bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock after valve replacement
Authors: Arafat Amr A , AlBarrak Mohammed , Kiddo Musab , Alotaibi Khaled , Ismail Huda H , Adam Adam I , Aboughanima Mohamed A. , Albabtain Monirah A. , Tantawy Tarek M , Pragliola Claudio
Published: January 2023

Background

Limited data evaluated the outcomes of extracorporeal membrane oxygenation (ECMO) in patients with prosthetic valves. This study aimed to compare the outcomes of ECMO support for postcardiotomy cardiogenic shock in patients with mechanical versus bioprosthetic valves.

Methods

This retrospective study included patients with ECMO support for postcardiotomy cardiogenic shock after valve replacement. Patients were grouped into bioprosthetic ( n = 49) and mechanical valve ( n = 22) groups.

Results

There were no differences in ECMO duration, inotropic support, intra-aortic balloon pump (IABP), stroke, duration of ICU, and hospital stay between groups. Postoperative thrombosis occurred in 2 patients with bioprosthetic valves (5.41%) and 2 with mechanical valves (14.29%), p = .30. All patients with thrombosis had central ECMO cannulation, concomitant IABP, and inotropic support during ECMO. All thrombi were related to the mitral valve. Three patients with thrombi had hospital mortality. Survival at 6, 12, and 36 months for bioprosthetic valve patients was 30.88%, 28.55%, and 25.34% and for mechanical valves was 36.36% for all time intervals (Log-rank p = .93). One patient had bioprosthetic aortic valve endocarditis after 1 year. Three patients with bioprosthetic valves had structural valve degeneration after 1, 2, and 5 years.

Conclusions

Outcomes of ECMO in patients with prosthetic valves are comparable between bioprosthetic and mechanical valves. Thrombosis might occur in both valve types and was associated with high mortality. ECMO could affect the long-term durability of the bioprosthetic valves.
Bridging cultures in palliative care: A qualitative study of the care of Indigenous Australians with advanced illness
Authors: Panozzo Stacey , Bryan Tamsin , Mason Toni , Garvey Gail , Lethborg Carrie , Boughey Mark , Philip Jennifer A
Published: January 2023

Background:

Lack of access, late engagement and limited referral for palliative care remain critical issues in supporting Indigenous Australians with life limiting illness.

Aim:

To explore the experiences and perspectives of Indigenous and non-Indigenous health professionals regarding the provision of palliative care for Indigenous people with advanced disease.

Design:

Qualitative study involving semi-structured focus groups/interviews with analysis following an inductive thematic approach.

Setting/participants:

A purposive sample ( n = 54) of medical, nursing, allied health and Indigenous Hospital Liaison Officers engaged in caring for Indigenous patients at a metropolitan teaching hospital in Australia.

Results:

Four overarching themes were identified regarding provision of palliative care for Indigenous patients. These were (1) the intersection of cultures – Indigenous peoples, health and palliative care, (2) bridging the cultural divide: the integral role of Indigenous Hospital Liaison Officers, (3) health professionals devolve their responsibility to provide culturally appropriate care and (4) building towards a more holistic, culturally aware provision of palliative care.

Conclusions:

For many Indigenous people, the health system may be experienced as inflexible, narrowly focused and even prejudiced and traumatising. For Indigenous patients at the end of life, these challenges are heightened. The Indigenous Hospital Liaison Officers, working at the intersections of these two cultures, are key to negotiating such challenges as they seek opportunities to facilitate communication and understanding between firmly held cultural needs.
Validation of the Violent Ideations Scale (VIS) in Spain
Authors: Urruela Carlota , Greco Ana M. , Díaz-Faes Diego A. , Zych Izabela , Pereda Noemí , Eisner Manuel , Ribeaud Denis , Murray Aja L.
Published: January 2023

Research has shown that violent ideations (VIs) may play a key role in aggression and violence. However, there is no tool to measure this construct adapted to the Spanish language so far. The current study aims to translate and evaluate the psychometric properties of the Violent Ideations Scale (VIS) in European Spanish. This study counts with a convenience sample of 752 native Spaniards or Spanish speakers residing in Spain, between 18- and 75-years old, 53% identified as female and 47% identified as male. The dimensionality, gender measurement invariance, concurrent validity and reliability of scores were assessed. Initial evidence of external validity was collected. Results confirmed the unidimensionality of the instrument. Measurement invariance held across females and males and reliabilities were high. VIS-ES scores correlated with aggressive behavior during the previous month. The VIS-ES seems suitable for use in non-clinical Spanish speaking samples.
Laser powder bed fusion of glass-filled polyamide-composite with enhanced physical properties
Authors: Negi Sushant , Mishra Vishal , Ror Ch. Kapil , Sharma Rajesh Kumar
Published: January 2023

Glass-filled polyamide (GF/PA) is an important engineering material for automotive industry because of its excellent physical, thermal and mechanical properties. But it is challenging to produce high quality functional parts through additive manufacturing technology like selective laser sintering (SLS). It is due to fact that SLS made parts exhibit high dependence on the sintering conditions. Thus, it becomes essential to adjust these sintering conditions accurately to improve physical properties like density and hardness to enhance the widespread use of this technology. Therefore, this study presents a statistical analysis of the SLS process parameters led by a design of experiment to extract information about their influence on hardness and density of the PA 3200 GF composite. GF/PA with a refresh rate of 60:40 was used for the part fabrication and the effect of five key sintering parameters has been considered for analysis. Experiments revealed that poor material integrity and weak interaction between the particles at lower energy density were the main reason for the lower hardness and density of fabricated parts.
Review on disposal, recycling and management of waste polyurethane foams: A way ahead
Authors: Banik Jyotiparna , Chakraborty Debdyuti , Rizwan Mohammed , Shaik Aabid Hussain , Chandan Mohammed Rehaan
Published: January 2023

With the burning issue of air, land and water pollution, the premonition of looking forward towards a future devoid of any kind of oil and gas reserves has caused a paradigm shift towards recycling, recovery of any synthetic polymer and also to dispose them off environmentally. Among them are plastics such as polyethylene terephthalate and poly vinyl chloride. Polyurethane (PU) is also under the scanner to dispose of or recycle it environmentally and sustainably. PU is at present the sixth most utilized polymer all over the world with a production of nearly 18 million tonnes per annum, which roughly estimates a daily production of PU products of greater than a million of cubic metres. Its thermostable nature is one of the major reasons for its higher preference over other polymers. This review article discusses the current disposal and technologies available to recycle waste PU foams and also sheds some light on some additional work being done in the field to upgrade the existing technology. Interestingly, some methods mentioned here are probably undergoing scale-up trials runs by now. Currently, the most researched and studied ones are mechanical recycling and glycolysis. But microbial and enzymatic disposal methods can be turned into full-scale industrial recycling processes in the near future. Additionally, we can see an archetypal shift from traditional oil-based sources to the agrarian sources.
Trusting and Learning From Virtual Humans that Correct Common Misconceptions
Authors: Schroeder Noah L. , Chiou Erin K. , Siegle Robert F. , Craig Scotty D.
Published: January 2023

Virtual humans are on-screen characters that are often embedded in learning technologies to deliver educational content. Little research has investigated how virtual humans can be used to correct common misconceptions. In this study, we explored how different types of narrative structures, refutation text and expository text, influence perceptions of trust, credibility, and learning outcomes. In addition, we conducted exploratory analyses examining how different measures of trust and credibility are related to each other and how these measures may mediate learning outcomes. Results showed that the type of narrative used did not influence any measure. However, the trust and credibility measures, while related to one another, were measurably distinct. In addition, only perceptions of message trust were significantly related to learning. Perceptions of message trust did not mediate learning outcomes, but were significantly predictive of learning at nearly the same effect as prior knowledge.
Aluminum foam development by filling architecture techniques and process optimization
Authors: Kumar Mandeep , Singh Ratnesh Kumar Raj , Jain Vivek
Published: January 2023

The aluminum foam is used in various industrial applications because of its superior strength to weight ratio. The FSP is used here for development of a precursor by processing a foamable mixture into the substrate. The filling of the foamable mixture is done by different techniques named: Buried hole, sandwich, and groove architecture. The developed precursor is then microwave heated for the development of foam. A comparison is made between the different filling techniques, number of passes and composition of the foamable mixture on the distribution of pores, size, porosity, and compressive behavior of the foam. It has been observed that the buried hole is more suitable for foam development owing to less wastage of foaming agent. The decomposed gases were fully utilized by trapping into the substrate. It is also observed that increasing the number of passes and weight % of TiH2, improves the distribution of pores. The buried hole technique shows the linear plateau stress in the compressive test as compared to other techniques. The highest porosity is close to 80% during buried hole technique, and the average pore diameter ranges between 0.4 and 1.69 mm for optimized samples.
An active oscillation reduction method for off-highway front loaders
Authors: Madau Riccardo , Vacca Andrea
Published: January 2023

Cabin vibration in construction machines is a known issue affecting both comfort and safety of the operators, and it also induces losses in machine productivity. The solution offered in commercial machines, known as the passive ride control, has the drawbacks of limited performance on a wide range of operating conditions and component costs, which has motivated research toward “active” alternatives that utilize electro-hydraulic systems without additional components. Nonetheless, the nonlinearities and the dynamic response of these systems constraint the performance of such alternatives, when compared to the commercial solution and therefore, their diffusion on the market. To address the challenges mentioned above, this article proposes an alternative hydraulic system layout to perform the ride control function based on connecting the boom lift actuators of the front-end loader in differential mode. This article describes the development of two active control strategies for this new ride control system that utilizes pressure and acceleration information to suppress cabin oscillations and presents the experimental tests on a full-size wheel loader. The results show a similar capability for reducing the oscillations achieved by the commercial solution and the one proposed in this research. In certain scenarios, the proposed formulation offers up to 10% of further improvement in terms of cabin oscillation reduction.
Ethnic differences in utilization of online health information sources: A test of the social inequality hypotheses
Authors: Rosenberg Dennis
Published: January 2023

The goal of the current study was to understand ethnic differences in use of online health information sources. Social stratification and social diversification hypotheses were used as study’s theoretical framework. The data were obtained from the 2017 Israel Social Survey (N = 2166). Multinomial and logistic regression techniques were used for the multivariate analysis. The results suggest that Israeli Arab respondents were less likely than Israeli-born Jewish respondents to seek health information using the Health Funds’ call centers or websites, other websites, and to utilize any number of the online health information sources. The findings provide a strong support for the social stratification hypothesis. The findings imply that members of minority population should be more encouraged to use (public) online health information sources as a means of taking greater responsibility for their health as well as for the health of their communities.
The Effect of Difference in Word Order on Semantic Processing in Hindi-English Bilinguals
Authors: Anand Geet Govind , Barhwal Kalpana K , Goyal Manish , Rao Bodepudi Narasimha
Published: January 2023

Background

The typology of word order in Hindi (Subject-Object-Verb, SOV) differs from that of English (Subject-Verb-Object, SVO). Bilinguals whose two languages have conflicting word order provide a unique opportunity to understand how word order affects language processing. Earlier behavioural and event-related brain potential (ERP) studies with Spanish-Basque bilinguals showed longer reading times and more errors in the comprehension of OSV sentences than SOV sentences in Basque language, indicating that non-canonical word orders (OSV) were difficult to process than canonical word order (SOV).

Purpose

This study was designed to explore how the difference in word order in Hindi and English languages affects N400 parameters in proficient Hindi−English bilinguals, using semantic congruity paradigm.

Methods

Twenty-five proficient Hindi−English bilingual subjects were asked to silently read the congruent and incongruent sentences presented in one word at a time in both the languages. ERPs were recorded from midline frontal, central and parietal sites.

Results

The mean amplitude of the N400 effect at the parietal sites in Hindi−English proficient bilinguals was larger for English than for Hindi but there was no significant difference in the N400 latencies.

Conclusion

Hindi−English bilingual subjects processed SOV and SVO sentences with equal ease as evidenced by the N400 latencies. Higher amplitude of the N400 effect with English sentences indicate that placing ‘Object’ as the final word makes sentences more predictable than verb as the final word. Understanding the word order difference might help to unravel the neurophysiological mechanisms of language comprehension and may offer some insights in terms of functional advantage of a particular word order in bilinguals.
Continuum damage mechanics-based finite-volume homogenization of unidirectional elastoplastic fiber-reinforced composites
Authors: Tu Wenqiong , Wang Shuaijun , Chen Qiang
Published: January 2023

The Finite-Volume Direct Averaging Micromechanics (FVDAM) method has been further extended to predict nonlinear behaviors of unidirectional boron/aluminum (B/Al) composites, induced by plastic deformation and ductile damage for the first time. The latter is considered by gradual stiffness degradation via the continuum damage mechanics (CDM) model. The convergence of homogenized and local response generated by the new FVDAM damage framework has been demonstrated by considering the hexagonal and square repeating unit cells (RUC) with different mesh discretizations under transverse tensile, transverse shear and axial shear loading paths. Then, the reliability of the developed approach to predict the nonlinear response of B/Al composites has been verified extensively vis-à-vis the experimental response available in the literature, under monotonic loading path with various off-axis angles. To accurately capture the experimental response, an RUC with actual microstructure characterized by a random fiber distribution is constructed and utilized in the numerical simulations. In addition, the developed model is also applied to predict the cyclic response of B/Al composites with different off-axis angles in further support of the theory’s potential to capture the macroscopic behaviors of B/Al composites under complex loading conditions.
Analysis of heart retransplantation outcomes in the new donor heart allocation system
Authors: Rempakos Athanasios , Doulamis Ilias P. , Papamichail Adamantia , Tzani Aspasia , Briasoulis Alexandros
Published: January 2023

Cardiac graft failure may require repeat heart transplantation (HTx). Outcomes of patients that undergo repeat HTx have not been well described. We compared patients that received repeat HTx with patients that received initial HTx by inquiring the United Network for Organ Sharing (UNOS) database between 2015 and 2021. The primary endpoint was all-cause mortality, while the role of baseline characteristics was also investigated. Patients were stratified according to whether they received initial HTx (n = 19,727, 97%) or repeat HTx (n = 578, 3%). Among the study population, 10,860 (53.5%) patients received a HTx using the old UNOS allocation system, whereas 9445 (46.5%) patients received a HTx after the implementation of the new UNOS donor allocation system in October 2018. In this sub-group of HTx recipients in the new allocation system era, the adjusted 1-year survival of repeat HTx patients remained lower than that of initial HTx patients (hazard ratio (HR): 1.19; 95% confidence interval (CI): 1.15, 3.18; p = 0.013). When we compared the 1-year survival of repeat HTx patients before and after the implementation of the new allocation system, the adjusted 1-year survival was similar between groups (HR: 1.14; 95% CI: 0.71, 1.84; p = 0.591). The unadjusted risk of 30-day mortality was not significantly different in the new vs old allocation system. Mortality associated with repeat HTx remained higher than initial HTx but the new donor allocation system implementation did not affect outcomes.
Radiographic measurement of leg-length change in the nonoperative leg during total hip arthroplasty: a potential indicator of imaging error?
Authors: Wagler Justin B , Muir Jeffrey M , Foley Kelly A , Paprosky Wayne G
Published: January 2023

Background:

Anteroposterior (AP) pelvic radiographs are subject to errors that may cause measurement inaccuracy in total hip arthroplasty (THA). Such errors may be detected by measuring pre- to postoperative leg-length changes in the nonoperative leg, which experiences no physical changes during THA.

Methods:

From AP pelvic radiographs, we measured pre- to postoperative leg-length changes (LLC) in the nonoperative legs of 67 patients who underwent primary THA using the trans-ischial line method.

Results:

An LLC of 0 mm was observed in the nonoperative leg in only 14 cases (21%). A LLC ⩾ 2 mm was observed in 27% (18/67) of cases, including 13% (9/67) with LLC ⩾ 3 mm and 6% (4/67) with LLC ⩾ 4 mm. A post-hoc analysis used a validated method to measure change in pelvic tilt between pre- and postoperative images and found that changes in pelvic tilt ⩾ 4° in the anterior and posterior directions created apparent lengthening (2.0 ± 1.4 mm, p  < 0.001 vs. 0–3° of tilt) and shortening (−2.1 ± 1.6 mm, p  < 0.001 vs. 0–3° of tilt) of the nonoperative leg, respectively.

Conclusions:

The current study provides evidence of measurement errors in leg length using AP pelvic radiographs following THA. Changes in pelvic tilt may be in part responsible for these errors, with the direction of change in pelvic tilt influencing the apparent lengthening or shortening of the lower limb. Ultimately, these findings may influence the radiographic measurement and interpretation of leg-length changes following THA.
Predictive Value of Flank Pain and Gross Hematuria on Long-Term Survival in Patients With Upper Tract Urothelial Carcinoma Treated by Radical Nephroureterectomy
Authors: Sun Ke Ning , Wu Jian Hong , Chen Zhi Hao , He Yi Jun , Chen Yi Ling , Hu Jin Zhong , Sheng Lu
Published: January 2023

Background:

Assessing the prognosis preoperatively in patients with upper tract urothelial carcinoma (UTUC) remains a challenge for urologists. Gross hematuria (GH) and flank pain (FP) are the 2 most common and easily perceived symptoms of UTUC. Therefore, we aimed to investigate the prognostic values of GH and FP in patients with UTUC after undergoing radical nephroureterectomy (RNU).

Methods:

This article retrospectively analyzed 179 patients with UTUC who underwent RNU and examined the associations between the FP, GH, and long-term survival. After dividing patients into 4 subgroups (presenting as GH without FP, FP without GH, no FP and GH, FP with GH), we focused on the prognostic values of the 4 subgroups using univariate and multivariate analyses. We then proposed a risk stratification model for UTUC based on the independent prognostic factors for cancer-specific survival (CSS) with external validation (146 additional UTUC patients formed the validation cohort).

Results:

Patients with FP had worse oncological outcomes than those without FP ( P < .05). After dividing the 179 patients into 4 subgroups, the “FP without GH” subgroup suffered the worst oncological outcomes ( P < .001). The Cox multivariate regression analysis showed that “FP without GH” ( P < .001), tumor multifocality ( P = .005), and pathological stage ( P = .004) were independent prognostic factors for CSS. Good performance of the risk stratification model was achieved in both the training and external validation cohorts.

Conclusion:

The presence of “flank pain without gross hematuria” was one of the independent risk factors of CSS and OS besides the pathological stage and tumor multifocality. To our knowledge, this is the first study that adding complaint to risk stratification model in UTUC.
Stretched kinship: Queer female university students negotiating family and identity
Authors: Boyd Annaliese , Wei John
Published: January 2023

For lesbian, gay, bisexual, transgender and queer + people, family and peer support are often important in their identity development during early adulthood. Young queer adults who have moved out of the family to pursue university education often seek out a sense of community and a feeling of kinship with other LGBTQ+ individuals as they journey through their identity transition. Based on semi-structured interviews with eight self-identified queer female students in a public university in New Zealand, this study examines their experience of ‘stretched kinship’ – moving out from the family (‘leaving home’), building peer connections in shared student accommodations (‘making home’) and developing more independent identities (‘coming out’) in relation to their original and alternative families. This paper helps us make sense of young queer people’s experiences transitioning from the family to university towards independence and adulthood.
Exploring factors influencing acceptability of online capacity building platform for HIV and AIDS monitoring and evaluation in Ghana
Authors: Dery Samuel KK , da-Costa Vroom Frances Baaba , Asem Charity K , Adzakpah Godwin
Published: January 2023

Introduction: Ghana’s multi-sectoral approach towards the management of HIV and AIDS has resulted in many community-level activities and programs aimed at stopping HIV infections and reducing the impact of HIV and AIDS. This study seeks to investigate whether Monitoring & Evaluation (M&E) officers in Ghana will be willing to join in an electronic learning platform which is web-based as a means of building M&E capacity. Methods: 123 out of 130 participants were involved in the study. Continuous and categorical variables were analysed using means and proportions. Structural equation Modelling technique was used to determine the factors associated with acceptability/intention to use. Results: The results showed that Attitude toward usage had a positive significant influence on acceptability/intention to use (AITU). In addition, experience with online learning and Internet discussion also had a positive influence on perceived usefulness and perceived ease of use respectively. The overall model shows 71% of variation of M&E officers’ attitude toward usage on acceptability/intention to use online M&E platform as observed by the covariates in the model. Conclusions: Attitude toward usage was observed to be the strongest determinant of the AITU online HIV/AIDS M&E platform for monitoring and evaluation activities.
Sustainability in the Mediterranean tourist ports: The role of certifications
Authors: Spinelli Riccardo , Benevolo Clara
Published: January 2023

This study investigates the sustainability practices of tourist ports, a little explored research area despite the environmental and social impacts of these infrastructures. Our research evaluates the diffusion of quality, environmental and social certifications among 225 Mediterranean tourist ports. We analyse the ports websites for an explicit graphic or textual reference to any certifications obtained. Our results show a limited adoption of certifications, with about half of the sample ports indicating possession of at least one certification. The port managers’ commitment towards certifications is limited, and focused on the most common ones – although not industry-specific – such as ISO 9001 and ISO 14001. The small size and limited entrepreneurial approach of the companies managing tourist ports are identified as contributing causes. A greater commitment to obtaining and communicating certifications is desirable, considering the increasing competition in the sector – which requires continuous innovation and improvement of processes and products – and the growing demand for quality and sustainability by nautical tourists.
Dementia Without Borders: Building community connections to reduce stigma and foster inclusion
Authors: Phinney Alison , Becker Marigrace , Burnside Lee , Malcolm Paulina , Puurveen Gloria
Published: January 2023

Around the world people with dementia face stigma and social exclusion. An interdisciplinary team from Seattle, Washington, and Vancouver, British Columbia led a collaborative project developing cross-border community partnerships to increase awareness and reduce stigma, promote social participation of people with dementia, and enhance their well-being. The work was organized around three themes - citizen engagement, social entrepreneurship, and creative expression – and involved regular meetings so researchers, community providers, and people with dementia and care partners could know each other better. Dementia Without Borders was organized as an end-of-project celebration, a public festival bringing together community members from both countries to share what the team had learned from each together. The event took place at the Peace Arch, an international park straddling the border between Washington and British Columbia. Over 140 people arrived on their respective sides, created banners, and walked together to the Peace Arch to meet and exchange gifts with those coming from the other country. A picnic shelter was used to display art created by people with dementia and outdoor tables allowed everyone to eat together and listen to poetry readings and musical performances. Feedback was overwhelmingly positive with many expressing a sense of hope and belonging. This project has leveraged the symbolic power of an international border to generate new ideas about fostering social inclusion and reducing stigma for people with dementia. It shows the importance of place and history, building relationships on trust and participation, and being flexible and responsive to opportunities for social innovation.
Poems and pedagogic frailty: uncovering the affective within teacher development through collective biography
Authors: Kinchin Ian , Balloo Kieran , Barnett Laura , Gravett Karen , Heron Marion , Hosein Anesa , Lygo-Baker Simon , Medland Emma , Winstone Naomi , Yakovchuk Nadya
Published: January 2023

To explore the affective domains embedded in academic development and teacher practice, a team of academic developers was invited to consider a poem and how it reflects the emotions and feelings underpinning experiences as teachers within Higher Education. We used a method of arts-informed, collective biography to evaluate a poem to draw upon and share memories to interrogate lived experiences. Our research is framed using the lens of pedagogic frailty model to see how affective and discursive encounters are produced and impact us. We contend that collective arts-based and biographical approaches can provide alternative ways for ourselves and teachers to examine their own pedagogic frailty.
“Will You be Our Qualitative Methodologist?” Reflections on Grant Work Responsibilities
Authors: Wolgemuth Jennifer R. , Jordan Lorien S.
Published: January 2023

Government funders increasingly encourage interdisciplinary mixed methods research projects that include qualitative methods. For qualitative methodologists, the opportunity to collaborate on interdisciplinary research teams may come at a cost when their expertise is marginalized relative to quantitative designs. Drawing on concepts from critical pragmatism and an ethics of care, we reflect on ethical tensions in our experiences as qualitative methodologists on government funded interdisciplinary research teams. Driven by an intersubjective and justice-oriented view of knowledge development and care as interdependence, we offer our thoughts, experiences, and guidance under four orienting concepts: collaboration, education, critique, and critical reflexivity. We culminate our reflection by offering a practical and responsible way forward for qualitative methodologists who accept grant work invitations, a way that holds promise for advancing interdisciplinary, critical, and care-based action in funded research.
Rationalism and the “rational actor assumption” in realist international relations theory
Authors: Schmidt Brian C , Wight Colin
Published: January 2023

The commitment to the rational actor model of state behavior is said to be a core assumption of realist theory. This assumption is listed in most textbook accounts of realism. Yet is rationality a core supposition of realist theory, and if so, what kind of rationality is implied in these claims? Debate on the relationship between realism, and what is often labeled as rationality is replete with misunderstandings. Authors deploy terms such as rationality, rationalism, and rational actor in diverse and contradictory ways. This article aims to cut through this confusion and provide an account of the different ways in which these terms are used in the field of International Relations (IR). We argue that much of the confusion surrounding rationalism/rationality in IR arises due to a failure to distinguish between rationalism as an epistemological position (the observer rationality assumption) and rationality as an ontological position (the rational actor assumption). We use this distinction to examine carefully the relationship between the concepts of rationalism/rationality in realist theory.
A self-liberation intervention using a pedometer to encourage physical activity among sedentary nursing staff: A randomized controlled trial
Authors: Chaisurin Patcharin , Lertwatthanawilat Wanchai , Rattanakanlaya Kanittha , Songkham Wanpen , Wongmaneerode Narumon , Udomkhamsuk Warawan
Published: January 2023

Objective:

Nurses make up the majority of the workforce in any healthcare system. Physical inactivity due to heavy workloads has been widely reported among nurses. This study aimed to examine whether a self-liberation intervention could help nurses increase their physical activity levels that would result in other health benefits.

Methods:

A two-armed randomized controlled trial was implemented among 40 nurses (20 per arm). The control arm received information about the benefits of physical activity, but with no intervention. The intervention arm received the same information and were given pedometers for 12 weeks to record their daily steps while also receiving weekly reminders. Measurements were taken for anthropometric data, self-reported physical activity, exercise stage-of-change, exercise self-efficacy, and pedometer steps (intervention arm only). All statistical analyses were two-sided, with p ⩽ 0.05.

Results:

The respondents’ mean age was 47.9 ± 7.02 years with 90% being female. After the intervention, the intervention arm achieved a higher self-efficacy score (4.60 ± 1.75 to 5.63 ± 2.48) while a decline was observed in the control arm (5.02 ± 2.08 to 4.50 ± 1.90). At baseline, 16.7% ( n = 3) of the control arm and 27.8% ( n = 5) of the intervention arm were classified as moderately physically active (McNemar’s test = 1.20, p = 0.549). After 12 weeks, this proportion increased to 27.7% ( n = 5) in the control arm and 50.0% ( n = 9) in the intervention arm (McNemar’s test = 5.00, p = 0.172). For the intervention arm, mean daily step counts rose from 8889 ± 579.84 at week 1 to 9930 ± 986.52 at week 12 and reached the level of statistical significance ( p < 0.01). Waist circumference of the intervention arm decreased significantly more than that of the control group ( p < 0.01).

Conclusion:

The self-liberation intervention using a pedometer had positive effects on assisting sedentary nursing staff to progress through the stages of health behavior change and on their exercise self-efficacy, which could further help increase their exercise adherence and overall physical and mental wellbeing.
Belief towards caesarean section: A community based study of male partners in Ebonyi State, Nigeria
Authors: Elom Nwamaka A , Nwimo Ignatius O , Ilo Cajetan I , Ngwakwe Patricia C , Ezugwu Uchechukwu A , Alegu Deborah N , Ojide Rita N , Okpata Onyekachi O
Published: January 2023

Introduction:

Caesarean section is a surgical procedure used in delivering a baby by incising the abdomen and uterus of the mother. In a typical Nigerian culture, it is seen as a method to deliver a baby when the mother is not strong. Based on this premise, most men show a very negative attitude towards the procedure. This negative attitude may translate to a belief which might not be wholesome.

Objectives:

To assess the belief of male partners towards caesarean section.

Methods:

A sample of 400 male partners was investigated. The instrument used for data collection was a 22-item valid and reliable (α = 0.98) questionnaire developed by the researchers. The questionnaire was administered to the participants on face-to-face approach. Data were analysed using percentages, mean, standard deviation, analysis of variance, t-test and multiple regression analysis.

Results:

Results data showed that the male partners studied had negative beliefs towards caesarean section. Significant differences existed in the belief of the respondents towards caesarean section as it relates to their age, level of education, occupation, religion and location of residence ( p < 0.05). Using a stepwise multiple regression model, all the socio-demographic variables studied played out to be significant ( p < 0.05) predictors of belief towards the subject matter.

Conclusion:

The male partners have negative belief towards caesarean section and the personal characteristics of the subjects predicted their belief towards the subject matter. The existing phenomenon can be changed through health campaigns and education using healthcare workers and health educators.
Longitudinal trends in parent-reported child sleep, physical activity, and screen use during the COVID-19 pandemic in New York City
Authors: Finkel Morgan A , Bryan Alexis , Partida Ivette , Raaen Laura , Duong Ngoc , Goldsmith Jeff , Woo Baidal Jennifer A
Published: January 2023

Objective:

To examine trends in child sleep, physical activity, and screen use during the COVID-19 pandemic in New York City with a prospective, longitudinal online survey of parents recruited from a large medical center.

Methods:

Data was collected Spring 2020 (“Complete Shutdown”) and Fall 2020 (“Partial Shutdown”). Outcomes were parental perceptions about changes in child sleep, physical activity, and screen time compared to before COVID-19; and contemporaneous measures of these child behaviors. We report contemporaneous responses and paired analyses to describe longitudinal changes.

Results:

Two hundred seventy-seven participants were surveyed during Complete Shutdown and 227 (81.9%) filled out a follow-up survey during Partial Shutdown. The largest percentage of parents at both time points perceived no change in child sleep, decreases in child exercise, and increases in child screen time. In paired analyses, perceptions shifted toward less sleep, more physical activity and less screen time from Complete Shutdown to Partial Shutdown.

Conclusion:

COVID-19 had negative impacts on child health behaviors that did not resolve over a 6-month period despite partial reopenings.
The Searsville Lake Site (California, USA) as a candidate Global boundary Stratotype Section and Point for the Anthropocene series
Authors: Stegner M Allison , Hadly Elizabeth A , Barnosky Anthony D , La Selle SeanPaul , Sherrod Brian , Anderson R Scott , Redondo Sergio A , Viteri Maria C , Weaver Karrie L , Cundy Andrew B , Gaca Pawel , Rose Neil L , Yang Handong , Roberts Sarah L , Hajdas Irka , Black Bryan A , Spanbauer Trisha L
Published: January 2023

Cores from Searsville Lake within Stanford University’s Jasper Ridge Biological Preserve, California, USA, are examined to identify a potential GSSP for the Anthropocene: core JRBP2018-VC01B (944.5 cm-long) and tightly correlated JRBP2018-VC01A (852.5 cm-long). Spanning from 1900 CE ± 3 years to 2018 CE, a secure chronology resolved to the sub-annual level allows detailed exploration of the Holocene-Anthropocene transition. We identify the primary GSSP marker as first appearance of 239,240Pu (372–374 cm) in JRBP2018-VC01B and designate the GSSP depth as the distinct boundary between wet and dry season at 366 cm (6 cm above the first sample containing 239,240Pu) and corresponding to October-December 1948 CE. This is consistent with a lag of 1–2 years between ejection of 239,240Pu into the atmosphere and deposition. Auxiliary markers include: first appearance of 137Cs in 1958; late 20th-century decreases in δ15N; late 20th-century elevation in SCPs, Hg, Pb, and other heavy metals; and changes in abundance and presence of ostracod, algae, rotifer and protozoan microfossils. Fossil pollen document anthropogenic landscape changes related to logging and agriculture. As part of a major university, the Searsville site has long been used for research and education, serves users locally to internationally, and is protected yet accessible for future studies and communication about the Anthropocene.

Plain Word Summary

The Global boundary Stratotype Section and Point (GSSP) for the proposed Anthropocene Series/Epoch is suggested to lie in sediments accumulated over the last ~120 years in Searsville Lake, Woodside, California, USA. The site fulfills all of the ideal criteria for defining and placing a GSSP. In addition, the Searsville site is particularly appropriate to mark the onset of the Anthropocene, because it was anthropogenic activities–the damming of a watershed–that created a geologic record that now preserves the very signals that can be used to recognize the Anthropocene worldwide.
Journey Mapping Healthcare Worker Experience With Heart Rhythm Meditation
Authors: Murry Logan T , Wilhelm Lisa , Corrigan John , Witry Matthew J
Published: January 2023

Background

Levels of stress and burnout continue to rise amongst healthcare workers. In addition to systemic and institution-level changes to healthcare practice environments, well-being interventions, resources, and support to assist healthcare providers are necessary. Meditation practices like Heart Rhythm Meditation (HRM) may provide benefits to healthcare workers, but healthcare worker experiences with HRM are not well understood.

Objective

To explore healthcare worker experiences with HRM using a journey mapping approach.

Methods

An exploratory cross-sectional online survey was administered between May and July of 2020 to a purposeful sample of 25 healthcare workers currently practicing HRM. Surveys consisted of 5 open-ended and 36 multiple-choice items mapped to five journey mapping domains: Discover, Search, Assess, Decide, Assist. Descriptive statistics for survey items were generated in addition to a visual representation of a Persona and associated journey map for HRM. Content analysis was performed on open-ended responses using a general inductive approach to code responses and identify representative quotes.

Results

Twenty surveys were completed for a response rate of 80%. The majority of respondents identified as women (n = 14). From the journey mapping output, the overall emotional experience score was an 8.2/10, suggesting respondents had positive experiences with HRM. Open-ended comments suggest that HRM provides important benefits to the personal and professional lives of healthcare workers. A small number of participants reported challenges like feeling difficult emotions during HRM practice.

Conclusion

Mapping the healthcare worker journey with HRM identified generally positive experiences with personal and professional benefits. While experiences were largely positive, HRM elicited difficult emotions from some individuals, suggesting that appropriate resources and support are required when considering HRM and other meditation forms.
Racial Discrimination Distress and Psychological Well-being: The Moderating Role of Ethnic-Racial Socialization in African American Emerging Adults
Authors: Jiménez Asha , Glover Ciara Smalls
Published: January 2023

Racial discrimination-related stress is assumed to be inherent in the frequency of the experience; consequently, few studies have examined individual differences in its appraisal. The current study addresses this gap by investigating racial discrimination distress, measured as reported appraisal and frequency, to improve the assessment of race-related risk. The interaction effect of racial discrimination distress and ethnic-racial socialization (ERS) on dimensions of psychological well-being for African American emerging adults was examined. Using a sample of 442 African American emerging adults ( Mage = 18.66, SD = 1.05, 80% women), path analyses revealed that racial discrimination distress predicted lower self-esteem and higher depressive symptoms. Racial pride and egalitarian messages were protective against the adverse relationship between racial discrimination distress and psychological well-being. The findings support the importance of race-related risk measurement and the role of ERS in models of normative development for African American emerging adults.
Agglomeration effects as spatially embedded social interactions: identifying urban scaling beyond metropolitan areas
Authors: Strumsky Deborah , Bettencourt Luis , Lobo José
Published: January 2023

Agglomeration is the tell-tale sign of cities and urbanization. Identifying and measuring agglomeration economies has been achieved by a variety of means and by various disciplines, including urban economics, quantitative geography, and regional science. Agglomeration is typically expressed as the non-linear dependence of many different urban quantities on city size, proxied by population. The identification and measurement of agglomeration effects is of course dependent on the choice of spatial units. Metropolitan areas (or their equivalent) have been the preferred spatial units for urban scaling modeling. The many issues surrounding the delineation of metropolitan areas have tended to obscure that urban scaling is principally about the measurable consequences of social and economic interactions embedded in physical space and facilitated by physical proximity and infrastructure. These generative processes obviously must exist in the spatial subcomponents of metropolitan areas. Using data for counties and urbanized areas in the United States, we show that the generative processes that give rise to scaling effects are not an artifact of metropolitan definitions and exist at smaller spatial scales.
Mental health treatment-seeking behaviors in medical students: A mixed-methods approach
Authors: Wang Jennifer , Fitzke Reagan E , Tran Denise D , Grell Jewel , Pedersen Eric R
Published: January 2023

Background:

Healthcare professionals can experience problems regarding mental health and emotional well-being (e.g. burnout) at a higher degree compared to their non-physician counterparts. Fear of stigma is often a barrier to seeking treatment among physicians. However, there is a shortage of studies related to mental health and treatment seeking among trainees and medical students.

Objectives:

This study sought to examine mental health in U.S. medical students, factors contributing to mental health symptoms, and obstacles to seeking treatment.

Design and Methods:

This cross-sectional study was conducted through a confidential survey sent out in fall 2021, with 510 U.S. medical student participants. This survey included scales to assess depression (the Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), past year symptoms of hazardous drinking (Alcohol Use Disorder Identification Test), and past 30-day binge drinking days. The survey also included free-response questions about their reasons for seeking mental health care if they did (facilitators) and any barriers that kept them from seeking treatment.

Results:

About one-quarter of participants met criteria for possible depressive (24%) or anxiety disorders (24%); 9% of the sample drank at hazardous drinking levels. Between 47% and 60% of those who screened positive for depression, anxiety, or hazardous drinking reported an unmet need for mental health services. Anxiety and depression were cited as the most common reasons to seek treatment; concerns about stigma from peers and professional retaliation were notable for being barriers to treatment.

Conclusion:

Our sample of medical students reported notable prevalence of probable depression or anxiety disorder, while also reporting needing more support to improve their mental health. Despite this, barriers exist that may discourage medical students from seeking needed treatments. Findings from this study aim to encourage discussion and positive change in the healthcare community regarding perception and attitudes toward mental health and substance use treatment.