bluuebunny/crossref_metadata_2025 huggingface dataset:
Deficits Pro forma and Substantive: Multilevel Policy Implementation in China’s Administrative Approval Intermediaries Reform
Authors: Zhang Nandiyang , Rosenbloom David H. , Dong Changgui
Published: April 2021

Policy implementation deficits tend to emerge and expand as implementation moves downward through multilevel administration. This article uses China as an example and examines its policy implementation at both its provincial and prefectural levels under the administrative intermediaries reform policy. By analyzing data from 225 prefectures in China and their component provinces, we identify two types of implementation deficits: deficits pro forma and substantive deficits. We highlight three factors mitigating both types of deficits and their exacerbation from the provincial level to the prefectural level: self-imposed requirements, top-down pressure, and demonstration effects from upper levels. We find that while self-imposed requirements have no binding effect, rigid executive directives from upper levels have the strongest effect on deficits mitigation while demonstration effects also play an important role in deficit reduction. Our research contributes to the implementation literature by distinguishing between pro forma and substantive deficits and by focusing on the middle layer of government as well as the phenomenon of deficit exacerbation across layers.
Evaluation of left ventricular systolic synchrony by peak strain dispersion in patients with rheumatoid arthritis
Authors: Ji Xiang , Zhang Xia , Feng Huijun
Published: April 2021

Objective

To investigate the clinical value of the peak strain dispersion (PSD) in evaluating left ventricular (LV) systolic synchrony in patients with rheumatoid arthritis (RA).

Methods

One hundred eleven patients with RA were divided into two groups according to their disease duration: <5 years (Group I, n = 60) and ≥5 years (Group II, n = 51). The control group comprised 57 healthy subjects without RA. All three groups were examined by transthoracic two-dimensional echocardiography. Traditional parameters were measured by conventional echocardiography. Two-dimensional speckle tracking imaging was used to analyze the PSD and LV global longitudinal strain (LVGLS). Related ultrasound and blood test results were analyzed and compared.

Results

The PSD gradually increased in the order of the control group, Group I, and Group II, and the difference among the groups was statistically significant. The LVGLS gradually decreased in the order of the control group, Group I, and Group II, and the difference among the groups was statistically significant. The PSD was negatively correlated with the LVGLS.

Conclusions

LV systolic synchrony in patients with RA gradually decreases as the disease course progresses. The PSD can be used as a new reliable index to evaluate LV systolic synchrony.
Intimate Partner Stalking/Pursuit: A Pathophysiology of Attachment Style
Authors: Creamer Catherine J. , Hand Christopher J.
Published: April 2021

Approximately half of stalking victims were previously in an intimate relationship with the perpetrator, and attachment style is strongly correlated with intimate partner stalking (IPS). In the first study to investigate polyvagal theory in IPS, we examined 58 adult participants’ attachment style, sex, history of IPS, vagal tone activity (i.e., heart rate variability; HRV), and cognitive processing disruptions (i.e., Stroop performance) in either participants who wished a relationship or in those who wished to maintain a relationship post-break-up. Results showed that males were more likely to perpetrate IPS than females. Anxious-style participants were more likely to have perpetrated IPS, showed greater cognitive disruption and HRV than avoidant-style participants. Our results support theories that attachment is a biological imperative with neurobiological implications that can be indexed physiologically and cognitively. This study is the first to demonstrate a pathophysiology of attachment style to IPS, in a replicable way. IPS is discussed as reflective of disordered arousal and related to anxiety. Recommendations for further research and clinically-relevant interventions are presented.
Factors Affecting the Availability of Abortion Providers
Authors: Medoff Marshall H.
Published: April 2021

This study, using state data, empirically examines the factors affecting the availability of abortion providers over the period 1992–2011. The empirical results found that the labor force participation of women and the percentage of women of reproductive age in the 18–24 age group were positively associated with the number of abortion providers in a state. The level of antiabortion activities and antiabortion attitudes were negatively associated with the number of abortion providers in a state. Also, a state’s abortion rate was positively associated with the number of abortion providers. The enforcement of a parental involvement law by a state significantly deters physicians or organizations from becoming or remaining abortion providers.

JEL Classifications: I11, I18, K32, K38
Prediction of drilled hole quality in bidirectional woven carbon fiber reinforced plastic using wavelet packets of force–torque signals
Authors: Barik Tarakeswar , Pal Kamal
Published: April 2021

Drilling of fibrous composites like carbon fiber reinforced plastics (CFRPs) is always considered a grim job to perform owing to its abrasiveness and inhomogeneous properties. Compared to the available studies, the present work addresses the parametric investigation on drilling capability of TiAlN- and TiN-coated drills over the uncoated one. The delamination factor, surface roughness, and circularity error in CFRP were considered as the quality features. The acquired thrust and torque were analyzed in the time domain as well as the time–frequency wavelet field, followed by a sensitivity analysis between decomposed original force–torque signals in different phases. Finally, an attempt was made to improve the predictability of drilled hole quality using decomposed wavelets of force and torque extended to hybrid force–torque wavelets of the best features to the developed regression models. The feed rate was more predominant than spindle speed on delamination evidenced by higher axial thrust particularly using coated tools. However, the coated drills generated more uniform torque than the uncoated drills and improved the drilled hole quality as well. The torque wavelet was a better indicator of hole surface integrity than force wavelets in which intermediate frequency band torque and low-/high-frequency band force wavelets were found to be more significant.
Abbreviated Assessment Tool of Learned Helplessness and Mastery Orientation: The Student Behavior Checklist—Brief
Authors: Rueger Sandra Y. , Cipra Alli , Choe Hyungjoon , Steggerda Jake C. , Kirby Andrea E. , Stone Lauren B.
Published: April 2021

Measurement limitations have hindered research on learned helplessness (LH) and mastery orientation (MO) in the classroom. We reduced the 24-item Student Behavior Checklist to a 6-item scale and tested the abbreviated measure for evidence of reliability and validity in a sample of 5th and 6th graders ( N = 299). We then replicated findings in an independent sample of middle school students ( N = 116). Results demonstrated strong support for construct validity of the Student Behavior Checklist-Brief (SBC-B), including a hierarchical two-factor structure indicating the distinctness of LH and MO and an overarching construct, which we refer to as learning approach. Results also demonstrated consistent evidence supporting criterion and convergent/discriminant validity, internal consistency reliability, and temporal stability. The SBC-B offers a psychometrically sound teacher-report measure of LH and MO.
Listening to the “HITS:” Screening for IPV in African American Co-Parents of Young Children
Authors: Bounds Dawn , Boakye-Donkor Aretha , Sumo Jen’nea , Schoeny Michael , Julion Wrenetha
Published: April 2021

Relationships among African American (AA) parents living apart can be contentious. A common assumption is that men are the perpetrators and women are the victims of violence. Research examining the symmetry of intimate partner violence (IPV) has not focused enough on AA parents who are co-parenting their young children while living apart. The purpose of this study is to explore reports of IPV among non-cohabiting AA co-parents of 2-6-year-old children enrolled in the Dedicated African American Dad Study (DAADS). Our objectives for this study are to characterize the nature of intimate partner relationships among non-co-residing co-parents by exploring the association between the quality of relationship and co-parenting fathers’ and mothers’ Hurt, Insult, Threaten, and Scream (HITS) scores. The HITS is a domestic violence screening tool for use in the community. As part of the screening protocol for study inclusion, we administered the HITS to father-mother dyads. Fathers were ineligible for participation if either parent reported HITS cut-off scores >10 and identified safety concerns for themselves when interacting with their co-parent. Among DAAD study parenting dyads, we noted symmetry in reports of IPV (i.e., both parents reported elevated HITS scores). The most frequently elevated HITS items were “insult or talk down to” and “scream or curse” indicating the preponderance of verbal conflict among parents in the study. The nature of IPV among co-parents in this study is predominantly verbal. In light of the potential for reciprocity in IPV, interventions for families in this context should focus on communication and problem solving to support fathers and mothers and minimize child harm.
Does Education Mitigate the Effect of Population Aging on Health Expenditure? A Panel Data Study of Latin American Countries
Authors: Borrescio-Higa Florencia , Valenzuela Patricio
Published: April 2021

Objective: To examine whether the effect of population aging on healthcare expenditures as a share of Gross Domestic Product (GDP) is attenuated in more educated countries. Method: The analysis is based on a dataset of 22 Latin American countries between 1995 and 2013. We estimate panel data models with country and time fixed effects, and control for potential nonlinear effects of population aging on health expenditure. Results: We find population aging increases health expenditure as a share of GDP in economies characterized by low levels of education, but this effect is mitigated in economies with higher levels of education. Results are driven by private health expenditures. Discussion: Results suggest population aging and education have a stronger influence on healthcare expenditures in less developed countries. This finding is important in a context in which the rapid growth of the aging population is likely to lead to significant costs in terms of health expenditures, but less so in more educated societies.
Investigations on machining characteristics and chip morphology in turning Al-Mn (AM) alloy using finite element simulation
Authors: Dutta Sunil , Narala Suresh Kumar Reddy
Published: April 2021

Finite element analysis has become an indispensable tool, often used in research and development, to provide valuable insights into the process. The studies in the metal cutting area mostly employ the Finite element method (FEM) due to its ability to highlight the physics involved in chip formation and the range of force generated in the cutting zone. The study involves investigations by adopting the Johnson-Cook (JC) constitutive model with energy-based damage criteria to simulate the turning of a fabricated AM (Mg alloy: 7 wt%Al-0.9 wt%Mn) alloy. For the FEM, the JC and Damage model constants are calculated using inverse identification methodology. The results obtained on the cutting force (Fc), cutting temperature (Tc), and chip-thickness (tc) at different combinations of turning parameters were analyzed and compared with the experimental values. The Predicted data was in line with the experimental data, and a variation of mostly less than 12% was observed. Thus, establishing the efficacy of inverse identification method. Further, the obtained results exhibit the significant influence of turning parameters on Fc(N), Tc(°C), and tc(mm) and enunciates crucial facts related to the AM alloy's machinability.
Optimization design of rockoons based on improved sequential approximation optimization
Authors: Li Jiaxin , Peng Ke , Wang Wenjie , Wu Zeping , Zhang Weihua
Published: April 2021

In this study, a multidisciplinary design optimization framework and detailed procedure based on improved sequential approximation optimization (SAO) and 3-degree-of-freedom trajectory simulation are proposed for conceptual design and parameters optimization of a rockoon (from rocket and balloon) system. A reliable and efficient strategy, which considers the approximation accuracy of the response surfaces in the sampling process, is proposed to reduce the evaluation times of the original model for finding the global optimal solution. Besides, a modified SAO algorithm based on the multistage adaptive sampling strategy is presented, and the obtained tested results verify the fine robustness, high efficiency, reliability, and validity of the proposed SAO algorithm. The objective is to minimize the liftoff gross mass of the launch vehicle which reflects the cost for satellite launching. Constraints are imposed to ensure the orbit injection accuracy and stability of the launch vehicle. Finally, based on the multidisciplinary design framework with modified SAO, the optimal design results in 12 design cases from various payload mass, objective orbit, and ignition altitude are discussed and compared with the generic launch vehicle.
The Development of the Liking Gap: Children Older Than 5 Years Think That Partners Evaluate Them Less Positively Than They Evaluate Their Partners
Authors: Wolf Wouter , Nafe Amanda , Tomasello Michael
Published: April 2021

After two strangers have briefly interacted with one another, both believe that they like their partner more than their partner likes them. A plausible explanation for this liking gap is that people are constantly worrying about how others are evaluating them. If so, one would expect the liking gap to emerge in young children as they become more concerned with their reputations and the impression they make on other people. The current study ( N = 241 U.S. children; age range = 4–11 years) supported this hypothesis, showing a liking gap beginning when children were 5 years old, the age at which they first become concerned with other people’s evaluations of them. Moreover, the liking gap became more pronounced as children got older. These findings provide the first developmental description of the liking gap and support the hypothesis that this phenomenon is related to individuals’ concerns for how others evaluate them.
Saving private W. H.: The surgical experiences of Dugald Blair Brown (1847–1896): Lieutenant-Colonel, FRCS, Edin., AMD
Authors: DePaolo Charles
Published: April 2021

Dugald Blair Brown, a military surgeon and Fellow of the Royal College of Surgeons, Edinburgh, published twelve papers containing 77 case studies of gunshot wounds that he had treated in the Anglo-Zulu War of 1879 and in the First Anglo-Boer War of 1880–1881. Brown devised a “conservative” method of surgery, the early development of which had been influenced by Thomas Longmore (1816–1895), Joseph Lister (1827–1912), F. J. von Esmarch (1823–1912), and Carl von Reyher (1846–1890). During these conflicts, Brown reacted to surgical practices unsuited to the battlefield and not in the interest of the wounded. One such practice was “expectant” surgery, the practitioners of which dangerously substituted natural healing for immediate wound resection. Brown also criticized “operative” surgeons who, when faced with gunshot wounds of the extremities, expeditiously amputated limbs. Viewing each case as diagnostically unique, Brown tried to salvage limbs, to preserve function, and to accelerate recovery. To achieve these objectives, he used debridement, antisepsis, drainage, nutrition, and limited post-operative intervention.
Sleep Disorders in Individuals With High Risk for Diabetes in Indian Population
Authors: Maity Kalyan , Nagarathna Raghuram , Anand Akshay , Patil Suchitra S. , Singh Amit , Rajesh SK , Ramesh Latha , Sridhar P , Thakur Uttam Kumar , Nagendra Hongasandra R
Published: April 2021

Background:

Sleep restores physiology and neurochemical components of our body and is essential for physical and mental health. Sleep disorders (SDs) are associated with insulin resistance and metabolic disorders. The association between SDs and diabetes needs to be understood in the Indian population.

Purpose:

The purpose was to investigate the association between SD and diabetes in the Indian population.

Methods:

As a part of nationwide Niyantrita Madhumeha Bharata Abhiyaan-2017 (NMB-2017), a cross-sectional study was conducted and data was collected from seven zones of India, after screening through the Indian Diabetes Risk Score (IDRS). The sleep quality was assessed on a scale of 1 to 4 (very good = 1, very bad = 4). The time taken to fall asleep (sleep latency) was assessed on a scale of 0 to 5 (“0” = nil and “5” = >1.5 h). Stress was assessed by the perceived stress scale.

Results:

Bad sleep quality was positively (odds ratio 1.055, CI [1.001, 1.113], and P < .01) associated with self-reported known diabetes. Increased time taken to fall in sleep (sleep latency) was associated significantly with IDRS high risk (odds ratio 1.085, CI [1.008, 1.168], and P = .01), with an average sleep latency /time takes to fall in sleep (maximum range 5 [>1.5 h], mode 2 [10 to 30 min]) minutes. Moderate stress was significantly associated with bad sleep quality (odds ratio 1.659).

Conclusion:

A positive association of bad sleep quality and stress with diabetes, and an increased sleep latency in the IDRS high-risk population point to the role of modifiable risk factors. Behavioral modification and stress reduction by using yoga may be beneficial in the better management of diabetes.
Quality of Drinking Water and Sanitation in India
Authors: Aneesh M.R.
Published: April 2021

Wide disparity exists in access to drinking water across social groups in rural and urban India. This article shows that the economically weaker sections or the lower quintile class does not have access to water within the premises both in rural and urban areas. This indicates that low income or wealth would mean poor access to basic amenities for households. Similarly, access to toilets and incidence of open defaecation reflect social disparities. The regression results show that an increase in the household income increases the predicted probability of maintaining an exclusive latrine. Further, compared to the ‘General Category’, the ‘Scheduled Castes’ and ‘Other Backward Classes’ have a lower probability of constructing an exclusive latrine facility, in the rural and urban areas.
Public Financing of Human Development in India: A Review
Authors: Mukherjee Sacchidananda , Badola Shivani
Published: April 2021

Role of public financing of human development (HD) is inevitable, especially for developing countries like India where access to resources and economic opportunities are not equitably distributed among people. Governments aim to achieve equity in distribution of resources through allocative and redistributive policies whereas macroeconomic stabilisation policies aim to achieve higher economic growth and stability in the price level. Expenditure policies of the governments envisage in delivering larger public goods and services to enable people to take part in economic activities by investing in human capital and infrastructure developments. Progressivity of the tax system helps in achieving equity by redistribution of resources among people. Being merit goods, expenditures on education, health, and poverty eradication make it a case for public investment which empowers people to improve human capital. The benefit of universal economic participation is expected to contribute in larger mobilisation of public resources over time. Lack of economic opportunities and earning a respectable income may increase dependence on public transfers which may reduce fiscal space of the governments to finance programmes to promote overall economic growth. The objective of this article is to review existing studies on public financing of HD in India and highlight emerging challenges.
MGNREGA Implementation in Tamil Nadu: Voices from the fields
Authors: Natesan Sarabjeet D. , Marathe Rahul R.
Published: April 2021

This article examines the implementation of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) in two districts of Tamil Nadu—Panchetti and Salem. It describes the functioning of the Act based on a preliminary field study and documents the views of implementers and beneficiaries. This analysis reiterates that the implementation should drive policy and that the evaluation lessons need to filter back to the design of the policy. More specifically, MGNREGA requirements can be improved on two counts: one, wage determination and wage rates; and two, evolving better techniques to measure labour productivity.
Confronting the Complexities of “Co-Production” in Participatory Health Research: A Critical, Reflexive Approach to Power Dynamics in a Collaborative Project on Parkinson’s Dance
Authors: Phillips Louise , Frølunde Lisbeth , Christensen-Strynø Maria Bee
Published: April 2021

The literature on participatory health research describes various ways of overcoming obstacles to the co-production of knowledge by redressing power imbalances. In this article, we propose an approach to understanding and analyzing co-production which conceptualizes power, not as an obstacle but as an intrinsic, productive force in bringing “co-production” into being. In the approach, “co-production” is understood and analyzed as a tensional, complex, unstable entity that emerges in power-imbued negotiations of meanings throughout the research process. Focusing on a participatory project on Parkinson’s dance, our purpose is to illustrate how the approach can generate knowledge about the complexities of “co-production.” We also demonstrate how the approach can provide a foundation for a relational ethics that confronts the complexities head-on. In conclusion, we discuss the insights gained into the possibilities and challenges of co-production and the value of the approach as a foundation for relational ethics.
The Mediating Role of Self-Efficacy in the Association Between Diabetes Education and Support and Self-Care Management
Authors: Juarez Lucía D. , Presley Caroline A. , Howell Carrie R. , Agne April A. , Cherrington Andrea L.
Published: April 2021

Diabetes self-management education and support enhance self-efficacy and promote self-management behaviors essential for diabetes management. We investigated the mediating effect of self-efficacy on the association between diabetes education or care coordination and self-care activities. We surveyed a population-based sample of adults with type 2 diabetes (19–64 years of age) covered by Alabama Medicaid. We examined whether receipt of diabetes education or care coordination were associated with improvements in diabetes self-care activities. We then examined if improvements were mediated by self-efficacy. Models were adjusted for age, gender, race, education, insulin use, diabetes duration, and depressive symptoms.

Results

A total of 1,318 participants were included in the study (mean age = 52.9 years, SD = 9.6; 72.5% female, 56.4% Black, 3.1% Hispanic). Diabetes education was associated with increases in self-care activity scores related to general diet, physical activity, glucose self-monitoring, and foot care; care coordination was associated with glucose self-monitoring. In addition, mediation analysis models confirmed that improvements in self-efficacy led to improved self-care activities scores, mediating the association of diabetes education and self-care activities.

Conclusions

Diabetes education and self-efficacy were associated with better self-care. Receiving diabetes education led to a higher likelihood of engaging in self-care activities, driven in part by increases in self-efficacy. Future interventions that aim to improve diabetes self-management behaviors can benefit from targeting self-efficacy constructs and from the integration of diabetes education in the care coordination structure.
Understanding Educators’ Implementation of an Equity-Focused PBIS Intervention: A Qualitative Study of Critical Incidents
Authors: Bastable Eoin , Falcon Sarah Fairbanks , McDaniel Sara C. , McIntosh Kent , Santiago-Rosario Maria Reina
Published: April 2021

With the emergence of interventions shown to reduce school discipline disparities, it is important to explore what variables influence educators to implement these approaches. In-depth interviews were conducted with a purposeful sample of 21 educators asked to describe their experiences implementing an equity-focused Positive Behavioral Interventions and Supports (PBIS) intervention. A qualitative method called the Enhanced Critical Incident Technique was used to generate 22 representative categories from 241 observable incidents reported. Findings included 14 helping categories, four hindering categories, and four categories describing what could have made implementing the intervention easier. Implications for enhancing educators’ use of equity-focused disciplinary approaches are discussed along with current research, theory, and consultation models.
Arteritic anterior ischaemic optic neuropathy: An update
Authors: Bajpai Vidhi , Madan Siddharth , Beri Sarita
Published: April 2021

Ischaemic optic neuropathy (ION) is a major cause of blindness. The clinical approach and management is a matter of debate for the treating neurologist and the ophthalmologist. Of the two broad varieties namely the posterior (PION) and anterior ischaemic optic neuropathy (AION), the arteritic variety of the AION (AAION) is usually due to giant cell arteritis. Giant cell arteritis may only present with visual loss in up to 25% of cases. AAION is a neuro-ophthalmic emergency. Early recognition and differentiation from AAION is imperative in order to prevent further devastating visual loss. A literature search was conducted on pubmed using key words as AAION, arteritic anterior ischaemic optic neuropathy, giant cell arteritis (GCA) and articles from the year 2000 till date were included. In any case very few reviews are available on AAION. The literature search on pubmed provided holistic overview about this clinical significant entity and the same is compiled in this review. Moreover the histopathologic features of a temporal artery biopsy have been described with its microscopic images. In any case reviews are mostly available on the Non arteritic variety of AION. This review recapitulates the diagnostic and management protocol of a patient presenting with AAION.
Ahmed glaucoma valve in vitrectomized eyes: An implantation technique to minimize early postoperative fluid-loss hypotony
Authors: Arpa Paolo , Arpa Cristina
Published: April 2021

Purpose:

To describe the application of a modified Ahmed glaucoma valve (AGV) surgical implantation technique in vitrectomized eyes, in order to minimize the risk of early postoperative hypotony, which leads to hemorrhagic complications.

Materials and methods:

Data of patients implanted with AGV using the surgical technique described were retrospectively reviewed. Inclusion criterion: glaucomatous eyes with previous history of pars plana vitrectomy. Intraocular pressure (IOP) measurement and ophthalmic examination were performed preoperatively and postoperatively weekly for 1 month for the detection of early hypotony, choroidal effusion/detachment, intraocular hemorrhage. The surgical technique consisted in creating a 5 mm long scleral tunnel with a 23 G needle reaching the anterior chamber at the iridocorneal angle, in which the Ahmed glaucoma valve tube was inserted.

Results:

Ten eyes of 10 patients were included. Median preoperative IOP was 30.5 mmHg [interquartile range (IQR) 28.3–33.0]; median postoperative IOP was 12.0 mmHg (IQR 9.3–13.0) at 1 week, and 12.5 mmHg (IQR 11.0–15.0) at 1 month. In no cases postoperative IOP was <8 mmHg. On the first postoperative day, five (50%) eyes showed few blood clots in the anterior chamber. On the second-week appointment, moderate choroidal effusion was observed in two eyes (20%). No hemorrhagic complications were observed.

Conclusions:

The creation of a long intrascleral tunnel with a 23 G needle for AGV implantation in vitrectomized eyes could be effective in decreasing leakage through the space between the valve tube and the sclerocorneal tissue. This technique is safe, easy to perform, feasible and fast. Due to its advantages and good postoperative results, it could also be adopted in non-vitrectomized eyes.
Ultrasound-guided percutaneous right brachiocephalic vein cannulation in a 5-year-old patient with bilaterally occluded internal jugular veins due to previous access by venous cut-down: A case report
Authors: Uzumcugil Filiz
Published: April 2021

The open surgical venous cut-down technique is widely performed in cases of long-term treatment including administration of chemotherapy, parenteral nutrition, or replacement therapies. However, it has been recommended to avoid this technique considering the resultant unpredictable alterations in the veins draining the relevant site, especially in patients who may need central venous cannulation (CVC) during disease progression. We aimed to report on CVC in a 5-year-old child who had previously undergone bilateral internal jugular venous access by the open venous cut-down technique, in order to highlight the importance of performing the Rapid Central Vein Assessment protocol prior to any intervention and considering to abandon the use of the open surgical venous cut-down technique by gaining experience with ultrasound-guided percutaneous techniques.
A practitioner study on the implementation of strategy instruction for boredom regulation
Authors: Nakamura Sachiko , Darasawang Pornapit , Reinders Hayo
Published: April 2021

This article recounts my experience in enhancing my students’ boredom regulation by designing, implementing, and evaluating a strategy instruction project. The project was undertaken with 25 Thai university students enrolled in my English oral communication course for 15 weeks. The project began with exploring how and why my students experienced boredom in my classroom and their habitual boredom coping strategies while examining and modifying the initial design of my strategy instruction. Between weeks 8 and 12, I implemented five boredom regulation strategy sessions by using reappraisals and boredom coping as key components. Students engaged in guided practice, developed their own boredom regulation strategy toolkit, shared their ideas with peers, and reflected on their strategy use. Triangulating data from whole-class surveys, focus group interviews, and the toolkits, I illustrate the positive impact of the project shown on my students’ boredom regulation and on my teacher-researcher development, despite the challenges associated with the complex nature of boredom regulation in an authentic instructional setting. This study sheds light on the ways that students and their teacher can work together to cope with boredom in second language (L2) classroom learning.
Living like a hetero: Southern homonormativity in Istanbul
Authors: Ozbay Cenk
Published: April 2021

Research on homonormativity in the Global North has burgeoned in the last 20 years as there have been developments to include sexual minorities as equal members of society. However, little is known about the emergent forms of homonormativity in the Global South where in most cases the improvements in terms of sexual rights and citizenship in the Global North did not echo. Despite the lack of the legal, economic, and cultural infrastructure, an inchoate Southern homonormativity unfolds among gay men through their gender performances, bodily presentations, class positions, and neoliberal aspirations. Southern homonormativity is a cultural formation that takes place in settings where there is no institutional change and legal reforms to define, recognize, and embrace the gay citizens (and families) as equal, legitimate, and respected members of society. By using interviews and ethnographic home visits in Istanbul, Turkey, this article explores how homonormativity is contextually driven and flexible, and how privileged gay men understand and navigate homonormative precepts in a context within the Global South.
An evaluation of an electronic audit and feedback system for patient safety in a tertiary hospital setting: A study protocol
Authors: Soresi James , Murray Kevin , Marshall Theresa , Preen David B
Published: April 2021

An electronic audit and feedback (e-A&F) system was developed to support healthcare providers’ awareness of their own performance, improve delivery of care and ultimately the safety of patients while in hospital. The point-of-care e-A&F system provides healthcare providers, from a 600-bed tertiary hospital in Western Australia, with near real-time feedback via web-based dashboards. The aim of this evaluation is to determine the implications of e-A&F across multiple dimensions and domains of care in a tertiary hospital setting. The study also aims to address the paucity in the literature by validating hypothesised design and implementation mechanisms on its effectiveness. Key datasets to be examined include those related to patient outcomes, staff behaviour and costs. Quantitative methods, such as interrupted time series analysis and multiple logistic regression analysis, amongst other methods, will be employed to achieve these aims.
Collective memories on the 2010 European debt crisis
Authors: Arnemann Laura , Konrad Kai A , Potrafke Niklas
Published: April 2021

We examine whether collective memories on the aid and reform programs chosen to handle the 2010 European debt crisis differ between citizens from borrower and lender countries. We use new international survey data for non-experts and experts in member countries of the euro area. The results show that non-experts from borrower and lender countries remember aspects of the programs in different manners; indicating biases for assessments of how the crisis outcomes are perceived in borrower and lender countries. Nation-serving biases may well explain that the 2010 European debt crisis has reduced the sense of belonging rather than bringing European citizens closer together.
Evolution of a sundown town and racial caste system: Norman, Oklahoma from 1889 to 1967
Authors: Givel Michael S
Published: April 2021

Sundown regions were post-Reconstruction localities that deliberately excluded African Americans, often well into the 20th century. While former states of the Confederacy instituted state-wide racial caste systems denying African Americans basic political and economic privileges and opportunities, what of localities outside the Deep South? This case study concludes that Norman, Oklahoma, located outside of the Deep South, was a sundown town from 1889 to 1967 or for 78 years. Sundown implementation practices resulting in ongoing racial cleansing and exclusion include a variety of extra-legal actions including violent racial expulsion in the beginning; Ku Klux Klan terror in the 1920s; ongoing freeze-out of local services such as hotel services; denial of home ownership; denial of employment; curtailment of political rights including voting and freedom of movement; an ominous reputation as a sundown town; continuing violence; and threats. The widespread act of systematically excluding African Americans after dark from Norman, in tandem with state legislation that outlawed interracial marriage and intimate relationships until 1967 and maintaining all white public colleges until 1948, contributed to a racial caste system based on unequal opportunities and privileges afforded to whites. Sundown practices were not only ongoing geographic and racist Jim Crow segregation issues as is sometimes stated, but also, a key approach to enforce a rigid racial caste system in the midst of a society with democratic ideals.
From visual rhetoric to multimodal argumentation: exploring the rhetorical and argumentative relevance of multimodal figures on the covers of The Economist
Authors: Tseronis Assimakis
Published: April 2021

Visual rhetoric is more often than not identified with the search for patterns of visual form and content which convey meaning in ways that resemble the meaning construed by known rhetorical figures. Despite the numerous proposals for the classification of figures construed verbally or visually, there has been no systematic attempt to account for the different ways in which these may contribute to the argumentative structure of persuasive messages. In this article, the author studies comparatively the figures of metaphor, antithesis and allusion, cued visually or verbo–visually in the multimodal genre of front covers. He starts from the assumption that the front cover constitutes a multimodal argument in the sense that it invites the reader to buy the specific issue on the grounds of the featured story and the stance that the editors express over it. The goal is to identify the semiotic configurations that distinguish one figure from the other, and to establish conditions under which these figures can be shown to contribute meaning that serves the argument conveyed by the front cover.
Racial/Ethnic Inequities in Adverse Childhood Experiences and Selected Health-Related Behaviors and Problems Among Maryland Adolescents
Authors: Johnson Renee M. , Hill Ashley V. , Jones Vanya C. , Powell Terrinieka W. , Dean Lorraine T. , Gilreath Tamika D.
Published: April 2021

We examined racial/ethnic inequities in the prevalence of adverse childhood experiences (ACEs) and examined the association between ACEs and selected health-related behaviors and problems. Data for this cross-sectional study come from the 2018 Maryland Youth Risk Behavior Survey/Youth Tobacco Survey, a statewide survey of high school students (n = 40,188). ACEs included caregiver verbal abuse and household food insecurity, substance use or gambling, mental illness, and involvement with the criminal justice system. We estimated the prevalence of ACEs overall and by race/ethnicity, and then used multiple logistic regression to determine associations between ACEs and emotional/behavioral problems, adjusting for race/ethnicity. Outcome variables included emotional distress, poor school performance, suicidal ideation, fighting, alcohol use, and marijuana use. More than one fifth of students reported each individual ACE. Differences in the prevalence of ACEs by race/ethnicity were statistically significant (p < .001). More than one fourth (25.8%) reported one of the five ACEs, 15.1% reported two, and 15.4% reported three or more. For each ACE, reporting having experienced it (vs. not) was associated with a >30% higher prevalence for each of the outcome variables. Among students who reported three or more ACEs (relative to none), the odds of emotional distress and suicidal ideation were more than 8 times greater. Among Maryland adolescents, ACEs are common, are inequitably distributed by race/ethnicity, and are strongly linked to behavioral health. Findings suggest the need to monitor ACEs as a routine component of adolescent health surveillance and to refocus assessment and intervention toward “upstream” factors that shape adolescent health.
Correlates of Alcohol-Using Network Size Among Men Who Have Sex with Men in San Francisco, CA
Authors: Garcia Alex , Rowe Chris , Turner Caitlin , Santos Glenn-Milo
Published: April 2021

Men who have sex with men (MSM) have a high prevalence of hazardous alcohol consumption. While network-level characteristics such as social network size have been indicated as upstream determinants of alcohol use in general population samples, no studies have examined factors associated with alcohol using network size (ANS), among MSM.

This secondary analysis examined demographic, substance use, and sexual behavior correlates of ANS using data from a diverse sample of alcohol-using MSM in San Francisco ( N = 252). Associations were calculated using multivariable negative binomial regression, adjusting for age, race, education, and employment.

The median ANS was 10. Factors associated with larger ANS in multivariable analyses included identifying as Hispanic/Latino, having completed a college education or higher, having a higher Alcohol Use Disorders Identification Test (AUDIT) score, having a greater number of sexual partners, polysubstance use, and being unaware of one’s own HIV status. Factors associated with smaller ANS included being between 18 and 24 years of age, reporting a low income, and having any lifetime history of injection drug use.

For MSM, ANS was associated with increased likelihood of hazardous alcohol use, as well specific individual-level substance use and sexual risk behaviors. These results highlight the role of ANS in hazardous alcohol consumption and sexually transmitted infection transmission among MSM. These results also indicate ways that research and intervention programs aimed at reducing alcohol use among MSM might be improved through network-based recruitment or engagement. Finally, these results suggest the need for further research on HIV-unknown MSM.
Relationship Between Physical Activity Levels and Psychological Well-Being Among Male University Students in South East, Nigeria: A Cross-Sectional Study
Authors: Ugwueze Fabian Chibunine , Agbaje Olaoluwa Samson , Umoke Prince Christian Ifeanachor , Ozoemena Eyuche Lawretta
Published: April 2021

This study aimed to evaluate the associations between physical activity (PA) and psychological well-being (PWB) among male university students. An institutionally based cross-sectional study was completed by 243 young men aged 18–30 years in a Nigerian public university. PA was measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and PWB was measured by Ryff’s Scale of Psychological Well-being (PWB). The mean age of the participants was 24.9 ( SD = 7.61) and majority (39.1%) of the participants was aged 18–22 years. Regarding PA, 16.0%, 64.2%, and 19.8% of the participants had low, moderate, and high PA levels, respectively. The mean total PWB score was 119.9 ( SD = 23.64). For the domains of PWB, male students had mean scores of 25.73 ( SD = 6.05), 19.42 ( SD = 6.82), 25.75 (6.10), 14.12 ( SD = 3.89), 13.70 ( SD = 4.04) and 21.12 (4.92) for self-acceptance, autonomy, positive relations, environmental mastery, purpose in life and personal growth, respectively. Total PA (total MET min/week) was associated with the total PWB scores ( β = 0.13, p < .05). The total PA METs was significantly associated with self-acceptance ( β = 0.13, p < .05). positive relations ( β = 0.16, p < .05), purpose in life ( β = 0.39, p < .05). Vigorous PA METs showed significantly negative effect on personal growth (β = −0.28, p < .05) and accounted for 2.0% of the variance of personal growth. PA accounted for 2.5% and 1.2% of the variance of positive relations and purpose in life, respectively., Most of the young men had moderate levels of PA and PWB. PA was significantly associated with PWB among the young men. Male sensitive evidence-based health promotion interventions should aim at promoting PA and PWB among male university students.
Effect of CeO2 on crack sensitivity and tribological properties of Ni60A coatings prepared by laser cladding
Authors: Yuling Gong , Meiping Wu , Xiaojin Miao , Chen Cui
Published: April 2021

All the time, the wear resistance of TC4 titanium alloy restricts its application in friction parts. In order to solve this problem, in this work, CeO2/Ni60A composite coatings (0, 1, 2, 3, 4 wt.% CeO2) were prepared on TC4 titanium alloy by laser cladding technology. The detection and characterization of the coatings were mainly carried out by X-ray diffraction (XRD), Scanning electron microscope (SEM), Energy-dispersive spectrometer, Vickers hardness test, and wear test. The results showed that appropriate proportion of CeO2 powder could effectively reduce the crack sensitivity of Ni60A coating on TC4 substrate. While the amount of CeO2 powder was 3wt.%, there were no obvious cracks, pores, and other defects in the coating. Coatings mainly consisted of Ti2Ni, TiC, TiB2, Ce2O3, and the substrate α–Ti. CeO2 has negligible influence on the composition of the phase, but it significantly increased the absorption rate of the powder to light, promoted the fluidity of the molten pool. Among five coatings, the average hardness of the 3Ce coating was the highest and the highest hardness value could reach 1163.7 HV0.3, which was 3.58 times higher than TC4 substrate, the friction coefficient was 0.307, and the wear rate was 1.11 × 10−5 mm3/N m, which reflected extremely high wear resistance performance. Adding an appropriate amount of CeO2 improved the microstructure of the coating, and realized the fine crystal strengthening of the coating.
The justification of non-obstetric ultrasound referrals: A safe and effective practice
Authors: Smith Shaunna , Parker Trevor , Parker Pamela
Published: April 2021

Introduction

In 2015 the British Medical Ultrasound Society released a referral justification document for rejection of inappropriate ultrasound referrals to help manage increasing demand and ensure correct utilisation of diagnostic imaging tests. In our trust, referrals that were not aligned with the guidance were cancelled and returned to general practitioners, providing reasons for cancellation and advising other diagnostic tests if appropriate. Methodology: In total, 1000 cases cancelled between April and August 2019 were retrospectively audited by a team of clinical specialist sonographers. Interoperator agreement against BMUS justification guidelines and safety of this cancellation process were established. Duplicate imaging referrals, referrals made that should have been placed on management pathways or referrals cancelled by the patient directly were excluded in the safety assessment.

Results

There was strong agreement amongst sonographers regarding cancellations. After exclusions, 389 cases were included for review. The majority (90.5%) required no onward imaging and were therefore deemed cancelled appropriately. There were 37 patients found with pathology on subsequent imaging, two of which were found to have cancer and the remainder with benign pathology.

Conclusions

Overall, we found the cancellation process to be safe and the justification document easy to utilise in practice. This process has ensured a minimal waiting time for ultrasound imaging is maintained and that demand can be managed to meet the available capacity.
Bipedicle strap flaps for reconstruction of longitudinal dorsal finger defects: a review of 42 cases
Authors: Martins Antoine , Artuso Mickael , Marc Claise Jean
Published: April 2021

We report our experience with 42 bipedicle strap flaps in 42 fingers of 37 patients for the reconstruction of long longitudinal dorsal finger defects. Twelve cases were compound lesions with tendon lacerations. All flaps healed without infection, congestion or necrosis. At follow-up, mean total active interphalangeal joint mobility was 150° and 108° in patients without and with tendon lacerations, respectively. The median scores of the short version of the Disability of Arm, Shoulder and Hand questionnaire were 5 and 7, respectively. Patients were able to return to work or to their daily activities after a mean of 6 weeks. The patients were satisfied with the appearance in 34 of the 42 flaps. We conclude that the flap is a useful option for reconstructing dorsal digital lesions. It has a texture similar to the normal dorsal digital skin, and it is easy to perform without needing microsurgery.

Level of evidence: IV