
Parent Engagement in Identifying and Serving Diverse Gifted Students: What Is the Role of Leadership?
Authors: Mun Rachel U. , Ezzani Miriam D. , Yeung Glorry
Published: June 2021

Parents play a vital role in identifying and cultivating talent for diverse gifted children but their experiences with schools and educational leaders are rarely studied. To examine parent perspectives on identifying and serving diverse gifted students, we conducted six focus groups with 39 parents of K-12 children from culturally, linguistically, and economically diverse backgrounds (CLED), and/or identified as twice exceptional (2E). Thematic analysis and its six-phase approach was used to analyze data. We found (a) that the majority of parents advocated for their gifted and talented children, (b) a lack of consistent and comprehensive strategies by educational leaders to promote parent engagement, (c) disproportionate communication from district leaders rendered engagement efforts less effective, (d) GT identification remained problematic to some parents, and (e) front line educators served a critical role in the bilateral relationship between school and family. Implications are discussed for researchers and educational leaders.
Orbital Apex Syndrome Due to Mucormycosis – Missed on Initial MRI
Authors: Marzoughi Sina , Chen Tychicus
Published: June 2021

A 64-year-old man with a history of diabetes mellitus and end stage renal disease presented with a several day history of cognitive decline, reduced right eye visual acuity accompanied with a complete right ophthalmoplegia in keeping with orbital apex syndrome. Initial MRI was unremarkable other than mucosal thickening in the frontal sinuses. He continued to clinically decline and repeat MRI revealed an edematous right optic nerve and a lack of enhancement within the sinuses was suspicion for invasive fungal infection. Given his history of diabetes, he was started on anti-fungal treatment and taken for debridement but passed away several days later. This case illustrates the importance of the orbital apex syndrome as a localization. Mucormycosis should be considered in acute onset ophthalmoplegia particularly in patients with diabetes and diabetic ketoacidosis. Empiric anti-fungal therapy should be started early for suspected rhino-orbital cerebral mucormycosis, although mortality remains high despite treatment.
Metastatic Merkel cell carcinoma and malignant melanoma in a single sentinel lymph node
Authors: Hamilton Amanda , Jayaratne Prasad , Zonta Mark
Published: June 2021

Merkel cell carcinoma (MCC) and malignant melanoma are aggressive skin cancers that usually arise in sun-exposed parts of the body. This report describes an 85-year-old man who underwent a wide local excision and sentinel lymph node biopsy for primary MCC and was subsequently found to have metastatic MCC and malignant melanoma within the left inguinal sentinel lymph node. Dual diagnoses of aggressive cutaneous carcinomas, although rare, may become more common in regions of high ultraviolet exposure and an ageing population. Currently, there are no guidelines for treating synchronous MCC and melanoma, however, immunotherapy with PD-1 inhibitors and anti-CTLA-4 receptor antagonists have shown therapeutic effect against these two cancers and should be considered in treatment planning.
Rainbow of colors: Inspissated bile syndrome secondary to hemolytic disease of the newborn and concomitant serum dynamics
Authors: Mugarab Samedi Veronica , Rahimi Mehrieh , Kalaniti Kaartigean , Lyon Martha , Daspal Sibasis
Published: June 2021

The recent clinical experience with hemolytic disease of the newborn and its post-icteric sequelae is limited among high-income countries because of nearly over four decades of effective prevention care. In this case, we will discuss the sequelae of a baby born with hemolytic disease of the newborn to an Rh negative mother with no prenatal care from remote northern Saskatchewan. Inspissated bile syndrome is a rare but serious complication of hemolytic disease of the newborn. The concentration of hemolytic products parallels with serum color changes.
Connection between nurse managers’ stress from workload and overall job stress, job satisfaction and practice environment in central hospitals: A cross-sectional study
Authors: Jäppinen Karita , Roos Mervi , Slater Paul , Suominen Tarja
Published: June 2021

Nurse managers’ workload is considered overwhelming and the resources and support insufficient. Stress from workload has adverse psychological and physical effects and impedes strategic, visible and active leadership. This study aimed to examine nurse managers’ stress from workload and its associations to overall job stress, job satisfaction and practice environment. A survey comprising the Nursing Context Index was administered to 490 nurse managers in Finnish central hospitals. The study was reported using the STROBE statement. The response rate was 42.7% ( n = 209). A statistical analysis revealed that almost every fifth nurse manager experienced high stress from workload with connection to higher job stress overall, higher intent to leave the organization, lower job satisfaction overall, personally and professionally, as well as a more negative perception of the practice environment. Nurse managers’ jobs require adequate resources, clear division of work and better empowering structures.
Factors Affecting Campus Loans in Western China
Authors: Zhang Chengfeng , Wu Qiao , Wang Huijuan , Luo Xia , Wei Ning , Pan BingYu , Tong Jiajun
Published: June 2021

Campus loans have become a part of the lives of Chinese college students. While such loans are convenient for students, they can also create considerable difficulties. In the context of unbalanced economic development between Western and Eastern China, this study aimed to understand the factors affecting the campus loan behaviors of college students in Western China. A sample of 568 undergraduate and graduate students from four universities in Western China was taken as the research object. Binary logistic regression and orderly logistic regression were used to study campus loan consumption factors. Students without state-subsidized loans were found to have stronger campus loan consumption intention and higher loan amounts, and recreational consumption was the main loan purpose. The factors affecting campus loan consumption included students’ family structure, parents’ education level, peer students’ consumption status, grade level, relationship status, and ability to assess loan risk. Based on the findings, suggestions are made for managing campus loan behavior from the perspectives of the individual, family, school, and government. This study can provide guidance for standardizing campus loans and adjusting college students’ consumption attitudes and behaviors.
Importance of the Open Data Assessment: An Insight Into the (Meta) Data Quality Dimensions
Authors: Šlibar Barbara , Oreški Dijana , Begičević Ređep Nina
Published: June 2021

Data are the most important resource of the 21st century. The open data (OD) movement provides publicly available data for the development of a knowledge-based society. As such, the concept of OD is a valuable information technology (IT) tool for economic, social, and human development, which adds value. To further develop these processes on a global scale, users need to manage the quality of OD in their practices. Otherwise, what is the point of using data just for the sake of using it (in science or practice) without thinking about data compliance with norms, standards, and so forth? This article aims to provide an overview of (meta)data quality dimensions, sub-dimensions, and metrics used within OD assessment-related research papers. To achieve this, the authors performed a systematic literature review (SLR) and extracted data from 86 relevant studies dealing with the evaluation of OD. The article endows the progress made so far in OD assessment research. Findings of reviewing the assessment of the OD in the light of existing (meta)data quality dimensions unveil the potential of metadata. Furthermore, the analysis disclosed the need for greater use of quantitative methods in research, and metadata can greatly assist in this.
The Impact of GDP and Its Expenditure Components on Unemployment Within BRICS Countries: Evidence of Okun’s Law From Aggregate and Disaggregated Approaches
Authors: Hashmi Shabir Mohsin , Khushik Ali Gul , Gilal Muhammad Akram , Yongliang Zhao
Published: June 2021

This article examines the responsiveness of changes in the unemployment rate to changes in output for Brazil, Russia, India, China, and South Africa (BRICS) using aggregate and disaggregated data from 1991 to 2018. We also split the entire sample period into two subsamples (from 1991 to 2008 and 2009 to 2018) to see the responsiveness of changes in the unemployment rate to changes in the GDP in pre and post global financial crisis period of 2007–2008. Three different econometric methods were employed for conducting the analysis. Results obtained from aggregated and disaggregated data for the entire sample and two subsamples confirm the validity of the Okun law for BRICS. The postcrisis period Okun’s law estimates are larger than those from the full sample and precrisis period. Disaggregated data results show private consumption is the main determinant of the unemployment rate and its estimate is negative and significant. Along with consumption expenditures, other variables that have relevancy in determining changes in the unemployment rate are government expenditures, exports, and imports. Based on aggregated and disaggregated data results, it is recommended that the relevant authorities must focus sustainable economic growth for reducing unemployment rate in the country. Particularly, they must incentivize consumption and government expenditures, boost exports, and curtail imports for reducing the unemployment rate.
A Multilevel Qualitative Perspective to Gendered Life Course, Socialization, and STEM Trajectories Among Emerging Adults in Spain
Authors: Petroff Alisa , Sáinz Milagros , Arroyo Lídia
Published: June 2021

The present study examines the five principles of the life course perspective—life span development, time and place, agency, timing, and linked lives—and their interplay on the experiences of 26 emerging adults (11 males and 15 females) during their transition from college completion into the STEM labor force in Spain. Findings derived from the in-depth interviews focus on the multilevel challenges these young people face and the set of strategies they develop to overcome them. From a gender perspective, the challenges reveal the structural inequalities (many associated with existing gender stereotypes) that women encounter throughout their educational and professional trajectory. The research also identifies how these women and men display agentic features (at a micro-level) and mobilize different types of networks (at a meso-level) to overcome this adverse structural context, especially, during the economic post-crisis in Spain.
Reduced Intraoperative Blood Loss and Hypothermia in Burn Surgery using Cardiopulmonary Bypass Pumps
Authors: Persad Amit , Mowbrey Kevin , Tredget Edward
Published: June 2021

Objective: Patients presenting with total body surface area (TBSA) >40% burns require significant surgical treatment. Two substantial challenges during these surgeries are limiting blood loss and maintaining core temperatures. To overcome these challenges, several techniques have been developed, ranging from the Pitkin syringe method to the pneumatic tourniquet strategy for large-volume hyperthermic insufflation. Here, we compare the pneumatic tourniquet method to a roller pump method for maintenance of intraoperative normothermia and control of bleeding. Methods: We conducted a retrospective chart review of 20 patients presenting with TBSA >40% burns, 10 of whom were treated with the rapid infusion roller pump and 10 of whom were treated with the pneumatic tourniquet technique. Patients from each group were controlled for % TBSA, presence of inhalation injury, age, and date of admission. We reviewed transfusion requirement and the intraoperative temperatures, as well as the average intraoperative drop in temperature. Results: We observed improvement in the infusion volume, operative time, intraoperative temperature drop, minimum intraoperative temperature, estimated blood loss, and amount of required transfusion. Conclusions: Our study suggests that the rapid infusion roller pump technique is capable of achieving superior intraoperative bleeding control and temperature maintenance compared to the pneumatic tourniquet technique, resulting in decreased transfusion requirement.
Acute Pancreatitis in a Patient With COVID-19 After the Resolution of Respiratory Symptoms
Authors: Muhammad Abrar Jeelani Hafiz , Sheikh Muhammad Mubbashir , Samuel Shirly Susan , Omotosho Yetunde Bernice , Sharko Artem , Albetar Rami
Published: June 2021

The gastrointestinal (GI) involvement, including acute pancreatitis (AP) from the novel coronavirus disease-2019 (COVID-19), is increasingly being reported. Recent evidence suggests that the pathogenesis of COVID-19 is mediated by the angiotensin-converting enzyme 2 (ACE-2) receptors and transmembrane protease serine 2 (TMPRSS2) for “priming,” which is highly expressed in the pancreas. To our knowledge, there is no other reported case of AP associated with COVID-19 after the respiratory symptoms are resolved. In this article, we present a patient with COVID-19, who came with intractable epigastric pain and resolved respiratory symptoms. A diagnosis of AP complicated with COVID-19 was made after laboratory and imaging workup, which was successfully managed conservatively.
Parachute-Induced Pectoralis Major Tears in Military Servicemembers: What Is the Functional Recovery?
Authors: Shaw K. Aaron , Brown Scott , Moreland Colleen M. , Antosh Ivan J. , Parada Stephen A.
Published: June 2021

Background:

Although the most common injury mechanism for pectoralis major (PM) tears is an eccentric loading mechanism typically caused by bench pressing, within the military, there is a unique injury mechanism associated with airborne operations. The results of operative repair for these parachute-induced PM tears have not been previously reported.

Purpose/Hypothesis:

To assess the functional outcomes in military servicemembers undergoing operative repair of parachute-induced PM tears. We hypothesized that functional recovery would be impaired with delayed surgical intervention.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were active duty military servicemembers who underwent operative repair for PM tears caused by a parachute-induced mechanism. Charts were reviewed to identify characteristic, injury, and surgical variables. Patients completed the functional outcome assessment with the Disabilities of the Arm, Shoulder and Hand (DASH) and the American Shoulder and Elbow Surgeons (ASES) questionnaires. Outcomes were compared between patients treated within 6 weeks of injury and those treated beyond 6 weeks.

Results:

Of the 68 identified PM tears, 25 were the result of parachute-induced mechanisms. A total of 13 patients consented and completed the functional outcome assessment. The mean patient age was 30.6 ± 6.4 years, and the mean follow-up period was 5.46 ± 1.26 years. Ten patients underwent repair within 6 weeks of injury, and the remaining 3 patients underwent repair at a mean of 338 days after injury (95% CI, -42.8 to 718.8 days), a significant difference between groups ( P = .006). All 13 patients were able to return to military duties at a mean of 6 months from injury. Patients treated within 6 weeks of injury had significantly higher functional outcomes (DASH score, 6.17 vs 26.67; P = .018; ASES score, 85.97 vs 49.5; P = .008), with greater strength performance compared with preinjury (bench press, 90.58% vs 38.95%; P = .0057; push-ups, 81.9% vs 23.8%; P = .023) compared with patients treated beyond 6 weeks of injury.

Conclusion:

Operative repair of parachute-induced PM tears within 6 weeks of injury provided a superior functional and strength recovery when compared with delayed surgical repair. Acute repair should be recommended for military servicemembers who experience this unique injury mechanism.
COVID-19 Impact on Pediatric Health: A survey of families in Wayne County, MI
Authors: Raheja Raksha , Pitman-Hunt Chaya , Haidar Sara , Gjorgjevska Slavica , Leja Jacqueline
Published: June 2021

Background. In response to the novel coronavirus disease (COVID-19), the state mandated “Stay At Home” order included closure of schools and public places and physical distancing measures. As a result, social interactions among children were significantly impaired and pediatric outpatient offices and vaccination rates declined. We sought to determine the impact of the COVID-19 pandemic on mental health as well as access to health care in our pediatric population in Wayne County, Michigan. Design/Methods. We conducted a survey through the Wayne County Public School Districts to elicit information regarding subjects’ access to pediatric health care as well as experiences pertinent to their child(ren)’s mental health. Results. Approximately 8500 surveys were sent to families and 278 responses were received. Responses revealed that 46% of children spent more time alone during the pandemic, 36.9% had changes in sleep, 25.6% had little pleasure in doing things, and 32.5% were unhappy or sad. 66.2% were able to make new visits during the pandemic, however, 20.1% missed their child’s doctors’ visits for reasons including clinic cancellations and fear of entering a healthcare setting. Conclusions. The results of this survey demonstrate significant mental health concerns among our pediatric population as approximately 1/3 of families reported changes in behavior or mental health. As school closures persist in response to the ongoing pandemic and social interactions remain limited, it is imperative that pediatricians screen for depression, behavioral problems and other mental health concerns and offer families help to identify appropriate community mental health resources.
Telemedicine Training in the COVID Era: Revamping a Routine OSCE to Prepare Medicine Residents for Virtual Care
Authors: Boardman Davis , Wilhite Jeffrey A , Adams Jennifer , Sartori Daniel , Greene Richard , Hanley Kathleen , Zabar Sondra
Published: June 2021

Background:

During the rapid onset of the pandemic, clinicians transitioned from traditional outpatient practice to virtual modalities for providing routine care to patient panels. Like training programs nationwide, telemedicine training and assessment had not been systematically incorporated into our residency. In response, a scheduled Internal Medicine (IM) Objective Structured Clinical Examination (OSCE) was adapted to a remote modality to become virtual care-focused learning experience for trainees and to provide valuable feedback to educators.

Methods:

Standardized Patients (SPs) rated residents on their communication (including information gathering, relationship development and patient education), patient activation and satisfaction, and telemedicine skills. Analyses included a comparison of domain scores for residents who participated in both the 2020 remote and 2019 in-person OSCEs, and a review of written resident comments about the virtual OSCE.

Results:

During 2020’s video visit OSCE (VOSCE), residents (n = 23) excelled at nonverbal communication but struggled with virtual physical exams and information gathering. In debrief, residents expressed substantial interest in more opportunity to practice virtual visit skills going forward. In comparing scores of the virtual care (2020) OSCE with the in-person (2019) version, the small subset of residents who participated in both assessments (n = 9) performed similarly on communication skills, patient satisfaction and activation. Patient education scores were significantly lower during the virtual care OSCE ( P = .008).

Conclusion:

Our reformulated OSCE accomplished 3 goals including; (1) physically distancing residents from SPs per COVID regulations, (2) providing residents with the opportunity to practice critical virtual visit skills, and (3) alerting our educators to curricular improvement areas. Our methods are useful for other institutions and have applications to the larger medical education community.
Substance Use Disorder: A Model for Integration in Undergraduate Medical Education
Authors: Pavuluri Haritha , Poupore Nicolas , Schmidt William Michael , Boniface Samantha Gabrielle , Jindal Meenu , Demosthenes Lauren
Published: June 2021

Substance Use Disorder (SUD) is a debilitating chronic illness with significant morbidity and mortality across the United States. The AAMC and LCME have supported the efforts for more effective medical education of SUD to address the existing stigma, knowledge, and treatment gaps. The Coronavirus 2019 (COVID-19) pandemic and associated social, economic, and behavioral impacts have added to this urgency. The University of South Carolina School of Medicine Greenville (USCSOMG), in collaboration with community organizations, has successfully implemented an integrated SUD education curriculum for medical students. Students learn about SUD in basic sciences, receive case-based education during clinical exercises, and are provided the opportunity to become a recovery coach and participate in the patient and family recovery meetings through this curriculum during preclinical years. During the clinical years, SUD education is enhanced with exposure to Medication for Addition Treatment (MAT). Students also partake in the care coordination of patients with SUD between the hospital and community recovery organizations. All students receive MAT waiver training in their final year and are prepared to prescribe treatment for SUD upon graduation. The experiences in this integrated curriculum integration can perhaps assist other organizations to implement similar components and empower the next generation of physicians to be competent and effective in treating patients with SUD.
Infrastructural and Knowledge Barriers to Accessing Acute Stroke Care at a Regional Tertiary Facility in Kenya
Authors: Mithi Caroline , Shah Jasmit , Mativo Peter , Sokhi Dilraj Singh
Published: June 2021

The delivery of definitive acute stroke care in Africaremains low due to prehospital barriers, and these are known to be country-specific. There have been no studies on elucidating these barriers in Kenya.

Objectives:

We sought to identify the nature of barriers to acute stroke care for patients presenting to our hospital in Nairobi, Kenya.

Materials and Methods:

We conducted a prospective cross-sectional study atour tertiary regional referral center from August 2018 to March 2019 for patients presenting with an acutestroke. We consented participants (patients or their registered next-of-kin) to fill out a questionnaire on their journey from stroke-onset to the ward bed, and about their knowledge about stroke.

Results:

We recruited 103 participants. Only 25.2% arrived to hospital within 3.5 h (early arrival) of stroke onset. The significant factors causing delay were:distance from hospital, traffic, visiting another hospital first, and lack of transport vehicle. Factors significantly associated ( P<.05) with early arrival were: older age, non-African ethnic origin, bystander present at stroke onset, living near (<15km) the hospital, and knowledge of stroke. Almost 80% believed stress was a major risk factor and that dizziness was a cardinal symptom. Only 50% knew of the availability of thrombolysis/thrombectomy and their roles in stroke treatment, and only 37.9% knew the correct time limits for these.

Conclusions:

We identified a number of prehospital barriers to reaching hospital on time for definitive stroke treatment, which have implications on the structure of emergency services for stroke in our city. Our study also revealed interesting observations on the public’s understanding about stroke, calling for a tailored public awareness campaign to improve stroke knowledge.
Anticipation and Organization: Seeing, knowing and governing futures
Authors: Flyverbom Mikkel , Garsten Christina
Published: June 2021

Anticipation is part of organizational attempts to manage their future affairs and shape their surroundings. Still, the ways in which organizations engage in anticipation have not been sufficiently conceptualized in the field of organization and management studies. This article conceptualizes organizational ways of shaping and orchestrating futures by engaging insights from Foucauldian scholarship that highlight the intersection between what we can see, know and govern. We highlight the importance of processes of knowledge production in governance efforts, and articulate how anticipatory governance is crafted through intricate combinations of resources such as narratives, numbers and digital traces. The main contribution is a conceptual typology outlining four different templates for anticipatory governance in organizational settings that we term ‘indicative snapshots’, ‘prognostic correlations’, ‘projected transformations’ and ‘phantasmagoric fictions’. We posit anticipatory governance as a knowledge-based, performative phenomenon that addresses potential and desirable futures in and between organizations. Such anticipatory activities gauge and guide organizational processes and modes of thinking and acting along different temporal orientations, and have governance effects that makes anticipation performative by its very nature. This understanding of anticipatory governance, we suggest, offers both conceptual contributions and empirical avenues for research in organization and management studies.
Book review: Jan Breman. Capitalism, Inequality and Labour in India
Authors: Ranjan Rohit
Published: June 2021

Jan Breman. Capitalism, Inequality and Labour in India. Delhi: Cambridge University Press, 2019, 279 pp., ₹ 536.00 (Paperback).