bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Housing Resident Perspectives on Smoking, Barriers for Smoking Cessation, and Changes in Smoking Mandates
Authors: Foster Bethany , Ledgerwood David M. , Struble Cara A. , Fodor Marina C. , Jordan Parada , Krishnan Abhinav C. , Turner Beverly , Pearson Claire , Twiner Michael J. , Levy Phillip D
Published: April 2022

Background

Individuals from low-income groups report disproportionate rates of cigarette use, secondhand smoke (SHS) exposure with increased morbidity and mortality. Smoking bans in public housing have been enacted in attempt to reduce tobacco use and SHS exposure among lower income individuals. This study investigated the support needs of tobacco users living in two public housing complexes in Detroit, Michigan (USA), including their perspectives on smoking, resources and barriers for smoking cessation, and the impact of policy changes.

Methods

This is a mixed-methods study, using a qualitative focus groups approach and a short survey, public housing residents interview data was analyzed to explore themes related to smoking-related issues. Specifically, six themes were assessed across four focus groups: (1) Quitting Smoking, (2) Current Smoking Cessation Resources, (3) Legal Mandates, (4) Education and Perceptions of Smoking, (5) Community Needs and Barriers, and (6) Medical Experiences.

Results

There were 59 participants; the majority (39/42, 93%) of smokers reported at least one quit attempt. During the focus groups, several participants indicated a desire to quit smoking but reported barriers to smoking cessation, such as lack of access to medications, social triggers to continue smoking, and socioeconomic stressors. A number of suggestions were provided to improve smoking cessation resources, including support groups, graphic images of smoking-related diseased tissue, and better communication with health care providers.

Conclusions

These findings demonstrate smoking bans in two public housing complexes can be effective yet are dependent upon a complex set of issues, including numerous barriers to care.
Preparing residents to practice integrated behavioral health care: Multi-site feasibility study of a competency-based curriculum
Authors: Martin Matthew P , Banks Elizabeth , Myerholtz Linda , Zubatsky Max , Suri Yash , Mauksch Larry
Published: April 2022

Objective

Workforce development is essential for the dissemination of team-based integrated behavioral healthcare. There is limited literature on training family medicine residents to function within an integrated behavioral health (IBH) system. The purpose of this pilot study was to assess the feasibility and value of an IBH competency-based curriculum for family medicine residents across multiple programs.

Methods

Residency programs were recruited using professional listservs and networks to test a competency-based, multi-modal curriculum for preparing residents to practice IBH in primary care. Faculty instructors who led the workshop were invited to complete semi-structured interviews to examine the feasibility and appropriateness of the curriculum. Interview data were analyzed using thematic analysis to identify, analyze, and report patterns. Residents completed a survey of perceived IBH skill and knowledge before and after training. A paired-sample t-test was used to determine significant differences pre- and post-training.

Results

All five instructors completed interviews. Results suggest IBH training is valuable. Instructors gave specific feedback on online modules, implementation flexibility, and adjusting faculty development to differing levels of experience. Nineteen of forty residents (48%) completed anonymous pre-, post-, and retrospective-training surveys. Residents reported an increase in competence after training.

Conclusion

The results of this pilot suggest that IBH training implementation is feasible, desirable, timely, and may improve resident ability to work on an IBH team. Training should accommodate variations in program structure and faculty expertise.
Respect Your Elders: Generativity and Life Satisfaction in Caregiving Grandparents
Authors: Scott Rachel K. , Nadorff Danielle K. , Barnett Melissa , Yancura Loriena
Published: April 2022

Erikson's theory of psychosocial development defines generativity as the drive to benefit future generations and leave a legacy. Generativity has been shown to predict life satisfaction, but generative concern and action can be impacted by factors such as perceived respect from younger generations. This study utilized caregiving grandparents aged 40 and older to assess the extent to which perceived respect mediated the relation between generativity and life satisfaction. Perceived respect from a grandchild mediated the relation between generative concern expressed by caregiving grandparents and life satisfaction after controlling for demographic variables that have been shown to influence heterogeneity and overall well-being in caregiving grandparent samples. These findings suggest that the relation between life satisfaction and generativity in grandparents may depend, in part, on perceived respect from grandchildren, intimating that the implications of generativity may be influenced by the perceived appreciation of its recipients.
Hope as an engine mediating the relation between parental attachment and social problem solving skills in adolescents
Authors: Hu Yuyang , Jiang Xu
Published: April 2022

Research has consistently supported the significance of parental attachment in behavioral development during adolescence. Based on the attachment theory and the engine of well-being model, the current study examined the mediating effect of hope in the relation between parental attachment and social problem-solving skills in Chinese early adolescents (N = 745, 6th to 8th grade, age range 11 to 15 years, mean = 12.76, SD = 0.74). Data were collected across two time points, with six months between each time. After confirming the measurement model, the structural equation modeling analysis results showed that hope fully mediated the relation between maternal and paternal attachment, respectively, and social problem-solving skills. The findings are consistent with previous research conducted in the United States showing the mediating role of hope in the relation between family resources and adolescents’ positive goal-directed behavior. These findings also support the application of the attachment theory and the engine of well-being model in Chinese culture and possibly Eastern culture in general. Implications for school psychologists and other mental health professionals to help parents understand how they influence adolescents’ social problem-solving skills (via hope), especially in the Eastern cultural context, are discussed.
Culture Creation and Change: Making Sense of the Past to Inform Future Research Agendas
Authors: Kim Yeun Joon , Toh Soo Min , Baik Sooyun
Published: April 2022

This review presents comprehensive analyses of extant research on culture creation and change. We use the framework of culture creation and change ( Kim & Toh, 2019 ), which consists of three unique perspectives, to understand past research on the antecedents of cultures. The basis of the functionality perspective is that environmental changes shape cultures, and thus, the created cultures enable an organization to address the demands of its environments effectively. In contrast, the leadership perspective argues that leaders have disproportional influence on cultures, and when exercising such influence, they are often unsuccessful at creating functional cultures. The leadership perspective comprises two subperspectives—the leader-trait and cultural transfer perspectives. The leader-trait perspective argues that when creating cultures, leaders often overlook the functionality of cultures but rely heavily on their traits. The cultural transfer perspective suggests that leaders often recreate the cultures that they have experienced in the past. Building on this framework, we review 74 studies in 68 articles across multiple disciplines to widen our understanding of culture creation and change. We then present agendas for future research guided by a four-stage model and a theory of coordinated actions for creating functional cultures. Finally, we discuss methodological limitations in past studies and offer possible solutions.
Does Segregation Still Matter? The Impact of Student Composition on Academic Achievement in High School
Authors: Rumberger Russell W. , Palardy Gregory J.
Published: April 2022

The Coleman report, published 12 years after the Brown decision, confirmed that widespread school segregation in the United States created inequality of educational opportunity. This study examines whether racial and socioeconomic segregation, which is on the rise in the United States, is still contributing to the achievement differences among students. The study used data from the National Education Longitudinal Survey of 1988 to estimate multilevel models of achievement growth between Grades 8 and 12 in mathematics, science, reading, and history for a sample of 14,217 students attending a representative sample of 913 U.S. high schools. The study found that the average socioeconomic level of students’ schools had as much impact on their achievement growth as their own socioeconomic status, net of other background factors. Moreover, school socioeconomic status had as much impact on advantaged as on disadvantaged students, and almost as much impact on Whites as on Blacks, raising questions about the likely impact of widespread integration. The impact of socioeconomic composition was explained by four school characteristics: teacher expectations, the amount of homework that students do, the number of rigorous courses that students take, and students’ feelings about safety. The results suggest that schools serving mostly lower-income students tend to be organized and operated differently than those serving more-affluent students, transcending other school-level differences such as public or private, large or small. This article then addresses the question of whether such school characteristics can be changed by policies to reform schools and funding systems versus policies to desegregate schools.
Value Change in Energy Systems
Authors: van de Poel Ibo , Taebi Behnam
Published: April 2022

The ongoing energy transition toward more sustainable energy systems implies a change in the values for which such systems are designed. The energy transition however is not just about sustainability but also about values like energy security and affordability, and we witness the emergence of new values like energy justice and energy democracy. How can we understand such value changes and how can or should they affect the design of future energy systems? This introduction to the special section on value change in energy systems introduces the main themes and questions. It discusses different understandings of values and value change, explains why the topic is important and how it can be methodologically studied.
“Being on the Positive End of Every Negative Statistic”: Expanding Inclusion of Gifted Education Through Considerations of Critical Consciousness as Double Giftedness
Authors: Bryson Brandy S.
Published: April 2022

The narrow manner in which giftedness is often regarded perpetuates the underrepresentation of students of Color in gifted education programs, particularly for Black students. This case study highlights the story of a gifted Black high school student attending a predominantly White high school in the South. Bianca’s story illuminates her struggle with myriad racialized challenges within and outside of school and, more importantly, demonstrates her sophisticated and critically conscious appraisal of structural inequities. Interpreted through the lens of critical consciousness, Bianca’s story of giftedness illuminates her complex understandings of societal and institutional workings. Given the complexity and effort required to participate in critical ways of knowing, especially concerning the ways in which race and racism function, this study highlights that critically conscious students like Bianca are, in fact, doubly gifted and can offer insights to expand commonly held notions of giftedness and greater inclusivity in gifted education. Implications for educators and policy makers are discussed.
MGNREGS Performance (2006–21): An Inter-State Analysis
Authors: Turangi Satyanarayana
Published: April 2022

With its several innovative features, the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) is considered to be a game changer for rural India. Assessing the first 15 years of its implementation, this article mainly presents collated key data on its performance in various Indian states and then seeks to explain why some indicators may look less successful in different states. Many factors contribute to variations in MGNREGS performance, but what effects were observed in economically backward states to protect impoverished rural Indians from sinking into distress scenarios? Based on the official figures, the article explores answers for the period of 2006–21.
Ticagrelor for patients undergoing coronary artery bypass grafting: A meta-analysis of randomized controlled trials
Authors: Xiang Feng , Lin Yifeng , Chen Binwu
Published: April 2022

Objective

Ticagrelor may be an alternative to aspirin as it provides robust and consistent platelet inhibition. However, the effect of ticagrelor treatment in patients undergoing coronary artery bypass grafting (CABG) has not been well confirmed. We conducted a meta-analysis to appraise whether ticagrelor therapy affects outcomes in CABG patients.

Methods

We searched PubMed, Embase, EBSCO, and Cochrane databases from its inception up to 4 December 2020 for randomized controlled trials that assessed ticagrelor versus non-ticagrelor in patients undergoing CABG. The primary outcome was the incidence of saphenous vein graft (SVG) occlusion at 1 year after CABG. Secondary outcomes were SVG occlusion at 7 days, major adverse cardiovascular events (MACE), and bleeding requiring reoperation.

Results

Seven trials including 4305 patients (2153 randomized to ticagrelor therapy and 2152 to non-ticagrelor therapy) were included. One-hundred and thirty of 1140 patients (11.4%) randomized to the ticagrelor group versus 175 of 1220 patients (14.3%) randomized to the non-ticagrelor group experienced SVG occlusion at 1 year after CABG. Compared to the control group, ticagrelor therapy yielded a significantly lower risk of SVG occlusion [RR 0.79 (0.64–0.97), p = 0.03]. In the subgroup analysis, ticagrelor plus aspirin compared with aspirin alone did not decrease the risk of SVG occlusion after 1 year [RR 0.65 (0.40–1.07), p = 0.09]. There was no difference in the incidence of SVG occlusion at 7 days [RR 0.67 (0.42–1.06), p = 0.09], MACE up to 1 year [RR 0.99 (0.81–1.21), p = 0.90], or bleeding requiring reoperation [RR 1.16 (0.80–1.70), p = 0.44].

Conclusions

Compared with non-ticagrelor therapy, ticagrelor decreased the risk of saphenous vein graft occlusion after 1 year in patients undergoing elective CABG with saphenous vein grafting.
COVID-19 related thrombosis: A mini-review
Authors: Cheng Nicole M , Chan Yiu Che , Cheng Stephen W
Published: April 2022

Introduction

COVID-19 associated VTE is a new disease entity with high morbidity and mortality. The aim of this paper is to review contemporary emerging literature on the incidence, pathophysiology, predictive prognostic indicators, and management consensus for Covid-19 related thrombotic complications, in particular DVT and PE.

Methods

A literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. All searches were done via PubMed. References of review articles were further screened according to the exclusion criteria.

Results

In total, 154 records were identified and 20 duplicates were removed. A final 68 articles were included in the qualitative analysis. COVID-19 related thrombosis can affect multiple organs of the body, presenting in the form of arterial or venous thrombosis such as ischemic stroke, myocardial infarction, mesenteric ischemia, limb ischemia, DVT, or PE. DVT and PE has an overall incidence of 6–26%, and severely ill COVID-19 patients have even higher incidence of thromboembolism. On the other hand, incidence of arterial thromboembolism is much lower with incidence of 0.7%–3.7%. D-dimer is found to be an independent risk factor, and IMPROVE score, Caprini score, and Padua score have all been used as predictors. International guidelines suggest the use of low molecular weight heparin (LMWH) or fondaparinux for prophylaxis of VTE, and therapeutic dosage of weight adjusted LMWH for treatment if confirmed diagnosis.

Conclusions

Contemporary rapidly evolving evidence shows that COVID-19 associated thrombosis was a novel clinical entity, especially in severely ill COVID-19 patients. There are multiple society-driven guidelines only, but without any level 1 evidence for management regimen. The ideal dose for prophylaxis is not established and may vary depending on balance of bleeding and thrombosis risk. The risk of bleeding may be increased in patients in intensive care unit.
Long-term integrity of 53 iliac vein stents after catheter-directed thrombolysis
Authors: Foegh Pia , Strandberg Charlotte , Joergensen Sanne , Myschetzky Peter S , Klitfod Lotte , Just Sven , Hansen Susanne , Baekgaard Niels
Published: April 2022

Background

Long-term surveillance data on venous stent integrity is sparse. There is limited knowledge on whether duplex ultrasound (DUS) can detect potential stent deformities such as kinking, straightening, and fracture, which may impact long-term patency of the stented veins.

Purpose

To assess venous stent integrity after at least five years of follow-up and to establish the efficacy of DUS as surveillance in patients with venous stent.

Material and Methods

A total of 45 patients with acute iliac-femoral deep vein thrombosis (DVT) treated with catheter directed thrombolysis (CDT) and stenting >5 years before follow-up. Stents were evaluated with 3D volume low dose non-contrast computed tomography (CT) and DUS for kinking, straightening, stent fracture, and patency. Results from CT scans and DUS were compared to assess the overall agreement between the methods.

Results

Median follow-up was 13.2 years (mean = 11.2 years; range = 5.2–15.8 years). 3D CT reconstructions showed normal stent configuration in 47 stents (89%). All intact stents were identified by DUS. In the remaining six stents, 3D CT reconstructions showed compression, tapering, kinking, and minor fracture. DUS recognized all stent complications except the minor fracture. Overall agreement between CT and DUS was 98% (kappa = 0.90). Two cases of stent occlusion were found.

Conclusion

The long-term physical resilience of iliac vein stents evaluated with 3D CT in patients treated with CDT for iliofemoral DVT was high. Stent deformities were mostly compression, whereas fracture was rarely seen. DUS seems to be sufficient to evaluate venous stent integrity.
Effect of taking aspirin before diagnosis on the prognosis of esophageal squamous cell carcinoma and analysis of prognostic factors
Authors: Jiang Jiang , Liu Junfeng , Gao Ping , Liu Junying
Published: April 2022

Objective

The 5-year survival rate of patients with esophageal squamous cell cancer (ESCC) is very low. However, long-term aspirin use has been suggested to have an adjuvant therapeutic effect. We therefore investigated the effect of long-term aspirin use before ESCC diagnosis on postoperative patient survival.

Methods

We carried out a retrospective cohort study of patients who underwent esophageal cancer resection in our hospital from 2008 to 2018. Patients were divided into an aspirin group (n = 79) and control group (n = 79), and were followed up until December 2019. We analyzed the clinicopathological and follow-up data of the patients during hospitalization, and the cyclooxygenase-2 (COX-2) protein expression levels by immunohistochemistry, and related these to postoperative survival.

Results

Patients who took aspirin had significantly lower survival rates than those who did not. COX-2-negative patients had better survival than patients with either low or high COX-2 expression levels. T stage was the only independent predictor of survival in patients who took aspirin.

Conclusions

Long-term regular use of aspirin before diagnosis had an adverse effect on postoperative survival in patients with ESCC. Different COX-2 protein expression levels were associated with significantly different postoperative survival rates, with COX-2-positive patients having the poorest survival.
Preclinical coronavirus studies and pathology: Challenges of the high-containment laboratory
Authors: Baxter Victoria K. , Montgomery Stephanie A.
Published: April 2022

The COVID-19 pandemic has highlighted the critical role that animal models play in elucidating the pathogenesis of emerging diseases and rapidly analyzing potential medical countermeasures. Relevant pathologic outcomes are paramount in evaluating preclinical models and therapeutic outcomes and require careful advance planning. While there are numerous guidelines for attaining high-quality pathology specimens in routine animal studies, preclinical studies using coronaviruses are often conducted under biosafety level-3 (BSL3) conditions, which pose unique challenges and technical limitations. In such settings, rather than foregoing pathologic outcomes because of the inherent constraints of high-containment laboratory protocols, modifications can be made to conventional best practices of specimen collection. Particularly for those unfamiliar with working in a high-containment laboratory, the authors describe the logistics of conducting such work, focusing on animal experiments in BSL3 conditions. To promote scientific rigor and reproducibility and maximize the value of animal use, the authors provide specific points to be considered before, during, and following a high-containment animal study. The authors provide procedural modifications for attaining good quality pathologic assessment of the mouse lung, central nervous system, and blood specimens under high-containment conditions while being conscientious to maximize animal use for other concurrent assays.
Atypical multiple myeloma in 3 young dogs
Authors: Wachowiak Ian J. , Moore A Russell , Avery Anne , Magunda Forgivemore , Harris Adam , Laurence Hannah , Fulkerson Christopher M. , Fulkerson Caroline V. , Messick Joanne B. , Strandberg Natalia J. , McGrath Stephanie
Published: April 2022

Three dogs under 12 months old were diagnosed with atypical multiple myeloma (MM), having an aggressive multifocal anaplastic round cell sarcoma in bone marrow, viscera, and/or peripheral blood, which were confirmed by cytology and immunohistochemistry to be of plasma cell origin. The intramedullary sarcomas caused myelophthisis, osteolysis, and hypercalcemia. Complete or free light chain monoclonal gammopathy in the serum and/or urine was demonstrated by protein electrophoresis and immunofixation. The polymerase chain reaction for antigen receptor rearrangement assay performed on 2 cases identified a clonally rearranged immunoglobulin gene. Neoplastic cells lacked expression of CD45, CD3, CD18, CD21, CD34, and MHCII by flow cytometry. Immunohistochemistry revealed MUM1 immunoreactivity of the neoplastic cells. Combining all data, the diagnosis was MM. An aggressive form of MM in young dogs should be a differential diagnosis for patients with an immunoglobulin-productive, B cell-clonal, CD45-negative, MUM1-positive discrete cell neoplasm arising from the bone marrow.
After Chernobyl: Welsh Poetry and Nuclear Power
Authors: Alexander Neal , Harris Jamie
Published: April 2022

This article examines the responses of Welsh poets, writing in both English and Welsh, to nuclear power in the period after the Chernobyl disaster of April 1986. Fall-out from Chernobyl contaminated upland areas of North Wales adjacent to the country's two nuclear power stations, Trawsfynydd and Wylfa, prompting a backlash against the nuclear industry. Welsh poets played key roles in the anti-nuclear movement during the 1980s and 1990s, writing poems that respond both to the Chernobyl disaster and to nuclear threats closer to home. Furthermore, we trace the long aftermath of Chernobyl in the poetry of R.S. Thomas and Robert Minhinnick, which is frequently contaminated with the imagery and vocabulary of nuclear disaster.
Mutable mobiles? Making space for an access-based car sharing market
Authors: Chimenti Gianluca , Kjellberg Hans
Published: April 2022

How is space made to matter in contemporary access-based markets? Drawing on the geographies of marketization and constructivist market studies, we examine how space is framed as a relevant quality to take into account in market exchange and how that qualification process itself is spatially situated. We trace a failed attempt to create an access-based car market in Stockholm, involving parallel but poorly synchronized site-specific effects of marketization across public and private realms. Our findings show how DriveNow sought to render its envisioned market spatially homogenous and the spatial interdependencies between this envisioned market and other (market and nonmarket) uses of space. We highlight the performation struggles between such alternative but overlapping spatial demarcations in specific microgeographies and show how seemingly similar spatial imaginaries can be materialized in different ways in one spatial realm.
Recent geomorphological changes in the Paraiba do Sul delta, South America East Coast
Authors: Souza André de Oliveira , Lämmle Luca , Filho Archimedes Perez , Donadio Carlo
Published: April 2022

The Paraiba do Sul River delta, a South America east coast system, presents deposits recording complex sedimentary dynamics in the deltaic plain during the Little Ice Age (LIA). The use of optically stimulated luminescence (OSL) dating, sediment grain-size characterization, and morpho-chronological analysis showed that from ∼450 to 100years (LIA period), both in lower to upper deltaic plain, remodeling occurred in conjunction with the coastline regression. The freshwater and sediment influx increases due to the moisture enhancements during the LIA resulted in the intensification of the fluvial dynamic, channel downcutting on the marine terrace, and sedimentary environments remodeling. Further, the base-level changes occasioned by the coastline regression strengthen the geomorphological dynamics associated with the recent changes in the Paraiba do Sul delta. Currently, the coastal erosion problem found in the area seems to reflect the coupling between climate dynamic (rainfall rates decrease) and multiple-scale anthropic intervention. Results show a high sensitivity of humid tropical deltaic systems to short-time climate events, further contribute to broadening discussions on the complexity of this delta system’s morphosedimentary evolution during the Late Holocene.
Single nucleotide polymorphism rs 2070874 at Interleukin-4 is associated with increased risk of type 1 diabetes mellitus independently of human leukocyte antigens
Authors: Osman Awad E , Brema Imad , AlQurashi Alaa , Al-Jurayyan Abdullah , Bradley Benjamin , Hamza Muaawia A
Published: April 2022

Introduction

Type 1 diabetes mellitus (T1DM) is characterized by autoimmune destruction of insulin-producing pancreatic beta (β-) cells. Previous studies suggested an imbalance between and pro- and anti-inflammatory cytokines exacerbates T1DM development.

Objectives

We aimed to test the hypothesis that patients with T1DM carry a higher frequency of regulatory genes associated with low levels of the anti-inflammatory cytokines interleukin-4 (IL-4), its receptor (IL-4R), and interleukin-10 (IL-10).

Methods

Accordingly, we compared frequencies of five different single nucleotide polymorphisms (SNPs) in T1DM patients and healthy controls who had been typed for HLA-DRB1, HLA-DQA1, and HLA-DQB1 genes.

Results

The frequencies of rs2070874 (IL-4) alleles C and T differed between T1DM patients and controls (cp = 0.0065), as did their codominant (cp = 0.026) and recessive (cp = 0.015) models. Increased frequencies were observed in T1DM patients for HLA alleles: DRB1*03 (pc < 0.0013), DRB1*04 (cp = 0.0169), DQA1*03 (cp = 0.0222), DQA1*05 (cp < 0.0006), DQB1*02 (cp = 0.0005), and DQB1*06 (cp < 0.0005). And lower frequencies were observed for: DRB1*07 (cp = 0.0078), DRB1*11 (cp = 0.0013), DRB1*13 (cp < 0.0364), DRB1*15 (cp < 0.0013), DQA1*01 (cp < 0.0006), and DQA1*02 (cp = 0.0348). Certain DRB1: DQA1: DQB1 haplotypes showed greater frequencies, including, 03:05:02 (p < 0.0001) and 04:03:03 (p = 0.0017), whereas others showed lower frequencies, including, 07:02:02 (p = 0.0032), 11:05:03 (p = 0.0007), and 15:01:06 (p = 0.0002). Stratification for the above HLA haplotypes with rs2070874 C/C exhibited no significant differences between T1DM patients overall and controls. However, when stratified for the vulnerable HLA haplotype (03:05:02/04:03:03), young patients in whom T1DM began at ≤13 years had a higher frequency of the SNP (rs2070874 C/C); a gene associated with low IL-4 production (p < 0.024).

Conclusion

This study suggests that possession of the rs2070874 C/C genotype, which is associated with low production of IL-4, increases the risk of T1DM in young individuals carrying vulnerable HLA alleles/haplotypes.
Maya Ta Maya Ho (Love is Love): A Qualitative Study on LGBTQI+ Experiences in Hospice & Palliative Care in Nepal
Authors: Baskaran Archit B. , Hauser Joshua
Published: April 2022

Objective(s)

LGBTQI+ disparities in hospice and palliative care have been vastly underrecognized in medical practice and research. This may result in LGBTQI+ community members distrusting health care professionals, avoiding encounters due to fears of discrimination or mistreatment, and seldom disclosing their identities to health care professionals. LGBTQI+ patients often lack familial emotional and caregiver support, a central theme of hospice and palliative care – for example, older LGBTQI+ people are twice as likely as cisgender heterosexual people to live alone and four times as likely to not have children. LGBTQI+ populations are also highly intersectional; therefore, members may be further stigmatized. Blue Diamond Society is a non-governmental organization in Nepal that specializes in LGBTQI+ advocacy and patient care. Our main objective in this study was to explore Nepali LGBTQI+ patients’ experiences in hospice and palliative care.

Methods

29 interviews were conducted with patients, health care professionals, family members, and administrators involved with Blue Diamond Society (BDS), a Nepali NGO that serves Nepal's LGBTQI+ community. Questions were developed based on open-ended questioning to abstract relevant life and health history information pertaining to experiences with BDS and palliative care. These interviews were translated and transcribed verbatim. Qualitative Content analysis was conducted to identify prevalent themes.

Results

Four themes were identified: Fear of Dying without Family; Understanding Oneself and Sense of Community; Patient as Advocate; and Intersectionality and Eliminating Reductionism.

Conclusions

This study elucidated themes inherent to the experiences of LGBTQI+ Nepali people receiving palliative and hospice care, ultimately describing the unique needs of LGBTQI+ Nepali patients in palliative and hospice care settings. In doing so, this study presents an intersectional focus on palliative and hospice care, elaborating on challenges specific to a deeply marginalized community that remains underrepresented in academia. Findings from this study describe an expanded notion of “palliation” to embody “whole-person care,” that is, the palliation of social and structural pain, in addition to the more traditional conceptions of palliation as purely physical, emotional, and/or spiritual. This study also identified the importance of acknowledging and affirming the intersectional marginalization at which LGBTQI+ Nepalis live, ranging from experiences with socioeconomic status, family and communal conflict, ethnicity, race, sex, gender, sexual orientation, age, and environmental resource scarcity. In further understanding and improving upon intersectional LGBTQI+ cultural humility, this study provides opportunities for further research on cross-cultural LGBTQI+ patient needs in hospice and palliative care in a variety of resource settings.
A facile way to construct Sr-doped apatite coating on the surface of 3D printed scaffolds to improve osteogenic effect
Authors: Chen Shangsi , Wang Yue , Ma Jun
Published: April 2022

Bone-like apatite coating fabricated by biomineralization process is a facile way for surface modification of porous scaffolds to improve interfacial behaviors and thus facilitate cell attachment, proliferation, and differentiation for bone tissue engineering. In this study, a Sr-containing calcium phosphate solution was made and used to construct a thick layer of Sr-doped bone-like apatite on the surface of 3D printed scaffolds via biomineralization process. Importantly, Sr-doped bone-like apatite could form and fully cover the 3D printed scaffolds surface in hours. The characterization results indicated that Sr2+ ions successfully replaced Ca2+ ions in bone-like apatite and the molar ratio of Sr/(Ca+Sr) was up to 8.2%. Furthermore, the Sr-doped apatite coating increased the compressive strength and Young’s modulus of composite scaffolds. The compatibility and bioactivity of mineralized scaffolds were evaluated by cell attachment, proliferation, and differentiation of MC3T3-E1 cells. It was found that Sr-doped apatite coating could gradually release Sr2+ ions and further promote cell attachment, proliferation rate, and the expression of alkaline phosphatase activity and osteogenic related genes, such as collagen type I (Col I), Runt-related transcription factor 2 (Runx-2), osteopontin, and osterix. Therefore, the Sr-doped apatite coating fabricated by this facile and rapid biomineralization process offers a new strategy to modify 3D printed porous scaffolds with significantly improved mechanical and biological properties for bone tissue engineering applications.
The Influence of the Baby-Friendly Hospital Initiative and Maternity Care Practices on Breastfeeding Outcomes
Authors: Shing Jeffery SY , Lok Kris YW , Fong Daniel YT , Fan Heidi SL , Chow Charlotte LY , Tarrant Marie
Published: April 2022

Background:

The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 to promote breastfeeding through hospital policy. Researchers have reported breastfeeding improvements after hospitals became “Baby-Friendly.” In Hong Kong, the first public hospital was designated as a Baby-Friendly Hospital in 2016.

Research Aim:

To examine the influence of the BFHI on breastfeeding by comparing breastfeeding outcomes in a study cohort recruited before the implementation of the BFHI and a cohort recruited after its implementation.

Methods:

This was a quasi-experimental interrupted time-series design. Two cohorts of mother-infant pairs ( N = 2369) were recruited immediately postpartum from four public hospitals in Hong Kong and followed up prospectively. Comparisons were made in five of the BFHI steps experienced in both cohorts and the duration of any and exclusive breastfeeding.

Results:

A higher proportion of participants from the post-implementation cohort breastfed and breastfed exclusively at all follow-up periods. Participants in the pre-BFHI cohort, on average experienced 3.10 ( SD = 1.42) of the BFHI steps, whereas the participants in the post-BFHI cohort experienced 3.59 (1.09) of the BFHI steps. Half of the participants discontinued any breastfeeding by 13 weeks in the pre-BFHI cohort; more than half in the post-BFHI cohort were still breastfeeding at 6 months postpartum ( p < .001). Giving only human milk in the first 48 hr of delivery and not providing pacifiers or bottles were associated with lower risk of not exclusive breastfeeding in both cohorts.

Conclusion:

Implementation of the BFHI was associated with improvements in breastfeeding practices and outcomes.
How Do Employers Belonging to Marginalized Communities Respond to Minimum Wage Increases? The Case of Immigrant-Owned Businesses in Seattle
Authors: Somashekhar Mahesh , Buszkiewicz James , Allard Scott W. , Romich Jennifer
Published: April 2022

Minimum wage opponents often argue that businesses owned by marginalized communities, which include woman-owned, Black-owned, and immigrant-owned businesses, are exceptionally vulnerable to minimum wage increases. Little research has investigated this claim. Using a unique survey of Seattle businesses that includes owners’ nativity status and was administered while the city began to phase in its $15 minimum wage ordinance, the authors find that immigrant-owned businesses respond to the higher minimum wage in ways that largely conform to the responses of other businesses. Nevertheless, immigrant-owned franchises are less likely than other franchises to fire employees, reduce employees’ hours, or lower the wages of employees earning more than $15 per hour. Evidence suggests that immigrant franchisees have a lower likelihood of passing the increased labor costs onto employees because they use fewer employees and rely more heavily on family labor compared to other franchisees. The authors’ findings suggest that firms owned by marginalized and nonmarginalized groups respond to municipal-level minimum wage increases in comparable ways. Nevertheless, marginalized status may matter more in certain sectors of the economy than in others.
The Importance of Being “Woke”: Charter Management Organizations and the Growth of Social Consciousness as a School Quality Marker
Authors: Hernández Laura E.
Published: April 2022

Charter management organizations (CMOs) have increasingly had to respond to questions surrounding their organizations—particularly in the context of the broader social awakening around systemic injustices and evidence of their racially inequitable practices. This study investigated how CMOs counteracted criticisms and managed perception by characterizing their organizations as socially and racially conscious. It compared social media content for one CMO population during two time periods that surround the 2016 election: 2014 to 2016 and 2017 to 2019. Findings suggest that the CMOs have increasingly characterized themselves as socially conscious, but their attentiveness to issues of race and racism remained temporally and topically bounded. The article concludes with a discussion of how CMOs’ evolving discourse may influence public perception and considers how CMOs perpetuate a form of neoliberal multiculturalism that normalizes market reform under the discursive cover of a bounded articulation of equity and racial justice.
Accounting for discrimination through categorization work: An examination of the target-of-discrimination group members’ practices
Authors: Zhang Tianhao
Published: April 2022

This paper examines members’ practices involved in accounting for discrimination against their own group in interaction. Applying membership categorization analysis to interviews conducted with Chinese international students in Japan, I show that membership categories and category-based knowledge constitute crucial resources for target-of-discrimination group members’ making discrimination intelligible and reasonable. Specifically, interviewee accounts for discrimination by bounding certain activities/traits to the membership category being discriminated against. Meanwhile, those activities/traits are displayed as sanctionable given the social relation the discriminating and the discriminated sides are embedded in. Consequently, discrimination becomes reasonable and understandable in its given context. Interviewer, drawing upon common-sense knowledge about social categories, regularly challenges interviewee’s account by problematizing the association between the proposed activities/traits and the membership category and by contending the proposed sanctionable nature of those activities/traits. Interviewee can either persist through such challenges by further categorization work or modify their original account of discrimination. As such, target-of-discrimination group members’ accounting for discrimination as reasonable and intelligible is collaboratively accomplished through participants’ categorization work in interaction.
Environmental sustainability in Asian countries: Understanding the criticality of economic growth, industrialization, tourism import, and energy use
Authors: Chikezie Ekwueme Daberechi , Lasisi Taiwo Temitope , Eluwole Kayode Kolawole
Published: April 2022

This paper examines the causation between economic growth, tourism import, industrialization, renewable energy, non-renewable energy use, trade openness, and environmental sustainability which is proxied by carbon emissions for 8 Asian countries (China, Japan, India, Indonesia, South Korea, Philippines, Thailand, and Vietnam) over 20 years. Causal relations were tested using Pooled Mean Group Autoregressive distributive lag model (PMG-ARDL) and Dumitrescu and Hurlin's (2012) panel granger causality test The PMG-ARDL model results reveal that in the long-run renewable energy usage, economic growth, and trade have a significant negative influence on the emission of carbon, while non-renewable energy usage, tourism import, and industrialization exhibit a significant positive impact on CO2 emissions of the sampled Asian countries. In the short run, renewable energy has a significant negative influence on CO2 emissions. While economic growth exhibit a significant positive influence on carbon emissions in the short-run. Furthermore, the Granger causality analysis reveals that there is a feedback mechanism between industrialization, tourism import, non-renewable energy, renewable energy, and CO2 emissions meaning that the future dynamics of carbon emissions in the sampled countries can be significantly explained by industrialization, tourism import, renewable energy, and non-renewable energy. Contrarily, trade and economic growth are good to explain the dynamics of carbon effusion of the sampled Asian countries in the future but without feedback. It is recommended that policymakers in Asian countries should formulate stringent environmental policies that will encourage industries in these countries to utilize clean energy sources so that economic growth will be achieved simultaneously with carbon neutrality.
Political party families and student social rights
Authors: Czarnecki Krzysztof
Published: April 2022

The article conceptualizes student funding systems in order to investigate their ideological and political underpinnings. Using different long-term measures of cumulative power of four-party families and their combinations, and the newly created Student Support and Fees Dataset, it shows that the variety of student social rights in 32 high-income democracies in 2015 can be linked to past partisan politics. Decommodification, understood as making higher education study unconditional on labour income of students and their families, was positively associated with the rule of pro-welfare parties and negatively with the rule of Conservative parties, in the preceding two decades. Individualization, that is the state support for student transition to independent adulthood, was positively associated with the rule of left-wing parties. This, however, applies only to their long-term impact in older democracies and is to a large extent conditional on a country’s wealth. Third, social rights distribution characterized by a low degree of targeting and large recipiency rate was similarly related to the Left rule, while the Conservatives ruling in the last two decades contributed to increasing inequalities in student social rights.
Fibroscan detection of fatty liver and liver fibrosis in patients with systemic lupus erythematosus
Authors: Yetginoglu Ozge , Atas Dilek Barutcu , Yilmaz Yusuf , Velioglu Arzu , Arikan Hakki , Alibaz-Oner Fatma , Direskeneli Haner , Tuglular Serhan , Asicioglu Ebru
Published: April 2022

Objective

Although liver dysfunction is not considered the main organ involvement in Systemic Lupus Erythematosus (SLE), the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50–60% of patients. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using Fibroscan as well as determine associated factors such as immunosuppressive medications.

Methods

Sixty SLE patients and 30 healthy controls were included. Patients with HBV, HCV or cirrhosis, malignancy, cardiac disease, or patients on dialysis were excluded. All participants underwent Fibroscan measurements.

Results

The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7 vs 26.7%, p = .597). Liver fibrosis was also similar between the two groups (26.7 vs 10.0%, p = .069). Since the majority of SLE patients were female, we performed a subgroup analysis in female patients ( n = 51) and controls ( n = 25). Fatty liver disease was similar between female SLE patients and controls (23.5 vs 24.0%, p = .964). However, liver fibrosis in female patients with SLE was increased compared to female controls (29.4 vs 4.0%, p = .011) and was associated with age (Exp (B) 95% CI: 1.083 (1.006–1.166), p = .034) and low-dose cumulative glucocorticoid use (Exp (B) 95% CI: 14.116 (1.213–164.210), p = .034).

Conclusion

The prevalence of fatty liver was similar between SLE patients and controls, while liver fibrosis was increased in the female patient group as compared to controls. Furthermore, liver fibrosis was associated with age and low dose cumulative glucocorticoid use. Interestingly, fatty liver did not precede liver fibrosis in the majority of cases, contrary to what is observed in the general population. Larger studies are needed to confirm our findings and determine whether immunosuppressive use has any impact on the development of liver fibrosis in SLE patients.
Efficiency of a randomized confirmatory basket trial design constrained to control the family wise error rate by indication
Authors: He Linchen , Ren Yuru , Chen Han , Guinn Daphne , Parashar Deepak , Chen Cong , Yuan Shuai Sammy , Korostyshevskiy Valeriy , Beckman Robert A.
Published: April 2022

Basket trials pool histologic indications sharing molecular pathophysiology, improving development efficiency. Currently, basket trials have been confirmatory only for exceptional therapies. Our previous randomized basket design may be generally suitable in the resource-intensive confirmatory phase, maintains high power even with modest effect sizes, and provides nearly k-fold increased efficiency for k indications, but controls false positives for the pooled result only. Since family wise error rate by indications may sometimes be required, we now simulate a variant of this basket design controlling family wise error rate at 0.025 k, the total family wise error rate of k separate randomized trials. We simulated this modified design under numerous scenarios varying design parameters. Only designs controlling family wise error rate and minimizing estimation bias were allowable. Optimal performance results when [Formula: see text]. We report efficiency (expected # true positives/expected sample size) relative to k parallel studies, at 90% power (“uncorrected”) or at the power achieved in the basket trial (“corrected,” because conventional designs could also increase efficiency by sacrificing power). Efficiency and power (percentage active indications identified) improve with a higher percentage of initial indications active. Up to 92% uncorrected and 38% corrected efficiency improvement is possible. Even under family wise error rate control, randomized confirmatory basket trials substantially improve development efficiency. Initial indication selection is critical.