bluuebunny/crossref_metadata_2025 huggingface dataset:
The Grief Experiences of Children with Developmental Disabilities: A Narrative Literature Review
Authors: Gaines Arlen G.
Published: September 2022

Background

Children with developmental disabilities have wide-ranging social, developmental, and communication challenges impacting their grieving process. This narrative review examined the literature relating to the grief experiences of children with developmental disabilities to identify implications for practice and areas for future research.

Methods

The literature review was conducted using five databases, and a hand search of dissertations with original research, due to the sparse body of published works.

Results

Nine works were included in the review, which were thematically synthesized into three categories: (1) Understanding of death concepts, (2) Social-emotional responses to loss, and (3) Disenfranchised grief.

Conclusions

Children with developmental disabilities are affected by loss, even if their comprehension of death concepts is impacted by their level of disability. They may experience challenges due to changes in routines and concrete thinking, and are at risk of disenfranchised grief. Future research is needed to inform developmentally appropriate grief interventions.
A journey towards a theology of health economics and healthcare funding
Authors: Duckett Stephen
Published: September 2022

Policy decisions in healthcare inherently involve value choices, but these are rarely made explicit. As a health economist participating in policy debates, I have become increasingly concerned about the profession’s implicit values and began to explore – through a PhD in theology – what a theologically informed basis for health economics, and healthcare funding in particular, might comprise. The result is articulation of a set of principles derived from the parable of the ‘Good’ Samaritan – compassion, social justice and stewardship.
Theodicy and divine love
Authors: Ward Keith
Published: September 2022

Evolution aids theodicy, seen not as a process of random errors, but of probabilistic emergence. The cosmos is emergent, creative, self-realizing, and productive of the intrinsic values of knowledge, beauty and love. God is the demand, power and promise of love in such an emergent universe disfigured by greed (the corruption of creative self-realization), yet destined for loving communion.
Transnational migrants and the socio-spatial superdiversification of the global city Tokyo
Authors: Yamamura Sakura
Published: September 2022

Tokyo illustrates a particularly interesting case of differential inclusions of transnational migrants in urban spaces, as the novel turn in migration policy in coordination with urban economic development has induced the arrival and diversification of migrant populations into the city. With the recent historic opening of the country to lower-skilled labour migration as well as measures to (re-) attract the global economy, thus incentivising transnational corporate professionals to relocate to specific national economic zones within the city, Tokyo is in a new socio-spatial diversification process. With a non-ethno-focal lens on transnational migration and focusing on upper-class transnational corporate migrants, this article discusses diversification regarding the newer arrivals of migrants who are differently included in the urban spaces as compared to older generations of migrants. It delivers novel accounts of a diversifying transnational migrant groups’ socio-spatial patterns within Tokyo, which illustrate the dynamics of differential inclusions resulting from the superdiversification of urban societies. The article gives new insights into the socio-spatial diversification dynamics of transnational urban spaces in a long-neglected but highly topical Asian arrival city, and conceptually reflects such localised superdiversification of urban spaces on a global scale.
Power, Legitimacy, and Institutions in the October 2019 Uprising in Chile
Authors: Guzmán-Concha César
Published: September 2022

The 2019 uprising in Chile was the outcome of an erosion of political arrangements and the politicization of popular unrest that developed over three decades. Two explanations for it—the political mobilization of the groups that emerged from the neoliberal reforms (the “new people” approach) and the mismatch between institutions and society (the “decoupling” approach)—can be reconciled by emphasizing the connections between elite and popular politics. Analyzing the long-standing relationship between power, legitimacy, and political institutions provides a framework for understanding this and other events of massive unrest.

El levantamiento de 2019 en Chile resultó de una erosión de los acuerdos políticos y la politización del malestar popular desarrollado a lo largo de tres décadas. Podemos reconciliar dos de las explicaciones al respecto—la movilización política de los grupos surgidos de las reformas neoliberales (el enfoque de la “gente nueva”) y el desajuste entre las instituciones y la sociedad (el enfoque de “desacoplamiento”)—si enfatizamos las conexiones entre la élite y la política popular. El análisis de la relación de larga data entre el poder, la legitimidad y las instituciones políticas nos proporciona un marco posible para entender este y otros eventos de disturbios masivos.
Marketization of Eldercare in Urban China: Processes, Effects, and Implications
Authors: Maags Christina
Published: September 2022

China is one of the most rapidly aging societies worldwide. As eldercare services have only been developed over the last two decades, the party-state has increased its efforts by promoting the marketization of eldercare services. Drawing on Vaittinen, Hoppania, and Karsio’s “political economy of care” framework, this study conducts a comparative analysis of marketization processes in Hangzhou and Nanjing to examine local government marketization strategies, their effects on service development, and their socioeconomic implications. I argue that local governments have pursued a “dual-track marketization” strategy. On the one hand, the means-tested public eldercare service infrastructure, which has existed since the Mao Zedong era, has been made subject to the kinds of neoliberal market reforms also found in, for example, European countries, while on the other hand, an entirely new private eldercare service infrastructure is being set up. As the market logic takes over, however, income- and gender-based social inequalities are enhanced.
Entrepreneurship in public administration and public policy programs in Germany and the United States
Authors: Grimm Heike M , Bock Charlotte L
Published: September 2022

The following contribution hypothesizes that it is crucial for future professionals in public administrations and organizations to be familiar with the concepts, tools, and techniques of policy, public, and social entrepreneurship to address societal, environmental, health, and wicked problems in an innovative and sustainable way. Attention is drawn to the importance of entrepreneurship as an essential asset and feature of public administration and public policy education at higher educational institutions in Germany and the United States. The paper aims at filling a research gap because knowledge about the interrelationships between entrepreneurship and public administration and public policy education is still underdeveloped. Emphasis is put on the discussion why entrepreneurship should be incorporated in curricula and how study programs have been designed or reformed, while placing emphasis on entrepreneurship in meeting current and complex challenges in the public sector. Findings from a systematic online assessment are presented which show whether and how policy, public and social entrepreneurship are taught as an integral element of current governance and public policy study programs and what difference it makes teaching and learning wise. The findings reflect a high demand for entrepreneurship education by public administration and public policy students, on the one hand, and a low incorporation in curricula, on the other hand. Two case studies from Germany and the United States are presented which serve as good practice examples on how to transfer public, policy, and social entrepreneurship into curricula.
Evaluating the Use of Tactile Shapes in Associative Learning for People Who Are Blind
Authors: Gupta Richa , Mannheimer Steve , Madhusudan Rao P. V. , Balakrishnan Meenakshi
Published: September 2022

Introduction: This work investigates if simple two-dimensional (2D) tactile shapes can facilitate encoding, retention, and retrieval of associated information in the form of one-word labels. It also questions the need for the resemblance of tactile graphics with respective visual referents. Methods: Four experiments were conducted using recall tasks with verbal and tactual triggers. Students who are blind from schools for blind students in Indianapolis, Indiana (USA) and New Delhi (India) participated in these experiments. Participants learned 12 shapes with assigned (two sets of) one-word labels categorized as consonant, dissonant, or abstract. Recall tasks were conducted after 1 week and after 4 months using verbal and tactual triggers. Results: The results of experiment 1 show that recall performance for consonant associations was higher than that for dissonant and abstract. Experiment 2 shows the recall performance using orally narrated verbal triggers, while experiments 3 and 4 use tactile triggers (both verbal and shape). Additionally, in experiment 4, the participants were observed recalling most associations after 4 months. Tactile verbal triggers (braille) invoked better recall accuracy as compared to tactile shape triggers. Discussion: The results and discussion with schema theory suggest that resemblance to visual referent (or similarity of tactile shape with real-life visual stimuli) is not necessary for learning associated labels. Additionally, simple 2D tactile shapes can support long-term retention of associated verbal information. The presence of primacy effect (better retention of first few associations) and distinctiveness effect (better retention of unique associations). Implications for Practitioners: The inferences of this work can influence the redesign of educational material and pedagogy for students with blindness by: (1) contributing to the development of a standardized set of symbols with associated meanings and using them for book annotation or indicating the genre of a graphic; (2) using simple tactile images instead of complex “visually correct” images.
Collectivism Impairs Team Performance When Relational Goals Conflict With Group Goals
Authors: Qin Xin , Chi Yam Kai , Ye Wenping , Zhang Junsheng , Liang Xueji , Zhang Xiaoyu , Savani Krishna
Published: September 2022

This research challenges the idea that teams from more collectivistic cultures tend to perform better. We propose that in contexts in which there are tradeoffs between group goals (i.e., what is best for the group) and relational goals (i.e., what is best for one’s relationships with specific group members), people in less collectivistic cultures primarily focus on group goals but those in more collectivistic cultures focus on both group and relational goals, which can lead to suboptimal decisions. An archival analysis of 100 years of data across three major competitive team sports found that teams from more collectivistic nations consistently underperformed, even after controlling for a number of nation and team characteristics. Three follow-up studies with 108 Chinese soccer players, 109 Singapore students, and 119 Chinese and the U.S. adults provided evidence for the underlying mechanism (i.e., prioritizing relational goals over group goals). Overall, this research suggests a more balanced view of collectivism, highlighting an important context in which collectivism can impair team performance.
Cross-Cultural Adaptation and Psychometric Validation of the Turkish Version of Pain Resilience Scale
Authors: Dereli Muge , Kahraman Turhan , France Christopher R.
Published: September 2022

The Pain Resilience Scale (PRS) is a useful tool that evaluates behavioral engagement and adaptively regulates cognitions and emotions despite the pain. This study aimed to translate the PRS to Turkish and investigate its psychometric properties. The Turkish version of PRS was completed online by 332 healthy adults, and a subset of 105 respondents was re-assessed after 7–14 days. The reliability of the adapted measure was evaluated in terms of internal consistency, relative, and absolute test-retest reliability. Validity was evaluated in terms of structural, construct, and known-group validity using positive and negative psychological scales. The Turkish version of PRS has a three-factor structure and its cumulative variance is 78.06%. The total PRS score and its subscales correlated positively with pain self-efficacy, general resilience, and quality of life, and negatively with pain catastrophizing, kinesiophobia, anxiety, depression, and disability. The PRS scores were significantly higher in those with high general resilience ( p < 0.001). The PRS had high internal consistency and test-retest reliability. Standard Error of Measurement (SEM) and Minimum Detectable Difference (MDD) were calculated as 2.9 and 8.0, respectively. The Turkish version of PRS is a reliable and valid instrument for measuring pain resilience in terms of behavioral perseverance and cognitive positivity.
Cultivating intellectual abilities and talents: The ‘forgotten’ Catholic contribution
Authors: Gellel Adrian-Mario , Camilleri Rosienne
Published: September 2022

The notion of the human person, together with the importance that the Catholic community has, since its inception, given to the educational enterprise, has led various authors, including Augustine, Abelard, and Aquinas, among others, to reflect on the meaning of intellect and talents and their effects on education. Yet such reflections were never standalone considerations but rather built in dialogue, and at times in confrontation, with the classics and secular treatises of the time. After outlining how the Catholic community conceptualizes the human person, this paper will touch upon the concepts of talent as developed and dealt with during the 12th century. The latter period has been chosen on the basis of the developments in pedagogical thought and practices. The paper aims to critically analyse the notion of ‘ingenium’ (understood as talents, innate abilities) against the main philosophical and pedagogical thought that has animated Catholic educational practices.
Bleeding and thrombotic complications and their impact on mortality in patients supported with left ventricular assist device for cardiogenic shock
Authors: Bekono-Nessah Ingrid , Rosenburg Alex , Bowles Christopher T , Riesgo-Gil Fernando , Stock Ulrich , Szydlo Richard R , Laffan Mike , Arachchillage Deepa J
Published: September 2022

Introduction

Thrombosis and bleeding are major complications in patients supported with left ventricular assist devices (LVADs). We aimed to assess the incidence of bleeding and thrombosis in patients supported with a HeartWare left ventricular assist device (HVAD), their predictive factors and their impact on mortality.

Methods

A single centre retrospective observational study of patients supported with HVAD over 5 years from January 2015 to October 2020.

Results

A total 139 patients (median age 52.5, 72.1% male) were included for analysis. The probability of 1-year survival was 73.1%. Advanced age (>60 years) and EuroSCORE II score (>20%) were independently associated with reduced survival. Major bleeding and thrombosis occurred in 46.8% and 35.3% respectively. Secondary mechanical circulatory support (MCS) increased likelihood of experiencing major bleeding (HR: 2.76, 95%1.65–4.62, p < 0.0001) whilst patients receiving aspirin were protected from bleeding and thrombosis (HR: 0.34 95% CI 0.19–0.58, p < 0.001). Pre-operative anaemia (HR: 3.02, 95% CI: 1.6–5.7, p = 0.014) and use of a secondary MCS device (HR: 2.78, 95% CI: 1.2–6.3, p = 0.001) were associated with an increased risk of thrombosis. Patients with any major bleeding (with or without thrombosis) had a 7.68-fold (95% CI 3.5–16.8) increased risk of death compared to those without. In contrast, ‘thrombosis only’ patients had 4.23-fold (95% CI 1.8–10.2) increased risk of death compared to those without thrombosis. The risk of mortality was increased in patients with any thrombosis and the risk of death was highest in patients with major bleeding and thrombosis (HR: 16.49 [95% CI 7.7–35.3]).

Conclusions

Major bleeding and thrombosis significantly increase the 1-year mortality. Optimal perioperative haemostasis and anticoagulation remains crucial in patients supported with HVAD.
A value-based approach to optimize red blood cell transfusion in patients receiving extracorporeal membrane oxygenation
Authors: Shudo Yasuhiro , Cheng Nathalie , He Hao , Rosenberg Corinne , Hiesinger William , Hadhazy Eric , Shepard John , Krishna Purnima , Resnik Josh , Fong Robyn , Hill Charles , Hsu Joe L , Maggio Paul M , Chang Sang-Ick , Boyd Jack H , Woo Y Joseph
Published: September 2022

Introduction

The risk, cost, and adverse outcomes associated with packed red blood cell (RBC) transfusions in patients with cardiopulmonary failure requiring extracorporeal membrane oxygenation (ECMO) have raised concerns regarding the overutilization of RBC products. It is, therefore, necessary to establish optimal transfusion criteria and protocols for patients supported with ECMO. The goal of this study was to establish specific criteria for RBC transfusions in patients undergoing ECMO.

Methods

This was a retrospective cohort study conducted at Stanford University Hospital. Data on RBC utilization during the entire hospital stay were obtained, which included patients aged ≥18 years who received ECMO support between 1 January 2017, and 30 June 2020 ( n = 281). The primary outcome was in-hospital mortality.

Results

Hemoglobin (HGB) levels >10 g/dL before transfusion did not improve in-hospital survival. Therefore, we revised the HGB threshold to ≤10 g/dL to guide transfusion in patients undergoing ECMO. To validate this intervention, we prospectively compared the pre- and post-intervention cohorts for in-hospital mortality. Post-intervention analyses found 100% compliance for all eligible records and a decrease in the requirement for RBC transfusion by 1.2 units per patient without affecting the mortality.

Conclusions

As an institution-driven value-based approach to guide transfusion in patients undergoing ECMO, we lowered the threshold HGB level. Validation of this revised intervention demonstrated excellent compliance and reduced the need for RBC transfusion while maintaining the clinical outcome. Our findings can help reform value-based healthcare in this cohort while maintaining the outcome.
The effect of relative cerebral hyperperfusion during cardiac surgery with cardiopulmonary bypass to delayed neurocognitive recovery
Authors: Kasputytė Greta , Bukauskienė Rasa , Širvinskas Edmundas , Razlevičė Ilona , Bukauskas Tomas , Lenkutis Tadas
Published: September 2022

Objective

Delayed neurocognitive recovery (dNCR) remains a common complication after surgery and the incidence of it is determined 30–80% after cardiac surgery with cardiac bypass (CPB) in eldery patients. Many researchers have identified that neuropsychological complications emerge from insufficient cerebral perfusion. Relative cerebral hyperperfusion also disrupts cerebral autoregulation and might play a significant role in dNCR development. The aim of this study is to determine hyperperfusion in the middle cerebral artery during CPB influence to dNCR development and brain biomarker glial fibrillary acidic protein (GFAP) impact in diagnosing dNCR.

Designs and methods

This prospective - case control study included patients undergoing elective coronary artery bypass grafting or/and valve surgery with CPB. For cognitive evaluation 101 patients completed Addenbrooke’s cognitive examination - ACE-III. To determine mild cognitive dysfunction, cut - off 88 was chosen. Mean BFV was monitored with transcranial Doppler ultrasonography (TCD) and performed before surgery, after induction of anaesthesia, during CPB and after surgery. Preoperative BFV was converted to 100% and used as a baseline. The percentage change of cerebral blood flow velocity during CPB was calculated from baseline. Patients with decreased blood flow velocity were included for further investigation. To measure glial fibrillary acidic protein, blood samples were collected after anaesthesia induction, 24 and 48 h after the surgery. According to the ACE-III test results, patients with relative hyperperfusion were divided into two groups: with Delayed neurocognitive recovery and without dNCR (non‐dNCR group).

Results

101 patients were examined, 67 (69.1%) men and 29 (29.9%) women, age 67.9 (SD 9.2) Increased percentage of BFV was determined for 40 (39.60%) patients. There were no differences in sex, haematocrit, paCO2, aortic cross-clamping or CPB time between the two groups. Percentage change of BFV was 105.60% in the non-dNCR group and 132.29% in the dNCR group, p = .033. Patients who developed dNCR in the early post-surgical period were significantly older, p < .001 and had a lower baseline of BFV, p = .004. GFAP concentration significantly increased in the dNCR group 48 hours after surgery, compared to the non-dNCR group, p = .01.

Conclusions

Relative hyperperfusion during CPB may cause dNCR. Elderly patients are sensitive to blood flow velocity acceleration during CPB. GFAP concentration increased 48 h after surgery in dNCR group but did not have any connection with risk factors.
Spatiotemporal analysis of blood plasma and blood cell flow fluctuations of cerebral microcirculation in anesthetized rats
Authors: Niizawa Tomoya , Sakuraba Ruka , Kusaka Tomoya , Kurihara Yuika , Sugashi Takuma , Kawaguchi Hiroshi , Kanno Iwao , Masamoto Kazuto
Published: September 2022

Cerebral hemodynamics fluctuates spontaneously over broad frequency ranges. However, its spatiotemporal coherence of flow oscillations in cerebral microcirculation remains incompletely understood. The objective of this study was to characterize the spatiotemporal fluctuations of red blood cells (RBCs) and plasma flow in the rat cerebral microcirculation by simultaneously imaging their dynamic behaviors. Comparisons of changes in cross-section diameters between RBC and plasma flow showed dissociations in penetrating arterioles. The results indicate that vasomotion has the least effect on the lateral movement of circulating RBCs, resulting in variable changes in plasma layer thickness. Parenchymal capillaries exhibited slow fluctuations in RBC velocity (0.1 to 0.3 Hz), regardless of capillary diameter fluctuations (<0.1 Hz). Temporal fluctuations and the velocity of RBCs decreased significantly at divergent capillary bifurcations. The results indicate that a transit of RBCs generates flow resistance in the capillaries and that slow velocity fluctuations of the RBCs are subject to a number of bifurcations. In conclusion, the high-frequency oscillation of the blood flow is filtered at the bifurcation through the capillary networks. Therefore, a number of bifurcations in the cerebral microcirculation may contribute to the power of low-frequency oscillations.
The additional value of high-resolution vessel wall imaging in screening suitable chronic internal carotid artery occlusion candidates for endovascular recanalization: comparison with digital subtraction angiography
Authors: Hou Yanwei , Ren Lei , Cao Chen , Zhang Heliang , Zhao Wei , Zhu Jinxia , Guo Zaiyu , Xia Shuang
Published: September 2022

Background

High-resolution vessel wall imaging (HR-VWI) can provide information about exact occluded length, etiology, and the presence of intraluminal thrombus or residual cavity.

Purpose

To investigate the extra value of HR-VWI in screening patients with chronic internal carotid artery occlusion (CICAO) for recanalization suitability in comparison with digital subtraction angiography (DSA).

Material and Methods

We retrospectively reviewed patients who underwent endovascular recanalization with no internal carotid artery signal on magnetic resonance angiography (MRA) and whose both preoperative DSA and HR-VWI data were available. Patients were classified into type I (focal occlusion distal to ophthalmic artery), type II or III (occlusion proximal or at/distal to clinoid segment), and near-occlusion. Occlusion etiology and suitability for recanalization were analyzed both on preoperative DSA and HR-VWI. Accuracy of occlusion classification and differences in the modified Rankin scale scores between the baseline and follow-up were estimated.

Results

A total of 20 patients were included. With intraoperative DSA as the gold standard, we found HR-VWI could additionally show intraluminal thrombi. Preoperative DSA misclassified one near-occlusion, one type I occlusion, and one type II occlusion as type III occlusions, and one near-occlusion as a type II occlusion. Therefore, compared with the preoperative DSA, three additional cases were successfully recanalized based on HR-VWI. The accuracy of HR-VWI was higher than preoperative DSA (100% vs. 80%). Prognosis improvement of type I was significantly better than type II and near-occlusion ( P<0.05).

Conclusion

HR-VWI can identify occluded etiology, extent, and classification of CICAO. This information is potentially useful in screening candidates for endovascular recanalization and helpful to indicate prognosis.
A symposium on Georg Simmel: Essays on art and aesthetics
Authors: Goodstein Elizabeth S. , Harrington Austin , Kemple Thomas , Marcucci Nicola
Published: September 2022

Georg Simmel has long been appreciated as a major theorist of the arts in society, as well as of aesthetic phenomena in general in social life. Yet Simmel’s essays in the area have remained dispersed for many years across the disparate parts of his corpus and have not been easy to survey in their full thematic cohesion and interconnection. This symposium article reflects on Austin Harrington’s comprehensive anthology of these writings in English, published in 2020, which assembles virtually all the relevant titles – many of them appearing in English for the first time. Among the central topics of discussion are Simmel’s fluid style of theorizing, his thinking about representation, reality and modernity in art, his relationships to philosophers and artistic personalities, and his legacy for the present.
Eccentric sleeve grinding for thermal management and dry grinding of carbon fibre reinforced composites
Authors: Handa Danish , Sooraj V.S.
Published: September 2022

Precision machining of Fibre Reinforced Polymer (FRP) Composites needs to be explored further while addressing advanced engineering applications. However, force and temperature-driven damages while machining FRP composites, due to the non-homogenous and low thermal conducting behaviour of fibre-matrix interfaces, place the barrier in this direction. Surface machining using abrasive wheels has been projected as a promising option for fine removal of material in FRPs. However, conventional dry grinding strategy exhibited high grinding force due to continuous interaction of abrasive cutting edges, leading to accumulation of heat at the grinding interface. As the cutting action is continuous, heat dissipation also becomes difficult in this situation. Temperature-driven damages on composite matrix and subsequent failure of reinforced fibres were serious concerns in this case. Although attempted in some situations, usage of cutting fluids was not recommended fully due to wetting effects and agglomeration of swarf that hinder the grinding efficiency. Eccentric Sleeve Grinding (ESG), using an intermittent-progressive cuttings scheme, is proposed in this work as a potential dry grinding strategy for FRPs. Control of heat accumulation through progressive cutting strategy and enhancement of heat dissipation through intermittency in cutting cycle appears to be the unique characteristics of ESG. Experimentation of ESG on carbon fibre reinforced composite samples showed promising grinding temperature reduction, which was justified through a significant reduction in grinding forces, surface defects and roughness.
Formation of polypropylene nanocomposite joint using silicon carbide nanowhiskers as novel susceptor for microwave welding
Authors: Foong Phey Yee , Voon Chun Hong , Lim Bee Ying , Teh Pei Leng , Bin Rojan Mohd Afendi , CB Gopinath Subash , Md Arshad Mohd Khairuddin , Parmin Nor Azizah , Low Foo Wah , A Rahim Ruslinda , Hashim Uda
Published: September 2022

Up to present, no study has reported on the use of silicon carbide nanomaterials (SiCNMs) as susceptor for microwave welding of thermoplastics. Therefore, in this study, silicon carbide nanowhiskers (SiCNWs) was attempted as the microwave susceptor for the microwave welding of polypropylene (PP). It was observed that SiCNWs are capable of absorbing microwave and converting them into heat, leading to a sharp increase in temperature until it reaches the melting point of PP substrates. The microwave welded joint is formed after the molten PP at the interface between PP substrates is cooled under pressure. The effect of microwave heating duration and solid loading of SiCNWs suspension was studied and reported. The formation mechanism of SiCNWs reinforced PP welded joint was proposed in this study. With these remarkable advantages of microwave welding and enhanced mechanical properties of the welded joint, it is believed that this study can provide a new insight into welding of thermoplastic and material processing through short-term microwave heating.
Dementia Care in the Last Year of Life: Experiences in a Community Practice and in Skilled Nursing Facilities
Authors: Bartley Mairead M. , Manggaard Jennifer M. , Fischer Karen M. , Holland Diane E. , Takahashi Paul Y.
Published: September 2022

Objective

People living with dementia often have high care needs at the end-of-life. We compared care delivery in the last year of life for people living with dementia in the community (home or assisted living facilities [ALFs]) versus those in skilled nursing facilities (SNFs).

Methods

A retrospective study was performed of older adults with a dementia diagnosis who died in the community or SNFs from 2013 through 2018. Primary outcomes were numbers of hospitalizations and emergency department visits in the last year of life. Secondary outcomes were completed advance care plans, hospice enrollment, time in hospice, practitioner visits, and intensive care unit admissions.

Results

Of 1203 older adults with dementia, 622 (51.7%) lived at home/ALFs; 581 (48.3%) lived in SNFs. At least 1 hospitalization was recorded for 70.7% living at home/ALFs versus 50.8% in SNFs ( P < .001), similar to percentages of emergency department visits (80.2% vs 58.0% of the home/ALF and SNF groups, P < .001). SNF residents had more practitioner visits than home/ALF residents: median (IQR), 9.0 (6.0-12.0) versus 5.0 (3.0-9.0; P < .001). No advance care plan was documented for 12.2% (n = 76) of the home/ALF group versus 4.6% (n = 27) of the SNF group ( P < .001). Nearly 57% of SNF residents were enrolled in hospice versus 68.3% at home/ALFs ( P < .001). The median time in hospice was 26.5 days in SNFs versus 30.0 days at home/ALFs ( P = .67).

Conclusions

Older adults with dementia frequently receive acute care in their last year of life. Hospice care was more common for home/ALF residents. Time in hospice was short.
Evaluation of the Diagnostic Value of Cell Population Data in Sepsis in Comparison to Localized Infection, Chronic Inflammation, and Noninfectious Inflammation Cases
Authors: Çevlik Tülay , Kaya Özlem , Gül Fethi , Turkal Rana , İnanç Nevsun , Direskeneli Haner , İlki Arzu , Şirikçi Önder , Haklar Goncagül , Cinel İsmail
Published: September 2022

Introduction

Sepsis, defined as an increase of 2 points or more in the sequential organ failure assessment score, is a life-threatening organ dysfunction caused by the dysregulated host response to infection. Volume-conductivity-scatter (VCS) parameters of cell counters which are known as cell population data (CPD) have been suggested to be beneficial in diagnosing sepsis. We aimed to evaluate the diagnostic value of CPD parameters in sepsis in comparison to nonsystemic infection cases (NSI) and non-infectious acute and chronic inflammatory conditions.

Materials and Methods

We prospectively included four groups of patients” data: sepsis (n = 66), localized infection (pneumonia, n = 59), chronic inflammation (rheumatoid arthritis, n = 92) and noninfectious inflammation (coronary artery bypass graft operation, n = 56) groups, according to their clinical status and laboratory results. Samples for cell counting and serum markers were collected on the same day of culture collection. VCS parameters were measured by Unicel DxH800 Coulter Cellular Analyzer (Beckman Coulter, USA).

Results

Mean neutrophil volume (MN-V-NE), was highest in the sepsis group [155(149-168)] compared to the localized infection [148(140-158)], chronic inflammation [144.5(142-149)] and noninfectious inflammation [149(145.2-153.7)] (P = 0.001, P < 0.001, P < 0.001, respectively). Neutrophil volume SD (SD-V-NE) was higher in the sepsis [21(18.8-23.7)], significantly differentiating sepsis from other groups. The area under curves of procalcitonin and hs-C-reactive protein were 0.846 and 0.837, respectively, in the receiver-operating characteristic curves (ROC) . CPD combinations, (SD-V NE + SD-V LY + SD-V MO), (SD-V NE + SD-V MO), and (MN-V NE + SD-V NE + SD-C LY + SD-V MO) had greater AUC values than procalcitonin’s.

Conclusion

VCS parameters might be promising for differentiating sepsis and non-sepsis cases. Additionally, obtaining these data routinely makes their prospects promising without any additional cost and time.
A Comparative Analysis of Knife and Firearm Homicides in the United States
Authors: Harms Joshua , Bush Madison
Published: September 2022

In the United States of America firearms are the most common weapons used to commit homicide. This has led the public, academics, media, and policy makers to largely neglect other means of homicide. The second most common weapon used in the commission of a homicide in the USA are knives. On average more than 1,500 people are murdered with a knife each year in the USA. Little attention in the USA is focused on knife violence. However, the same is not true across the globe. After reviewing an international selection of literature, the current study aims to analyze both the victims and offenders of knife homicide in the USA by comparing them to the offenders and victims of firearm homicide. This was accomplished by analyzing data from the Supplementary Homicide Reports from 2014 to 2016. Comparisons between firearm and knife homicides included victim and offender demographics, as well as the relationship between the victim and offender. Bivariate and multivariate analysis are used to show that the victims and offenders of knife homicides are a significantly different group from the victims and offenders of firearm homicide. In the USA victims and offenders of knife violence are more likely to be female, less likely to be minorities, and are significantly older than firearm victims and offenders. The victim and offender in the case of a knife homicide are also significantly more likely to be closely related to one another. Unlike many other countries, in the USA the problem of knife violence appears much more similar to domestic violence than the typical street crime involving firearms. Because of this, knife homicides should not be approached with the same theoretical framework as firearm homicide. Additionally, the policies needed to effectively counter this problem will be different from those intended to deter firearm homicide.
Associations Between Classroom Climate, Empathy, Self-Efficacy, and Countering Hate Speech Among Adolescents: A Multilevel Mediation Analysis
Authors: Wachs Sebastian , Castellanos Melisa , Wettstein Alexander , Bilz Ludwig , Gámez-Guadix Manuel
Published: September 2022

Although hate speech is widely recognized as an online phenomenon, very few studies have investigated hate speech among adolescents in offline settings (e.g., schools). At the same time, not much is known about countering hate speech (counterspeech) among adolescents and which factors are associated with it. To this end, the present study used the socio-ecological framework to investigate the direct and indirect links among one contextual factor (i.e., classroom climate) and two intrapersonal factors (i.e., empathy for victims of hate speech, self-efficacy regarding intervention in hate speech) to understand counterspeech among adolescents. The sample is based on self-reports of 3,225 students in Grades 7 to 9 (51.7% self-identified as female) from 36 schools in Germany and Switzerland. Self-report questionnaires were administered to measure classroom climate, empathy, self-efficacy, and counterspeech. After controlling for adolescents’ grade, gender, immigrant background, and socioeconomic status (SES), the 2-(1-1)-1 multilevel mediation analysis showed that classroom climate (L2), empathy for victims of hate speech (L1), and self-efficacy toward intervention in hate speech (L1) had a positive effect on countering hate speech (L1). Classroom climate (L2) was also positively linked to empathy for victims of hate speech (L1), and self-efficacy toward intervention in hate speech (L1). Furthermore, classroom climate (L2) was indirectly associated with countering hate speech (L1) via greater empathy (L1) and self-efficacy (L1). The findings highlight the need to focus on contextual and intrapersonal factors when trying to facilitate adolescents’ willingness to face hate speech with civic courage and proactively engage against it.
Carbon nanotubes-filled polylactic acid/polycaprolactone biodegradable blends: Effect of the polycaprolactone viscosity and carbon nanotubes addition on the microstructure, electrical and mechanical properties
Authors: Al-Saleh Mohammed H , Al-Shboul Tamer S
Published: September 2022

The effects of polycaprolactone (PCL) viscosity and carbon nanotubes (CNT) content on the microstructure, morphology development, tensile strength, and electrical percolation behavior of CNT/polylactic acid (PLA)/PCL blends were investigated. PLA/PCL blends with a volume ratio of 80/20 were prepared using a low viscosity PCL (PCL1) and a high viscosity PCL (PCL2). The microstructure analysis showed finer dispersion of PCL2 than PCL1 within the PLA matrix. The addition of CNT changed the PLA/PCL morphology from dispersed to co-continuous due to the localization of the nanotubes in the PCL domain (i.e. the minor domain). In addition, the introduction of CNT reduced the PCL domain size and improved the adhesion at the PLA/PCL interface. For the electrical percolation behavior, PLA/PCL2 blend exhibited a percolation threshold concentration (EPTC) of 0.5 wt.% CNT compared to 1.0 wt.% CNT for the PLA/PCL1 blend. This remarkably lower EPTC for the PCL2-based blend is in line with the microstructure analysis that indicated finer dispersion of PCL2 than PCL1 within the PLA matrix. The tensile strength analysis showed that adding up to 5 wt.% CNT does not influence the PLA/PCL blend’s tensile strength. However, remarkable adhesion and tensile strength enhancements were obtained at a CNT content of 10 wt.% and above.
Hormonal Therapy in Pretreated Patients With Recurrent Ovary Granulosa Cell Tumor
Authors: Dogan Izzet , Aydin Esra , Topuz Samet , Saip Pinar , Salihoglu Mehmet Y. , Aydiner Adnan
Published: September 2022

Objective: To evaluate the effectiveness of hormonal therapy (HT) in patients with recurrent adult ovary granulosa cell tumors. Methods: The clinical and treatments features of the patients who received HT were studied retrospectively. The efficacy and safety of HT were evaluated. The Kaplan-Meier technique was used to conduct survival analysis. Results: The research involved a total of thirteen patients. The median age of the participants was 49 years (range: 34-61). Since diagnosis, the median number of surgeries has been three (range: 2-8). At least one chemotherapy regimen has been administered to 12 (92.3%) patients. Ten of the patients (76.9%) had at least two metastatic areas. Lung metastases were found in two (15.4%) of the patients. Inhibin B levels were elevated in 81.2% of patients before hormone treatment. The patients received different HTs (Leuprolide acetate + anastrozole-three patients, leuprolide acetate + tamoxifen-six patients, only anastrozole-three patients, only tamoxifen-one patients). The median progression-free survival was found 17.7 months (95 % CI: 14.7-20.6). In four (33.4%) patients, an overall response (complete or partial) was identified. A stable response was observed in eight (66.7%) patients. Conclusions: HT is effective in pretreated individuals with recurrent ovarian granulosa cell tumors, according to this research. Despite the limited number of patients and treatment variability, disease control was achieved in all patients. Also, we found that Inhibin B levels were associated with treatment response.
Sociodemographic Factors and Neighborhood/Environmental Conditions Associated with Social Isolation Among Black Older Adults
Authors: Taylor Harry O. , Tsuchiya Kazumi , Nguyen Ann W. , Mueller Collin
Published: September 2022

Objectives: To investigate sociodemographic factors and neighborhood/environmental conditions associated with social isolation (SI) among Black older adults. Methods: We utilized data from the 2014 and 2016 Leave-Behind Questionnaire from the Health and Retirement Study (HRS LBQ) among those who self-identified as Black ( N = 2.323). Outcome variables for our study included SI from adult children, other family members, friends, disengagement from social participation and religious services, being unmarried, and living alone. These indicators were also combined into an overall SI index. Critical predictors included gender, age, household income, education, employment status, neighborhood cohesion, neighborhood disorder, urbanicity, and region of residence. Results: Sociodemographic factors of gender, education and household income were significantly associated with SI indicators. Additionally, some neighborhood/environmental conditions were associated with SI indicators. Discussion: SI was found to be patterned by sociodemographic factors. These results can be used to develop effective interventions to mitigate SI among Black older adults.
Role of Artificial Intelligence and Machine Learning in the prediction of the pain: A scoping systematic review
Authors: Sankaran Ravi , Kumar Anand , Parasuram Harilal
Published: September 2022

Artificial Intelligence in healthcare is growing quickly in diagnostics and treatment management. Despite the quantity and variety of studies its role in clinical care is not clear. To identify the evidence gaps and characteristics of the Artificial Intelligence and Machine Learning techniques in predicting/diagnosing the pain? Pubmed/Embase were searched from the inception to October 2021 for articles without any language restrictions specifically addressing the following: the accuracy of AI in pain considering Brain Imaging, Patient-reported measures, and Electrophysiology, the ability of AI to differentiate stratify severity/types of pain, the ability of AI to predict pain and lastly the most accurate AI technique for given inputs. All the included studies were on humans. Eight hundred forty abstracts were reviewed, and 23 articles were finally included. Identified records were independently screened and relevant data was extracted. We performed conceptual synthesis by grouping the studies using available concepts of AL/ML techniques in diagnosing pain. Then we summarized the number of features/physiological measurements. Structured tabulation synthesis was used to show patterns predictions along with a narrative commentary. A total of 23 articles, published between 2015 and 2020 from 12 countries were included. Most studies were experimental in design. The most common design was cross sectional. Chronic or acute pains were predicted more often. Compared to control, the pain prediction was in the range of 57%–96% by AI techniques. Support Vector Machine and deep learning showed higher accuracy for classifying pain. From this study, it can be inferred that AI/ML can be used to differentiate healthy controls from patients. It can also facilitate categorizing them into new and different clinical subgroups. Lastly, it can predict future pain. The limitations are with respect to studies done after the search period. AL/ ML has a supportive role in pain diagnostics.
From a ‘just transition for us’ to a ‘just transition for all’
Authors: Galgóczi Béla
Published: September 2022

This article will demonstrate that, given the complexity of inequalities in the climate-environment-social nexus, fragmented policies for a just transition that focus on only one dimension of inequality will not deliver the results needed to justify proclaiming a ‘just transition for all’. By reframing the sustainability trilemma for the case of the climate emergency and deconstructing the concept of a ‘just transition’ based on the relevant literature and selected case studies, we shall highlight some of the concept’s inherent contradictions. The article will argue that a holistic approach requires a reframing of the role of the welfare state.
Reliability and Validity of a Novel Measure of Nonviolent Communication Behaviors
Authors: Cheung Cherry T.Y. , Cheng Clement Man-Him , Lam Stanley Kam Ki , Ling Henry Wai-Hang , Lau Kim Ling , Hung Suet Lin , Fung Hong Wang
Published: September 2022

Purpose: Nonviolent communication (NVC) has been increasingly recognized as a potentially beneficial approach that could promote empathy, resolve conflicts, and improve psychosocial well-being. No validated measure is available to assess or quantify NVC-specific characteristics or behaviors. This paper describes the development and pilot psychometric evaluation of a self-report measure for assessing behaviors characteristic of NVC (e.g., awareness of feelings, honest self-expression). Method: We analyzed data in an online convenience sample of young adults (N = 205). Results: The 7-item Nonviolent Communication Behaviors Scale (NVCBS) was found to have satisfactory internal consistency (α = 0.789 to 0.810), good test-retest reliability (ICC = 0.781) and a single-factor structure. The NVCBS was also positively correlated with empathy while negatively correlated with negative beliefs about emotions, demonstrating its construct validity. Discussion: The study provides a reliable and valid measure of NVC behaviors which can facilitate future studies on NVC. Directions for future research are discussed.
Syrian Crisis Impacts on the International Refugee Education Fund in Jordan
Authors: Al Tal Raed , Sallam Safa' , Ali Hikmat
Published: September 2022

This research evaluates the impacts of the international organizations’ fund on urban Syrian refugees’ educational environment in Jordan. It combines a mixed method theoretical and technical approach to answering the question of the research: what are the impacts of the international agencies’ resilience programmatic response on the refugee educational challenges induced by the Syrian crisis? The findings revealed that the donors have improved school buildings and enhanced the educational environment in terms of academic performance, sense of belonging, safety, and success. The results also show a high correlation between the spatial distribution of projects and the concentration of noncamp Syrian refugees in Jordan. The results revealed that schools and neighboring communities were not fully engaged in decision-making which left a gap in fulfilling the social and cultural needs. This research can be used as an assessment tool of refugee educational strategies especially when promoting education in host-sensitive conflict regions.