bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in Cancer Treatment for Oral Cavity, Oropharynx, and Larynx in 2016 Versus 2009: SEER Patterns of Care Studies
Authors: Weeks Kristin S. , Lynch Charles F. , Pagedar Nitin
Published: August 2021

Purpose:

To determine if there was a higher percentage of patients treated surgically and with advanced radiotherapy in 2016 (N = 897) versus 2009 (N = 1136), the patient and tumor characteristics associated with surgical care and advanced radiotherapy, and if chemotherapy or targeted agent use varied over time for squamous cell carcinoma of the head and neck.

Methods:

We utilized Surveillance Epidemiology and End Results Patterns of Care datasets. Rao-Scott Chi-square tests and logistic regressions were applied to determine differences in surgery, advanced radiotherapy (RT), and chemotherapy by year.

Results:

There was a lower prevalence of surgery only treatment in 2016 versus 2009 with exception of oral cavity stages IVB/IVC and unknown, and larynx stage unknown. Advanced RT was more common in 2016 for patients receiving definitive RT among all sites, excluding stages I/II glottic larynx. Among each site (oral cavity, oropharynx, and larynx) lower stage was associated with increased odds of surgery. Among each site, advanced RT was more common in patients receiving definitive versus postoperative RT. For the larynx site, 2016 versus 2009 was associated with greater odds of advanced RT. Systemic treatment with fluorouracil, taxanes, or cetuximab was less prevalent in 2016.

Conclusion:

In 2016 versus 2009, there was largely not a higher percentage of patients treated surgically. There was a higher prevalence of advanced RT for definitive care. Further investigations of these patterns are needed, including trend analysis.
Otolaryngology Resident Education and Perceptions of e-cigarettes
Authors: Koo Elliot Y. , Jin Vivian , Weinreich Heather M. , Wenig Barry L.
Published: August 2021

Objective:

To date, there are no reports of otolaryngology residents’ knowledge and confidence in discussing e-cigarette use. The purpose of this study was to evaluate otolaryngology resident e-cigarette knowledge and confidence in counseling patients on e-cigarette use.

Study Design:

Cross-sectional national survey

Setting:

Accreditation Council for Graduate Medical Education otolaryngology residents in the United States.

Methods:

US otolaryngology residents were distributed surveys electronically in September 2020.

Results:

A total of 150 participants replied for a response rate of 8.88%. The majority, 93.10% have not received formal education on e-cigarettes during their residency training. The most common resource of e-cigarette information overall was social media (78.46%). Within academia, the most common resources of e-cigarette education were patient interactions (63.16%) and colleagues (54.74%). Patients commonly inquire residents about e-cigarettes for smoking cessation (85.07%) and their long-term health effects (83.58%). Almost 67% of residents rarely or never ask patients about e-cigarette use. Only 4.35% of residents are not confident discussing traditional cigarette use, while 58.70% are not confident discussing e-cigarettes.

Conclusion:

Otolaryngology residents have not received formal education in e-cigarettes and are not confident discussing e-cigarettes with their patients. This highlights the need for e-cigarette education during otolaryngology residency to improve patient e-cigarette counseling.
A Consideration for Surgical Management in Select T4b Oral Cavity Squamous Cell Carcinoma
Authors: Chen Michelle M. , Chang Clifford M. , Dermody Sarah , Rosko Andrew J. , Mierzwa Michelle L. , Swiecicki Paul L. , Spector Matthew E. , Worden Francis P. , Prince Mark E. P. , Chinn Steven B.
Published: August 2021

Objectives:

The role of surgery for conventionally “unresectable” (cT4b) oral cavity squamous cell carcinoma is unclear. We analyzed factors associated with overall survival in cT4b relative to cT4a oral cavity squamous cell carcinoma.

Methods:

We identified 6830 cT4a and 522 cT4b oral cavity squamous cell carcinoma chemoradiation or surgery + adjuvant therapy patients in the National Cancer Data Base from 2004 to 2016. The main outcome was overall survival. Statistical analysis was performed using chi-squared tests, univariable and multivariable regression analysis.

Results:

The cT4b group had a higher rate of positive margins (30.4% vs 21.3%, P = .009) and downstaging (41.2% vs 13.1%; P < .001) compared to cT4a, while only 1.7% were upstaged. cT4b surgery + chemoradiation patients had similar survival to cT4a surgery + radiation (HR 0.93; 95% CI, 0.70-1.25) and cT4a surgery + chemoradiation patients (HR, 0.92; 95% CI, 0.69-1.23), while cT4b surgery + radiation patients had worse OS (HR, 1.55; 95% CI, 1.05-1.47).

Conclusions:

Clinical T4b staging is a poor predictor of pathologic staging given a high rate of downstaging on final pathology. Surgical resection with adjuvant chemoradiation is an option in select cT4b oral cavity squamous cell carcinoma patients.
Mental health stigma among community members in Afghanistan: A cross-sectional survey
Authors: Nine Sean B , Najm Abdul Fattah , Allan Emily B , Gronholm Petra C
Published: August 2021

Background:

Stigma is a barrier to mental healthcare. Understanding context-specific stigma is important in designing mental health interventions.

Aim:

This study explored the nature and patterns of mental health stigma among community members in Afghanistan.

Methods:

Using cross-sectional data ( n = 718), descriptive and inferential analyses were conducted. Multivariable linear regression identified determinants of stigma, as reflected by: (1) preference for social distance in relation to depression and psychosis, and (2) intended stigmatising behaviours in relation to mental illness.

Results:

In descriptive analyses, stigma toward depression and psychosis, especially regarding work and marriage, was found. The label of ‘mental illness’ was especially stigmatising. Most respondents would disclose a mental health problem to family only. Findings of inferential analyses included: stigma was positively associated with higher socioeconomic status, depression and belief in dangerousness; and negatively associated with urban location, female gender, familiarity and belief in a positive prognosis.

Conclusions:

This study provides new insights on stigma, to inform action in Afghanistan, an under-researched context. Further research and actions must prioritise supportiveness at the family level, especially in remote regions and address cultural issues of the social cost of associating with mental illness. More culturally appropriate, non-stigmatising language surrounding mental illness should be developed.
‘Timepass’ and ‘setting’: The meanings, relationships and politics of urban informal work in Delhi
Authors: Routray Sanjeev
Published: August 2021

The engagement of people in extremely low-wage work in major cities of the Global South and their withdrawal from labour-organising activities arise from several factors. Among these is the hegemonic meaning construction of work as ‘timepass’ or leisure and as an opportunity for sociality and neighbourliness that is central to the social reproduction of everyday life. Drawing on ethnographic fieldwork in Delhi, this article examines how work regimes are marked by a ‘commission economy’, whereby various stakeholders in the chain of surplus accumulation demand a commission for their services. The possibility of undertaking informal economic activities is contingent on a host of improvisations that are founded upon discipline, violence and also solidarity. In this respect, various stakeholders possess what they refer to as a ‘setting’, which alludes to an active process of economic and non-economic relationship-building with both state and non-state agencies within both formal and informal arenas. To ‘do setting’ is a dynamic spatial process that draws on negotiations with the aim of shaping favourable relationships and outcomes in particular urban spaces. It entails the use of social and cultural resources, everyday political negotiations and extra-judicial solutions.
The politics of hyperregulation in La Paz, Bolivia: Speculative peri-urban development in a context of unresolved municipal boundary conflicts
Authors: Horn Philipp
Published: August 2021

In Bolivia, urbanisation increasingly takes place in peri-urban settings situated outside the boundaries of cities. Unlike previous research that considers peri-urban developments such as rural-to-urban land use transitions to be characterised by state absence and little regulation and planning, this article demonstrates that such developments occur precisely because of the presence of particular multi-scalar governance configurations. Drawing on case study material from peri-urban La Paz, the article demonstrates how legislative reforms by Bolivia’s national government on decentralisation and municipal delineation, which failed to establish clear jurisdictional boundaries, create a situation of hyperregulation whereby multiple local authorities claim political control over the same territory by deploying distinct and at times conflicting, legal and planning frameworks. While hyperregulation enables a loose coalition of elite actors, including government authorities, resident leaders of peri-urban settlements and private sector representatives, to advance specific political and socio-economic interests, it puts ordinary residents in a situation of permanent uncertainty. The article contributes to and further nuances conceptual debates on calculated informality which uncover how states deliberately create legally ambiguous systems to facilitate speculative urban developments. Unlike previous studies which highlight that this is mainly achieved through state engineering, and particularly by suspending or violating the law, this article demonstrates that legal ambiguity and irregularity can also be generated through multi-scalar governance configurations that (1) involve a number of elite actors, including state authorities but also private sector and civil society representatives and (2) create a situation in which different regulatory systems co-exist without coordination.
Predictors of outcome after CABG in the South-Asian community: a propensity matched analysis
Authors: Salmasi Mohammad Yousuf , Ravishankar Ramanish , Abdullahi Yusuf , Hartley Philip , Kyriazis Panagiotis G , Athanasiou Thanos , Punjabi Prakash
Published: August 2021

Background:

Ethnicity is not incorporated into standardized pre-operative risk-stratification tools for cardiac surgery. This study compared short-term outcomes following coronary artery bypass graft (CABG) surgery in South Asian and non-Asian patients.

Methods:

Consecutive patients undergoing isolated CABG surgery via sternotomy between the years 2011 and 2019 were retrospectively analyzed. Initially, 1957 patients were identified (799 South-Asian, 40.8%). The patient groups were then propensity matched according to 10 relevant pre-operative covariates (age, body mass index, pulmonary disease, renal failure, smoking, diabetes, ventricular function, renal failure): 675 non-Asian patients were matched against 675 Asian patients.

Results:

Operative mortality was 1.77% and similar between the two groups (p = 0.447). Multivariate regression analysis found predictors of operative mortality to be pre-operative serum creatinine, age, left ventricular (LV) impairment, and extent of coronary disease. The effect of creatinine on mortality was selective for South-Asian patients (p = 0.015). LV impairment was a predictor of mortality in non-Asian patients, however this effect did not exist in South-Asian patients. Predictors of short-term complications (composite of death, stroke, reoperation, hemofiltration, and pneumonia) were age and creatinine (coefficient 0.002, 95% CI 0.0004–0.004, p = 0.019) in the overall cohort. Subgroup analysis found age to remain a selective negative predictor of complications in South-Asian patients. Cox regression analysis found creatinine, age, and LVEF to influence 10-year survival, whilst ethnicity was not a predictor.

Conclusion:

This study highlights the cumulative risk associated with ethnicity and renal disease in predicting short-term outcomes following CABG. This warrants further investigations in larger populations, thus guiding pre-operative risk-stratification.
Symbolic Representation, Expectancy Disconfirmation, and Citizen Complaints Against Police
Authors: Lee Euipyo , Nicholson-Crotty Sean
Published: August 2021

The theory of symbolic representation expects that citizens will view the actions of government as more legitimate when administrators share their characteristics. Although there is support for this assertion in some service areas, the evidence in policing is mixed. We draw on Expectancy Disconfirmation Theory to develop the expectation that policing is an area where we may be unlikely to see a positive relationship between representation and positive citizen perceptions of government officials. We test this expectation in an individual-level analysis of citizen complaints against police from four American cities between 2014 and 2017. The results suggest that, all else equal, complaints against Black officers are as or more likely to be filed by Black citizens than by citizens of other races. We conclude with a discussion of the implications of these results for both the study of representative bureaucracy and for the management of police citizen interactions.
Efficacy and safety of trastuzumab emtansine in older patients with HER2-positive advanced breast cancer: a real-world study
Authors: Cil Ibrahim , Kucukarda Ahmet , Atcı Muhammed Mustafa , Secmeler Saban , Paksoy Nail , Ferhatoglu Ferhat , Ak Naziye , Ayhan Murat , Tataroglu Ozyukseler Deniz , Onder Arif Hakan , Avci Okan , Oyman Abdilkerim , Okten Ilker Nihat , Gulturk Ilkay , Akagunduz Baran , Basoglu Tugba , Cakir Emre , Hacibekiroglu Ilhan , Ozcelik Melike , Aydiner Adnan
Published: August 2021

Introduction:

Ado-trastuzumab emtansine (T-DM1) is an antibody–drug conjugate and its survival advantage has been shown in advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer. However, clinical trials underrepresent patients ⩾65 years of age, leading to a lack of information in this population. We analyzed the real-world outcomes of older women who were treated with T-DM1 therapy.

Methods:

We performed a multicenter, observational, retrospective analysis of patients aged ⩾65 years treated with T-DM1. A total of 93 patients from 10 cancer centers were involved in the study. Our goal was to determine the survival, response rates, and toxicity profile in T-DM1–treated patients, as well as the factors that influence survival.

Results:

Median follow-up was 12.2 months. Objective response rate was 29%. Median progression-free survival (PFS) and overall survival (OS) were 8.47 and 15.0 months, respectively. In multivariate analysis, Eastern Cooperative Oncology Group Performance Score 2 was found to be an independent prognostic factor for worse PFS (hazard ratio [HR] 1.81, p = 0.032) and OS (HR 2.33, p = 0.006). Any adverse event (AE) was seen in 92.5% of patients; grade 3 or 4 AEs were seen in 30.1%. Dose reduction or treatment discontinuation rates were 11.8% and 6.5%, respectively.

Conclusion:

The efficacy of T-DM1 was acceptable and it was generally well-tolerated among older patients with advanced HER2-positive breast cancer.
The rate effect on fracture mechanics of dam concrete based on DIC and AE techniques
Authors: Bu Jingwu , Wu Xinyu , Xu Huiying , Chen Xudong
Published: August 2021

In order to study the effect of loading rate on fracture behavior of dam concrete, wedge splitting tests of various loading rates (0.1, 0.01, and 0.001 mm/s) are carried out on two kinds of full-graded dam concrete notched cubes with side lengths of 300 and 450 mm, respectively. Digital image correlation and acoustic emission technique are used to measure the deformation and acoustic emission parameters of the dam concrete. Test results show that: the peak load and fracture energy of dam concrete specimens increases with the increase of loading rate. And the higher the loading rate is, the fracture of concrete shows more obvious brittleness. Influenced by the boundary effect, the CTOD increases with the increasing of loading rate, however, the length of crack decreases as loading rate increases. With the loading rate increases, the energy mutation area is more obvious, while the accumulated acoustic emission energy is affected by both the loading rate and the maximum aggregate size. The number of acoustic emission three-dimensional locating points and the shear signal decrease with the increase of loading rate, which is attributed to that the faster the loading rate is, the less sufficient the development of micro cracks in concrete is. The test results can supply experimental data to the fracture mechanics of dam concrete.
Automated Assessment of Passing Sight Distance on Rural Highways using Mobile LiDAR Data
Authors: Agina Samaa , Shalkamy Amr , Gouda Maged , El-Basyouny Karim
Published: August 2021

Providing sufficient Available Sight Distance (ASD) that meets the minimum design requirements is crucial for highway safety. Previous work on sight distance assessment focused on Stopping Sight Distance (SSD) with little attention given to Passing Sight Distance (PSD). Insufficient PSD could lead to severe collisions such as head-on and sideswipe crashes. To address this gap, this paper introduces an automated method for PSD assessment on two-lane highways using mobile Light Detection and Ranging (LiDAR) data. The procedure involved extracting centerline lane marking, defining passing-allowed and passing-prohibited regions, computing the ASD, and comparing the existing centerline marking pattern (i.e., passing and no-passing zones) to a proposed lane marking that is based on the ASD for passing maneuvers. Regions that meet the design standards, substandard zones, and non-optimal design regions were all defined. A reallocation of PSD zones was conducted based on the ASD including modifying the existing lane marking pattern, which resulted in increasing the total length of passing zones by up to 20%, providing more, but safer, passing opportunities. A high-level safety assessment of historical collisions showed clusters of crashes along regions where passing is currently allowed at locations where the ASD is less than standard requirements. The proposed framework represents a tool by which transportation agencies could assess PSD, upgrade the design of existing highways, and investigate the consequences of PSD limitations to ensure compliance with standards during highway service life.
“I Didn’t Meet My Mother; I Saw My Mother”: The Challenges Facing Long-Term Care Residents and Their Families in the Age of COVID-19
Authors: Avidor Sharon , Ayalon Liat
Published: August 2021

The present research examines the effects of protective measures due to the coronavirus disease 2019 (COVID-19) pandemic within long-term care (LTC) settings on residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including the physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision-making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families, staff, and management.
He Tūhononga Whaiaro: A Kaupapa Māori Approach to Mate Wareware (Dementia) and Cognitive Assessment of Older Māori
Authors: Menzies Oliver , Dudley Margaret , Garrett Nick , Elder Hinemoa , Daniels Piripi , Wilson Denise
Published: August 2021

Aim:

The aim of this study is to investigate Māori (Indigenous peoples of Aotearoa New Zealand) understandings of dementia ( mate wareware) and develop a framework to inform assessment of cognitive impairment.

Method:

Qualitative, kaupapa Māori (M āori approach) research with 241 older Māori ( kaumātua) involving 17 focus groups across Aotearoa New Zealand (NZ) and eight families ( whānau) from one region. We thematically analyzed transcribed data from audio-recorded interviews.

Results:

Two overarching themes, namely, connection ( Tūhononga) and self ( Whaiaro), and eight subthemes in particular mind ( hinengaro), spirit ( wairua), body ( tinana), family ( whānau), social connection ( whanaungatanga), identity and role ( tuakiri), place ( wāhi), and ancestors ( tūpuna) emerged. Māori language ( Te Reo Māori) was important for cognitive health.

Conclusion:

The findings embedded in cultural values improve understanding of dementia ( mate wareware) in Māori. These themes can inform the assessment of older Māori with cognitive impairment. For those without cognitive impairment, the Tūhononga Whaiaro framework suggests factors potentially crucial for healthy aging in Māori.
Adoption of circular economy for food waste management in the context of a developing country
Authors: Ali Yousaf , Jokhio Danyal Hakeem , Dojki Amna Ali , Rehman Obaid ur , Khan Feroz , Salman Aneel
Published: August 2021

Food wastage is a global concern with high economic, social and environmental impacts. Pakistan, a developing country, is also significantly affected by the adverse impacts of food wastage. For overcoming this problem, the transition from a Linear to a Circular Economy (CE) for the management of food wastage can serve as a viable strategy. However, there are barriers of political, technical and cultural nature, which are impediments in the path of this transition. This study aims to identify and prioritize these barriers in order of their significance. This research study evaluated and ranked these barriers using a Fuzzy Multi-Criteria Decision Making (MCDM) technique, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). A total of 15 barriers were analyzed, and the ‘complicated intrinsic nature of CE’, ‘misleading information about shelf-life leading to waste rather than distribution’, ‘the poor economic viability of start-ups with CE model’, ‘corporate and organizational hesitance to change/innovate’ and ‘technological backwardness of farmers/growers on the agricultural production side’ were ranked as the most significant hurdles. The novelty of this study lies in its application. This study is unique as it has focused on developing countries and proposed policy recommendations for the transition towards a CE. In light of the above-mentioned results, this study provides policy recommendations for public and private sector policymakers that would facilitate the food industry in shifting towards the CE model.
Modelling the stiffness of plastic springs manufactured via additive manufacturing
Authors: Sacco Enea , Moon Seung Ki
Published: August 2021

The helical spring is one of the most used components in mechanisms but there is little research on the application of 3D printing, also called Additive Manufacturing, to springs. Therefore, the objective of this paper is to derive a model for the stiffness of 3D printed springs. The equation assumes that springs are made of orthotropic material and with a rectangular wire cross-section, that is, die springs. A second version of the equation has also been postulated that accounts for the misalignment of the deposited tracks with respect to the direction of the coils due to the coil pitch. The two models are compared to various springs printed with PLA and ULTEM 9085 and are found to accurately predict the stiffness of real, 3D printed springs. These equations allow the design and manufacturing of helical die springs for applications with few load cycles and that require chemical and radiation resistance, such as in space. The equations are also the first step in the development of models for new kinds of springs, such as linear conical springs or hollow wire die springs.
Eco-driving control of electric vehicle with battery dynamic model and multiple traffic signals
Authors: Naeem Hafiz Muhammad Yasir , Bhatti Aamer Iqbal , Butt Yasir Awais , Ahmed Qadeer
Published: August 2021

Limited capacity and short life cycle of a battery are the major impediments in development of practical Electric Vehicles (EVs). Eco-driving is an optimization technique through which a velocity trajectory that consumes minimum energy is advised to the driver. However, presence of traffic signals to control large traffic network degrades the performance of eco-driving; as applying brakes to stop and then maximum re-acceleration to restart a trip consumes lot of energy. Eco-driving problem with multiple traffic signals and static model of battery has been proposed as Two Point Boundary Value Problem (TPBVP). TPBVP fails to solve multi-phase problem as a single phase due to discontinuity of the co-states at the junction, that is, start of a new phase. This paper investigates an optimal solution with both EV and battery dynamics in the presence of multiple traffic signals as Multi Point Boundary Value Problem (MPBVP) using multiple shooting technique. Traffic signals come at some intermediate points of a trip. MPBVP ensures continuity at the junction to solve the multi-phase problem as a single phase through inter dependencies between each phases. Goal of this work is not only to solve constrained eco-driving problem with traffic signals but also include charging and discharging limits on battery that indirectly improves battery’s life cycle. Results indicate that EV has crossed all the traffic signals during their green duration without applying brakes with also satisfying all the other constraints and continuity condition. Moreover, it can be seen that energy consumption using MPBVP is also marginally lesser as compared to TPBVP.
Scattering of journals cited in legal theses and dissertations
Authors: Bangani Siviwe , Moll Michiel
Published: August 2021

The study employed bibliometrics methods to analyse the scattering of 596 journals cited in legal master’s theses and doctoral dissertations in three South African law schools from 2014 to 2018. In addition, the study included an analysis of the extent of citation of different sources and examined the effect of use of non-legal journals by law students. It was found that students used 449.2 documents on average in writing a doctoral dissertation and 110.9 references per master’s thesis. Journals received more citations than any other document formats although 16 master’s theses were completed without citing a single journal. Generally, the journals cited in legal theses and dissertations conform to Bradford’s Law but they differ in their level of conformity by law school. There was a high degree of overlaps between Zone 1 journals in the three law schools. All journals in the core lists were available in all the law schools which was attributed to the strength of collections in these schools. The results support the application of bibliometric analyses to legal master’s theses and doctoral dissertations to make collection development decisions. In making those decisions, however, law librarians would have to look beyond the Zone 1 journals of their own institution for wider access. These results also serve as a caution to law librarians to look beyond the traditional law journals in de/selecting journals, as some of the non-legal journals in this study made it to the core list of cited periodicals. Furthermore, this study points to the strength of library collections in the top law school libraries in the country.
Building and enhancing library services: Patrons’ awareness of, and engagement with social media in academic libraries in Ghana
Authors: Mensah Monica , Bosire Onyancha Omwoyo
Published: August 2021

This study sought to examine academic libraries’ patrons’ level of awareness of, and engagement with social media in the use of academic libraries services in Ghana. The study employed the cross-sectional survey whereby quantitative data were collected from a total of 417 respondents, who consisted of students and library staff from public, private and technical universities in Ghana. Findings indicated that the academic libraries have adopted and used a number of social media applications, with Facebook and instant messaging as the most popular and frequently used platforms, for the provision and access to library services and resources as well as for contacting the academic libraries. However, the level of awareness, extent of use, as well as the level of engagement with the platforms was low as social media tools adopted by the libraries were not prevalent among the library patrons. Recommendations and conclusions based on the research findings are offered in the paper. This study uses a cross-sectional survey, with the data being collected at a specific point in time. However, due to rapid technological change and trends, future research studies could consider longitudinal studies to investigate the adoption and use of social media in academic libraries across time and environment. The analysis of social media use for academic library services from both the library staff and library patrons’ perspectives will inform decisions on how to improve the use of such platforms for effective and efficient library services delivery and access.
Problematizing “Planning Ahead”: A Cross-Cultural Analysis of Vietnamese Health and Community Workers’ Perspectives on Advance Care Directives
Authors: Nguyen Nga , Zivkovic Tanya , de Haas Rachael , Faulkner Debbie
Published: August 2021

Informed by values of autonomy and self-determination, advance care planning assumes that individuals should independently take control of their future health. In this article, we draw on research conducted with Vietnamese health and community workers to problematize individualized approaches to planning ahead, reframe notions of “cultural and linguistic barriers,” and expose how homogeneous messages about care at the end of life are not readily translatable within and across diverse groups. Anthropological and feminist critiques of inclusion and exclusion are used to reorientate Anglophone framings of the individual and of cultural and linguistic differences. In this article, we suggest that it is the narrow singularity of care for the self—rather than diverse relationalities of care—that should be overcome if aging and end-of-life care policy and practice is to be broadened and made relevant to migrant and non-English-speaking groups.
Experiences of Pain in Hospitalized Children During Hematopoietic Stem Cell Transplantation Therapy
Authors: Plummer Karin , McCarthy Maria , McKenzie Ian , Newall Fiona , Manias Elizabeth
Published: August 2021

Children undergoing hematopoietic stem cell transplantation (HSCT) are vulnerable to pain due to the intensity and toxicity of this treatment. An instrumental case study design of two qualitative phases was conducted to examine the pain experiences of hospitalized children during HSCT therapy and how contextual factors related to the pediatric HSCT environment influenced their experience of pain. The Social Communication Model of Pain provided the conceptual framework for the study. In Phase 1, semi-structured interviews were conducted with parents of a child undergoing HSCT therapy at two time points. Phase 2 was conducted as a naturalistic observational study of the clinical care provided to children and semi-structured interviews with health-care providers. Children experienced complex and multifaceted pain with physical, psychological, and contextual contributors. Understanding the many factors contributing to the child’s pain experience can inform strategies to improve the management of pain during HSCT therapy.
Effects of Illness Perception on Self-Care Agency and Hopelessness Levels in Liver Transplant Patients: A Descriptive Cross-Sectional Study
Authors: Demir Bilsev , Demir İlker
Published: August 2021

Individuals with liver transplantation (LT), hopelessness, and lack of self-care may occur and change in the illness perceptions; however, no study has examined the effects of the illness perceptions on self-care agency and hopelessness levels in individuals with LT. This study was conducted to examine the effects of the illness perceptions of patients who had received LT surgery on their self-care agency and hopelessness levels. A descriptive cross-sectional study with a convenience sample ( N = 120) was conducted at a center in eastern Turkey. The data were collected by using the “Brief Illness Perception Questionnaire” (B-IPQ), “Self-Care Agency Scale” (SCAS), “Beck Hopelessness Scale” (BHS). In the study, the mean total B-IPQ, SCAS, BHS scores was found as 57.50 ± 3.61, 83.83 ± 9.43, 10.19 ± 3.81, respectively. There was a positive and significant relationship between the B-IPQ and BHS total scores.
The CYP3A5 and ABCB1 Gene Polymorphisms in Kidney Transplant Patients and Establishment of Initial Daily Tacrolimus Dosing Formula
Authors: He Yuting , Ma Yixiao , Fu Qian , Liang Jianbo , Yu Xuegao , Huang Hao , Zhong Liangying , Huang Bin
Published: August 2021

Background

Tacrolimus is an immunosuppressive drug used to prevent organ rejections. Many factors could influence blood concentration of tacrolimus.

Objective

To detect genotypes of cytochrome P450 3A5 ( CYP3A5) and ABCB1 in kidney transplant patients and establish initial daily tacrolimus dosing formula based on genotypes of CYP3A5 and ABCB1 and patients’ clinical parameters.

Methods

Sequence specific primer polymerase chain reaction (PCR) and PCR restriction fragment length polymorphism were used to detect genotypes of CYP3A5 and ABCB1. The blood cell, procalcitonin, C-reactive protein, height, weight, age, gender and other clinical parameters were recorded. Multiple linear regression analysis and Pearson correlation analysis were used to conduct date analysis.

Results

102 cases were enrolled in cohort 1, and there were 10 cases of CYP3A5 *1/*1 (9.8%), 28 cases of CYP3A5 *1/*3 (27.5%), and 64 cases of CYP3A5 *3/*3 (62.7%). The distributions of ABCB1 C3435T genotype were CC 36 (35.3%), CT 52 (51.0%), and TT 14 (13.7%). The distributions of ABCB1 G2677T/A genotype were GG 39 (38.2%), GT 40 (39.2%), and TT 23 (22.5%). The formula was 7.499 + (0.053 × Weight) − (0.029 × Hemoglobin concentration) − (1.045 × CYP3A5 genotype) ( CYP3A5 genotype: *1/*1 type inputs 0, *1/*3 type inputs 1, *3/*3 type inputs 2). The predicted doses from the established formula had a significant correlation ( r = 0.605) with actual clinical doses ( P < 0.05).

Conclusion and Relevance

Hemoglobin concentration, weight, and CYP3A5 genotype should be considered using tacrolimus. The initial daily tacrolimus dosing formula established can make a good prediction.
Picturebooks as Critical Literacy: Experiences and Perspectives of Translingual Children From Refugee Backgrounds
Authors: Vehabovic Nermin
Published: August 2021

This multiple case study is part of a larger investigation of literacy practices in “Our Home,” an after-school program that provides learning support to children from refugee backgrounds. I asked, “What happens when translingual children from refugee backgrounds respond to multicultural, transnational, and translingual picturebooks?” Informed by critical literacy theories, I illuminate the experiences and perspectives of four children as they interacted with and engaged in dialogic reading of picturebooks; these critical literacy practices, along with observational data, are reported in profiles. Findings from this study reveal the ways in which children from refugee backgrounds found problematic aspects of assumptions in stories, reflected on different and contradictory perspectives, articulated the power relationships between characters, and offered alternative thoughts centered on social justice. This research expands the field’s knowledge of what doing critical literacy work with young translingual students in an after-school program looks, feels, and sounds like.
Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles
Authors: Kim Bu Ki , Chung Young Taek
Published: August 2021

Purpose:

To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle.

Setting:

Onnuri Smile Eye Clinic, Seoul, Republic of Korea.

Design:

Retrospective case series.

Methods:

This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical).

Results:

At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B ( p < 0.001), and when ICL was horizontally and vertically implanted in group C ( p = 0.021), respectively. And the mean SE was −0.11 ± 0.30, −0.34 ± 0.42, −0.3 ± 0.56 and −0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B ( p = 0.039), and when the ICL was horizontally and vertically implanted in group C ( p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C.

Conclusions:

The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.
Safety, Feasibility, and Acceptability of a New Virtual Rehabilitation Platform: A Supervised Pilot Study
Authors: Escalante-Gonzalbo Ana María , Ramírez-Graullera Yoás Saimon , Pasantes Herminia , Aguilar-Chalé José Jonathan , Sánchez-Castillo Gloria Ixchel , Escutia-Macedo Ximena Ameyalli , Briseño-Soriano Tania María , Franco-Castro Paulina , Estrada-Rosales Ana Lilia , Vázquez-Abundes Sandra Elizabeth , Andrade-Morales David , Hernández-Franco Jorge , Palafox Lorena
Published: August 2021

Purpose:

Stroke is the leading cause of disability in adults worldwide, with hemiparesis being the most prevalent consequence. The use of video games and movement sensors could contribute to improving patients’ chances of recovery. We performed a supervised pilot study to validate the safety, feasibility, and acceptability of a new virtual rehabilitation platform in patients with chronic post-stroke upper limb hemiparesis.

Methods:

The participants (n = 9) participated in 40 rehabilitation sessions, twice a week, for a period of 20 weeks. Their experiences with the platform were documented using a Likert-scale survey. Changes in motor function were evaluated using the Chedoke Arm and Hand Activity Inventory (CAHAI) and the Wolf Motor Function Test (WMFT).

Results and conclusions:

All participants expressed that they enjoyed the experience and felt comfortable using the platform. Preliminary results showed significant motor recovery ( P = .0039) according to the WMFT scores. Patients with significant impairment showed no improvement in upper limb task-oriented motor function after therapy. The new platform is safe and well-accepted by patients. The improvement in motor function observed in some of the participants should be attributed to the therapy since spontaneous functional recovery is not expected in chronic stroke patients.
How well do children in the North East of England function after a mental health crisis during the COVID-19 pandemic: A service evaluation
Authors: Staite Emily , Howey Lynne , Anderson Clare
Published: August 2021

The COVID-19 pandemic has affected millions of people, and some researchers postulate that a mental health crisis will follow. The immediate effects of the COVID-19 pandemic on children’s mental health are now starting to be published, and results appear to be mixed. There is no research, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from Child and Adolescent Mental Health Services (CAMHS) Crisis Teams in the UK during the COVID-19 pandemic. This service evaluation aims to do this using data from an NHS trust that supports 1.4 million people in the North East of England. We compared functioning, as measured by the Outcome Rating Scale (ORS), before and after treatment for young people discharged from the CAMHS Crisis Team between December 2019 and December 2020. ORS scores were significantly higher at the end of treatment (t(420) = −57.36, p < 0.001) with a large effect size (d = −1.56). Fifty eight percent of patients exhibited significant and reliable change (i.e. functioning improved to a ‘healthy’ level). No patients significantly deteriorated in functioning after accessing the crisis service.
Acceptability and feasibility of the World Health Organization’s Caregiver Skills Training implemented in the Italian National Health System
Authors: Salomone Erica , Ferrante Camilla , Salandin Arianna , Ferrara Federica , Torchio Elisabetta , Foletti Giulia , Ghersi Sabrina ,   CST Italy Team,   WHO CST Team, Pacione Laura , Servili Chiara
Published: August 2021

The Caregiver Skills Training programme is an evidence-informed group intervention developed by the World Health Organization to counter the treatment gap for neurodevelopmental disorders in children. We examined feasibility and acceptability of Caregiver Skills Training in public child neuropsychiatry services in Italy. Following a formative adaptation process and a pre-pilot implementation, the programme was piloted in six centres. Caregivers of children (2–5 years) with autism spectrum disorder were randomised to either Caregiver Skills Training ( n = 43) or treatment as usual ( n = 43). Professionals’ and caregivers’ experiences in the treatment arm were examined with focus groups and questionnaires. The programme was largely considered acceptable, relevant and feasible. Specific implementation challenges and suggestions for optimising the package are discussed.

Lay abstract

Across the globe, children with neurodevelopmental disorders, including autism, have limited access to care through public services. To improve access to care the World Health Organization developed a novel, open-access programme: the Caregiver Skills Training programme. The Caregiver Skills Training consists of nine group sessions and three individual home visits, focused on training the caregiver on how to use everyday play and home routines as opportunities for learning and development. We implemented Caregiver Skills Training in public child neuropsychiatry services in Italy and examined with questionnaires and focus groups how feasible it was to deliver the programme in public health settings and how acceptable and relevant it was for caregiver users. We found that the Caregiver Skills Training was largely considered acceptable and relevant for families and feasible to deliver. We discuss potential solutions to address the specific implementation challenges that were identified, such as strategies to improve training of interventionists and overcome barriers to caregiver participation.
A guilty pleasure: The legal, social scientific and feminist verdict against rap
Authors: Khan Ummni
Published: August 2021

This article draws on governance theory, critical theory and cultural criminology to interrogate how legal, social scientific and feminist discourses converge to construct rap music as a pressing social problem. While each discourse has its own preoccupations, ideologies and internal contestation, the overarching message is that rap music is a potential source of danger that conveys anti-social attitudes. Suspicion is sometimes also cast on musicians themselves. While I compare three overlapping fields, the ultimate purpose is to problematize the supposedly progressive approach to interpreting and mobilizing against songs deemed harmful. Significantly, I argue that much of the social science scholarship and feminist activism that addresses hip hop music perpetuates anti-Black stereotypes and dovetails with repressive state apparatuses. Among other things, social science and feminist criticism of rap hermeneutically support the use of rap lyrics as evidence of criminality—a distinctly non-progressive, racialized legal practice.
Students as co-researchers in a school self-evaluation process
Authors: O’Brien Shivaun , McNamara Gerry , O’Hara Joe , Brown Martin , Skerritt Craig
Published: August 2021

School self-evaluation (SSE) or data-based decision making is now a common feature of mainstream education in an increasing number of jurisdictions. The participation of stakeholders including students, is promoted internationally as a key feature of effective SSE. Despite this, very little research has been carried out on how education systems might involve students in SSE and even less research has explored how student involvement can move beyond mere tokenism. Similar to many other jurisdictions, Irish schools are encouraged to include students in SSE. However, the research to date would indicate that while students are frequently consulted through the use of surveys they have little or no involvement in decisions that are made as part of the SSE process at a whole school level. This case study explores an atypical approach to student engagement in SSE which was tested in one Irish post-primary school where students participated as co-researchers along with their teachers in the SSE process. In doing so, student participation in SSE shifted from student as data sources to students as co-researchers. Students became members of the SSE Team, responsible for consulting with the wider staff team, student body and parents. They were actively involved in the completion of a whole school self-evaluation report on assessment and the development of a school improvement plan. The study outlines the key stages of the project and how student participation evolved through the process. Interviews conducted with both the teacher and student members of the SSE Team illuminates the experience of the students and staff on the SSE team. The findings indicate that this approach resulted in significant positive outcomes for the school and the individuals involved, but there were also a number of challenges. Student involvement resulted in greater awareness among, and participation of the wider staff team in the SSE process. However, it required more resources and time than is usually the case for an SSE process in Irish schools. The research suggests that this level of participation by students may require a more systematic and sustained engagement of students in decision making at a classroom level in order to build capacity of students to contribute to decision making at a whole school level on an ongoing basis. This study may have an application in jurisdictions aiming to include students in SSE, particularly at a higher level, and it also provides a glimpse into the deliberate planning and structures required if schools are to move beyond an instrumentalist, compliance model of ‘student voice’ towards a more authentic model of inclusive democracy.