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Bert and I met on June 9, 1963, fell madly in love, talked incessantly, got engaged in October and married two months later, astonished by our commonalities and delighted by [...]

On the day my husband Bert finally accepted that he was dying, we had a deeply emotional, unstintingly honest talk about what he wanted me to do when he was [...]

Bert and I met on June 9, 1963, fell madly in love, talked incessantly, got engaged in October and married two months later, astonished by our commonalities and delighted by [...]

My name is Letty Bastian, and I am an Endorsed Emergency Nurse Practitioner and Traditional Chinese Medicine Acupuncture student at RMIT University, Melbourne. I have been working in emergency nursing [...]

The research developed a circularity framework that can be adopted at Mtapa urban open market in Gweru, Zimbabwe. The market has experienced a significant increase in vendors since many smaller open markets were closed in 2020 during covid-19 pandemic in a bid to clean up the city. However, rapid development and overcrowding have led to challenges in waste management which pose health risks to vendors. To address these challenges, the research utilised a descriptive case-study design combining both qualitative and quantitative data collection and analysis methods. Data was collected using questionnaires, semi structured interviews and direct-field observation. Analysis was conducted using soft wares such as Microsoft Excel and Statistical Package for Social Sciences (SPSS). Content analysis was used to analyse qualitative data. A relationship between level of education and participation in circular initiatives was tested, yielding a chi-square p-value of 0.001. This indicates that a lack of knowledge among vendors is a significant barrier to the adoption of circularity practices. The lack of waste recycling infrastructure was also a major barrier for waste management and waste recycling at Mtapa Open Market. The study highlights the importance of implementing circularity through developing a framework which lays out measures that can be adopted to enhance sustainability and address waste management. Therefore, the study concludes that there is need for circularity at Mtapa Open Market, that has opportunity for market growth and revenue generation. The study recommends the need for waste utilisation, recycling and adoption of circular economy with involvement of major stakeholders such as the Gweru City Council, Environmental Management Agency and Mtapa Open Market vendors.

I came of age as a feminist under the banner 'The Personal Is Political.' Launched in 1970 to counter a culture-wide assumption that our dissatisfactions were trivial, the slogan raised [...]

If you're in a room full of mainstream Jews who hew to the uncritical AIPAC line about Israel, you undoubtedly know that 'apartheid,' 'racist' and 'fascist' are three words you [...]

Objective: Clinical guidelines provide recommendations on the minimal blood vessel diameters required for arteriovenous fistula creation but the evidence for these recommendations is limited. We compared vascular access outcomes of fistulas created in agreement with the ESVS Clinical Practice Guidelines (i.e. arteries and veins >2 mm for forearm fistulas and >3 mm for upper arm fistulas) with fistulas created outside these recommendations.Methods: The multicenter Shunt Simulation Study cohort contains 211 hemodialysis patients who received a first radiocephalic, brachiocephalic, or brachiobasilic fistula before publication of the ESVS Clinical Practice Guidelines. All patients had preoperative duplex ultrasound measurements according to a standardized protocol. Outcomes included duplex ultrasound findings at 6 weeks after surgery, vascular access function, and intervention rates until 1 year after surgery.Results: In 55% of patients, fistulas were created in agreement with the ESVS Clinical Practice Guidelines recommendations on minimal blood vessel diameters. Concordance with the guideline recommendations was more frequent for forearm fistulas than for upper arm fistulas (65% vs 46%, p= 0.01). In the entire cohort, agreement with the guideline recommendations was not associated with an increased proportion of functional vascular accesses (70% vs 66% for fistulas created within and outside guideline recommendations, respectively; p= 0.61) or with decreased access-related intervention rates (1.45 vs 1.68 per patient-year, p= 0.20). In forearm fistulas, however, only 52% of arteriovenous fistulas created outside these recommendations developed into a timely functional vascular access.Conclusions: Whereas upper arm arteriovenous fistulas with preoperative blood vessel diameters <3 mm had similar vascular access function as fistulas created with larger blood vessels, forearm arteriovenous fistulas with preoperative blood vessel diameters <2 mm had poor clinical outcomes. These results support that clinical decision-making should be guided by an individual approach.

In Hebrew, ahavat Yisrael means 'love of one's fellow Jews.' But for many of the millions of Jews who define their Judaism in a nationalist as well as, or rather [...]

The inferior alveolar nerve block (IANB) is a dental anesthetic injection that is critical to the performance of many dental procedures. Dental students typically learn to administer an IANB through videos and practice on silicone molds and, in many dental schools, on other students. This causes significant stress for both the students and their early patients. To reduce discomfort and improve clinical outcomes, we created an anatomically informed virtual reality headset-based educational system for the IANB. It combines a layered 3D anatomical model, dynamic visual guidance for syringe position and orientation, and active force feedback to emulate syringe interaction with tissue. A companion mobile augmented reality application allows students to step through a visualization of the procedure on a phone or tablet. We conducted a user study to determine the advantages of preclinical training with our IANB simulator. We found that in comparison to dental students who were exposed only to traditional supplementary study materials, dental students who used our IANB simulator were more confident administering their first clinical injections, had less need for syringe readjustments, and had greater success in numbing patients.

Cyber-slacking interrupts classroom teaching and learning activities and is associated with poor academic performance. Based on the theory of planned behavior (TPB), this study aimed to investigate whether both cognitive (i.e., attitudes, perceived norms, and perceived behavioral control) and affective (i.e., fear of missing out [FoMO]) factors contribute to classroom cyber-slacking intention and behavior among Chinese university students. We recruited a convenience sample of 431 undergraduate students (M= 19.34, SD= 1.08; 66.4% female; 33.6% male) from mainland China who completed an online survey (i.e., items measured cognitive factors of cyber-slacking, cyber-slacking behavior, FoMO, and demographic information). The findings of correlational, hierarchical multiple regression, and path analysis with bootstrapping approach showed that both cognitive and affective factors were positive correlates of cyber-slacking intention and behavior and explained the variance in cyber-slacking intention. Moreover, attitudes, perceived norms, perceived behavioral control, and FoMO had statistically significant indirect effects (via intention) on cyber-slacking behaviors, whereas perceived behavioral control alone has a direct impact on cyber-slacking behaviors. The findings not only lend more credence to TPB, suggesting that cognitive factors are reliable correlates of both classroom cyber-slacking intention and behavior, but also showed affective factors, such as FoMO, can be used to reduce students’ cyber-slacking intention and, subsequently, their behavior. Based on these findings, interventions for reducing classroom cyber-slacking are discussed.

As the youth mental health crisis continues to worsen, there is a need for more evidence-based social-emotional interventions that can be applied in schools – the setting in which youth are most likely to seek and receive mental health treatment (Simon et al., 2015). Further, exploring ways to culturally adapt interventions for marginalized students is essential. The Ecological Validity Model (EVM; Bernal & Sáez-Santiago, 2006) guides the cultural adaptation process. This study examined the social validity of a promising school-based positive psychology intervention adapted using the EVM. A total of 98 middle school students with diverse backgrounds provided quantitative ratings of their perception of the adapted WBPP. Among those students, 70% participated in individual interviews providing qualitative information about their experiences with the adapted WBPP. Using a sequential explanatory mixed methods design, the findings indicated that participants believed the intervention content was appropriate, goals were significant, and outcomes were important. Participants requested more attention be given to their unique life experiences and adding interactive session activities. Given this initial evidence to support the acceptability of the adapted WBPP, future studies should explore the effectiveness of this program among students who reflect the diversity of public schools.

The article focuses on the profound impact of Rabbi Michael Lerner's work and his legacy. Topics include his dedication to integrating spirituality with activism, his role in fostering interfaith dialogue and critiques of systemic issues, and his influence on advancing ideas about human meaning and transformation.

When I was a girl, my mother told me I must always wear clean panties in case I got hit by a bus. If my skirt flared up, what would [...]

Designer Letty Allen faced a considerable task when tackling this project. The client wanted to remodel the outdated, inefficient kitchen while including a functional office space, all of which needed [...]

El presente artículo se centra en las plumas tapiragede los textiles miniatura con arte plumario hallados en el templo Huaca de la Luna del sitio Huacas de Moche (Valle de Moche, Perú), asociados a la ocupación Chimú (1000-1440 dC). El tapiragees una técnica de manipulación biológica, practicada por ciertos grupos amazónicos, que altera el color de las plumas de algunos psitácidos de los géneros Aray Amazona. Para confirmar la existencia de plumas tapirageen estos textiles, se realizó una identificación taxonómica macroscópica y microscópica de las plumas arqueológicas. Por último, se aplicaron análisis arqueométricos de microscopía de barrido electrónico (SEM) y microscopía digital para identificar los cambios en las microestructuras de las plumas, como también las especies de las plumas mismas. Los resultados muestran que las plumas de los textiles chimúes de Huaca de la Luna presentan plumas tapirage, lo que permite discutir sobre las relaciones de intercambio entre la costa norte peruana y la Amazonia, y avanzar en la interpretación de los significados de estas plumas en los rituales de la cultura Chimú, por su valor simbólico y capacidad de acceso a estas bienes por parte de estas comunidades costeras.

Imagine you live in a rural area out West and your neighbors keep trying to drive you off your land. One day, dozens of masked men smash your windows and [...]

I've been obsessed with Black-Jewish relations for half a century. As a young adult, I was emotionally and ideologically invested in the storied civil rights alliance of the 1950s and [...]

Alice Shalvi, now 92, is the most famous Israeli whom the average American Jew has never heard of. Revered Hebrew University English professor, principal of the Pelech school, founder of [...]

The European Commission has made grants available for supporting the collection of road safety performance indicators (called ‘KPIs’) within the EU. 18 EU Member States are participating in this project. For each of the eight KPIs considered, a common methodology for data collection and analysis has been developed by European experts; the methodological guidelines are available at the Baseline website (baseline.vias.be). Data collection and analysis is currently being finalized; the KPIs will be available in October 2022. They will constitute the basis for monitoring road safety progress at national and EU level, will facilitate the formulation of targets at European an national level, and will support decision makers on the most appropriate measures to be taken to improve road safety. Several EU countries have already integrated the monitoring of the KPIs in their road safety strategy.

WHEN I FIRST GOT MY BREAST CANCER DIAGNOSIS IN FALL 2009, I THOUGHT of a slogan from the early days of the women's movement: 'Laugh, and the world laughs with [...]

Hard to believe it's come to this: The word 'antisemitism,' coined in the 19th century by a German journalist, is being weaponized by Jews against Jews. That tragedy-laden term, exploited [...]

Yibing Huang. Contemporary Chinese Literature: From the Cultural Revolution to the Future. New York: Palgrave Macmillan, 2007. x, 219 pp. $90.00, ISBN 13: 978-1-4039-7982-7; ISBN 10: 1-4039-7982-0. Contemporary Chinese Literature: [...]

Yuko Kikuchi, editor. Refracted Modernity: Visual Culture and Identity in Colonial Taiwan. Honolulu: University of Hawai'i Press, 2007. viii, 285 pp. Hardcover $62.00, ISBN 978-0-8248-3050-2. A bona fide book on [...]

Jing Tsu. Failure, Nationalism, and Literature: The Making of Modern Chinese Identity, 1895-1937. Stanford, CA: Stanford University Press, 2005. xii, 329 pp. Hardcover $55.00, ISBN 0-8047-5176-5. To claim that modern [...]

Hope swelled in many hearts when President Biden indicated he would deep-six the prior administration's 'Deal of the Century,' which would have enshrined Israel's creeping annexation and ever-expanding settlement project [...]

One day last spring, I got a call from a woman I didn't know, asking if I objected--as she did--to a work of mine being included in The New Jewish [...]

Rong Cai. The Subject in Crisis in Contemporary Chinese Literature. Honolulu: University of Hawai'i Press, 2004. xii, 282 pp. Hardcover $55.00, ISBN 0-8248-2761-9. Paperback $25.00, ISBN 0-8248-2846-1. Post-Deng Xiaoping China [...]

The hoopla around the new Hulu series Mrs. America is driving me nuts. The disclaimer at the top of each episode doesn't help: 'This program is based on actual events [...]

Recently I taught a workshop at the Institute of Formation and Religious Studies in Manila. The group included a large number and variety of women religious from different Asian countries, [...]

This article focuses on the learning style preferences of achieving and underachieving gifted middle school students. Learning style was determined through administration of the Learning Style Inventory (LSI). Both groups [...]

Background: Mortality and morbidity related to AIDS have decreased among HIV-infected patients taking highly active antiretroviral therapy (HAART), but previous studies may have been confounded by other changes in treatment. Objective: To assess the benefit of HAART in patients with advanced AIDS and anemia. Design: Prospective, multicenter cohort study. Setting: The Viral Activation Transfusion Study (VATS), with enrollment from August 1995 through July 1998 and follow-up through June 1999. Patients: 528 HIV-infected patients with cytomegalovirus (CMV) seropositivity or disease who were receiving a first red blood cell transfusion for anemia. Measurements: In a person-year analysis of follow-up before and after initiation of HAART, Poisson regression was used to calculate crude ratios and rate ratios adjusted for CD4 count, HIV RNA level, calendar period, time on study, sex, ethnicity, and injection drug use. Results: At baseline, patients had a median CD4+ lymphocyte count of 0.015 x 10(super 9) cell/L, median plasma HIV RNA level of 4.8 log(sub 10) copies/mL, and median hemoglobin concentration of 73 g/L. Use of HAART increased from 1% of active patients in January 1996 to 79% of active patients in January 1999. The crude death rate was 0.24 event/person-year among patients taking HAART and 0.88 event/person-year among those not taking HAART (rate ratio, 0.26; adjusted rate ratio, 0.38; P < 0.001 for both comparisons). Rates of non-CMV disease were 0.15 event/person-year after HAART and 0.45 event/person-year before HAART (crude rate ratio, 0.34 [P < 0.001}; adjusted rate ratio, 0.66 [P < 0.05]). Rates of CMV disease were 0.10 event/person-year after HAART and 0.25 before HAART (crude rate ratio, 0.42 [P < 0.01]; adjusted rate ratio, 1.01 [P > 0.2]). Results were similar in patients with baseline CD4+ lymphocyte counts less than 0.010 x 10(super 9) cells/L. Conclusions: The data support an independent reduction in mortality and opportunistic events attributable to HAART, even in patients with very advanced HIV disease. However, patients with CMV infection or disease may not have a reduction in new CMV events due to HAART.

Glucose-dependent insulinotropic peptide (GIP) is known to be degraded by dipeptidyl peptidase IV (DPP IV), forming an inactive metabolite, but the extent of the enzyme's role in regulating the biological [...]

IMPORTANCE: Feeding intolerance is a common condition among preterm infants owing to immaturity of the gastrointestinal tract. Enteral insulin appears to promote intestinal maturation. The insulin concentration in human milk declines rapidly post partum and insulin is absent in formula; therefore, recombinant human (rh) insulin for enteral administration as a supplement to human milk and formula may reduce feeding intolerance in preterm infants. OBJECTIVE: To assess the efficacy and safety of 2 different dosages of rh insulin as a supplement to both human milk and preterm formula. DESIGN, SETTING, AND PARTICIPANTS: The FIT-04 multicenter, double-blind, placebo-controlled randomized clinical trial was conducted at 46 neonatal intensive care units throughout Europe, Israel, and the US. Preterm infants with a gestational age (GA) of 26 to 32 weeks and a birth weight of 500 g or more were enrolled between October 9, 2016, and April 25, 2018. Data were analyzed in January 2020. INTERVENTIONS: Preterm infants were randomly assigned to receive low-dose rh insulin (400-μIU/mL milk), high-dose rh insulin (2000-μIU/mL milk), or placebo for 28 days. MAIN OUTCOMES AND MEASURES: The primary outcome was time to achieve full enteral feeding (FEF) defined as an enteral intake of 150 mL/kg per day or more for 3 consecutive days. RESULTS: The final intention-to-treat analysis included 303 preterm infants (low-dose group: median [IQR] GA, 29.1 [28.1-30.4] weeks; 65 boys [59%]; median [IQR] birth weight, 1200 [976-1425] g; high-dose group: median [IQR] GA, 29.0 [27.7-30.5] weeks; 52 boys [55%]; median [IQR] birth weight, 1250 [1020-1445] g; placebo group: median [IQR] GA, 28.8 [27.6-30.4] weeks; 54 boys [55%]; median [IQR] birth weight, 1208 [1021-1430] g). The data safety monitoring board advised to discontinue the study early based on interim futility analysis (including the first 225 randomized infants), as the conditional power did not reach the prespecified threshold of 35% for both rh-insulin dosages. The study continued while the data safety monitoring board analyzed and discussed the data. In the final intention-to-treat analysis, the median (IQR) time to achieve FEF was significantly reduced in 94 infants receiving low-dose rh insulin (10.0 [7.0-21.8] days; P = .03) and in 82 infants receiving high-dose rh insulin (10.0 [6.0-15.0] days; P = .001) compared with 85 infants receiving placebo (14.0 [8.0-28.0] days). Compared with placebo, the difference in median (95% CI) time to FEF was 4.0 (1.0-8.0) days for the low-dose group and 4.0 (1.0-7.0) days for the high-dose group. Weight gain rates did not differ significantly between groups. Necrotizing enterocolitis (Bell stage 2 or 3) occurred in 7 of 108 infants (6%) in the low-dose group, 4 of 88 infants (5%) in the high-dose group, and 10 of 97 infants (10%) in the placebo group. None of the infants developed serum insulin antibodies. CONCLUSIONS AND RELEVANCE: Results of this randomized clinical trial revealed that enteral administration of 2 different rh-insulin dosages was safe and compared with placebo, significantly reduced time to FEF in preterm infants with a GA of 26 to 32 weeks. These findings support the use of rh insulin as a supplement to human milk and preterm formula. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02510560

Introduction: Nursing homes (NHs) are an ideal environment in which to implement interventions aimed at reducing inappropriate prescriptions. Quality indicators (QIs) may be useful to standardize practices, but it is unclear how they mediate change. In the framework of a quantitative study aimed at reducing the prescription of anticholinergic drugs among NH residents using QIs, we performed a qualitative study to describe the investigators’ perception of the utility of QIs. Methods: Qualitative study using focus group methodology. Focus groups were recorded and transcribed, and analyzed by thematic analysis. Participants were purposefully recruited from among the medical directors of the NHs in the quantitative study. Results: Five medical directors participated in two focus group meetings. The main themes to emerge were: (1) communication is key to introducing new practices and achieving lasting uptake; (2) improved coordination and communication provided useful information to help interpret the quantitative results observed: e.g., participants reported that they were able to obtain contextual and patient-specific information that explained why some prescribers had consistently, but justifiably “poor” performance on the quantitative indicators; (3) negative aspects reported included reluctance to change among prescribers and the tendency to shirk responsibility. Conclusion: From the point of view of medical directors of NHs participating in an interventional program to reduce inappropriate prescriptions of anticholinergic drugs, the main factor driving the success of the program was communication, which is key to achieving adherence. Improved communication provides useful insights into the reasons why no quantitative reduction is observed in objective quality indicators.

Since the founding of the Jewish State, it has been axiomatic in international politics that the United States has a 'special relationship' with Israel. This relationship (which is supported by [...]

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Because my daughter Abigail is a very clever woman, she first made it sound like a gift: 'Our friend Jane just started a personal organizing service. I'm buying you a [...]

It's too early to choose a presidential candidate. When Hillary Clinton ran for president, her being a woman was icing on the cake. I love icing, so I jumped into [...]

Some couples meet cute: He finds her wallet, she picks up his mail by mistake, her beagle mounts his schnauzer. Zach Levy met Cleo Scott at the founding conference of [...]