bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of antibiotic prescribing patterns among inpatients using World Health Organization indicators: A cross-sectional study
Authors: Tadesse Tesfaye Yimer , Molla Mulugeta , Yimer Yohannis Shumet , Tarekegn Benyas Shishigie , Kefale Belayneh
Published: May 2022

Objective:

Even though antibiotic resistance is one of the most serious threats to global public health, it is becoming more common due to inappropriate antibiotic prescribing patterns. Thus, the purpose of this study is to assess antibiotic prescribing patterns among inpatients at an Ethiopian comprehensive specialized hospital.

Methods:

An institutional-based cross-sectional study was used. During the study period, data were collected from the charts of admitted patients in selected wards of Debre Tabor comprehensive specialized hospital. The World Health Organization’s developed questionnaire and conventional antibiotic prescribing indicators were used to assess rational drug usage, with an emphasis on antibiotic prescribing trends. The data were analyzed using SPSS 25.0 statistical software.

Results:

For 861 patients admitted to medical and pediatric wards, a total of 1444 antibiotics were prescribed. Overall, 60.6% of inpatients were prescribed at least one antibiotic, with an average (mean ± SD) number of antibiotics prescribed per patient of 1.7 ± 1.6. During their hospital stay, patients were given antibiotics for an average (mean ± SD) of 6.4 ± 2.7 days. Furthermore, 83.3% of antibiotics were prescribed for therapeutic purposes, whereas 100% were provided for empiric purposes. Ceftriaxone was the most commonly administered antibiotic in the study settings (49.2%). During the study period, Debre Tabor comprehensive specialized hospital had access to 67.5% of key antibiotics.

Conclusion:

The antibiotic prescribing pattern in our study diverged from the World Health Organization-recommended guidelines. Furthermore, all antibiotics were given without a culture or sensitivity test in every case. Setting up an antibiotic stewardship program, introducing antibiotic use based on culture and sensitivity tests, and adopting institutional guidelines could all help to address this issue.
Impact of government policies on individual choices of food and potential impact on outcomes and nutrition among vulnerable population during COVID-19 pandemic in low- to middle-income country: Literature review
Authors: Kamanga Patricia
Published: May 2022

Corona Virus Disease 2019 (COVID-19) is a highly infectious disease which has affected almost all countries globally. The disease is caused by the corona virus, transmitted from human to human through droplet infection. The virus was first identified in China in December 2019, and spread worldwide. Despite the virus being highly infectious, there is no cure for coronavirus disease COVID-19. The current global approach in the fight against COVID-19 focuses on travel bans including border closures, restrictions on mass gatherings, and mass vaccination of all adults. However, the travel bans and border closures have shown to negatively affect availability, accessibility, and affordability of basic needs such as food, especially for populations in the low- to middle-income countries. This is so since a good percentage of population in low- to middle-income countries live on hand to mouth, and cannot afford adequate food stock to sustain them for a long period of time. In addition, there is a challenge to afford purchasing storage facilities such as refrigerators for storage of fresh foods. Therefore, the purpose of this narrative literature review is to unveil the impact of government policies on individual choices of food and potential impact on outcomes and nutrition in children, elderly and chronically ill individuals in the COVID-19 pandemic era in low- and middle-income countries from 2020 to 2021.
Expecting parents’ perceptions of the digital parental support “childbirth journey” constructed as a serious game—an intervention study
Authors: Bäckström Caroline , Rolfson Tanja , Engström Henrik , Knez Rajna , Larsson Margaretha
Published: May 2022

Objective

The aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game.

Methods

In this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis.

Results

Participants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey.

Conclusions

The Childbirth Journey intervention was concluded to be a valuable digital complement to in-person professional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.
Latecomers’ Isomorphic R&D Strategy and the Relationship With Performance: A Study on Chinese Pharmaceutical Firms
Authors: Zhao Ziyi , Zhou Banghao
Published: May 2022

Institutional environment plays a key role in shaping latecomers’ strategic choices. Conforming with the institutional environment is believed to alleviate uncertainties and resource deficiency for latecomers. However, does being isomorphic with institutional environment help latecomers in R&D activities that aims at making differences? The purpose of this study is to comprehensively explore how the interplay of institutional and competitive pressures from institutional environment manifests in latecomers’ R&D practices. Based on multiple case studies of four pharmaceutical firms in China, the occurrence of isomorphic R&D strategy and its relationship with performance have been uncovered in this paper. The subjective initiative and efficiency predictability of isomorphic R&D strategies are characterized through investigating its differences with general isomorphic behaviors.

With these findings, this study provides a strategic approach to study institutional isomorphism, draws the attention on the dynamic interaction between institutional context and R&D strategies and adds to the literature on latecomer firms’ R&D strategies.
Severity and Correlates of the Symptoms of Depression, Anxiety, and Stress in a Nationally Representative Sample of Turkish Secondary Boarding School Counselors
Authors: Şahin Ertuğrul , Topkaya Nursel , Gençoğlu Cem
Published: May 2022

The aim of this study was to examine the severity of the symptoms of depression, anxiety, and stress in a nationally representative sample of secondary boarding school counselors and their association with sociodemographics, school counselor self-efficacy, self-esteem, happiness, and stressful life events. Participants consisted of 181 (52.5% women; M = 26.91) school counselors working at different secondary boarding schools across Turkey who completed the measures related to sociodemographics, happiness, self-esteem, school counselor self-efficacy, stressful life events, depression, anxiety, and stress. After confirming construct validity and reliability of the self-esteem, depression, anxiety, and stress scales, data were analyzed using descriptive statistics, Pearson product moment correlation analysis, and multivariate multiple regression analysis. The study results suggested that depression, anxiety, and stress symptoms are prevalent among school counselors, approximately 23% of whom experience at least moderate symptoms of depression and stress, and approximately 31% experience at least moderate symptoms of anxiety. Moreover, the results indicated that the most commonly experienced symptoms were dysphoria in depression, situational anxiety in anxiety, and impatience in stress among school counselors. This study also found that sociodemographic factors and school counselor self-efficacy were not associated with symptoms of depression, anxiety, and stress. However, higher levels of happiness and self-esteem and fewer stressful life events experienced within the past year consistently showed a negative association with exhibiting decreased symptoms of depression, anxiety, and stress among school counselors. Self-care activities focusing on increasing self-esteem and happiness and teaching skills to cope effectively with stressful life events may help to diminish the symptoms of depression, anxiety, and stress among secondary boarding school counselors.
A Multilevel Analysis of Factors Associated With Stunting in Children Less Than 2 years Using Multiple Indicator Cluster Survey (MICS) 2017–18 of Punjab, Pakistan
Authors: Haq Wajiha , Abbas Faisal
Published: May 2022

Stunting is an important issue as it leads to many adverse consequences on children’s health. Pakistan is in public health crisis due to higher stunting rates in children. World Health Organization entails the prevalence of stunting to be less than 2.5% in a healthy population, but every third child is stunted in Punjab (largest province of Pakistan by area and population). By using the Multiple Indicator Cluster Survey (MICS) Punjab, 2018 and employing multilevel logistic regression analyses, this study finds that children whose mothers are educated and have better access to drinking water and antenatal care have lower odds of stunting. Access to better and accessible health care, education especially of girls/women, and clean water can reduce stunting in children. The government needs to give special attention to these factors to help children grow healthy.
Adoption Factors and Moderating Effects of Age and Gender That Influence the Intention to Use a Non-Directive Reflective Coaching Chatbot
Authors: Terblanche Nicky , Kidd Martin
Published: May 2022

Chatbots are increasingly applied in various contexts including helping professions, such as organizational and life coaching. Coaching facilitates individual wellness, behavioral change, and goal attainment in a reflective, non-directive manner, and is considered one of the fastest-growing professions. The use of knowledge imparting service chatbots have been studied; however, the application of chatbots in coaching has received scant research attention, raising the question about which factors and moderating effects play a role in the adoption of reflective, non-directive coaching chatbots. In this study, we applied a modified Unified Theory of the Acceptance and Use of Technology (UTAUT) model to determine factors and moderating effects of age and gender that influence the adoption of a goal-attainment coaching chatbot. Partial least squares structural equation modeling (PLS-SEM) was used for the analysis of a cross-sectional UTAUT survey ( n = 226). Performance expectancy, social influence, and facilitating conditions had significant roles as direct determinants of intent to use the coaching chatbot. Gender moderated performance expectancy and age showed a moderation tendency on effort expectancy. This study on non-directive, reflective chatbots in the organizational, and life coaching domains contributes to our understanding of how to design chatbots aimed at helping people find their own answers.
Leader’s Toxicity at Workplace: How Leader’s Decadence Affect Employees? A Pakistani Perspective
Authors: Qureshi Muhammad Azeem , Ramish Muhammad Sufyan , Ansari Junaid , Bashir Muhammad Adnan
Published: May 2022

Several studies have found adverse effects of abusive leadership on employees and organizations in the recent past. However, the cultural norms in Pakistan demand an abusive leadership approach. Pakistani culture is high in power distance, abuse of power is a norm, and people are accustomed to autocracy. Since most of the studies addressing the negative effects of abusive leadership were conducted in the west, it is necessary to examine whether abusive leadership is an effective leadership approach in the cultures that experience high power distance. There is a paucity of literature addressing the issue in question. In addition, existing literature does not explain how abusive leaders affect employees’ attitudes and behaviors with clarity. This research makes an ontological contribution and discusses the philosophical origins of abusive leadership theory. Furthermore, this research draws the inference using the groundings of conservation of resource theory, leader-member exchange theory, and aggression displaced theory to propose that abusive leaders deteriorate employees’ quality of working life experience. Employees with poor working-life experience are more likely to be involved in counterproductive work behavior, planning to leave the organization, and are less likely to show organizational citizenship behavior. Dyadic data were collected from 474 respondents based on purposive sampling technique from private sector organizations in Pakistan. Results of structural equation modeling using AMOS v23 supported all the proposed hypotheses. Results imply that the moral content of leadership requires special attention, and abusive leadership is not an appropriate leadership approach because of its adverse effects on employees’ attitudes and behaviors.
The Road to the Future: A Multi-Technique Bibliometric Review and Development Projections of the Leader–Member Exchange (LMX) Research
Authors: Premru Maruša , Černe Matej , Batistič Saša
Published: May 2022

This study examines the evolution of leader–member exchange (LMX) research. We apply bibliometrics to analyze the extant literature published from the beginning of the construct development, complementing existing qualitative and meta-analytic reviews of the LMX field. We use a combination of three bibliometric techniques—document co-citation analysis, co-word analysis, and bibliographic coupling. Our approach enables us to identify the most influential topics, determine the underlying structure and development of the field by interpreting bibliometric results against the backdrop of the invisible colleges framework, as well as detect emerging topics. We conclude by providing important theoretical and methodological implications, suggesting the emergence of new sub-fields and future opportunities for new connections among specific existing sub-streams of LMX, leadership, and management research.
Islamic Organization and the Perception of riba (Usury) and Conventional Banks Among Muslims: Evidence From Indonesia
Authors: Harahap Burhanudin , Risfandy Tastaftiyan
Published: May 2022

At least seven verses in the Qur’an and many hadiths highlight that riba (usury) is forbidden in Islam and should be avoided by Muslims. However, when we bring this issue into the modern context, especially its application in economics and banking, Muslims might say differently. Some Muslims with contemporary arguments could say that banks’ interest is not similar to riba because riba is only in the context of excessive lending and taking advantage of others’ needy. We survey 626 people in Indonesia and finds that 93% of Muslims said that riba is indeed prohibited in Islam, but some of them disagree if riba is similar to the conventional bank’s lending-borrowing mechanisms. In this article, we also empirically find that their involvement in the Islamic organization could strengthen their perception that riba is not similar to the bank’s interest rate.
Occupational Health and Safety of Immigrant Hotel Housekeepers
Authors: Shapoval Valeriya , Sönmez Sevil , Hsieh Yu-Chin (Jerrie) , Apostolopoulos Yorghos
Published: May 2022

Background:

The accommodations sector is one of the largest employers of immigrant and minority workers in the United States. Hotel housekeepers represent the industry’s largest workforce while facing difficult work conditions, health hazards, and psychological stress. This is one of the few empirical studies that address the working conditions of housekeepers in the United States and their perspective of health challenges they face.

Methods:

A cross-sectional survey study was conducted with hotel housekeepers ( N = 140) in Florida and in collaboration with the local labor union as a rapid assessment of occupational health and safety risk exposures, work-related injuries, coping mechanisms, and perceived management responses. Experienced union workers recruited study participants and administered interviewer-administered surveys. The analysis included descriptive statistics and multivariate regression.

Findings:

Sampled hotel housekeepers were found to work under significant time pressures to complete excessive workloads and to experience chemical and biological exposures and physical and psychosocial strains. Poor work equipment/insufficient supplies had a negative impact on hotel housekeepers’ health, these include heavy wet towels vacuum cleaners having a significant effect on ( p < .001) sprains and strains. Poor cleaning supplies had a significant effect ( p < .001) on chemical burns. Other significant findings are provided in the article.

Conclusion/Application to Practice:

While housekeeping work conditions include many challenges, relatively simple changes by hotels’ management can provide potential relief and improve workers’ health and safety outcomes, such as functional equipment, sufficient inventory, management support, and proper rest breaks—subsequently increasing workers’ health and reducing accidents, and thus potentially improving productivity at a relatively low cost.
Age-Dependent Differences of Paraspinal Muscle Endurance and Morphology in Chinese Community Population Without Chronic Low Back Pain
Authors: Han Gengyu , Wang Wei , Yue Lihao , Fan Zheyu , Li Zonglin , Li Jiaming , Sun Zhuoran , Li Weishi
Published: May 2022

Study Design:

Cross-sectional study.

Objectives:

Our aim was to describe age-dependent changes of lumbar paraspinal muscle endurance and morphology in Chinese healthy population. We also explored the relationship between paraspinals endurance and morphology.

Methods:

A total of 181 participants from Chinese community population without chronic low back pain were included. The participants were divided into three groups: young (20-39 years old, n = 29), middle (40-59 years old, n = 93), and elderly (≥ 60 years old, n = 59). The Ito test was performed to evaluate the isometric endurance of paraspinal muscles. The total cross-sectional area (TCSA) and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured at L1-L5 levels on magnetic resonance imaging. Physical activity level was evaluated using the physical activity index and comorbidities were assessed by the modified 5-item frailty index.

Results:

The elderly group had a shorter performance time of endurance test than the young group and middle-aged group. Correlation analysis showed that age had a significant correlation with endurance test, the average MF TCSA, MF FI, ES TCSA and ES FI of L1-5. In addition, PAI had a significant correlation with endurance test and MF FI. In multiple linear regression analysis, paraspinals endurance was associated with MF FI, ES FI, physical activity level and comorbidities.

Conclusion:

Age-related decreases in paraspinals endurance and TCSA, and an increase in FI were revealed. Besides, paraspinal muscles FI, but not TCSA, was negatively associated with the endurance of paraspinals.
Leadership Behaviour in Covid-19 Crisis Response: A Personal Strategy Proposition
Authors: Rameshan Pallikara
Published: May 2022

This paper analyses the personal strategy driving COVID-19 crisis behaviours of 20 country leaders. It explains the concept of personal strategy and establishes its theoretical basis. It also reviews leaders’ COVID-19 action contexts, actions and associated dynamics to infer the personal strategy driving their behaviour. The article finds the best personal strategy for COVID-19 crisis management as ‘crisis resolution’ and its variants adopted by leaders with a track record in crisis management or facing serious political compulsions—the latter, with a ‘career turnaround’ motive, were focused on erasing unfavourable political image. Leaders following personal strategies of self or negative orientations were the least successful or most unpopular. The article categorizes personal strategies broadly as crisis-focused, negative-focused, ideology-focused and mixed-focused, and it shows that personal goals and personal strategies of country leaders could be interpreted with existing theories. Drawing from a previous study on the same 20 leaders, the article shows that personal strategy of ‘crisis-focus’ is associated with positive styles of crisis action and leader behaviour, ‘negative-focus’ is related to negative action and behavioural styles, and ‘mixed-focus’ is linked to ‘strategic’ actions and transactional behaviour. Except for ideology-focus, leaders’ choice of personal strategy is not found exclusively related to the developmental or geopolitical status of their countries, which proves that personal strategy is a leader phenomenon. Differences in personal strategy among leaders led to different results in different countries—positive orientation resulted in positive outcomes and negative focus caused negative outcomes. The article concludes that personal strategy as a medium of transmitting leader traits into leader behaviour through support of personal goal can fill the gap in the current literature in connecting personal traits to leader behaviour.
Direct Cash Transfers in Emerging Economies: The Case of India
Authors: Dar Vandita , Sethi Madhvi , Baby Saina
Published: May 2022

Social welfare systems across the developing world have witnessed a significant transformation in the last 20 years with direct cash transfers becoming an increasingly preferred means of tackling poverty and inequality. While this movement finds its roots in Latin America, a large number of developing countries including India have since modified their welfare systems, incorporating direct cash transfers as an alternative to in kind benefits and subsidies. India’s Direct Benefit Transfer (DBT) system, which has been in existence since the past five years, has 316 schemes under its aegis now. While it would be premature to evaluate its success or failure, it would definitely be an interesting and worthwhile exercise to see how Indian states fare in terms of DBT. With Amartya Sen’s pathbreaking Capability Approach as the premise, this research is a unique attempt to explore and identify variables that determine and impact DBT transfers at the Indian state level using multiple regression. We find that literacy and the JAM (Jan-Dhan, Aadhaar, Mobile) Index emerge as significant variables impacting DBT transfers in states. This study contributes to the current literature on social welfare systems and highlights the importance of development architecture in emerging economies.
A Case of Concurrent Disseminated Coccidioidomycosis and Embryonal Carcinoma When Lice and Fleas Coexist
Authors: Ke Michael , Heidari Arash , Valdez Michael , Tsiyer Allen , Kuran Rasha , Johnson Royce
Published: May 2022

Coccidioidomycosis (CM) is a fungal infection endemic to the southwestern United States with a wide range of clinical presentations depending on the infected organ systems. Most infections are asymptomatic. Coccidioidomycosis causes a primary pulmonary infection and when symptoms occur, they most often resemble community-acquired pneumonia. One percent of cases disseminate, typically via hematogenous or lymphatic spread. It is in these cases that more severe symptoms may present and potentially overlap with those characteristics of other systemic illnesses. This is a case of CM disseminated to lymph nodes in a 24-year-old man with concomitant metastatic embryonal carcinoma. It is difficult to identify the primary etiology for many components of this patient’s presentation, including diffuse lymphadenopathy and multiple pulmonary nodules. Furthermore, the relationship between these 2 concurrent disease processes is not entirely clear. Factors that may contribute include the well-known phenomenon of locus minoris resistentiae (LMR) or potentially a shared immune failure between infectious organisms and malignant cells.
Racial Differences in Trust and Risk Disclosure Preferences Among Older Registered Research Volunteers Screened for Prodromal Synucleinopathies
Authors: Marshall Carly , Havis Isabelle , Herreshoff Emily , Lewis Cate , Kotagal Vikas
Published: May 2022

Background/Objectives

The equitable enrollment of minority participants in synucleinopathy trials is an emerging public health concern. Differing views regarding risk disclosure may influence research involvement in at-risk adults.

Methods

We conducted a brief mailed survey, including questions about trust and hypothetical risk disclosure preferences, to 100 participants in the Healthier Black Elders Center cohort in Detroit, MI and 100 participants in the Claude D. Pepper Older Americans Independence Center Research Participant Program at the University of Michigan.

Results

125 recipients without a diagnosis of a neurodegenerative disorder returned the survey, 52 (41.6%) of whom identified as being Black or African American. Black respondents reported less trust in medical providers (t=2.02, p=0.045) and medical researchers (t=2.52, p=0.013) and a greater desire to be informed about the presence of unchangeable risk factors for neurodegenerative disorders (t=2.02, p=0.045).

Conclusions

These findings have implications for the recruitment of representative populations in prodromal neurodegenerative research.
Book review: Saiyid Zaheer Husain Jafri, Beyond the Chronicles: ‘Recovering’ Histories of the Institutions and Families (Persian Documents in India, 17th–19th C.)
Authors: Moosvi Shireen
Published: May 2022

Saiyid Zaheer Husain Jafri, Beyond the Chronicles: ‘ Recovering’ Histories of the Institutions and Families (Persian Documents in India, 17th–19th C.) (New Delhi: Gyan Publishing House), 2021, 216 pp., ₹ 790 (Hb).
Book review: Robert Eric Frykenberg, ed., Land Control and Social Structure in Indian History and Robert Eric Frykenberg, ed., Land Tenure and Peasant in South Asia
Authors: Habib Irfan
Published: May 2022

Robert Eric Frykenberg, ed., Land Control and Social Structure in Indian History (Delhi: Primus Books), 2020, 273 pp., ₹300 (Pb) [originally published in 1969].

Robert Eric Frykenberg, ed., Land Tenure and Peasant in South Asia, (Delhi: Primus Books), 2020, ₹350 (Pb) [originally published 1977].
Book review: Amiya P. Sen, Vidyasagar: Reflections on a Notable Life
Authors: Bandopadhyay Arun
Published: May 2022

Amiya P. Sen, Vidyasagar: Reflections on a Notable Life (Hyderabad: Orient BlackSwan), 2021, 240 pp., ₹925.
Handloom Cloth Production in Colonial United Provinces: The Response to Industrial Competition
Authors: Rai Santosh Kumar
Published: May 2022

This article briefly traces some general trends defining the existence of handloom weaving industry in United Provinces in the late nineteenth century and the first half of the twentieth century. Handloom industry, in spite of the dislocation through large imports of British cloth, still remained the largest employing sector in this region, after agriculture. Use of machine-made yarn play a part in the survival of the handloom weaver, and there being now escalating competition between Indian and British mill yarn for supplying the local handloom industry. Handspun yarn ultimately became a miniscule part of the yarn market. The article analyses the ways in which the region’s handloom weavers were affected by these changes, by focusing on the shifts towards production of special kinds of cloth and search for investments, raw material and market. Such changes also meant that the previous inter-community forms of dependence tended to be transformed into intra-community forms of exploitation.
Prejudice and Identity: Hindi High Caste Journals, United Provinces (1918–30)
Authors: Srivastava Nishtha
Published: May 2022

Nationalism is a fluid concept which needs contextual understanding. Construction of communal and caste identities played an important role in countering or qualifying nationalism in the United Provinces (UP) (1918–30). This article investigates the contents of some of the Brahman caste journals in order to study the evolution of identify consciousness, the construction of the ‘self’ vs. the ‘other’, where the self was always the Hindu upper caste, and the ‘other’ was invariably the ‘Musalman’. It is clear that identity consciousness had an overarching presence in middle-class UP in the 1920s—a presence which is clearly traceable in the caste journals published in that decade.
Teaching Undergraduate Social Determinants of Health: “Bad” Neighborhoods, “Those” People, and Dispelling the Stereotypical Portrayal of Poor, Urban Communities
Authors: Osiecki Kristin M. , Mejia Angie
Published: May 2022

The current racial climate, the subsequent protests taking place in the state of Minnesota, and the social spotlight that followed, brought forth the importance of creating anti-racism initiatives in higher education. This article describes a significant curriculum redesign of an undergraduate social determinants of health (SDOH) course to include a module on examining social and community context with an emphasis on racism, discrimination, and violence. Course materials focused on a notorious urban housing project subject to media scrutiny, and a corrupt political system that resulted in policies perpetuating generational segregation, poverty, and violence. SDOH factors are presented in an upstream public health approach from the lens of individuals, and their perceptions of top down, uncontrollable institutional level forces that impact their quality of life. This module aims to disrupt students’ deep-rooted understanding about underserved urban populations and introduces them to a nuanced understanding of intersectionality around five key SDOH. The module incorporates an intersectional analysis within the praxis of public health and sociology to explore discrimination, institutional racism, and segregation beyond public health data driven indicators that examine race and disparate health outcomes. We found that preconceived notions of student knowledge, behavior, and belief systems contribute to the stereotypical views of urban, poor minority populations. Students discovered that despite neighborhood dysfunction, residents created strong social cohesive networks, were political advocates for change, and sought promised governmental economic opportunities. Students are better informed about “those” people in “bad” neighborhoods that struggle to overcome decades of institutionally designed obstacles created from subversive policies.
Relationship between Resilience and the Impostor Phenomenon among Undergraduate Medical Students
Authors: Camara Gisele Ferreira , de Santiago Campos Isabele Fontenele , Carneiro Amanda Galdino , de Sena Silva Ismael Nobre , de Barros Silva Paulo Goberlânio , Peixoto Raquel Autran Coelho , Augusto Kristopherson Lustosa , Peixoto Arnaldo Aires
Published: May 2022

Introduction

Impostor Phenomenon (IP) is the inability to internalize success and a tendency to attribute success to external causes. Social and institutional support are strategies to avoid the problem, but only partially successful. Resilience has been considered protective against mental health disorders in medical students. This study aims to investigate the association between IP and resilience in undergraduate medical students.

Methods

Using Clance Impostor Phenomenon Scale (CIPS), Connor-Davidson Resilience Scale (CD-RISC), and a socio-demographic questionnaire, we conducted a cross-sectional, quantitative study with undergraduate medical students.

Results

The study included 425 pre-clerkship medical students of average age of 23.03 years. The prevalence of IP was 47.76% (CIPS ≥ 62 score, as recommended in prior literature.) and there were no differences among age, gender, current semester, religion. The majority student's CD-RISC score was 68.57 ± 14.66 and there was no statistical difference in resilience scale among age, gender, religion and training semester. “Other religions” group was associated with a higher resilience score when compared to “Catholic” or “Non-religious” students. We found an inverse correlation between the level of resilience by CD-RISC and the level of symptoms related to IP by CIPS (ρ = −0.409; p-value < .001).

Conclusions

Findings from this study suggest that higher levels of resilience are likely protective against IP among undergraduate medical students. Furthermore, the non-inclusion of medical internship students and the cross-sectional design of this study are restraining aspects noticed within the project, suggesting the need for further studies to adjust those limitations.
The Melody of Universalism: Political Thought in Rabindra Sangeet
Authors: Sen Sucharita
Published: May 2022

This article searches for Tagore’s political thought by an analysis of his songs. Existing literature has largely focussed on Tagore’s novels, letters, poems and short stories to understand his political vision. In this article, I argue that in tandem with his literary compositions, Tagore’s musical creations also have the potential to shed much light on his political thought. A keen observer of social upheavals, Tagore aimed to resolve the specific problems which were paralysing the Bengal of his times. So emerged his songs promoting Hindu–Muslim unity, India’s composite culture and spiritual regeneration of the human soul. Beneath these apparently different themes, there remained an urge for universalism, fraternity and unity which was abound in his musical expositions. This article deconstructs Tagore’s songs to analyse their meaning and their relation to the wider contemporary cultural ambience. The political thought of Tagore, as reflected in his songs, however, should not be interpreted independent of and abstracted from his literary contributions. This article, therefore, situates his songs in the ongoing discourse on Tagore’s political thought, alongside his stories, poems and novels.
Repression of Uyghur Muslims and the Freedom of Religious Beliefs in China
Authors: Anand Amit
Published: May 2022

China has been accused by the international community for placing tight constraints on the religious freedom of Uyghurs in the northwest Xinjiang Uighur Autonomous Region (XUAR). It has been widely reported that China has placed in detention over a million Uyghur Muslims in order to ‘re-educate’ them to adapt to ‘Chinese culture’. It has been alleged that China is using a system of surveillance, control, and suppression of religious activity aimed particularly at Uyghurs accusing them of actively involving in separatist activity with foreign funding in order to destabilise the region. Note that, China has also brought in polices on regulation of religious affairs that makes it difficult for a religious body or a church, mosque to exist in China without prior State approval. The policy also gives unfettered power of oversight to the government over minority religious institutions and their day to day management.

In light of the above, this article examines the issue of right to freedom of religion or belief in the backdrop of China’s treatment of Uyghur Muslims in the Xinjiang region. Further, this article also comments upon China’s current domestic policy regulating religion and its commitment at the international level to protect and promote freedom of religion or belief of all its citizens.
Assessing the Quality of Universities: A Gedankenexperiment Derived from Creating Stakeholder Value
Authors: Fisher Nicholas I.
Published: May 2022

World University Ranking (WUR) systems play a significant role in how universities are funded and whom they can attract as faculty and students. Yet, for the purpose of comparing universities as institutions of higher education, current systems are readily gamed, provide little guidance about what needs to be improved, and fail to allow for the diversity of stakeholder needs in making comparisons. We suggest a list of criteria that a WUR system should meet, and which none of the current popular systems appears satisfy. By using as a starting point the goal of creating value for the diverse and sometimes competing stakeholder requirements for a university, we suggest via a thought experiment a rating process that is consistent with all the criteria, and a way in which it might be trialled. Also, the resulting system itself adds value for individual users by allowing them to tune it to their own particular circumstances. However, an answer to the simple question ‘Which is the best university’ may well be: there is no simple answer.
The Hyperintense study: Assessing the effects of induced blood pressure increase and decrease on MRI markers of cerebral small vessel disease: Study rationale and protocol
Authors: Janssen Esther , ter Telgte Annemieke , Verburgt Esmée , de Jong Joost JA , Marques José P , Kessels Roy PC , Backes Walter H , Maas Marnix C , Meijer Frederick JA , Deinum Jaap , Riksen Niels P , Tuladhar Anil M , de Leeuw Frank-Erik
Published: May 2022

Background:

Neuroimaging markers of cerebral small vessel disease (SVD) are common in older individuals, but the pathophysiological mechanisms causing these lesions remain poorly understood. Although hypertension is a major risk factor for SVD, the direct causal effects of increased blood pressure are unknown. The Hyperintense study is designed to examine cerebrovascular and structural abnormalities, possibly preceding SVD, in young adults with hypertension. These patients undergo a diagnostic work-up that requires patients to temporarily discontinue their antihypertensive agents, often leading to an increase in blood pressure followed by a decrease once effective medication is restarted. This allows examination of the effects of blood pressure increase and decrease on the cerebral small vessels.

Methods:

Hyperintense is a prospective observational cohort study in 50 hypertensive adults (18–55 years) who will temporarily discontinue antihypertensive medication for diagnostic purposes. MRI and clinical data is collected at four timepoints: before medication withdrawal (baseline), once antihypertensives are largely or completely withdrawn ( T = 1), when patients have restarted medication ( T = 2) and reached target blood pressure and 1 year later ( T = 3). The 3T MRI protocol includes conventional structural sequences and advanced techniques to assess various aspects of microvascular integrity, including blood-brain barrier function using Dynamic Contrast Enhanced MRI, white matter integrity, and microperfusion. Clinical assessments include motor and cognitive examinations and blood sampling.

Discussion:

The Hyperintense study will improve the understanding of the pathophysiological mechanisms following hypertension that may cause SVD. This knowledge can ultimately help to identify new targets for treatment of SVD, aimed at prevention or limiting disease progression.
MINocyclinE to Reduce inflammation and blood brain barrier leakage in small Vessel diseAse (MINERVA) trial study protocol
Authors: Brown Robin B , Tozer Daniel J , Loubière Laurence , Hong Young T , Fryer Tim D , Williams Guy B , Graves Martin J , Aigbirhio Franklin I , O’Brien John T , Markus Hugh S
Published: May 2022

Background:

Cerebral small vessel disease (SVD) is a common cause of stroke and cognitive impairment. Recent data has implicated neuroinflammation and increased blood-brain barrier (BBB) permeability in its pathogenesis, but whether such processes are causal and can be therapeutically modified is uncertain. In a rodent model of SVD, minocycline was associated with reduced white matter lesions, inflammation and BBB permeability.

Aims:

To determine whether blood-brain barrier permeability (measured using dynamic contrast-enhanced MRI) and microglial activation (measured by positron emission tomography using the radioligand 11C-PK11195) can be modified in SVD.

Design:

Phase II randomised double blind, placebo-controlled trial of minocycline 100 mg twice daily for 3 months in 44 participants with moderate to severe SVD defined as a clinical lacunar stroke and confluent white matter hyperintensities.

Outcomes:

Primary outcome measures are volume and intensity of focal increases of blood-brain barrier permeability and microglial activation determined using PET-MRI imaging. Secondary outcome measures include inflammatory biomarkers in serum, and change in conventional MRI markers and cognitive performance over 1 year follow up.

Discussion:

The MINERVA trial aims to test whether minocycline can influence novel pathological processes thought to be involved in SVD progression, and will provide insights into whether central nervous system inflammation in SVD can be therapeutically modulated.
Closet Dalithood: Traumatized Caste Performativity and the Making of an Urban Aesthetics of Caste in Yashica Dutt’s Coming Out as Dalit (2019)
Authors: Gurjar Kunwar Nitin Pratap , Srishti
Published: May 2022

With the publication of Yashica Dutt’s (2019) Coming Out as Dalit, a clear shift in Dalit autobiographical writing tradition is becoming visible, and this article tries to capture that shift by locating it within a global discourse on marginality and discrimination. This shift enables Dutt to rebrand a certain understanding of caste from a birth-marked identity to a more free-floating and performative understanding of caste. The emphasis on the performative aspect of caste provides it the necessary synergetic value to attach with multiple global discourses around marginality, discrimination, sexuality, and race. The article highlights how Dutt’s text is trying to develop a new urban aesthetics of caste to capture the sensibilities of a dominantly urban and global audience, and at the same time, expanding and signifying the understanding of caste. The article argues that it is this attempt to develop a new aesthetic formulation of caste that can explain the use of what is primarily a queer symbol of expression ‘coming out’ to couch the expression of caste discrimination. The article further indicates how similar synergies are developed with racial discourses and, finally, argues how these attempts can be understood as part of a global response to inequalities and the right to the city, making and expanding Dalit literature’s participation in the category of protest literature.
Bowed, Bent and Broken: Investigating Enrolments of Scheduled Castes/Tribes to Technical Higher Education Programmes in Kerala
Authors: John Kishore Thomas , Ali Rofin Thirunelvelikaran Mohammed , Rejikumar G.
Published: May 2022

The Kerala model of development is well regarded in the literature, with numerous authors citing how it brought forth high social development and egalitarianism into the state. Kerala, unlike its neighbours, has traditionally resisted private expansion of higher education, arguing for the cause of social equity, fairness and justice for deprived sections. However, post the millennium, growth in technical institutions offering professional higher education courses have been prolific in the state. Against this backdrop, this study investigates how the most backward sections of the state comprising Scheduled Castes (SC) and Scheduled Tribes (ST) have fared in enrolments to such programmes. Using data retrieved from the available public records, the analysis finds that SC/ST sections are grossly under-represented across the entire spectrum of professional higher education courses in the state that offer technical programmes. The enrolments are far below the expected levels, underperforming all other South Indian states and the national average by a significant margin. The study suggests that this data is deliberately withheld by the government to the public. The research argues that Kerala is at a critical juncture, where in the absence of disruptive government intervention, the situation would worsen. These findings severely dent Kerala’s claims on being an inclusive society and its narrative on development orientation. A phenomenon of social exclusion encountered in the state is explained and illustrated. Thereafter, the article discusses the implications of the findings, while suggesting policy initiatives and regulatory actions that can help provide respite and relief for the deprived SC/ST communities.
Return to Play After Isolated Syndesmotic Ligamentous Injury in Athletes: A Systematic Review and Meta-analysis
Authors: Salameh Motasem , Hantouly Ashraf T. , Rayyan Abdallah , Dabbas Jood , Toubasi Ahmad A. , Hartnett Davis A. , Blankenhorn Brad
Published: May 2022

Background:

Syndesmotic ankle sprains are common and challenging injuries for athletes. The management of such injuries is controversial, with a paucity of evidence on treatment protocols with unpredictability regarding the time lost to participate in sports following injury. The present study seeks to review and report the return to play (RTP) time and examine the outcomes and complications of ankle syndesmotic sprains in the athletic population.

Methods:

PubMed, Cochrane Library, and Google Scholar were queried in August 2021 for case series, cohorts, and randomized controlled trials that evaluated return to play time after ankle syndesmotic sprains. The primary outcomes were the rate and time to return to play after syndesmotic ankle sprains for both surgical and nonsurgical treatment. Secondary outcomes included short-term complications and recurrence.

Results:

Eighteen articles were eligible for meta-analysis with a total of 1133 syndesmotic sprains. The overall RTP was 99% (95% CI 0.96, 1.00), the overall mean RTP was 52.32 days (95% CI 39.01, 65.63). Pooled RTP for surgically treated patients was 70.94 days (95% CI 47.04, 94.85), whereas it was 39.33 days (95% CI 28.78, 49.88) for nonsurgically treated cases. A low incidence of recurrence and complications were reported.

Conclusion:

This article reports a high rate of RTP after syndesmotic sprains. Grade of injury and surgical vs conservative management can affect the time to RTP in high-level athletes. Level of Evidence: Level IV, systematic review and meta-analysis.