bluuebunny/crossref_metadata_2025 huggingface dataset:
Indo-Iran Relations: Impact of Third-party Influence
Authors: Omidi Ali , Hafeez Mahwish
Published: November 2023

Close historical, social, cultural and economic ties and geographical proximity present ample opportunity for both Iran and India to advance their national interests by forging strong bilateral relations. Rich in energy resources, particularly oil and gas, Iran can meet India’s growing demand for energy while serving as an international transit route in India’s march towards global prominence and power. India, on the other hand, can help Iran in its testing times to end its isolation and contribute to its economic development. The ground reality, however, is different. India, while maintaining some level of cooperation with Iran, has been increasingly looking towards other countries like Saudi Arabia and Iraq to meet its energy demands. Based on descriptive-analytical research methodology, the article posits that the shift in the Indian foreign policy paradigm from Nehruism during the Cold War period to pragmatism in the post-Cold War period has negatively impacted Iran–India relations. A number of additional factors hinder the development of positive Iran–India relations. The present article considers the role of third countries such as the United States, Israel, Saudi Arabia, Pakistan and China as important factors impeding positive Tehran–Delhi relations.
Populist party-producer group alliances and divergent developmentalist politics of minimum wages in Poland and Hungary
Authors: Naczyk Marek , Eihmanis Edgars
Published: November 2023

In the advanced peripheral economies of East-Central Europe, right-wing populist parties have increasingly politicized the dualism between larger, export-competitive foreign-owned enterprises and smaller, inward-oriented and less productive domestically owned firms. By focusing on the two most-similar cases of right-wing populist governments in the region—namely, Hungary and Poland, this paper documents a striking attempt by Poland’s Law and Justice party to use increases in the minimum wage and social security contributions as a developmentalist tool that should force domestically owned firms to achieve greater efficiency and technological upgrading. In sharp contrast, Hungary’s Fidesz party has systematically compensated minimum wage increases with cuts in employer social contributions and has refrained from assigning developmentalist aims to labor cost increases. Both parties have cultivated a cross-class electoral base and have faced electoral trade-offs in emphasizing minimum wage increases. Yet we argue—and show through a comparative historical analysis—that variation in their policy approaches stems from their distinct, electorally motivated, alliances with influential producer groups and the distinct policy quid pro quos they have struck with those groups, namely, organized labor for Law and Justice and organized business for Fidesz.
Gender dysphoria: Reconsidering ethical and iatrogenic factors in clinical practice
Authors: Halasz George , Amos Andrew
Published: November 2023

Objective

To examine the treatment of gender dysphoria described in Bell v Tavistock (UK 2020). Bell documents the treatment and sequelae of a 16-year-old adolescent referred to the Tavistock with gender dysphoria. Her case highlights contrasts between gender affirming care and comprehensive care.

Conclusions

Consistent with other western centres, in the 2010s, the Tavistock began treating patients with gender dysphoria under the ‘Dutch protocol’ for gender affirming care. Bell reveals concerning lapses of clinical governance influenced by activists and linked to patient harm. The recent suspension of a senior child psychiatrist from an Australian public hospital service after questioning the evidence base and ethical foundation of gender affirming care underlines the need to resolve these uncertainties to address the crisis in the treatment of gender dysphoria.
Mental Health Reform Processes and Service Delivery Shift From the Hospital to the Community in Belgium and Hong Kong
Authors: Honyashiki Mina , Decoster Jeroen , Lo William Tak Lam , Shimazu Taichi , Usuda Kentaro , Nishi Daisuke
Published: November 2023

Aim:

We aimed to illustrate and compare the processes of mental health policies aiming at a service delivery shift from the hospital to the community using implementation science, and to identify important implementation strategies.

Methods:

This study had a comparative case study design. The cases were the Belgian mental health reform, and the person-centered model of mental health in Hong Kong, China. Several documentary sources were reviewed, including the published literature and websites. Data on policy processes were extracted, analyzed using directed content analysis, and categorized into constructs of the conceptual model for evidence-informed policy formulation and implementation arranged for the mental health policy.

Results:

Several similarities were identified in the strategies for active implementation and dissemination; official staff allocation, and training to the community psychiatric services, an approach to adjust the number of psychiatric hospital beds, and promoting collaboration between health care sectors and social welfare sectors. Under distinct social contexts, differences were found in all processes.

Conclusions:

Each of the described policy processes can serve as a model for countries in similar social contexts seeking to shift their psychiatric service delivery. Furthermore, our findings suggest widely applicable implementation strategies for policies aiming at a service delivery shift.
Consensual nonmonogamous relationships during the COVID-19 pandemic
Authors: Copulsky Daniel , Hammack Phillip L
Published: November 2023

With its emphasis on practices like social distancing and periods of intermittent isolation, the COVID-19 pandemic likely presented unique challenges for individuals who engage in consensual nonmonogamy (CNM). Interviews with 16 practitioners of CNM in the United States conducted in May–July, 2021 revealed five themes about how COVID-19 impacted their relationships: (1) slowing down relationship activity and progress; (2) speeding up relationship changes and milestones; (3) providing the opportunity for reflecting on nonmonogamous identities and relationships; (4) facilitation of clarifying intentions around nonmonogamous relationships; and (5) offering unique opportunities to apply skills from safer sex negotiations to navigating safety with precautions related to COVID-19. Findings illuminate how members of a community whose intimate practices were uniquely impacted in a time of limited sociality made meaning of their experience and charted the course for relationship trajectories.
Enhancing critical social work practice: Using text-based vignettes in qualitative research
Authors: Kia Hannah
Published: November 2023

There exist ongoing calls among social work scholars and practitioners to cultivate applied knowledge of critical and emancipatory practice. In this paper, I explore the utility of text-based vignettes as instruments that can be used to elicit insight from marginalized service users on critical social work practice. To do this work, I draw on data from interviews with 20 transgender and gender diverse (TGD) social service users, along with 10 social workers, whose responses to a text-based vignette were originally used to build an understanding of the constituents of equitable social work practice with TGD people. Incorporating critical pragmatism as a conceptual framework and constructivist grounded theory as a methodological orientation, I analyze data from this study as an exemplar that substantiates the promise of using text-based vignettes in qualitative social work research to generate knowledge of critical social work practice. Specifically, I demonstrate how text-based vignettes in this study (1) contextualized the meaning, significance, and impact of oppression for service users, (2) built insight on practice that reflects solidarity and allyship, and (3) identified opportunities for social workers’ reflexive use of professional power to effect change. Accounting for the tensions between empiricism and critical praxis in social work, I consider the promise of incorporating text-based vignettes to develop empirical social work literature that is rooted in the voices of marginalized service users.
Subtle Changes in Tacrolimus Levels Have an Impact on Early Donor-Specific Antibodies in Kidney Transplantation
Authors: Henderson Megan , Awdishu Linda , Morris Gerald P. , Fabbri Kassandra , Shah Mita , Khan Adnan , Kerr Janice
Published: November 2023

Introduction: The impact of each immunosuppressive agent on de novo donor-specific antibodies in kidney transplant recipients varies among extant literature. Project aims: Patterns in immunosuppression and the effects on incidence of de novo donor-specific antibodies were evaluated. Design: Adult kidney transplant recipients from 2017 to 2019 without preformed antibodies were sampled. Allograft function, de novo donor-specific antibodies, tacrolimus concentrations, duration of goal-dose antiproliferatives, and steroid doses were recorded. Outcomes included incidence of de novo donor-specific antibodies, and their relation to tacrolimus concentrations, time at goal-dose antiproliferatives, and steroid doses. Results: Recipients (N = 153) were followed for 1 year; all were crossmatch negative and received rabbit antithymocyte globulin induction. Sixteen (10%) recipients developed de novo donor-specific antibodies in a median of 31 days [interquartile range, IQR: 12-67 days], most were Class II antibodies (87.5%). Incidence of de novo donor-specific antibodies did not differ based on induction dosing. Tacrolimus levels in the first month were lower for patients with de novo donor-specific antibodies (8.8 ng/mL vs 10.4 ng/mL, P < .01). There was no difference in time on goal antiproliferative doses, but higher steroid doses (0.4 vs 0.3 mg/kg/d; P = .02) were noted in patients with antibodies. Steroid dosing was likely impacted by baseline risk factors. Conclusion: A significant association was found between lower tacrolimus concentrations early post-transplant and incidence of de novo donor-specific antibodies. This highlighted the importance of clinician attention to subtle changes in tacrolimus and the impact it can have on antibody risk in the early post-transplant period.
To STEM or Not to STEM? Analyzing Socioeconomic and Demographic Factors of STEM Degree Attainment in Ecuador With an Emphasis on the Gender Gap
Authors: Guerrero Alicia , Alejandra Ruano Maria , Avilés-Guamán César , Vaca Gonzalo
Published: November 2023

Despite the importance of STEM careers in nations’ development, they are not the preferred careers to study in Ecuador. Although the decision to pursue a STEM career has been analyzed, most studies use data from developed countries. This article analyzes the factors that characterize Ecuadorian STEM professionals using socioeconomic and demographic variables. Results show that women and individuals from households in the lowest quintile of per-capita income are less likely to have a STEM degree.
Case Report: Successful Treatment of Aberrant Left Subclavian Artery With a Right-Sided Aortic Arch
Authors: Matta Rishabh , Shah Anil , Bandesha Harmanpreet , Thiagarajasubramanian Shruthi , Muluk Satish
Published: November 2023

Right sided aortic arches with concomitant aberrant left subclavian arteries are exceedingly rare anatomical variants. We present a case of a 45 year old male that presented with symptoms consistent with dysphagia and known right sided aortic arch with an aberrant left subclavian artery. Though previous reports of repair have indeed been reported, we confirm that a hybrid approach to these anatomic variants remain feasible and with symptom resolution for patients.
Investigating the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease: A cross-sectional study from Iran
Authors: Rad Parvin Zandi , Gharibi Tayebeh , Vahedparast Hakimeh , Bagherzadeh Razieh
Published: November 2023

Introduction

Despite the effect of coronary artery disease on sexual function and the relation between sexual function and marital satisfaction, few studies have investigated the effect of treatment adherence on marital satisfaction. The present study aims to investigate the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease.

Methodology

In this cross-sectional study, 385 women with coronary artery disease in Bushehr-Iran, 2021, were selected using a convenient sampling method. The data were collected using the demographic form, Seyed Fatemi medication adherence scale, female sexual function index, and evaluation and nurturing relationship issues, communication, and happiness marital satisfaction scale. The data was analyzed using univariate and multivariate logistic regression tests.

Results

The mean (± standard deviation) age of the participants was 52.19 ± 12.15 years old. Considering the effect of demographic variables, treatment adherence ( β = 0.164, P = 0.001) and sexual function ( β = 0.156, P = 0.001) were positive predictors of marital satisfaction.

Conclusion

Treatment adherence was a positive predictor of marital satisfaction. Healthcare providers should pay attention to the family consequences of non-adherence to treatment. Moreover, when counseling patients to adhere to the treatment, they should mention the physical benefits as well as psychological and family outcomes in order to motivate patients to follow their treatment.
The importance of cancer prevention policies to inform and guide preventative and screening measures for people with intellectual disabilities: The COST project “Cancer- Understanding Prevention in Intellectual Disabilities”
Authors: Vukovic Vladimir , Banda Amina , Carneiro Lara , Dogan Soner , Knapp Peter , McMahon Martin , Milutinovic Dragana , Soylar Pinar , Sykes Kate , Tosun Betul , Yava Ayla , Trajkovski Vladimir , Wells John , Cuypers Maarten
Published: November 2023

Cancer is a global public health problem, but its exact prevalence in people with intellectual disabilities is still uncertain. This population, with limited health skills and complex health needs, faces many challenges in cancer prevention, screening, timely diagnosis and treatment. Furthermore, they are often underrepresented in general cancer prevention and screening policies across Europe, leading to widened disparities in health outcomes and premature mortality. Thus, unified national and local policies are needed to reduce inequalities and promoting a pan-European inclusion of people with intellectual disabilities. Our goal is to raise public awareness of this issue, including the involvement of people with intellectual disabilities, and promote engagement from relevant stakeholders. The COST Action ‘Cancer- Understanding Prevention in Intellectual Disabilities’ (CUPID) project will address health inequalities faced by people with intellectual disabilities in relation to cancer, and support the development of policy recommendations specifically tailored to their unique cognitive and healthcare needs, having a positive long-term impact on quality of life.
From traditional regionalism to national distinction: German television co-productions through time
Authors: Weissmann Elke
Published: November 2023

This article offers a historical perspective on co-productions of high-end television drama in Germany. It argues that such co-productions have seen three distinct phases that although overlapping, are described by industry insiders and critics as distinct periods where one form of co-production is dominant at a particular time but then becomes residual as other forms take over. These three forms are, first, public broadcaster-led co-productions, second, ‘Europudding’ co-productions, and finally, distinctive co-productions in TVIV. This article shows that these phases are connected to stylistic as well as industrial changes, which do not always overlap with the description of industry insiders.
Differences of Chemical Constituents and Pharmacological Activities of Traditional Herbs Before and After Honey-Frying
Authors: Truong Minh-Nhut , Huynh Le-Truong , Vu Thi-Hiep , Phan Nguyen-Duc D. , Thi Lan-Phuong L.
Published: November 2023

Processing is one of the important and crucial parts that has been applied in traditional oriental medicine for a long time. The traditional ingredients were processed on the basis of the Yin Yang theory, Five Elements theory, and folk experiences. Among many processing techniques, honey-frying is a process enhancing the effects of traditional herbs on the Spleen and Stomach organs. This report provides an overview of the differences between chemical constituents and pharmacological activities of some traditional ingredients before and after roasting with honey.
Technologies of inclusion and marginalization: Mobile phones and multiple exclusion homeless women
Authors: Williams Heather , Faith Becky , Waldman Linda
Published: November 2023

Little is known about women experiencing multiple exclusion homelessness (MEH) in the UK, and even less about their use of mobile phones. MEH describes a subset of homeless people with multiple and complex needs who experience forms of deep social exclusion. Marginalized and socially excluded women often avoid social services and survive through remaining elusive and invisible. This evasion is reflected in their mobile phone practices in which both use and nonuse are expressions of their limited agency in the face of profound structural inequalities. This study explores MEH women's agency articulated through mobile phone ownership and usage in a UK coastal city. Through “deep hanging out” participant observation and interviews, it illuminates the complex ways in which MEH women access and manage mobile phones. It highlights paradoxical tensions between connection and invisibility; for example, homeless support services provide budget feature phones to MEH clients to ensure their improved safety and connectivity; however, MEH women sell these phones to meet their immediate needs. In so doing, these women reject the provision and discourse of stripped-back, financially compromised UK homeless support services. Through their mobiles, MEH women also engage with social media in uncertain ways, an activity which rather than providing connectivity and access, reaffirms social marginalization. Thus, MEH women's deep social exclusion is both mediated and reinforced by their mobile media practices.
Structured like a language model: Analysing AI as an automated subject
Authors: Magee Liam , Arora Vanicka , Munn Luke
Published: November 2023

Drawing from the resources of psychoanalysis and critical media studies, in this article we develop an analysis of large language models (LLMs) as ‘automated subjects’. We argue the intentional fictional projection of subjectivity onto LLMs can yield an alternate frame through which artificial intelligence (AI) behaviour, including its productions of bias and harm, can be analysed. First, we introduce language models, discuss their significance and risks, and outline our case for interpreting model design and outputs with support from psychoanalytic concepts. We trace a brief history of language models, culminating with the releases, in 2022, of systems that realise ‘state-of-the-art’ natural language processing performance. We engage with one such system, OpenAI's InstructGPT, as a case study, detailing the layers of its construction and conducting exploratory and semi-structured interviews with chatbots. These interviews probe the model's moral imperatives to be ‘helpful’, ‘truthful’ and ‘harmless’ by design. The model acts, we argue, as the condensation of often competing social desires, articulated through the internet and harvested into training data, which must then be regulated and repressed. This foundational structure can however be redirected via prompting, so that the model comes to identify with, and transfer , its commitments to the immediate human subject before it. In turn, these automated productions of language can lead to the human subject projecting agency upon the model, effecting occasionally further forms of countertransference. We conclude that critical media methods and psychoanalytic theory together offer a productive frame for grasping the powerful new capacities of AI-driven language systems.
3D-Printed Musical Instruments: Lessons Learned from Five Case Studies
Authors: Simian Ricardo
Published: November 2023

The music field is lively and creative, and innovation in the final product is a leading force in the sector. However, the physical instruments used by musicians to produce their craft are highly conservative and have developed little over the last centuries. Computers, audio software, and electronic musical instruments have been integrated into musical practice, but acoustic instrument design has remained virtually frozen. Although mass production methods are frequently applied to musical instrument production nowadays, the designs have changed minimally, which makes the musical landscape unique. Additive manufacturing (AM) provides novel possibilities that can be of interest in music and musical research. In this article, we present the results of five case studies on AM use within specific musical niches. Each niche represents a unique market space and cultural background that is critical in tradition-oriented environments. Starting from the analysis of these five case studies, we extract lessons on AM application to unique environments. From these, we discuss the potential for AM-driven innovation in design and production in general and propose a holistic evaluation matrix for identifying suitable market niches.
Paradoxes of probation: Statutory limitation on the possibility of probation decreased the severity of judgments
Authors: Mamak Kamil , Dudek Joanna , Koniewski Maciej , Kwiatkowski Daniel
Published: November 2023

Probation is a tool to decrease the severity of the legal system. In theory, more instruments of probation mean fewer people deprived of liberty. However, Poland previously faced a paradoxical situation: there was a significant crime rate drop and a growing number of suspended punishments, but—at the same time—the incarceration rate was high. Many argued that the cause of this state of affairs was the overuse of probation instruments. Almost half of suspended punishments of deprivation of liberty were ultimately enforced. The 2015 reform of the Polish criminal law aimed to decrease the statutory possibility of using probation. This study compares trial outcomes from before and after the reform. We examine files from district courts in 13 cities in Poland for two offences: drug possession and drunk driving. We conclude that the limit on probation decreases the severity of the legal system.
‘As You Sow So You Reap’: A Multi-case Study on Reshaping Workforce Well-being Through Positive Sustainability at Construction Firms
Authors: Biswas Wendrila , Chakraborty Debarun
Published: November 2023

The nature of work has immensely changed in the last few years and so are the workforce expectations. Employees are steadily reassessing why and where they work. Even amidst workplace upheavals, they are in dire search for a sense of purpose to align themselves with that of their firms, whereas organizations still feel that employees sense transaction rather than appreciation. Thereby working with two opposite thoughts and feelings, companies have overlooked the essentials of employee well-being. Here, the role of positive outlook/perspectives of a firm emerge as a vital facet that can help to sustain authentic and motivating experiences at work. Thus positive sustainability at workplace can satiate the employees’ want for social cohesion, trust and purpose. The present work is a multi-case study on four construction firms of West Bengal who were eager to design moments that reflected sustenance of positive aspects amidst all odds. The study revealed five crucial elements of positive sustainability (going beyond the pursuit of perfection, fostering learning agility and grit, mindful gratitude, managing energy rather than time, trust is crucial) which the firms have restored over time. Such aspects have brought about unique transformation at work and lead to resourcefulness.
Magnetic Resonance Imaging Characteristics of a Lateral Ligament Injury in Acute Ankle Sprains Among Athletes
Authors: Kim Jin Su , Kim Min Seok , Kim Do Kyun , Lee Sung Hyun
Published: November 2023

Background:

It is important to identify the location and pattern of lateral ligament injuries that are related to the development and prognosis of chronic ankle instability in athletes with ankle sprains.

Purpose:

To describe the location and pattern of lateral ligament injuries on magnetic resonance imaging (MRI) in elite-level or amateur athletes with acute ankle sprains and to further assess the risk of associated concomitant injuries.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) of 110 athletes with an ankle lateral ligament injury (mean age, 24.7 years) were evaluated. MRI scans were evaluated for the location and pattern of ATFL and CFL tears such as sleeve avulsions as well as concomitant deltoid ligament injuries, bone contusions, and osteochondral lesions of the talus (OLTs).

Results:

On MRI, 52 (47.3%) athletes had an isolated ATFL tear, 56 (50.9%) athletes had both ATFL and CFL tears, and 2 (1.8%) athletes had an isolated CFL tear. ATFL injuries occurred at the fibula, midsubstance, and talus in approximately equal numbers, whereas the majority of CFL injuries occurred at the calcaneal insertion. Concomitant deltoid ligament injuries were identified in 18 (16.4%) athletes. In addition, concomitant bone contusions and OLTs were identified in 38 (34.5%) and 6 (5.5%) athletes, respectively. Using linear-by-linear analysis, CFL injuries correlated with concomitant deltoid ligament and bone injuries ( P = .023 and P = .001, respectively) and a sleeve injury pattern ( P = .005).

Conclusion:

After an acute ankle ligament rupture, almost all athletes involved in this study had injured their ATFL, and approximately 50% had a concomitant injury to the CFL. The rate of sleeve-type CFL injuries at the calcaneal insertion was high, and concomitant deltoid ligament injuries and OLTs were associated with this pattern of injury.
Twitter (X), Fast Fashion and Backlash: Argumentation and Ethics on Social Media
Authors: Balabanova Ekaterina , Palmieri Rudi , Liu Zixiu
Published: November 2023

Social media backlashes have emerged as important phenomena complicating how businesses communicate online and representing significant brand risk. This article demonstrates the value of content analysis and argumentation theory for understanding and responding to social media backlash events, using two examples from the UK fashion industry (hashtags #ThanksItsASOS and #boycottboohoo). The results provide lessons about the way backlashes operate in practice, how to analyze these effectively, and have implications for business approaches to communicating about Corporate Social Responsibility and managing social media. The authors conclude with suggestions for training on social media and CSR for businesses.
History Repeats Itself: The Relevance of Historical Pandemics to the Medical School Curriculum
Authors: Jones M , Quenby S , Odendaal J
Published: November 2023

Introduction

The dramatic global impact of the coronavirus pandemic has increased consideration on epidemiological progressions of pandemics. Measures implemented to reduce viral transmission have been largely historical, comparable in nature with the 1918 and 2009 influenza pandemics, demonstrating the importance of clinicians’ awareness on historical pandemics. Despite this, literature suggests medical students’ knowledge on previous pandemics is poor.

Objectives

This study aims to gather stakeholder information from UK medical students on the importance of including the history of pandemics in the medical school curriculum.

Methods

A cross-sectional cohort study conducted via a mixed question type online survey was distributed to all UK medical schools to explore stakeholder views. Grounded theory emergent coding was used to generate themes to free-text answers and SPSS and Excel were used to analyse quantitative data using pivot tables and Fishers exact tests.

Results

Two hundred and forty-one students consented to take part from eight medical schools in the UK with 98% of these students completing the questionnaire. 34% of students reported having teaching on pandemics with 78% of students stating it would be beneficial. Knowledge was poor with 5.7% of students achieving 100% on knowledge-based questions. 72% of students believed that learning about the history of medicine would be beneficial with 87% of these students referring to ‘benefiting (the) future’ in their answers. Additionally, 79% of students thought it would be beneficial to learn about historical pandemics with reference to the current COVID-19 pandemic.

Conclusion

To date, this is the only UK based study assessing stakeholders’ views on including the history of pandemics in the medical school curriculum. Our findings demonstrate that medical students wish to have more historical content included in their degree to better prepare tomorrow's doctors for situations that may occur when history repeats itself.
Book review: Kudret Bulbul, Md. Nazmul Islam and Md. Sajid Khan (Eds.), Rohingya Refugee Crisis in Myanmar: Ethnic Conflict and Resolution
Authors: Obaidullah Md. , Hossain Meherab
Published: November 2023

Kudret Bulbul, Md. Nazmul Islam and Md. Sajid Khan (Eds.), Rohingya Refugee Crisis in Myanmar: Ethnic Conflict and Resolution (Singapore: Palgrave Macmillan, 2022), 424 pp. €139.99, ISBN 978-981-16-6463-2 (Paperback).
Carbon Footprint of Wool at Cradle to Farm-Gate Stage in Victoria, Australia
Authors: Li Xue , Sun Lirong , Zhang Jianhua , Li Xin , Yang Yi , Zhu Lisha , Zhang Ying , Wang Laili
Published: November 2023

The raw material acquisition stage of wool involves raising sheep and a large amount of input and output, resulting in substantial greenhouse gas emissions. To date, the research literature on wool carbon footprint is limited, and there is a lack of research on Victoria. These studies did not consider the influence of changes in weight and productive lifespan. This study aims to address this knowledge gap by calculating the wool carbon footprint in Victoria and improving the calculation method. In this article, 20,000 sheep in Victoria were investigated. The average weights of the sheep were obtained by curve fitting and calculating. Two scenarios with 5-year and 6-year productive lifespans were used to calculate the carbon footprint of merino wool by the mass allocation method, economic allocation method, and protein mass allocation method. Results revealed that the carbon footprint of wool for the 5-year and 6-year productive lifespans were 14.158–49.040 kg carbon dioxide equivalent (CO2-e)/kg wool and 16.743–52.882 kg CO2-e/kg wool. Rumination and excretion accounted for the largest proportion, followed by phosphate fertilizer, electricity, and potash fertilizer. The longer the productive lifespan and the heavier the sheep, the greater the greenhouse gas emissions from rumination and excretion, leading to a larger carbon footprint for wool. For the same productive lifespan, the economic allocation method produced the highest carbon footprint for wool compared to the mass allocation method, which produced the lowest carbon footprint. This study provides a reference for the subsequent carbon footprint accounting of wool from cradle to farm-gate and helps the wool industry save energy and reduce emissions.
Race-Based Experiences and Coping as Predictors of BIPOC Mental Health Provider Burnout and Stress During COVID-19
Authors: Kirk Keri F. , Jackson Jessica , Sagui-Henson Sara , Wang Emily , Semaan Farah , Prescott Maximo R. , Welcome Chamberlain Camille E. , Castro Sweet Cynthia , Ijebor Ellen E. , Knott Lindsey
Published: November 2023

The current study evaluated work- and client-related burnout, perceived stress, and race-based stress with a focus on Black, Indigenous, or Persons of Color (BIPOC) mental health providers. An online survey ( n = 82) was distributed in the United States between July 17, 2020, and November 5, 2020. Demographic variables, racial discrimination during coronavirus disease 2019 (COVID-19), perceived stress, and the coping variables were assessed. The majority of respondents were women (85%), BIPOC identifying (72%), aged 25 to 34 years (43%), psychologists (50%), and had been practicing for 9 years. In total, 68% and 27% of providers reported moderate to severe work- and client-related burnout, respectively. Another 87% reported moderate to high stress. Factors associated with a higher level of burnout include being younger, having fewer years of experience, and being a social worker or family therapist. Among BIPOC providers, greater experiences of racial discrimination were associated with higher work-related burnout and stress. Greater use of maladaptive coping was associated with higher burnout and stress, yet we found no associations with the use of adaptive coping. Racial discrimination during COVID-19 was significantly associated with work-related burnout and perceived stress within a sample of predominantly BIPOC mental health providers. These findings reinforce the need for more focused support for mental health providers to ensure a healthy and resilient future workforce.
Experiences of engaging a death doula: qualitative interviews with bereaved family members
Authors: Rawlings Deb , Van Dinther Kristine , Miller-Lewis Lauren , Tieman Jenifer , Swetenham Kate
Published: November 2023

Background:

There has been an emerging trend of adopting a death doula, a non-medical advocate and guide for people at the end of life and their families. While there has been growing empirical research regarding the work of death doulas, no studies have been undertaken with the families who have engaged them.

Objectives:

To understand the experiences of families who used a death doula in terms of what they did for the patient and family; to understand the benefits and drawbacks of using a death doula; and to use family insight to determine cultural shifts towards death and dying, and what the death doula phenomenon tells us around our attitudes towards death and dying.

Methods:

We recruited and interviewed 10 bereaved family members to learn about their experiences using a death doula. This qualitative research took an interpretive phenomenological approach, and thematic analysis was used to analyse the data.

Results:

The most valuable attribute the families gained from death doulas was an increase in death literacy resulting in personal empowerment. Empowerment enabled positive end-of-life experiences for the family and personalised deaths for the patient. A novel finding was that the connections and knowledge shared between the death doula and family had a resonant effect, resulting in families being more comfortable with death and keen to share their knowledge with others. Therefore, family engagement of a death doula led to an increase in community awareness around death and dying.

Conclusion:

Family members’ experience with a death doula was overwhelmingly positive, empowering them practically and emotionally to deliver the best end-of-life care. Empathy and sharing of knowledge by death doulas were valued by families and resulted in an increase in death literacy which provided families with opportunities to ‘pay it forward’. Furthermore, the relationships formed between doulas and families have the potential for a lasting, resonant effect.
Evaluation of parameters used in echocardiography and ultrasound protocol for the diagnosis of shock etiology in emergency setting
Authors: Ramadan Asmaa , Abdallah Tamer , Abdelsalam Hassan , Mokhtar Ahmed , Razek Assem Abdel
Published: November 2023

Background

Early recognition and appropriate treatment has shown to decrease morbidity and mortality in patients with undifferentiated shock. There are many ultrasound protocols in shock; each protocol combines core ultrasound elements such as IVC and cardiac assessment which includes detection of cardiac tamponade, left ventricular function and right ventricular strain.Valvular assessment is absent in majority of ultasound protocols, while lung ultrasound is included in some of them.

Objective

In this study we investigated which parameters used in Echo – US protocol help differentiate shock types.

Methods

This cross sectional study was conducted on 150 patients with shock (140 patients were included while, 10 patients were excluded).Sensitivity and specificity of different parameters used in the Echo-US protocol were analyzed to detect which parameters can diffentiate shock types.

Results

Velocity time integral of Aorta and IVC maximum diameter were good discriminators for distributive shock, with area under the ROC curve (AUC) = 0.8885 (95% CI 0.8144 to 0.9406) and 0.7728 (95% CI 0.6832 to 0.8473) (Z = 10.256 p < 0.0001) and (Z = 5.079 p < 0.0001) respectively. Left ventricular systolic function, presence of pneumonia, pneumothorax or valve vegetations were of great value in differentiating shock types, while CUST, FAST, TAPSE and RV diameter were not useful in differentiating shock types.

Conclusion

Ultrasound and echocardiography are powerful tools that can be used to identify shock etiology when the clinical picture overlaps.
The perceived self-efficacy of senior, middle, and operations managers of the incident command system dealing with emergencies and disasters during the COVID-19 pandemic
Authors: Aminafshar Asiye , Sartipi Majid , Pakzad Abdolrazzagh
Published: November 2023

Background

Natural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran.

Methods

The study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura’s self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed.

Results

The number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant.

Conclusion

Even training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.
HBV pregenome RNA as a predictor of spontanous HBeAg seroconversion in HBeAg-positive chronic hepatitis B patients
Authors: Song Guangjun , Yang Ruifeng , Jin Qian , Liu Juan , Rao Huiying , Feng Bo , Xie Yandi
Published: November 2023

Background

Previous studies have indicated that HBV pregenome RNA (HBV pgRNA) could predict HBeAg seroconversion among the chronic hapatitis B (CHB) patients treated with pegylated interferon (Peg-IFN) or nucleos(t)ide analogues (NAs). However, the data about the prediction of HBV pgRNA for spontaneous HBeAg seroconversion is limited.

Methods

One hundred thirteen CHB patients with HBeAg-positive in the immune active phase were followed up for 76 weeks without antiviral treatment. Based on the laboratory test results of liver function, HBeAg, anti-HBe, and HBV DNA at week 76, patients were assigned to two groups: spontaneous HBeAg seroconversion (group A, n = 18) and non-spontaneous HBeAg seroconversion group. Among the latter group, 36 patients were selected as controls (group B, n = 36).

Results

At week 12, between group A and group B, there was a significant difference in the level of HBV pgRNA (group A 6.35 ± 1.24 log10 copies/ml and group B 7.52 ± 0.79 log10 copies/ml, P = 0.001), and the difference enlarged at week 28. The receiver operating characteristic curves (AUROCs) of the HBV pgRNA level and the ∆HBV pgRNA at week 28 were 0.912 (P = 0.001, 95% CI: 0.830–0.994), and 0.934 (P = 0.001, 95% CI: 0.872–0.996), respectively. The optimal cutoffs of HBV pgRNA and the reduction from baseline (∆HBV pgRNA) at week 28 for spontaneous HBeAg seroconversion prediction were 5.63 log10 copies/ml and 1.85 log10 copies/ml, respectively. The positive predictive value and negative predictive value of HBV pgRNA and ∆HBV pgRNA at week 28 were 86.7% and 87.2%, 87.5% and 89.5%, respectively. And the combination of the HBV pgRNA level and the HBV pgRNA decreased could provide better prediction.

Conclusions

HBV pgRNA is a sound predictor for spontaneous HBeAg seroconversion among the CHB patients in immune active phase. Dynamic monitoring of HBV pgRNA is helpful for clinical treatment decision.
Evaluation of the impact of COVID-19 pandemic on hospital-acquired infections in a tertiary hospital in Malaysia
Authors: Ismaeil Rehab , Nahas Abdul Rahman Fata , Kamarudin Norhidayah Binti , Abubakar Usman , Mat-Nor Mohamad Basri , Mohamed Mohamad Haniki Nik
Published: November 2023

Background

Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital.

Method

This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records.

Results

There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19.

Conclusion

Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
Patterns of use of symptomatic treatments for Alzheimer's disease dementia (AD)
Authors: DiBello Julia R. , Lu Yifei , Swartz Jina , Bortnichak Edward A. , Liaw Kai-Li , Zhong Wenjun , Liu Xinyue
Published: November 2023

Background

Symptomatic treatment for Alzheimer's disease (AD) dementia could temporarily slow symptom worsening and improve the quality of life for both AD dementia patients and their caregivers. A comprehensive evaluation of symptomatic treatment patterns using recent data for newly diagnosed AD dementia has not been performed and compared across different countries.

Methods

The drug name, time to the first therapy, duration, discontinuation or switches were described in newly diagnosed AD dementia patients in two databases (a major U.S. health plan [US] and UK-Clinical Practice Research Datalink [CPRD GOLD]). This analysis included patients with newly diagnosed AD dementia in 2018–2019, who initiated symptomatic AD drug therapy, with ≥ 1 year baseline period and ≥ 1 year of follow-up.

Results

Over median follow-ups of 698 and 645 days, 63% and 65% of AD dementia patients used symptomatic treatments, with 34% and 77% newly initiating therapy, constituting analytic samples of 7637 patients in the US database and 4470 patients in the CPRD, respectively. The median time to the first therapy was 14 days for US and 49 days for CPRD; donepezil ranked the as most frequently used (69% vs 61%), followed by memantine (19% vs 28%) in the US database and CPRD, respectively. Median time on first therapy was 213 and 334 days, and 30% and 12% of patients proceeded to a second treatment in the US and CPRD databases, respectively.

Conclusion

Approximately two thirds of newly diagnosed AD dementia patients utilized approved symptomatic treatment. Time on first therapy was relatively short (< 1 year) and the majority did not move to a second therapy, highlighting the need for better adherence and persistence to existing AD symptomatic therapies and the need for additional therapies to alleviate the significant burden of AD dementia.
Melanoma and CLL co-occurrence and survival: role of KC history
Authors: Zhao Yayi , Amorrortu Rossybelle P. , Stewart Sandra C. , Ghia Kavita M. , Williams Vonetta L. , Sondak Vernon K. , Tsai Kenneth Y. , Pinilla-Ibarz Javier , Chavez Julio C. , Rollison Dana E.
Published: November 2023

Background

Survival following melanoma and chronic lymphocytic leukemia (CLL) have both been individually associated with previous history of non-melanoma skin cancers (specifically keratinocyte carcinomas [KC]). Furthermore, melanoma and CLL have been reported to occur within the same patients. The survival experience of patients with both cancers is understudied, and the role of history of KC is unknown. Additional research is needed to tease apart the independent associations between KC and CLL survival, KC and melanoma survival, and the co-occurrence of all three cancers.

Methods

A retrospective cohort study was conducted among patients who were diagnosed with melanoma and/or CLL at a comprehensive cancer center between 2008 and 2020. Multivariable Cox regression models were used to examine the association between history of KC and survival following melanoma and/or CLL with careful consideration of calendar year of diagnosis, treatment regimens and other risk factors. A nested case–control study comparing patients with both CLL and melanoma to those with only CLL or only melanoma was conducted to compare blood parameters across the three groups.

Results

A time-dependent association was observed between history of KC and favorable melanoma survival within 4 years following diagnosis and poorer survival post 7 years after melanoma diagnosis. History of KC was not significantly associated with survival following the diagnosis of CLL, after adjustment for clinical factors including historical/concurrent melanoma. Patients with co-occurring melanoma and CLL tended to be diagnosed with melanoma first and had elevated blood parameters including white blood cell and lymphocyte counts as compared with patients who were diagnosed with only melanoma.

Conclusions

History of KC was an independent predictor of survival following melanoma but not of CLL. Additional studies are needed to determine if blood parameters obtained at the time of melanoma diagnosis could be used as a cost-effective way to identify those at high risk of asymptomatic CLL for the promotion of earlier CLL diagnosis.