bluuebunny/crossref_metadata_2025 huggingface dataset:
“Sometimes I Do Not Understand Exactly Where the Difficulties Are for My Students”: Language, Literacy, and the New Mainstream in Community Colleges
Authors: Bunch George C. , Schlaman Heather , Lang Nora , Kenner Kylie
Published: June 2020

Objective: To inform efforts to boost college completion and professional preparation for the linguistically diverse New Mainstream, we explored language and literacy demands, and how faculty conceive of those demands, in one allied health program at one community college in California. We also explore the implications for the preparation of community college students in academic and professional preparation programs more generally. Method: We examined program documents and outlines of courses in the allied health program and interviewed eight faculty members teaching these courses. We analyzed data using deductive and inductive codes and drafted a program overview of assignments, associated language and literacy demands, and identifiable genres and metagenres. We also conducted member checks with key faculty members to clarify and deepen our understanding. Results: Despite our efforts to focus on disciplinary dimensions of language and literacy in the allied health program, we found that course outlines and instructors tended instead to emphasize general reading and writing competencies, critical thinking, and problem-solving. Discussing students’ language and literacy challenges, instructors underscored challenges common to English-dominant and language-minority students, including problems with students’ study skills, critical thinking, problem-solving, or time committed to their studies. Contributions: We argue that, although focusing on general academic and life skills is important for the diversity of students served by community colleges, a deeper focus on disciplinary and professional language and literacy practices is warranted by both instructors and institutions to prepare and support the New Mainstream in completing college and succeeding in the workforce.
Exploring Critical Thinking as an Outcome for Students Enrolled in Community Colleges
Authors: Roohr Katrina C. , Burkander Kri
Published: June 2020

Objective: Using data from HEIghten® Critical Thinking, a student learning outcomes assessment, the purpose of this study was to evaluate what variables are associated with higher critical thinking performance for students enrolled in various community college programs and to evaluate performance differences across demographic and college-level subgroups as well as student perceptions. Method: With data from 1,307 students enrolled across 34 U.S. and Canadian higher education institutions (72% enrolled in 2-year institutions), we utilized a hierarchical regression to identify variables associated with critical thinking performance. Critical thinking performance differences were evaluated using analyses of variance (ANOVAs) and t-tests across student demographic and college experience subgroups and across student perceptions. Results: Results of this study showed (a) consistent significant predictors associated with higher critical thinking performance; (b) a positive relationship between critical thinking performance and the frequency of using critical thinking in college courses; (c) significant, but relatively small performance differences across demographic and college experience subgroups; and (d) positive relationships between student perceptions and critical thinking performance. Conclusion: This study added to the limited literature evaluating critical thinking skills for community college students. Overall, results suggest that institutions should focus attention to the frequency at which students are using critical thinking throughout their courses, which could increase student performance in this particular area, especially if critical thinking is an explicit outcome within the course. Results also suggested the need to emphasize critical thinking skills more across various community college programs and across non-STEM-focused programs. Suggestions for future research are discussed.
“It Takes a Lot of Planning”: Sexual Minority Young Adult Perceptions of Gay and Lesbian Parenthood
Authors: Park Nicholas , Schmitz Rachel M. , Slauson-Blevins Kathleen
Published: June 2020

Lesbian and gay parents are becoming more prevalent, visible, and accepted in the United States. Despite these shifts, legal and social obstacles continue to shape pathways to parenthood. For many lesbians and gay men, access to parenthood is difficult, uncertain, and varies geographically. Using focus group interviews, this study explores how 36 Midwestern gay, lesbian, and bisexual young adults without children perceive gay and lesbian parenting and their own parenthood prospects. Themes included perceptions of legal and social barriers to parenthood, assumptions of the mounting economic obstacles and constraints surrounding parenthood, and concerns with navigating legal relatedness when establishing their families. This research provides insight into how emerging adulthood is experienced by sexual minority young adults in a shifting legal and social climate full of uncertainty regarding LGBTQ rights and parenthood. Policy implications and future research are discussed surrounding sexually diverse people’s accessibility in pursuing parenthood.
How Do Mothers’ and Fathers’ Work–Family Conflict Impact Children’s Problem Behaviors?
Authors: Yucel Deniz , Latshaw Beth A.
Published: June 2020

Using 509 mother/father–child dyads drawn from Wave 8 of The German Family Panel (pairfam), this study examines the direct effects of mothers’ and fathers’ work–family conflict (WFC) on children’s internalizing (emotional) and externalizing (conduct) problem behaviors. We also test whether these effects are moderated by several child characteristics and family characteristics. Results suggest that both mothers’ and fathers’ WFC are associated with greater emotional problems, whereas only mothers’ WFC is associated with greater conduct problems. The detrimental effect of fathers’ (mothers’) WFC on emotional problems is stronger for older children and girls (households with a preschool-aged child and boys). While there is no direct effect of fathers’ WFC on conduct problems, results show that the detrimental effect of mothers’ WFC on conduct problems is stronger for boys, as well as in households with more children and those with a preschool-aged child.
Social distancing and inequality in the United States amid COVID-19 outbreak
Authors: Zhai Wei , Liu Mengyang , Peng Zhong-Ren
Published: June 2020

Amid sweeping efforts to get Americans to stay at home to slow the spread of the coronavirus disease, we geovisualized how foot traffic has increased or declined in relation to six types of trips across the United States: homes, workplaces, retail and recreation establishments, parks, grocery stores and pharmacies, and transit stations. The geovisualization shows that most West and East Coast cities have reduced extensive movements while many Middle American cities even increased their movements, such as trips to grocery stores and parks. We further found that the poorest communities reduced fewer movements than the wealthiest communities, except for the trips to parks.
Empowerment or Threat: Perceptions of Childhood Sexual Abuse in the #MeToo Era
Authors: de Roos Melissa S. , Jones Daniel N.
Published: June 2020

The rise of the #MeToo movement has shed light on the prominence of sexual violence, and its victims who often remain silent. Despite increasing awareness, victims or survivors of sexual violence who disclose may be faced with negative reactions such as disbelief or blame. Such reactions extend to child victims of sexual abuse. This study aimed to shed light on gender differences in responses to sexual violence against a backdrop of #MeToo. Through an online survey ( N = 253) on Amazon’s Mechanical Turk, we assessed participants’ exposure to and perception of the #MeToo movement. In addition, we measured proximity to a victim or perpetrator of sexual violence. The effect of these variables on participants’ response to a disclosure of childhood sexual abuse was examined. Results indicated that men are more likely to perceive the movement as threatening than women. Furthermore, a discrepancy in proximity to sexual violence emerged, with women more likely to know a victim and men more likely to know a perpetrator. In response to a disclosure of childhood sexual abuse, men were more likely to respond in a skeptical manner than women. Positive perceptions of the #MeToo movement translated into more supportive responses to a disclosure. Proximity to a victim of sexual violence did not impact how people responded to a disclosure, but proximity to a perpetrator was associated with a more negative response. Although the aim of this movement is to give a voice to victims of sexual violence, it may trigger a defensive response from men, which makes them more skeptical toward disclosures of victimization.
Short-Term Versus Long-Term Effects of the Louisville Enterprise Zone Incentives: A Response to Sumei Zhang
Authors: Lambert Thomas E.
Published: June 2020

Zhang wrote that the Louisville enterprise zone (EZ) was more successful than what previous research showed and that variations in research design have led to conflicting or mixed reviews of many local economic development policies that are based on the EZ concept. She mentions a study and an article on the Louisville, Kentucky EZ and implies the time horizon used to evaluate it was too short. This Forum/Letter to the Editor points out that the Louisville EZ went through multiple transformations and expansions over its history from 1983 to 2003, and as noted in the first of two studies, the original zone showed virtually no progress from 1983 to 1990. Several other unpublished papers pointed out the same results when the original EZ and other parts of the expanded EZ were analyzed up to the last years of the 20th century. Finally, this Forum/Letter to the Editor argues that and provides reasons for the methodology employed by Lambert and Coomes as a superior way of analyzing the Louisville EZ when compared with the methods employed by Zhang. The main reason why Zhang showed success in the EZ is because she mostly evaluates it in its final form in the late 1990s after it had annexed many sections of Jefferson County, which were not as nearly economically disadvantaged as the original Louisville EZ established in 1983.
Modelling the Effects of Creative Advertisements on Consumers: An Empirical Study
Authors: Chavadi Chandan A. , Arul M J , Sirothiya Monika
Published: June 2020

Promoting analysts and experts concur that creativity is one of the fundamental components for success in advertising. In this paper, we examine consumer perceptions and build a comprehensive model of ad (advertising) creativity. We have also enlisted the determinants of creativity and have developed a scale to measure it. Research results demonstrate that divergence and relevance factors significantly influence ad creativity and divergence is the leading factor for creativity. Further, we studied the creativity practices in the sample ds and listed the best combination of creativity dimensions which can influence purchase intentions. Another objective of this research was to examine the effects of ad creativity on consumer processing variables and consumer response variables for the Television ads. Findings indicate that creative ads significantly influence consumer processing and response variables. This study provides rating scales to advertising managers to judge the creativity of ad campaigns or of a proposed ad and furthers our understanding of relationships among the key variables. It reinforces conceptual models that give ad creativity a pivotal role in the advertising world.
Developing Snake Ladder Game Learning Media to Increase Students’ Interest and Learning Outcomes on Social Studies in Elementary School
Authors: Syawaluddin Ahmad , Afriani Rachman Sidrah , Khaerunnisa
Published: June 2020

Background and Objective. One of the challenges that social studies presents to teachers in class is the lack of students’ interest in the material. This study aims to develop snakes and ladders learning media for use in the subject of social studies in elementary school.

Method. The research design used is the Four-D Research and Development (R&D) model by Thiagarajan (Santoso & Albaniah). The criteria used as a reference for the effectiveness of the learning media are students’ participation, interest, and learning outcomes, whereas for the practicality, the criteria are the implementation and teachers’ ability to use the learning media. The research employed descriptive statistics analysis and inductive-deductive flow analysis.

Results. The results show that the snakes and ladders learning media on social studies appear to be valid and practical, and can effectively improve elementary school students’ interest and learning outcomes. The learning media is considered valid based on the experts’ validation with average 4.3 (good). The effectiveness of this learning media meets the criteria: (1) student participation in the learning process is high and (2) student learning outcomes meet the minimum learning mastery standard average at 79.04 of the ideal score of 100 and the completeness test of learning outcomes with the probability value of one sample t-test of 0.00 <0.05. The practicality of the learning media is shown through the observation result of the implementation of the media with an average of 4.4 (good), whereas the results of the student interest questionnaire show that of 25 students (92%) responded that they were happy with the subject matter taught, 80% of students responded that they were happy with the learning.

Conclusion. The snakes and ladders learning media on social studies can enhance students’ interest and learning outcomes in elementary education.
Rapid qualitative and quantitative analyses of anthocyanin composition in berries from the Tibetan Plateau with UPLC-quadruple-Orbitrap MS and their antioxidant activities
Authors: Jia Qiangqiang , Dong Qiuxia , Sang Qingni , Wang Mingfang , Zhang Hongyang , Zhou Yiqun , Li Yuxi , Xiao Tingting , Hu Ping , Zhang Shoude
Published: June 2020

Nitraria tangutorum B. (NT), Hippophae rhamnoides L. (HR), Lycium ruthenicum M. (LR), Lycii fructus (LF), Rosa xanthina L. (RX), and Rubuscor chorifolius L. f. (RC) are six berries from Tibetan Plateau. They have been used in traditional folk medicine with a long history, which are rich in anthocyanins. However, detailed study of their anthocyanins remains scarce. Therefore, a method for rapid simultaneous identification and quantification of 12 anthocyanins from berries using UPLC-Quadruple-Orbitrap MS system (UPLC-Q-Orbitrap MS) was established in this work. It was verified with limit of detection (3.86–11.61 µg/L), limit of quantification (3.86–11.61 µg/L), precision (0.95–2.38%), repeatability (0.96–2.08%), stability (0.86–2.31%), mean recovery (95.8–103.1%), recovery range (93.1–107.2%) and RSD less than 5.21%. It was then used in the analysis of anthocyanins in six berries species; 8, 7, 7, 7, 6 and 9 species of anthocyanins have been identified in NT, LF, LR, HR, RC and RX, respectively based on their own retention time and exact mass in positive mode, and for the first time quantified successfully in each berry (31.11 ± 0.42–2978 ± 25.67 μg.g−1). Finally, 2, 2-azinobis (3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) radical scavenging activity (0.92 ± 0.12–5.61 ± 0.23 mM TE/100 g), ferric reducing antioxidant power (FRAP) (1.23 ± 0.15–7.42 ± 0.28 mM TE/100 g) and total antioxidant activity (T-AOC) assays were used to evaluate the antioxidant activities of the six berries.
The prisoner dilemma: Inconsistent decisions for continuing life-sustaining treatment between a patient with very limited communication and their surrogate
Authors: Brummett Abram
Published: June 2020

This case raises the difficult question of how to respond to patients who appear to lack decision-making capacity, yet retain limited communication that allows them to state a preference for life-sustaining treatment that conflicts with the choice of their surrogate. I argue that the patient’s preference should be honored, even though the patient lacks decision-making capacity, and the preference contradicts the wishes of the surrogate.
Responding to Low Coefficient Alpha: Potential Alternatives to the File Drawer
Authors: Chretien Janice Lambert , Nimon Kim , Reio Thomas G. , Lewis Julie
Published: June 2020

To the detriment of human resource development (HRD) theory building and research, many scholars may think that research data with a low coefficient alpha is destined for the file drawer; this does not have to be the case. Contemporary literature suggests that many scholars do not know how to move forward with data that yields α < .70. In addition, an investigation revealed that many scholars practice the method of item deletion to increase alpha. Besides supporting the case that discarding research simply because of low coefficient alphas may be unnecessary, a guide is presented to demonstrate how scholars and scholar–practitioners may be able to analyze data when an initial estimate of internal reliability is low. We caution that deleting items may increase reliability at the cost of validity. As an alternative, this study demonstrates that eliminating subjects can increase alpha and maintain the integrity of the scale. This guide presents generalizability theory as a means to identify the source of error variance in data as well as a step-by-step process to correct for low coefficient alpha. The guide is illustrated with data and R syntax.
Dreaming of the Future: Reflections of a Latina College Student Receiving DACA Protection in the Trump Era
Authors: Rogers Jennifer
Published: June 2020

The Deferred Action for Childhood Arrivals (DACA) program provides legal protection to enhance access for a narrow subcategory of undocumented immigrants. Following the presidential election, a series of actions have pushed many of these recipients into limbo, leading to uncertainty and fear for these young students. This case study examined the intersectional identity and experiences of a first-generation Latina college student who is an undocumented immigrant and has received protection under the DACA program.
Locomotor Kinematics and Kinetics Following High-Intensity Stepping Training in Variable Contexts Poststroke
Authors: Ardestani Marzieh M. , Henderson Christopher E. , Mahtani Gordhan , Connolly Mark , Hornby T. George
Published: June 2020

Background and Purpose. Previous studies suggest that individuals poststroke can achieve substantial gains in walking function following high-intensity locomotor training (LT). Recent findings also indicate practice of variable stepping tasks targeting locomotor deficits can mitigate selected impairments underlying reduced walking speeds. The goal of this study was to investigate alterations in locomotor biomechanics following 3 different LT paradigms. Methods. This secondary analysis of a randomized trial recruited individuals 18 to 85 years old and >6 months poststroke. We compared changes in spatiotemporal, joint kinematics, and kinetics following up to 30 sessions of high-intensity (>70% heart rate reserve [HRR]) LT of variable tasks targeting paretic limb and balance impairments (high-variable, HV), high-intensity LT focused only on forward walking (high-forward, HF), or low-intensity LT (<40% HRR) of variable tasks (low-variable, LV). Sagittal spatiotemporal and joint kinematics, and concentric joint powers were compared between groups. Regressions and principal component analyses were conducted to evaluate relative contributions or importance of biomechanical changes to between and within groups. Results. Biomechanical data were available on 50 participants who could walk ≥0.1 m/s on a motorized treadmill. Significant differences in spatiotemporal parameters, kinematic consistency, and kinetics were observed between HV and HF versus LV. Resultant principal component analyses were characterized by paretic powers and kinematic consistency following HV, while HF and LV were characterized by nonparetic powers. Conclusion. High-intensity LT results in greater changes in kinematics and kinetics as compared with lower-intensity interventions. The results may suggest greater paretic-limb contributions with high-intensity variable stepping training that targets specific biomechanical deficits. Clinical Trial Registration. https://clinicaltrials.gov/ Unique Identifier: NCT02507466
Reactive Balance Adaptability and Retention in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis
Authors: Mohamed Suhaimy Mohamed Suhair Bin , Okubo Yoshiro , Hoang Phu D. , Lord Stephen R.
Published: June 2020

Aim. To compare reactive balance in people with multiple sclerosis (MS) with healthy controls and to examine the ability of people with MS to adapt their reactive balance and retain training effects. Data Sources. Electronic databases (PubMed, EMBASE, PsychINFO) and reference lists of included articles from inception to February 25, 2019. Study Selection. Case-control and intervention studies that assessed reactive balance using mechanical perturbations in people with a confirmed diagnosis of MS. Results. Meta-analyses of 9 studies (n = 342) showed that people with MS have significantly worse reactive balance than healthy controls (standardized mean difference [SMD] 0.78, 95% CI 0.44-1.11, P < .0001, I2 = 47%). Specifically, people with MS have greater center of mass displacements (SMD 0.41, 95% CI 0.05-0.77, P = .02, I2 = 9%) and longer response times (MD (ms) 31.45, 95% CI 19.91-42.98, P < .0001, I2 = 75%) in response to standing perturbations than healthy controls. Subsequent meta-analyses revealed training comprising repeated exposure to perturbations improved response times ( P < .001) and training effects on response times could be retained for 24 hours ( P < .001) in people with MS. Conclusions. Reactive balance assessments can highlight functional impairments related to falls in people with MS, and perturbation training can acutely improve reactive balance control and such improvements can be retained for 24 hours in this population. Systematic review registration number: CRD42019126130.
Benign Hand Tumors (Part I): Cartilaginous and Bone Tumors
Authors: Yue Kai-Lou C. , Lans Jonathan , Castelein René M. , Suster David I. , Nielsen G. Petur , Chen Neal C. , Lozano-CalderÓn Santiago A.
Published: June 2020

Background: Benign tumors of the hand present in a wide array of histological subtypes and compose most of the bony tissue tumors in the hand. This study evaluates the characteristics and treatment of benign bone tumors in light of one institution’s experience. Methods: Histologically confirmed benign tumors of the hand were retrospectively identified using International Classification of Diseases codes from 1992 to 2015. A medical chart review was conducted to collect patient characteristics and tumor epidemiology and treatment. Results: A total of 155 benign bone tumors were identified. The median age of patients at the time of surgery was 39.9 ± 12.8 years. All bone tumors were located in the digits, and most were treated by intralesional curettage (n = 118, 76%). Pathologic fractures occurred in 79 bone tumors (51%). Conclusion: Enchondromas (n = 118, 76%) were the most common bone tumor in this series, whereas giant cell tumors were the most destructive and also had the highest recurrence rate (40%). Awareness of tumor features may help physicians with diagnosis, and awareness of recurrence rates is important when counseling patients.
Primary Care Comprehensiveness and Care Coordination in Robust Specialist Networks Results in Lower Emergency Department Utilization: A Network Analysis of Medicaid Physician Networks
Authors: She Zhaowei , Gaglioti Anne H. , Baltrus Peter , Li Chaohua , Moore Miranda A. , Immergluck Lilly C. , Rao Arthi , Ayer Turgay
Published: June 2020

Background: Care coordination is an essential and difficult to measure function of primary care. Objective: Our objective was to assess the impact of network characteristics in primary/specialty physician networks on emergency department (ED) visits for patients with chronic ambulatory care sensitive conditions (ACSCs). Subjects and Measures: This cross-sectional social network analysis of primary care and specialty physicians caring for adult Medicaid beneficiaries with ACSCs was conducted using 2009 Texas Medicaid Analytic eXtract (MAX) files. Network characteristic measures were the main exposure variables. A negative binomial regression model analyzed the impact of network characteristics on the ED visits per patient in the panel. Results: There were 42 493 ACSC patients assigned to 5687 primary care physicians (PCPs) connected to 11 660 specialist physicians. PCPs whose continuity patients did not visit a specialist had 86% fewer ED visits per patient in their panel, compared with PCPs whose patients saw specialists. Among PCPs connected to specialists in the network, those with a higher number of specialist collaborators and those with a high degree of centrality had lower patient panel ED rates. Conclusions: PCPs providing comprehensive care (ie, without specialist consultation) for their patients with chronic ACSCs had lower ED utilization rates than those coordinating care with specialists. PCPs with robust specialty networks and a high degree of centrality in the network also had lower ED utilization. The right fit between comprehensiveness of primary care, care coordination, and adequate capacity of specialty availability in physician networks is needed to drive outcomes.
Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice
Authors: Deyo-Svendsen Mark , Cabrera Svendsen Matthew , Walker James , Hodges Andrea , Oldfather Rachel , Mansukhani Meghna P.
Published: June 2020

Opioid use disorder (OUD) is a cause of significant morbidity and mortality in the United States. Although efforts are being made to limit access to prescription opioids, the use of heroin and synthetic opioids as well as death due to opioid overdose has increased. Medication-assisted treatment (MAT) is the pairing of psychosocial intervention with a Food and Drug Administration (FDA)–approved medication (methadone, buprenorphine plus naltrexone) to treat OUD. MAT has resulted in reductions in overdose deaths, criminal activity, and infectious disease transmission. Access to MAT in rural areas is limited by shortages of addiction medicine-trained providers, lack of access to comprehensive addiction programs, transportation, and cost-related issues. Rural physicians express concern about lack of mentorship and drug diversion as reasons to avoid MAT. The prescribing of MAT with buprenorphine requires a Drug Enforcement Agency (DEA) waiver that can easily be obtained by Family Medicine providers. MAT can be incorporated into the outpatient practice, where patient follow-up rates and number needed to treat to effect change are similar to that of other chronic medical conditions. We describe a case of opioid overdose and a suggested protocol for the induction of MAT with buprenorphine/naloxone (Suboxone) for OUD in a rural family medicine outpatient practice. Treatment access is facilitated by utilizing the protocol, allowing office staff work to the extent allowed by their licensure, promoting teamwork and minimizing physician time commitment. We conclude that improved access to MAT can be accomplished in a rural family medicine outpatient clinic by staff that support and mentor one another through use of a MAT protocol.
Mental Health and Psychosocial Needs of Patients Being Treated for Opioid Use Disorder in a Primary Care Residency Clinic
Authors: Hooker Stephanie A. , Sherman Michelle D. , Lonergan-Cullum Mary , Sattler Adam , Liese Bruce S. , Justesen Kathryn , Nissly Tanner , Levy Robert
Published: June 2020

Purpose: Primary care is an ideal setting to deliver efficacious treatments for opioid use disorder (OUD). Primary care providers need to be aware of other concerns patients with OUD might have in order to provide comprehensive care. This study describes the prevalence of mental health, comorbid substance use, and psychosocial concerns of patients seeking treatment for OUD in primary care and their relation to 6-month treatment retention. Methods: Patients (N = 100; M age = 34.9 years (SD = 10.8), 74% white, 46% female) with OUD who were starting treatment with buprenorphine at an academic family medicine residency clinic completed surveys of mental health concerns (depression, anxiety, trauma), psychosocial needs (food insecurity, income, transportation, employment), and demographic variables. Chart reviews were conducted to gather information on comorbid substance use, mental health diagnoses, and 6-month treatment retention. Results: Mental health symptoms were highly prevalent in this sample (44% screened positive for anxiety, 31% for depression, and 52% for posttraumatic stress disorder). Three-quarters reported use of illicit substances other than opioids. Many patients also had significant psychosocial concerns, including unemployment (54%), low income (75%), food insecurity (51%), and lacking reliable transportation (64%). Two-thirds (67%) of the sample were retained at 6 months; patients who previously used intravenous opioids were more likely to discontinue treatment ( P = .003). Conclusions: Many patients receiving treatment for OUD have significant mental health problems, comorbid substance use, and psychosocial concerns; interestingly, none of these factors predicted treatment retention at 6 months. Primary care clinics would benefit from having appropriate resources, interventions, and referrals for these comorbid issues in order to enhance overall patient well-being and promote recovery.
Does Culture Matter? A Comparative Study on the Motivations for Online Identity Reconstruction Between China and Malaysia
Authors: Huang Jiao , Kumar Sameer , Hu Chuan
Published: June 2020

On social network platforms, people may reconstruct an identity due to various reasons, such as vanity, disinhibition, bridging social capital, and privacy concerns. This study aims to identify cultural differences in the motivations for online identity reconstruction between China and Malaysia. Data were collected from China and Malaysia using an online survey. A total of 815 respondents (418 Chinese and 397 Malaysians) participated in this study. Differences were found not only between Chinese and Malaysian participants but also among participants from different ethnic groups (e.g., the Malaysian-Malays and the Malaysian-Chinese). This study adds knowledge to the research concerning online identity reconstruction by taking into account national culture. It also extends the cross-cultural research concerning social network platforms and sheds light on the specific differences between Chinese and Malaysian participants. The findings of this study can help service providers to deploy specific strategies to better serve social network platform users from different countries.
The Diffusion of Discrete Event Simulation Approaches in Health Care Management in the Past Four Decades: A Comprehensive Review
Authors: Liu Shiyong , Li Yan , Triantis Konstantinos P. , Xue Hong , Wang Youfa
Published: June 2020

This study systematically examines the diffusion of the discrete event simulation (DES) approach in health services and health care management by examining relevant factors such as research areas, channels with the objective of promoting the application of DES in the health field. We examined 483 journal papers referencing this approach that were published in 230 journals during 1981 to 2014. The application of DES has extended from health service operational research evaluation to the assessment of interventions in diverse health arenas. The increase in the number of adopters (paper authors) of DES and the increase in number of related channels (journals publishing DES-related articles) are highly correlated, which suggests an increase of DES-related publications in health research. The same conclusion is reached, that is, an increased diffusion of DES in health research, when we focus on the temporal trends of the channels and adopters. The applications of DES in health research cover 22 major areas based on our categorization. The expansion in the health areas also suggests to a certain extent the rapid diffusion of DES in health research.
Safety and feasibility of rivaroxaban in deferred workup of patients with suspected deep vein thrombosis
Authors: Fronas Synne G. , Dahm Anders E. A. , Wik Hilde S. , Jørgensen Camilla T. , Gleditsch Jostein , Raouf Nezar , Holst René , Klok Frederikus A. , Ghanima Waleed
Published: June 2020

Guidelines suggest using empiric low-molecular-weight heparin if the diagnostic workup of deep vein thrombosis (DVT) is expected to be delayed. The role of direct oral anticoagulants for deferred compression ultrasound imaging (CUS) in patients with suspected DVT remains unexplored. The main objective of the study was to assess the safety of deferring CUS with therapeutic doses of rivaroxaban. We prospectively included consecutive outpatients referred to the Emergency Department at Østfold Hospital, Norway, with suspected first or recurrent lower-extremity DVT between February 2015 and November 2018. Patients were discharged with rivaroxaban 15 mg twice daily while awaiting CUS within 24 hours if D-dimer level was ≥0.5 mg/L fibrinogen-equivalent units. The primary outcome was the rate of major bleeding incidents from study inclusion until DVT was confirmed and anticoagulation therapy continued, or otherwise up to 48 hours following administration of the last tablet of rivaroxaban. The secondary outcome was the rate of progressive DVT symptoms or symptoms or signs of pulmonary embolism between hospital discharge until venous thromboembolism was diagnosed. Six hundred twenty-four of 1653 patients referred with suspected DVT were included (37.7%; 95% confidence interval [CI], 35.4-40.1). DVT was diagnosed in 119 patients (19.1%; 95% CI, 16.1-22.3). There were no major bleeding incidents, yielding an observed major bleeding rate of 0% (1-sided 95% CI <0.4). No patients experienced major complications in the interval that CUS was deferred (0%; 95% CI, 0.0-0.6). Deferring CUS for up to 24 hours in patients with suspected DVT with therapeutic doses of rivaroxaban is a safe strategy. This trial was registered at www.clinicaltrials.gov as #NCT02486445.
Delayed extensive brain edema caused by the growth of a giant basilar apex aneurysm treated with basilar artery obliteration: a case report
Authors: García-Pérez Daniel , Panero Irene , Eiriz Carla , Moreno Luis Miguel , Munarriz Pablo M. , Paredes Igor , Lagares Alfonso , Alén José F.
Published: June 2020

Background

Partially thrombosed giant aneurysms at the basilar apex (BA) artery are challenging lesions with a poor prognosis if left untreated. Here we describe a rare case of extensive brain edema after growth of a surgically treated and thrombosed giant basilar apex aneurysm.

Case presentation

We performed a proximal surgical basilar artery occlusion on a 64-year-old female with a partially thrombosed giant BA aneurysm. MRI showed no ischemic lesions but showed marked edema adjacent to the aneurysm. She had a good recovery, but 3 months after surgical occlusion, her gait deteriorated together with urinary incontinence and worsening right hemiparesis. MRI showed that the aneurysm had grown and developed intramural hemorrhage, which caused extensive brain edema and obstructive hydrocephalus. She was treated by a ventriculoperitoneal shunt placement. Follow-up MRI showed progressive brain edema resolution, complete thrombosis of the lumen and shrinkage of the aneurysm. At 5 years follow-up the patient had an excellent functional outcome.

Conclusions

Delayed growth of a surgically treated and thrombosed giant aneurysm from wall dissection demonstrates that discontinuity with the initial parent artery does not always prevent progressive enlargement. The development of transmural vascular connections between the intraluminal thrombus and adventitial neovascularization by the vasa vasorum on the apex of the BA seems to be a key event in delayed aneurysm growth. Extensive brain edema might translate an inflammatory edematous reaction to an abrupt enlargement of the aneurysm.
Self–reported specific learning disorders and risk factors among Hungarian adolescents with functional abdominal pain disorders: a cross sectional study
Authors: Major János , Ádám Szilvia
Published: June 2020

Background

Despite its increasing clinical significance and diagnostic challenges, little is known about functional abdominal pain disorders (FAPDs) in Central-Eastern Europe. In this paper, the prevalence and potential sociodemographic correlates of FAPDs among Hungarian adolescents are explored.

Methods

A cross-sectional, nationwide, questionnaire study in a representative sample of 657 adolescents has been conducted. With a response rate of 80.2%, 522/527 (99.1%) questionnaires were eligible for data analysis (N = 267, 51.1% girls, mean age 14.8, SD 2.4 years). The questionnaire included sociodemographic variables (age, sex, place of residence, marital status of the parents, family income, religion, educational level of parents), questions regarding self–reported specific learning disorders and the Questionnaire for Paediatric Gastrointestinal Symptoms Rome ΙΙΙ Edition.

Results

The prevalence of FAPDs was 11.9% (N = 62). FAPDs were significantly associated with female sex. Living in a county town showed a negative correlation with FAPD. Adolescents with self–reported arithmetic learning disorders had an 8.7-fold likelihood of FAPD (OR, 8.7; 95% CI (3.5–21.9). Adolescent girls reported pain in all subtypes of FAPDs more frequently than adolescent boys except functional abdominal pain syndrome. The most prevalent FAPD was abdominal migraine (N = 32, 6.1%), followed by irritable bowel syndrome (N = 24, 4.6%).

Conclusions

The prevalence of FAPDs in Hungary is similar to that reported worldwide, however, contrary to international data, abdominal migraine is the most frequently encountered FAPD in Hungary. In addition to well-known correlates of FAPDs, such as female sex and place of residence, arithmetic learning disorders have also been identified as correlating with the prevalence of FAPDs. Our results suggest culture-specific differences in the distribution of FAPDs, and confirm the significance of school performance indicators such as specific learning disorders as a correlate of FAPDs.
Frequency and correlates of violence against patients with schizophrenia living in rural China
Authors: Wang Qian-Wen , Hou Cai-Lan , Wang Shi-Bin , Huang Zhuo-Hui , Huang Ying-Hua , Zhang Ji-Jie , Jia Fu-Jun
Published: June 2020

Background

Violence against patients with schizophrenia is very common, however it is rarely studied in China, especially in primary health care institutions of rural areas. Therefore, we investigated the frequency of violence against patients with community-living schizophrenia in rural China and examined its associated factors and impact on quality of life (QoL) and social function.

Method

A survey was conducted among 487 patients with schizophrenia living in rural communities. Data about violent victimization experiences in the past 6 months, demographic information, and clinical characteristics were collected by questionnaires.

Results

We found that 92 (18.9%) of 487 subjects experienced at least one type of violent event in the past 6 months. Logistic regression analysis suggested that a history of conducting dangerous behaviors(OR = 1.702, P = 0.02, 95%CI: 1.05–2.73), higher Brief Psychiatric Rating Scale (anxiety domain) score (OR = 1.15, P = 0.02, 95%CI: 1.01–1.304) and lower hospitalization rates (OR = 0.89, P = 0.04, 95%CI: 0.81–0.99) were significantly associated with violent victimization in patients with schizophrenia. Analysis of covariance showed the victims of violence tended to have worse social function in patients with schizophrenia living in rural communities of China (P = 0.04).

Conclusions

Individuals with schizophrenia living in rural China had a high risk of being exposed to violence and violent victimization of patients with schizophrenia had adverse consequences for social function. More attention is needed for those patients experiencing violent events, because they are simultaneously possible to conduct dangerous behaviors.
Human Toxoplasma gondii infection in Nigeria: a systematic review and meta-analysis of data published between 1960 and 2019
Authors: Karshima Solomon Ngutor , Karshima Magdalene Nguvan
Published: June 2020

Background

Over 70% of the worlds’ population is infected byToxoplasma gondii; a pathogen capable of causing cerebral toxoplasmosis in HIV patients and neonatal complications like miscarriage, chorioretinitis, hydrocephalus, cerebral calcification and foetal death in the third trimester of pregnancy. In spite of this, the burden of this zoonotic pathogen is poorly understood in Nigeria. The aim of the present study therefore, is to determine the burden ofT. gondiiamong normal individuals, HIV patients and pregnant women as well as the distribution of the infection across Nigeria.

Methods

Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from six electronic databases (AJOL, Google Scholar, PubMed, Scopus, Science Direct and Web of Science). Pooled prevalence (PP) and heterogeneity were determined by the random-effects model and the Cochran’s Q-test respectively. The quality of each study and publication bias were assessed by the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger’s regression asymmetry test respectively, while the robustness of a pooled estimate was tested by the single study omission analysis.

Results

Exactly 5834 of the 16,230 individuals examined forT. gondiiinfection by 50 studies across 17 Nigerian States were positive for the infection. Overall PP was 32.92% (95% CI: 27.89, 38.37), with a range of 14.41% (95% CI: 5.32, 33.54) to 86.82% (95% CI: 66.13, 95.69) across sub-groups. Pooled prevalence was significantly higher (p < 0.001) among pregnant women (40.25%; 95% CI: 33.19, 47.73) and HIV patients (31.68, 95% CI: 20.53, 45.41) than normal individuals (23.32, 95% CI: 17.25, 30.75).T. gondiiprevalence declined by over 58% during the 59 years reviewed.

Conclusion

Toxoplasma gondiiinfection is moderately prevalent in Nigeria. Highest prevalence estimates were observed among pregnant women and in the south-south region. For effective control of the disease in Nigeria, a holistic approach involving on-farm, environmental, public health and animal components are suggested.
Minimally invasive surgery for paravertebral or psoas abscess with spinal tuberculosis — a long-term retrospective study of 106 cases
Authors: Zhang Zhifa , Hao Yongyu , Wang Xiangyu , Zheng Zhirong , Zhao Xuelin , Wang Chunguo , Zhang Xifeng , Zhang Xuesong
Published: June 2020

Background

Minimally invasive surgery (MIS) is a common treatment option for paravertebral or psoas abscesses (PAs) in patients with spinal tuberculosis (ST). However, its efficacy remains controversial. The aim of the study was to evaluate the efficacy of MIS for PA with ST combined with anti-tuberculous chemotherapy.

Methods

A total of 106 consecutive patients who underwent MIS for ST with PA from January 2002 to Oct 2012 were reviewed. The MIS involved computed tomography (CT)-guided percutaneous catheter drainage and percutaneous catheter infusion chemotherapy. Clinical outcomes were evaluated based on the changes observed on preoperative and postoperative physical examination, inflammatory marker testing, and magnetic resonance imaging (MRI).

Results

The mean follow-up period was 7.21 ± 3.15 years. All surgeries were successfully completed under CT-guidance without intraoperative complications and all patients experienced immediate relief of their symptoms, which included fever and back pain. The preoperatively elevated erythrocyte sedimentation rate and C-reactive protein values returned to normal at a mean period of 3 months postoperatively. Solid bony union was observed in 106 patients and no abscesses were found on MRI examination.

Conclusion

MIS carries advantages in terms of less invasiveness, precise drainage, and enhanced local drug concentration. While the technique has not been fully characterized and clinically prove, its use in addition to conservative chemotherapy and open debridement and instrumental fixation may be recommended for patients with ST and PA.
Utilization of the national cluster of district health information system for health service decision-making at the district, sub-district and community levels in selected districts of the Brong Ahafo region in Ghana
Authors: Odei-Lartey Eliezer Ofori , Prah Rebecca Kyerewaa Dwommoh , Anane Edward Apraku , Danwonno Harry , Gyaase Stephaney , Oppong Felix Boakye , Afenyadu Godwin , Asante Kwaku Poku
Published: June 2020

Background

There is growing interest in the use of reliable evidence for health decision-making among low-and middle-income countries. Ghana has deployed DHIMS2 to replace the previously existing manual data harmonization processes.

Methods

This cross-sectional study was conducted in 12 districts comprising 12 district directorates, 10 district hospitals, 29 sub-district health centers, and 38 community health facilities in the Brong-Ahafo Region. Data collection tools were developed based on the Measure Evaluate assessment tools designed for evaluating the performance of routine information systems management tools. Utilization was assessed based on documented evidence and data was analyzed using STATA version 14.

Results

Although 93% of the health facilities studied submitted data unto the DHIMS2 platform, evidence suggested low use of this data in decision-making, particularly at the community level facilities where only 26% of the facilities used data from DHIMS2 to inform annual action plans and even less than 20% examined findings and issued directives for action. At the district level, 58% issued directives based on DHIMS2 information, 50% used DHIMS2 information for Advocacy purposes and 58% gave feedback reports based on DHIMS2 data for action. Functional computers were lacking across all facilities.

Conclusions

Activities relating to the use of DHIMS2 information skew towards data quality checking with less focus on examining findings, making comparisons, and taking action-based decisions from findings and comparisons. Improving factors like internet access, availability of functional ICTs, frequency of supervisory visits, staff training and the provision of training manuals may facilitate the use of DHIMS2 in decision-making at all levels of the district health system.