bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of coach education on coaching effectiveness in youth sport: A systematic review and meta-analysis
Authors: Li Longxi , Olson Hannah O. , Tereschenko Irina , Wang Anni , McCleery Julie
Published: September 2024

Sport plays a crucial role in the health and wellbeing of young people. While positive outcomes from sports participation are often assumed, studies show that these depend significantly on coaches’ attitudes and behaviors, which shape the sporting environment and influence participants’ experiences and outcomes. This study provides a systematic review with meta-analysis of various coach education program interventions (CEPIs), aiming to answer the question: How do CEPIs impact coaching effectiveness compared to standard coaching practices without such programs? Analyzing a total of 45 studies ( N = 180,658), this systematic review is divided into a narrative section followed by a meta-analysis. Positive effects of CEPIs were observed in 78% of the studies, seen in coaches’ knowledge gain, attitude shifts, and behavioral changes, as well as in athletes’ physical and psychological outcomes, both within and outside of sport. Overall, a significant moderate to large effect of CEPIs on coaching effectiveness ( g = 0.47, k = 264, 95% CI [0.36, 0.59]) was noted. Specifically, a large overall effect on coach outcomes ( g = 0.73, k = 71, 95% CI [0.47, 1.00]) and a moderate to large overall effect on athlete outcomes ( g = 0.38, k = 193, 95% CI [0.28, 0.47]) were observed. These findings generally support the positive impact of CEPIs on coaching effectiveness across the reviewed studies. However, the effects varied in magnitude, scalability, and sustainability for coaches and athletes. The discussion focuses on insights derived from CEPIs and future improvement strategies.
Preparing for general practice in a remote and rural setting
Authors: Downes Thomas J. , Dawson Kate
Published: September 2024

General practice uniquely offers the opportunity to work in a wide variety of settings across the UK. Practicing in remote and rural settings provides opportunities to work in picturesque landscapes, develop additional clinical skills, and make a difference to the lives of people in a close community. GPs working in these areas face challenges such as isolation and building resilience is needed for a sustainable career. Clinicians interested in rural medicine will have varying levels of experience prior to practicing in this setting and the need for preparation will differ according to experience. Remote and rural areas vary, for example by accessibility, infrastructure, and community needs, so preparation will need to take account of these factors. This article provides guidance for those GPs preparing for a placement or work as a GP in a remote, rural setting.
Dystonia: Far more than just a pain in the neck
Authors: Kyle Stuart
Published: September 2024

Movement disorders, stemming from central nervous system dysfunction, affect voluntary and involuntary movements. These include hypokinetic disorders, like Parkinson’s disease and akinetic-rigid syndromes (multiple-system atrophy and progressive supranuclear palsy), and hyperkinetic disorders, like tremor, chorea, akathisia, myoclonus and tics. These conditions are difficult to diagnose, and thorough clinical evaluation, imaging and specialised tests can help in reaching a diagnosis. Dystonia, marked by involuntary muscle contractions, varies in severity and profoundly impacts quality of life. Treatment options include medication, neurotoxin injections, deep brain stimulation, and other therapies. A multidisciplinary approach and ongoing research are crucial for improving outcomes and quality of life for those affected.
Knee osteoarthritis: disease burden, available treatments, and emerging options
Authors: Langworthy Michael , Dasa Vinod , Spitzer Andrew I.
Published: September 2024

Osteoarthritis (OA) is a prevalent condition that affects nearly 528 million people worldwide, including 23% of the global population aged ⩾40, and is characterized by progressive damage to articular cartilage, which often leads to substantial pain, stiffness, and reduced mobility for affected patients. Pain related to OA is a barrier to maintaining physical activity and a leading cause of disability, accounting for 2.4% of all years lived with disability globally, reducing the ability to work in 66% of US patients with OA and increasing absenteeism in 21% of US patients with OA. The joint most commonly involved in OA is the knee, which is affected in about 60%–85% of all OA cases. The aging population and longer life expectancy, coupled with earlier and younger diagnoses, translate into a growing cohort of symptomatic patients in need of alternatives to surgery. Despite the large number of patients with knee OA (OAK) worldwide, the high degree of variability in patient presentation can lead to challenges in diagnosis and treatment. Multiple society guidelines recommend therapies for OAK, but departures from guidelines by healthcare professionals in clinical settings reflect a discordance between evidence-based treatment algorithms and routine clinical practice. Furthermore, disease-modifying pharmacotherapies are limited, and treatment for OAK often focuses solely on symptom relief, rather than underlying causes. In this narrative review, we summarize the patient journey, analyze current disease burden and nonsurgical therapy recommendations for OAK, and highlight emerging and promising therapies—such as cryoneurolysis, long-acting corticosteroids, and gene therapies—for this debilitating condition.
How to lose friends and alienate people: The social and political consequences of Europe’s housing crisis
Authors: Drea Eoin
Published: September 2024

This article identifies the shortage of affordable, secure housing as a key driver of political alienation, particularly among young people. The social consequences of this trend for this group include, but are not limited to, delayed independent living and family formation, declining mental health and diminishing belief in their ability to match the living standards of their parents. Increasingly vulnerable and insecure, many young people now link the issue of housing with inward migration. Left unresolved, this issue will further polarise (and radicalise) the political choices of younger generations in the years ahead. In response, this article proposes three immediate actions. First, a dramatic expansion of construction for all types of housing where excess demand exists. Second, the use of public money to ensure that housing options exist for people of all ages, social classes and income levels. Public money should not be utilised for schemes which ultimately inflate house prices further. Third, to tackle widening intergenerational inequalities, existing housing wealth must be taxed fairly.
Diabetic Peripheral Neuropathy: Emerging Treatments of Neuropathic Pain and Novel Diagnostic Methods
Authors: Røikjer Johan , Borbjerg Mette Krabsmark , Andresen Trine , Giordano Rocco , Hviid Claus Vinter Bødker , Mørch Carsten Dahl , Karlsson Pall , Klonoff David C. , Arendt-Nielsen Lars , Ejskjaer Niels
Published: September 2024

Background:

Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes, often leading to severe neuropathic pain. Although other diabetes-related complications have witnessed a surge of emerging treatments in recent years, DPN has seen minimal progression. This stagnation stems from various factors, including insensitive diagnostic methods and inadequate treatment options for neuropathic pain.

Methods:

In this comprehensive review, we highlight promising novel diagnostic techniques for assessing DPN, elucidating their development, strengths, and limitations, and assessing their potential as future reliable clinical biomarkers and endpoints. In addition, we delve into the most promising emerging pharmacological and mechanistic treatments for managing neuropathic pain, an area currently characterized by inadequate pain relief and a notable burden of side effects.

Results:

Skin biopsies, corneal confocal microscopy, transcutaneous electrical stimulation, blood-derived biomarkers, and multi-omics emerge as some of the most promising new techniques, while low-dose naltrexone, selective sodium-channel blockers, calcitonin gene-related peptide antibodies, and angiotensin type 2 receptor antagonists emerge as some of the most promising new drug candidates.

Conclusion:

Our review concludes that although several promising diagnostic modalities and emerging treatments exist, an ongoing need persists for the further development of sensitive diagnostic tools and mechanism-based, personalized treatment approaches.
Postmarketing Analysis of Eosinophilic Adverse Reactions in the use of Biologic Therapies for Type 2 Inflammatory Conditions
Authors: Gershnabel Milk Dafna , Lam Kent K. , Han Joseph K.
Published: September 2024

Background

Temporary eosinophilia is a potential adverse reaction of monoclonal antibody therapies in the treatment of a variety of type 2 inflammatory conditions, including asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP). The pathophysiology, epidemiology, and clinical significance of eosinophilia and eosinophilic adverse reactions following the initiation of biologic therapy are unclear.

Objectives

To describe the postmarketing, eosinophilic adverse reactions with clinical significance in patients treated with the 3 biologic therapies approved by the U.S. Food and Drug Administration (FDA) for CRSwNP: dupilumab, omalizumab, and mepolizumab.

Methods

The FDA Adverse Event Reporting System (FAERS) Public Dashboard was searched for eosinophilic adverse reactions related to dupilumab, omalizumab, and mepolizumab treatments from November 2004 to December 2022. Data regarding each of the eosinophilic adverse reactions were extracted and analyzed.

Results

A total of 218, 270, and 134 reports of eosinophilic adverse reactions were reported among patients who were treated with dupilumab, omalizumab, and mepolizumab, respectively. The most common eosinophilic adverse reaction was eosinophilic granulomatosis with polyangiitis (338 patients), followed by eosinophilic respiratory tract reactions (158 patients). The most common indication for biological treatment among the reaction groups was asthma.

Conclusions

Eosinophilic adverse reactions are rare but consequential complications of biological treatment. They are more common among patients treated for asthma and chronic rhinosinusitis with nasal polyposis. Measuring and monitoring blood eosinophil levels may be appropriate in specific clinical instances when patients are started on different biologic therapies for type 2 inflammatory conditions.
Shock-tube tests on conventional windows: Exploring retrofit concepts for enhanced blast protection
Authors: Andrae Matthias , Kastenmeier Andreas , Gebhardt Jakob , Ehrlich Ingo , Gebbeken Norbert
Published: September 2024

Ensuring blast protection for existing buildings, especially addressing the vulnerability of conventional windows, is a significant challenge. Such unprotected windows can shatter even with moderate blast loads, posing a substantial risk of injury to occupants. This article discusses experimental research on enhancing the blast protection of single casement windows with insulating glass units and frames made of unplasticized polyvinyl chloride (uPVC). A retrofit concept using anti-shatter films, metallic sash reinforcements, adhesive bonding of the glazing to the sash frame, and a burglary resistance fitting-system was developed and tested in an explosion-driven shock-tube. Moreover, novel patches made of glass fiber-reinforced polymer applied to the corners of the window frames have been tested and proven effective in providing additional strength to the window. The study concludes that the tested combination of retrofit measures can significantly reduce hazards from window fragments without compromising functionality or aesthetics.
Emergency safe havens
Authors: Caldwell Tom , Riccitiello Mike
Published: September 2024

This paper describes how to find or create protective shelter in disaster zones. Federal Urban Search & Rescue (US&R) teams pre-stage directly in the path of on-coming hurricanes and floods, and these forward-positioned teams must seek out buildings and rooms that can survive these events. Safe havens are also needed for those civilians who can’t be evacuated, including the disabled and critically ill. Safe havens are also important in the aftermath of a disaster. Critical work continues for days or weeks at disaster zones, at places where buildings and infrastructure are severely damaged, and where hazards persist. Protected spaces are needed for ongoing humanitarian and medical care for survivors. Rescuers, law enforcement, and medical personnel also need safe interior spaces to eat and rehab. US&R teams and other first responders also seek out safe havens inside the “red zone”, the areas of intense damage and hazards where first responders must operate during rescue, fire-fighting, or HazMat mitigation. The authors describe how safe havens can be rapidly identified or created in disaster zones. This aspect of protective structures is of growing importance as the world population becomes more vulnerable to natural and man-made disasters.
Pseudo-Meigs syndrome due to bilateral serous ovarian adenocarcinoma: A case report
Authors: Semina T. , Kannangara S. , Silva S.
Published: September 2024

Pseudo-Meigs syndrome is a rare entity where pleural effusion and ascites disappear after resection of a benign or malignant pelvic tumour. We report a 48-year-old woman presented with shortness of breath and abdominal distention. She had a right-sided massive pleural effusion and ascites. Pleural and ascitic fluid analysis revealed exudative effusion in the absence of pyogenic foci, tuberculosis or malignant cells. Contrast-enhanced computed tomography of the abdomen showed bilateral ovarian malignancy with peritoneal deposits and ascites which was later confirmed as serous adenocarcinoma. Surgical resection of the tumour led to the resolution of the pleural effusion and ascites suggestive of Pseudo-Meigs syndrome. The presentation due to bilateral ovarian serous adenocarcinoma has not been reported in the literature.
Multicentre study comparing outcomes of RIRS using traditional suction ureteral access sheath (SUAS) and flexible and navigable suction UAS (FANS)
Authors: Ong Chloe Shu Hui , Somani Bhaskar Kumar , Chew Ben Hall , Fong Khi Yung , Bin Hamri Saeed , Sridharan Vikram , Ragoori Deepak , Soebhali Boyke , Tiong Ho Yee , Heng Chin Tiong , Wong Michael , Gadzhiev Nariman , Teoh Jeremy Yuen-Chun , Castellani Daniele , Traxer Olivier , Gauhar Vineet
Published: September 2024

Objective:

We aim to compare the stone-free rate (SFR), complications, and re-treatment rates in retrograde intrarenal surgery (RIRS) using a traditional suction ureteral access sheath (SUAS) with the more advanced flexible and navigable suction UAS (FANS).

Materials and methods:

Retrospective analysis was performed on patients who underwent RIRS using SUAS versus FANS across five institutions internationally as part of an audit. We analysed baseline and pre-operative characteristics such as stone location and density, intra-operative characteristics such as type of ureteroscope and laser, laser, and fluoroscopy time, as well as post-operative complications and residual fragments (RFs).

Results:

A total of 45 patients were included in each arm, with no significant difference in baseline characteristics. The commonest sheath size in the FANS group was 10–12 Fr (64.4%), while 11–13 Fr was preferred in SUAS (73.3%). Despite similar lasers (thulium fibre laser (TFL) and high-power holmium laser with MOSES), stone dusting (48.9%) and popcorning (95.6%) were carried out in FANS with minimal need for baskets (4.4%), while popcorning (64.4%) and basket extraction (40.0%) were required in SUAS. Although FANS had significantly longer operative times (65 minutes versus 55 minutes), it also had significantly higher rates of 100% SFR (80.0% versus 13.3%), and lower rates of clinically significant residual fragment (CSRF) (8.9% versus 53.3%), clinically insignificant residual fragment (CIRF) (11.1% versus 33.3%), and reintervention for CSRF (4.4% versus 37.8%). In addition, minor complications such as intra-operative oozing from mucosa not requiring intervention (8.9% versus 31.1%) and post-operative fever (11.1% versus 40.0%) were less common in FANS. On additional multivariate analysis, FANS was the only significant factor for higher SFR.

Discussion and conclusion:

The results of our study demonstrate that with its flexible and navigable tip, FANS proves advantageous over SUAS in terms of improving immediate SFR with negligible complications. By navigating the sheath into targeted individual calyces, fragments and dust are more successfully aspirated. FANS can therefore help to achieve the trifecta of high single-stage SFR, minimal minor and no major complications, and negligible reintervention rates.

Level of evidence:

Not applicable.
Towards digital readiness of evidence-based practice in a regional cancer center using role-based business process and data modeling
Authors: Odeh Yousra , Al-Ruzzieh Majeda , Al Rifai Anwar , Mustafa Hiba , Odeh Mohammad
Published: September 2024

Introduction

Evidence-based practice is a problem-based solving approach to clinical practice that encourages nurses providing personalized patient care while utilizing the necessary scientific evidence for a better understanding of risks and benefits of diagnostic tests and treatments. Digital transformation of an organization begins with attaining an acceptable digital readiness level. One approach entails specifying and modeling their processes and the respective data models.

Objectives

In Jordan, at King Hussein Cancer Center—an international and regional accredited cancer care hospital—their nursing practice requires obtaining a standardized specification of evidence-based practice processes and their respective conceptual data model that is currently not specified for digital readiness.

Methods

The design science research methodology was adopted to deliver two increments. The first was concerned with the design, development, and demonstration of eight evidence-based practice processes specified using BPMN. The second was related to the design and development, demonstration, and evaluation of a respective derived data model of the case study. Both increments involved interviews with domain experts for elicitation and validation.

Results

Eight evidence-based practice process models were identified and specified using BPMN along with their associated data models, where one representative process model was utilized in this research to demonstrate the effectiveness of process and data modeling towards digital readiness of evidence-based practice in regional cancer center.

Conclusions

Both deliverables enabled the evidence-based practice management to attain common understanding to identify inefficiencies, redundancies, and areas for improvement that can be addressed through digital solutions. Evidence -based practice BPMN process models were considered as a road map to follow up a project implementation and a rich visualization to perform data analytics to identify evidence-based practice trends, patterns, and insights that can inform strategic data-driven decisions. Both deliverables were concluded necessary for developing respective information systems in the journey towards digital transformation.
Social media and the ordinary: Marginalized voices in neo/non-liberal China
Authors: Wallis Cara
Published: September 2024

Thirty years into China’s internet development, much recent scholarship has focused on rather daunting forces—big data, algorithmic control, surveillance, and platformization, to name a few. This article centers the “small,” or how social media is articulated to the ordinary practices, pursuits, feelings, passions, ethical decisions, and struggles for voice of people who are socially, economically, and/or politically marginalized. I focus on these processes and practices among marginalized young creatives and domestic workers in a context I call “neo/non-liberal China,” which manifests as an amplification of prior discourses regarding self-responsibilization, happiness, and harmony along with greater social stratification, platformization, repression, and an emphasis on creativity and innovation. The analysis is grounded in theories of “ordinary affects,” or the inarticulable energies, passions, and forces that move bodies, and “ordinary ethics,” or the ethical aspects of practices, choices, and judgments that make up daily life and, thus, selfhood. I argue that centering diverse marginalized individuals’ passions, feelings, and ordinary ethical decisions, as these are articulated to social media, enables deeper insight into their dreams and goals and the challenges and obstacles they face in achieving these. Their experiences also speak to larger ongoing transformations in China.
The Impact of Diabetes Education by Clinical Pharmacist on Quality of Life and Treatment Satisfaction of Sudanese Individuals With Type II Diabetes Mellitus: Randomized, Double-Blind, Controlled Trial
Authors: Badi Safaa , Suliman Sara Zainelabdein , Almahdi Rayan , Aldomah Mohammed A. , Ahmed Mohamed H. , Elkheir Habab Khalid , Ibrahim Mohamed Izham Mohamed
Published: September 2024

Background:

Patients’ satisfaction with their treatment directly impacts the control of their diabetes. Quality of life is crucial for patients with diabetes mellitus to maintain long-term health and minimize complications. The current study aimed to evaluate the impact of diabetes education on quality of life (QoL) and treatment satisfaction of patients with type 2 diabetes mellitus.

Methods:

The current study was a randomized controlled trial. Patients with type 2 diabetes who were attending the diabetes clinic for 1 year were recruited. The overall sample in this study was 364 participants; 182 controls 182 cases. The interventional and control group participants were assigned randomly by simple random sampling technique. Controls were managed per usual care while cases were managed per usual care plus education done by the researcher. Pre-structured standardized questionnaires were used to collect the data. Data were processed and analyzed by using SPSS; version 28.

Results:

More than three-fourth of the participants; 76.4% were females. The average (±SD) age of the cases was 54.5 (±10) years, while was 56 (±9.8) years for controls. The overall median (IQR) years of DM diagnosis for all participants was 8 (4-14) years. The results showed a statistically significant difference between the mean satisfaction score from baseline to 12 months in the cases compared the controls ( P < .001). Furthermore, there are statistically insignificant differences between the changes of mean overall QoL score from baseline to 12 months among the 2 groups.

Conclusion:

The education provided improved self-reported treatment-satisfaction among individuals with diabetes .A statistically insignificant differences in QoL between the 2 groups compared to baseline have been shown at the study end. The trial registration number is PACTR202311766174946 which was registered by pan African clinical trials registry, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26928 .
An Association Between State Laws Limiting Local Control and Community Smoke-Free Indoor Air in the United States
Authors: Azagba Sunday , Ebling Todd , Korkmaz Alperen , King Jensen Jessica , Qeadan Fares , Hall Mark
Published: September 2024

This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers’ Rights Foundation. The primary outcome variable is the presence of a “100% smoke-free policy,” across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.
Ascending Sliding Arch Aortoplasty for Coarctation of the Aorta and Hypoplastic Aortic Arch to Avoid Compression of a Retroaortic Innominate Vein
Authors: Palacios-Macedo Alexis , Díliz-Nava Héctor , Pérez-Juárez Fabiola , Villar-Cantoral Santiago , Balderas Krystell Martínez , Silva-Estrada Jorge , García-Benítez Luis
Published: September 2024

The retroaortic innominate vein variant usually courses asymptomatically. However, when associated with coarctation of the aorta and hypoplastic aortic arch, modifications in the surgical technique to correct the aorta should be done to avoid compression of the vein. The ascending sliding arch aortoplasty, which allows the vein to be brought anterior to the aorta, can be a good alternative, as shown in these two cases.
“Sometimes I Get So Extremely Tired”: Sámi Healthcare Staff Experiences of Cultural Load in Practice
Authors: Ness Tove Mentsen , Mehus Grete
Published: September 2024

The study aim was to explore how Sámi healthcare staff experience working as an ethnic minority in the Norwegian healthcare system. This was a qualitative focus group and individual interview study inspired by interpretive description, with 14 participants. The results indicate that Sámi healthcare staff experience various degrees of cultural load in their jobs. This was shown through the two themes: “Feeling responsible for Sámi patients and non-Sámi colleagues” and “Feeling exhausted as a Sámi healthcare worker.” To provide culturally safe care for all Sámi patients and their families, it is vital to ensure the well-being of the small number of Sámi healthcare personnel. Therefore, we emphasize the need for training programs for non-Sámi healthcare staff to provide them with the knowledge needed to support their encounters with Sámi patients in culturally safe ways. Sámi healthcare staff cannot take all responsibility for teaching their non-Sámi colleagues and acting as cultural mediators in all situations that non-Sámi staff find challenging. The risk of cultural load and burnout is very present. Nursing departments in universities and leaders in primary and secondary healthcare need to address these issues in order to ensure culturally safe care to all patients and support Sámi healthcare staff.
Enhancing Telehealth Accessibility for Older Adults in Underserved Areas: A 4M Framework Approach
Authors: Lee Soohyoung Rain , Maxi Andrea , Kim Laurie , Kim Yihyun , Choe Ian , Hong Chelin , Kim Pearl , Reed Peter S. , Kim Yonsu , Shen Jay , Yoo Ji Won
Published: September 2024

Background: Telehealth has emerged as a vital alternative to traditional healthcare delivery, particularly for rural and underserved populations. While efforts to enhance telehealth accessibility have primarily focused on technological solutions, the effectiveness of its telehealth and the role of physician training in bridging racial and ethnic disparities in telehealth usage remains underexplored. This study evaluates the impact of a trained-physician-delivered, age-friendly telehealth model on healthcare accessibility and outcomes. Methods: A retrospective analysis was conducted on 214 older patients (60+) at an urban primary care facility in Nevada, USA. Patients received telehealth services from either trained or non-trained physicians, with the trained group utilizing a 4M-based telehealth model focusing on Medication, Mentation, Mobility, and What Matters. Results: Findings revealed lower exposure to both general and 4M-based telehealth among Hispanic and Asian patients compared to their white counterparts. Telehealth usage did not significantly reduce hospital or emergency department visits overall. However, certain types of 4M-based telehealth, such as What Matters and Medications, reduced hospital and ED visits. Implications: The development and implementation of telehealth education curricula for healthcare providers could make telehealth more accessible to minority patients, potentially reducing unnecessary emergency department visits and addressing disparities in telehealth access.
Health Care Access and Quality of Life of Community-Dwelling Senior Citizens in Pampanga, Philippines
Authors: Carandang Rogie Royce , Olea Ann Dreyko , Legaspi Precious Kaila , Quimen Yessamin , Ebrada Ma. Niña , Miranda Kevin Jace
Published: September 2024

This study examined the association between healthcare access and quality of life (QOL) among senior citizens in Pampanga, Philippines. We conducted a cross-sectional study among 410 community-dwelling senior citizens aged 60 and above. Using validated scales, we assessed both healthcare access and QOL. Descriptive statistics were employed to characterize the senior citizens, and multiple linear regression was used to examine the association between healthcare access and QOL. Senior citizens, averaging 69 years old, were predominantly women, single/widowed, and with comorbidities. They reported high healthcare access (mean = 120.13) and moderate QOL (mean = 70.79). Environmental health scored highest in QOL domains, while social relationships scored lowest. Overall healthcare access was positively associated with overall QOL (B [unstandardized beta] = .22, 95% CI [confidence interval] 0.10, 0.33) and its domains. Significant associations with overall QOL were observed for accessibility (B = 1.95, 95% CI 0.98, 2.91) and affordability (B = −1.60, 95% CI −2.46, −0.74). Filipino senior citizens in Pampanga demonstrated high healthcare access and moderate QOL. The study highlights the importance of healthcare access in enhancing senior citizens’ QOL, particularly regarding accessibility and affordability. Further research is needed to explore the nuanced relationships between healthcare access subscales and specific QOL domains.
Guidelines for the Use of Literature Reviews in Master’s Theses in Public Health
Authors: Juárez Sol P. , Honkaniemi Helena
Published: September 2024

Literature reviews constitute a core competence for public health professionals. Many public health graduate students thus choose to conduct a literature review for their thesis, but may face challenges delivering a high-quality systematic review due to time and resource constraints. Informed by the principle of constructive alignment, this article thus provides guidelines for conducting a systematized literature review on quantitative studies within the scope of a master’s thesis in public health, incorporating key elements of a systematic review (i.e., transparency, reproducibility) in a pedagogical context. Based on the authors’ research and supervision experience with the methodology at Stockholm University, this description of best practice presents 12 steps for successfully completing a quantitative systematized literature review, including formulating research questions, conducting searches, extracting and synthesizing findings, and thesis writing, while outlining the tasks of students, supervisors, and examiners in alignment with different learning outcomes. This guide can be used by postgraduate educators to effectively enhance the skills of future public health professionals.
Challenges Facing Women Entrepreneurship: A Developing Country Perspective
Authors: Ssekiziyivu Bob , Takwi Francis Mbah , Kabahinda Eunice
Published: September 2024

This article examines the challenges faced by women entrepreneurship in Kampala City, Uganda. Our main objective was to investigate the impediments to the growth of businesses owned by women. We adopted a qualitative phenomenological approach for the study in order to get an in-depth understanding of impediments to the growth of businesses owned by women. Random purposeful sampling was used to select 13 women entrepreneurs. The results indicate that competition, liquidities and financial challenges, discouragement by men, discrimination, limited family support, harassment, limited business time, lack of trainings and poor business location are the major challenges faced by women entrepreneurs in Kampala, Uganda. The study provides a significant contribution to the already existing literature on women entrepreneurship by providing initial evidence of the practical challenges they face as entrepreneurs using evidence from a developing country—Uganda. Besides, the study suggests the need to provide more entrepreneurial skills to women to enable them to manage their businesses appropriately. Also, women need to be empowered to easily access finances to help them boost their businesses to trade globally.
Vaccination practices and knowledge among adults with hemoglobinopathies in Greece: a nationwide survey
Authors: Delicou Sophia , Manganas Konstantinos , Xydaki Aikaterini , Evliati Loukia , Myrilla Ioanna , Rubatis Leonidas , Kostaridou Stavroula
Published: September 2024

Background:

Hemoglobinopathies, such as sickle cell disease and thalassemia, are genetic disorders that affect hemoglobin structure or production, leading to various health complications, including an increased risk of infections. Vaccinations play a crucial role in managing these conditions by providing essential protection against preventable diseases. Ensuring timely and appropriate immunizations is vital for reducing infection-related morbidity and improving the overall health and quality of life for affected individuals.

Objectives:

Our objective was to assess vaccination coverage, as well as knowledge, attitudes, and practices toward vaccination in Greek patients with hemoglobinopathies.

Design and methods:

A nationwide survey of hemoglobinopathy patients in Greece using a 37-item questionnaire was conducted anonymously via Google Forms. It covered demographics, previous vaccinations, vaccine-preventable infections, beliefs about vaccines, and antibiotic prophylaxis post-splenectomy. The survey was distributed through Thalassemia and Sickle Cell Units and organizations.

Results:

Participants were predominantly university-educated married women aged 30–50 years with transfusion-depended thalassemia ( n = 149, 60.5%) or sickle cell anemia ( n = 52, 21.1%). Reported childhood vaccination rates aligned with Greece’s national immunization program. However, adult coverage was suboptimal across all age groups for measles (10%), varicella (27%), zoster (2% for over 50 years old individuals), hepatitis A (13.9% of those with chronic liver disease) and hepatitis B (41%), pneumococcal (81.3%), meningococcal (37%), tetanus (20.3%), and influenza (67.1%) vaccines compared to guidelines. Participants relied predominantly on healthcare providers for vaccine information but perceived limited engagement. Those over age 50 demonstrated lower adult vaccination rates and higher misconceptions compared to younger cohorts.

Conclusion:

Addressing educational and access gaps could help protect this vulnerable population. Our findings highlight the need for coordinated efforts to optimize adult immunization for those with hemoglobinopathies.
Marriage migration, intimacy and genre in Helen Hoang’s The Bride Test (2019) and Brigitte Bautista’s You, Me, U.S. (2019)
Authors: Burge Amy
Published: September 2024

A significant strand of cultural and social studies research on late modernity has focused on intimacies; in particular, ‘mediated intimacies’ (Attwood et al., 2017; Barker et al., 2018; Gill, 2009), exploring how the media, in its various forms, represents and affects intimate relationships. Romance fiction, the most popular global genre, offers a key source text for exploring intimate and romantic relationships and the ways culturally and politically specific forms of intimacy are shared transnationally. Of particular interest is the increase in the twenty-first century of romantic stories that deal with the intersection of intimacy and migration.

This article brings together critical work on intimacy and affect, scholarship on popular romance, and research on migration and transcultural exchange to explore how contemporary Anglophone popular romance fiction mediates intimate relationships in the context of migration. Focusing on two romance novels featuring South East Asian migration to the USA — Brigitte Bautista’s You, Me, U.S. (2019) and Helen Hoang’s The Bride Test (2019) — I explore how these novels represent marriage migration and its relationship to and impact on intimacy. Both novels are aware of existing stigmas around marriage migration (the risk of abuse or fraudulent marriage), but the association of marriage with ‘authentic’ romantic love in the romance genre ultimately serves to uphold such stigmas, rather than challenge them. The texts pay equally close attention to the performativity of romantic love, noting how heteronormative, western norms of romance are required for migrants but, in the case of You, Me, U.S., can also be queered. These texts are concerned with the movement of people and cultures while themselves travelling across borders as products of a transnational, global publishing market. These fictions, then, showcase how their particular articulations of intimacy offer new insights for scholars interested in marriage migration.
PCSK1N as a Tumor Size Marker and an ER Stress Response Protein in Corticotroph Pituitary Adenomas
Authors: Abusdal Merisa , Normann Kjersti R , Nyman Tuula A , Øystese Kristin A B , Sundaram Arvind Y M , Dahlberg Daniel , Lekva Tove , Bollerslev Jens , Berg Jens P , Olarescu Nicoleta C
Published: September 2024

Context

Silent corticotroph adenoma (SCA) exhibits more tumor aggressiveness features than functioning adenomas (FCAs).

Objective

We aimed to investigate proprotein convertase subtilisin/kexin type 1 inhibitor (PCSK1N) expression in CA and examine if endoplasmic reticulum (ER) stress-induced responses affect cell survival in a corticotroph tumor cell model.

Methods

Clinical and imaging characteristics were recorded in 33 patients with FCA (20 women, 11 macroadenomas) and 18 SCAs (8 women, all macroadenomas). Gene expression of pro-opiomelanocortin (POMC), T-box transcription factor 19(TBX19)/TPIT, proprotein convertase subtilisin/kexin type 1 (PCSK1)/PC1/3, and its inhibitor PCSK1N, was measured by reverse transcription–quantitative polymerase chain reaction in adenoma tissue. Mouse pituitary corticotroph tumor (AtT-20) cells were treated with tanespimycin (17-AAG), an HSP90 chaperone inhibitor, to induce ER stress, followed by gene and protein analyses.

Results

POMC, TPIT, and PCSK1 expression were higher, whereas PCSK1N was lower in FCA compared to SCA. PCSK1N correlated with POMC (rs = −0.514; P < .001), TPIT (rs = −0.386; P = .005), PCSK1 (rs = −0.3691; P = .008), and tumor largest diameter (rs = 0.645; P < .001), in all CA. Induction of ER stress by 17-AAG in AtT-20 cells led to a decrease of Pomc and an increase of Pcsk1n gene expression at 24 hours. Moreover, a downregulation of cell cycle, apoptosis, and senescence pathways, and alterations in cell adhesion and cytoskeleton, were observed at the protein level.

Conclusion

PCSK1N is higher in SCA compared with FCA, and associated with corticotroph cell markers and tumor size. PCSK1N is likely to be part of the adaptive response to ER stress, potentially conferring a survival advantage to the corticotroph tumor cell in conjunction with other proteins.
Effect of Spironolactone and Cyproterone Acetate on Breast Growth in Transgender People: A Randomized Clinical Trial
Authors: Angus Lachlan M , Leemaqz Shalem Y , Kasielska-Trojan Anna K , Mikołajczyk Maksym , Doery James C G , Zajac Jeffrey D , Cheung Ada S
Published: September 2024

Context

Transgender people with sex recorded male at birth desiring feminization commonly use cyproterone acetate or spironolactone as antiandrogens with estradiol, but the optimal antiandrogen is unclear.

Objective

We aimed to assess the effect of antiandrogens on breast development. We hypothesized this would be greater in those treated with cyproterone acetate than spironolactone due to more potent androgen receptor antagonism and suppression of serum total testosterone concentrations.

Methods

A randomized clinical trial was conducted between 2020-2022 at an outpatient endocrinology clinic. Transgender people aged 18+ years old commencing feminizing gender affirming hormone therapy were included. The intervention was standardized estradiol therapy plus either spironolactone 100 mg daily or cyproterone acetate 12.5 mg daily for 6 months. The primary outcome was breast development as measured by the breast–chest distance. Secondary outcomes included estimated breast volume, suppression of serum total testosterone concentration <2 nmol/L, and Gender Preoccupation and Stability Questionnaire (GPSQ).

Results

Sixty-three people (median age 25 years) were enrolled, randomized, and included in intention to treat analysis (cyproterone acetate n = 32, spironolactone n = 31). At 6 months, there was no between-group difference in breast–chest distance (mean difference 0.27 cm, 95% CI −0.82 to 1.35, P = .6) or estimated breast volume (mean difference 17.26 mL, 95% CI −16.94 to 51.47, P = .3). Cyproterone acetate was more likely to suppress serum testosterone concentration to <2 nmol/L (odds ratio 9.01, 95% CI 1.83 to 4.44, P = .008). Changes in GPSQ were similar between groups.

Conclusion

Antiandrogen choice should be based on clinician and patient preference with consideration of side effects. Further research is needed to optimize breast development in transgender people.
Intergenerational Power Shift and the Rise of Nonarranged Marriages Among Refugees
Authors: Foster Andrew D. , Gökçe Merve Betül , Kırdar Murat Güray
Published: September 2024

The experiences of war and refugee status can alter intrafamily dynamics, with implications for family formation, including marriage. We use the nationally representative Syrian Migrant Sample of the 2018 Turkey Demographic Health Survey (TDHS-S) to conduct a duration analysis of marriage outcomes among Syrian refugees in Turkey, tracking women throughout their residence in prewar Syria (before the conflict began in 2011), postwar Syria (after the conflict began but before arrival in Turkey), and Turkey. We find that early marriage was more prominent among refugees who were unmarried at the time of migration than among those married before migration; the mean marriage age dropped from 19.6 in prewar Syria to 19.1 in postwar Syria and 18.1 in Turkey. Using the TDHS-S and prewar Syrian surveys, we show that this finding aligns with the observed declines in household income and young women's opportunity cost of marriage. Our duration analysis also reveals a notable shift from traditional arranged marriages to more modern marriage forms among refugees in Turkey. An intergenerational power shift might drive the shift toward nonarranged marriages. After arrival in Turkey, wealth and employment of parents decline among refugees. In contrast, Syrian youth in Turkey have higher age-adjusted employment rates than in prewar Syria. Moreover, nonarranged marriages increase more among demographic groups with stronger intergenerational power shifts than among groups with weaker shifts.
Demographic History and English Culture
Authors: Werlin Julianne
Published: September 2024

In England, the period from the late Middle Ages through early modernity was bookended by demographic change. On one edge, there was the Black Death and subsequent plague pandemics, which halved the population, reshaping English society in their wake. On the other, there was the demographic transition of the mid-eighteenth century, which reduced death rates and led to modern family structures. Between these two epochal events, demographic trends shaped English customs and values, and were in turn shaped by them. The articles in this special issue draw on cutting-edge demographic research to offer new interpretations of the effects of plague, patterns of marriage, evolving forms of labor, and the morality of crime and charity, among other subjects. Together, they illustrate how quantitative studies in historical demography can shed light on key transformations in culture and society—and vice versa.
The Effect of Capital Gains Taxes on Business Creation and Employment: The Case of Opportunity Zones
Authors: Arefeva Alina , Davis Morris A. , Ghent Andra C. , Park Minseon
Published: September 2024

The Tax Cuts and Jobs Act of 2017 established a new program called Opportunity Zones (OZs) that reduces or eliminates capital gains taxes on investment in a limited number of low-income Census tracts. We provide a model illustrating how a change in capital taxation affects employment in existing and new establishments. We then use establishment-level data to show that, in its first two years, the OZ designation increased employment growth relative to comparable tracts by between 3.0 and 4.5 percentage points in metropolitan areas. The job growth occurred in multiple industries and persisted into 2021 rather than quickly disappearing. However, most of the jobs created by the program were likely taken by residents who live outside of the designated tracts, consistent with only 5% of U.S. residents working in the same Census tract as the one in which they live.

This paper was accepted by Tomasz Piskorski, finance.

Funding: The authors are grateful for the financial support of an award from UW-Madison’s Fall Research Competition.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.03223 .
KENTOSHI E O APOCALIPSE ATÔMICO
Authors: Sasse Pedro
Published: September 2024

Conforme o mundo avança em um caminho cada vez mais incontornável na direção de uma crise climática irreversível, vemos popularizarem-se ficções apocalípticas e pós-apocalípticas que se propõem a imaginar as consequências extremadas do antropoceno nas condições de vida do nosso planeta. No entanto, não é a primeira que a ficção experimenta uma intensa produção de obras do gênero. Ao longo do século XX, sobretudo após o ataque de Hiroshima e Nagazaki, produzimos por décadas uma ficção apocalíptica dedicada a pensar a recém-descoberta capacidade do homem de aniquilar o planeta de forma mais rápida e fulminante: por meio das bombas atômicas. Enquanto o fim da Guerra Fria levou a um progressivo abandono dessa temática na ficção, o trágico acidente de Fukushima, ao menos localmente, trouxe à superfície certos traumas nacionais que encontraram novamente na ficção uma forma de refletir sobre os horrores do apocalipse nuclear. Uma dessas obras é o romance Kentoshi (献灯使), de Yoko Tawada, publicado em 2014 e, posteriormente traduzido para o inglês como The Last Children of Tokyo, ainda sem edição em português. Pretendemos, assim, colocar em diálogo o romance de Tawada com a tradição dos apocalipses atômicos, analisando os caminhos que a autora escolheu para retomar a reflexão sobre esse tema na cultura japonesa.