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Since its first appearance as the infrastructure supporting Bitcoin, blockchain has received different waves of attention from practitioners and academics. Besides the degree of interest, the attention to blockchain has often focused not merely on its own potential and characteristics but on its applications field. However, looking at its application and deployment in domains other than cryptocurrency or the nascent non-fungible tokens (NFTs), blockchain technology does not seem to be widely adopted or is still in its early stages. Given this, we are interested in how managers and the general public are informed about new technology other than through academic papers or the specialized press. In this paper, we analyze how blockchain has been presented by speakers invited to give TED and TEDx Talks to identify the most common terms used to present blockchain in these talks using a multi-methods approach (qualitative analysis and big data analysis) and see if the discourse surrounding blockchain has shifted over time. The results of this study show how the different perspectives brought by broadcasters like TED often overshadow a technological innovation like the blockchain in its evolution and application by the fact that the focus is instead shifted to products and services built on it. Also, this study shows how different degrees of attention and expertise are associated with each fashion wave of new or emergent technology innovations.

The paper presents a comparative study of the pulsatile attenuation amplitude (PAA) within the optic nerve head (ONH) at four different areas calculated from retinal video sequences and its relevance to the retinal nerve fiber layer thickness (RNFL) changes in normal subjects and patients with different stages of glaucoma. The proposed methodology utilizes processing of retinal video sequences acquired by a novel video ophthalmoscope. The PAA parameter measures the amplitude of heartbeat-modulated light attenuation in retinal tissue. Correlation analysis between PAA and RNFL is performed in vessel-free locations of the peripapillary region with the proposed evaluating patterns: 360 & DEG; circular area, temporal semi-circle, nasal semi-circle. For comparison, the full ONH area is also included. Various positions and sizes of evaluating patterns in peripapillary region were tested which resulted in different outputs of correlation analysis. The results show significant correlation between PAA and RNFL thickness calculated in proposed areas. The highest correlation coefficient R-temp = 0.557 (p<0.001) reflects the highest PAA-RNFL correspondence in the temporal semi-circular area, compared to the lowest value in the nasal semi-circular area (R-nasal = 0.332, p<0.001). Furthermore, the results indicate the most relevant approach to calculate PAA from the acquired video sequences is using a thin annulus near the ONH center. Finally, the paper shows the proposed photoplethysmographic principle based on innovative video ophthalmoscope can be used to analyze changes in retinal perfusion in peripapillary area and can be potentially used to assess progression of the RNFL deterioration.

The question of whether it is appropriate to attribute authorship to deceased individuals of original studies in the biomedical literature is contentious. Authorship guidelines utilized by journals do not provide a clear consensus framework that is binding on those in the field. To guide and inform the implementation of authorship frameworks it would be useful to understand the extent of the practice in the scientific literature, but studies that have systematically quantified the prevalence of this phenomenon in the biomedical literature have not been performed to date. To address this issue, we quantified the prevalence of publications by deceased authors in the biomedical literature from the period 1990-2020. We screened 2,601,457 peer-reviewed papers from the full text Europe PubMed Central database. We applied natural language processing, stringent filtering and manual curation to identify a final set of 1,439 deceased authors. We then determined these authors published a total of 38,907 papers over their careers with 5,477 published after death. The number of deceased publications has been growing rapidly, a 146-fold increase since the year 2000. This rate of increase was still significant when accounting for the growing total number of publications and pool of authors. We found that more than 50% of deceased author papers were first submitted after the death of the author and that over 60% of these papers failed to acknowledge the deceased authors status. Most deceased authors published less than 10 papers after death but a small pool of 30 authors published significantly more. A pool of 266 authors published more than 90% of their total publications after death. Our analysis indicates that the attribution of deceased authorship in the literature is not an occasional occurrence but a burgeoning trend. A consensus framework to address authorship by deceased scientists is warranted.

Introduction This study investigates the profiles of 25 faculty members of the area of Social and Legal Sciences, from seven Spanish universities, who were selected by students with disabilities. Specifically, the aim of this paper is to understand why, despite their lack of pedagogical and disability training, they are considered to be inclusive faculty members. Objective For this purpose, we analysed the professional characteristics of these academics, their conceptions about disability, what actions they carry out to provide an inclusive response and how they consider that the current situation of university students with disabilities could be improved. Methods Semi-structured individual interviews were used to collect the data. Subsequently, a progressive analysis of the data was performed, using an inductive system of categories and codes. Results and conclusions The results show that these faculty are responsible, involved and committed to their teaching performance. Moreover, they regard reasonable adjustments as a fundamental requirement to handle the different needs of students with disabilities. This paper–which can also be useful for faculty and researchers in other areas of knowledge–comes to the conclusion that training is relevant for becoming an inclusive faculty member. Nevertheless, good will and eagerness to do one’s job properly are even more important aspects.

Introduction This study investigates the profiles of 25 faculty members of the area of Social and Legal Sciences, from seven Spanish universities, who were selected by students with disabilities. Specifically, the aim of this paper is to understand why, despite their lack of pedagogical and disability training, they are considered to be inclusive faculty members. Objective For this purpose, we analysed the professional characteristics of these academics, their conceptions about disability, what actions they carry out to provide an inclusive response and how they consider that the current situation of university students with disabilities could be improved. Methods Semi-structured individual interviews were used to collect the data. Subsequently, a progressive analysis of the data was performed, using an inductive system of categories and codes. Results and conclusions The results show that these faculty are responsible, involved and committed to their teaching performance. Moreover, they regard reasonable adjustments as a fundamental requirement to handle the different needs of students with disabilities. This paper–which can also be useful for faculty and researchers in other areas of knowledge–comes to the conclusion that training is relevant for becoming an inclusive faculty member. Nevertheless, good will and eagerness to do one’s job properly are even more important aspects.

Academic journals provide a key quality-control mechanism in science. Yet, information asymmetries and conflicts of interests incentivize scientists to deceive journals about the quality of their research. How can honesty be ensured, despite incentives for deception? Here, we address this question by applying the theory of honest signaling to the publication process. Our models demonstrate that several mechanisms can ensure honest journal submission, including differential benefits, differential costs, and costs to resubmitting rejected papers. Without submission costs, scientists benefit from submitting all papers to high-ranking journals, unless papers can only be submitted a limited number of times. Counterintuitively, our analysis implies that inefficiencies in academic publishing (e.g., arbitrary formatting requirements, long review times) can serve a function by disincentivizing scientists from submitting low-quality work to high-ranking journals. Our models provide simple, powerful tools for understanding how to promote honest paper submission in academic publishing.

Introduction This study investigates the profiles of 25 faculty members of the area of Social and Legal Sciences, from seven Spanish universities, who were selected by students with disabilities. Specifically, the aim of this paper is to understand why, despite their lack of pedagogical and disability training, they are considered to be inclusive faculty members. Objective For this purpose, we analysed the professional characteristics of these academics, their conceptions about disability, what actions they carry out to provide an inclusive response and how they consider that the current situation of university students with disabilities could be improved. Methods Semi-structured individual interviews were used to collect the data. Subsequently, a progressive analysis of the data was performed, using an inductive system of categories and codes. Results and conclusions The results show that these faculty are responsible, involved and committed to their teaching performance. Moreover, they regard reasonable adjustments as a fundamental requirement to handle the different needs of students with disabilities. This paper–which can also be useful for faculty and researchers in other areas of knowledge–comes to the conclusion that training is relevant for becoming an inclusive faculty member. Nevertheless, good will and eagerness to do one’s job properly are even more important aspects.

Introduction This study investigates the profiles of 25 faculty members of the area of Social and Legal Sciences, from seven Spanish universities, who were selected by students with disabilities. Specifically, the aim of this paper is to understand why, despite their lack of pedagogical and disability training, they are considered to be inclusive faculty members. Objective For this purpose, we analysed the professional characteristics of these academics, their conceptions about disability, what actions they carry out to provide an inclusive response and how they consider that the current situation of university students with disabilities could be improved. Methods Semi-structured individual interviews were used to collect the data. Subsequently, a progressive analysis of the data was performed, using an inductive system of categories and codes. Results and conclusions The results show that these faculty are responsible, involved and committed to their teaching performance. Moreover, they regard reasonable adjustments as a fundamental requirement to handle the different needs of students with disabilities. This paper-which can also be useful for faculty and researchers in other areas of knowledge-comes to the conclusion that training is relevant for becoming an inclusive faculty member. Nevertheless, good will and eagerness to do one's job properly are even more important aspects.

Introduction This study investigates the profiles of 25 faculty members of the area of Social and Legal Sciences, from seven Spanish universities, who were selected by students with disabilities. Specifically, the aim of this paper is to understand why, despite their lack of pedagogical and disability training, they are considered to be inclusive faculty members. Objective For this purpose, we analysed the professional characteristics of these academics, their conceptions about disability, what actions they carry out to provide an inclusive response and how they consider that the current situation of university students with disabilities could be improved. Methods Semi-structured individual interviews were used to collect the data. Subsequently, a progressive analysis of the data was performed, using an inductive system of categories and codes. Results and conclusions The results show that these faculty are responsible, involved and committed to their teaching performance. Moreover, they regard reasonable adjustments as a fundamental requirement to handle the different needs of students with disabilities. This paper–which can also be useful for faculty and researchers in other areas of knowledge–comes to the conclusion that training is relevant for becoming an inclusive faculty member. Nevertheless, good will and eagerness to do one’s job properly are even more important aspects.

This paper discusses the merging of two optimization algorithms, atom search optimization and particle swarm optimization, to create a hybrid algorithm called hybrid atom search particle swarm optimization (h-ASPSO). Atom search optimization is an algorithm inspired by the movement of atoms in nature, which employs interaction forces and neighbor interaction to guide each atom in the population. On the other hand, particle swarm optimization is a swarm intelligence algorithm that uses a population of particles to search for the optimal solution through a social learning process. The proposed algorithm aims to reach exploration-exploitation balance to improve search efficiency. The efficacy of h-ASPSO has been demonstrated in improving the time-domain performance of two high-order real-world engineering problems: the design of a proportional-integral-derivative controller for an automatic voltage regulator and a doubly fed induction generator-based wind turbine systems. The results show that h-ASPSO outperformed the original atom search optimization in terms of convergence speed and quality of solution and can provide more promising results for different high-order engineering systems without significantly increasing the computational cost. The promise of the proposed method is further demonstrated using other available competitive methods that are utilized for the automatic voltage regulator and a doubly fed induction generator-based wind turbine systems.

This paper discusses the merging of two optimization algorithms, atom search optimization and particle swarm optimization, to create a hybrid algorithm called hybrid atom search particle swarm optimization (h-ASPSO). Atom search optimization is an algorithm inspired by the movement of atoms in nature, which employs interaction forces and neighbor interaction to guide each atom in the population. On the other hand, particle swarm optimization is a swarm intelligence algorithm that uses a population of particles to search for the optimal solution through a social learning process. The proposed algorithm aims to reach exploration-exploitation balance to improve search efficiency. The efficacy of h-ASPSO has been demonstrated in improving the time-domain performance of two high-order real-world engineering problems: the design of a proportional-integral-derivative controller for an automatic voltage regulator and a doubly fed induction generator-based wind turbine systems. The results show that h-ASPSO outperformed the original atom search optimization in terms of convergence speed and quality of solution and can provide more promising results for different high-order engineering systems without significantly increasing the computational cost. The promise of the proposed method is further demonstrated using other available competitive methods that are utilized for the automatic voltage regulator and a doubly fed induction generator-based wind turbine systems.

This paper discusses the merging of two optimization algorithms, atom search optimization and particle swarm optimization, to create a hybrid algorithm called hybrid atom search particle swarm optimization (h-ASPSO). Atom search optimization is an algorithm inspired by the movement of atoms in nature, which employs interaction forces and neighbor interaction to guide each atom in the population. On the other hand, particle swarm optimization is a swarm intelligence algorithm that uses a population of particles to search for the optimal solution through a social learning process. The proposed algorithm aims to reach exploration-exploitation balance to improve search efficiency. The efficacy of h-ASPSO has been demonstrated in improving the time-domain performance of two high-order real-world engineering problems: the design of a proportional-integral-derivative controller for an automatic voltage regulator and a doubly fed induction generator-based wind turbine systems. The results show that h-ASPSO outperformed the original atom search optimization in terms of convergence speed and quality of solution and can provide more promising results for different high-order engineering systems without significantly increasing the computational cost. The promise of the proposed method is further demonstrated using other available competitive methods that are utilized for the automatic voltage regulator and a doubly fed induction generator-based wind turbine systems.

Background Both laparoscopic surgery and computer games make similar demands on eye-hand coordination and visuospatial cognitive ability. A possible connection between both areas could be used for the recruitment and training of future surgery residents. Aim The goal of this study was to investigate whether gaming skills are associated with better laparoscopic performance in medical students. Methods 135 medical students (55 males, 80 females) participated in an experimental study. Students completed three laparoscopic tasks (rope pass, paper cut, and peg transfer) and played two custom-designed video games (2D and 3D game) that had been previously validated in a group of casual and professional gamers. Results There was a small significant correlation between performance on the rope pass task and the 3D game, Kendall's tau(111) = -.151,P= .019. There was also a small significant correlation between the paper cut task and points in the 2D game, Kendall's tau(102) = -.180,P= .008. Overall laparoscopic performance was also significantly correlated with both the 3D game, Kendall's tau(112) = -.134,P= .036, and points in the 2D game, Kendall's tau(113) = -.163,P= .011. However, there was no significant correlation between the peg transfer task and both games (2D and 3D game),P= n.s.. Conclusion This study provides further evidence that gaming skills may be an advantage when learning laparoscopic surgery.

Morbidity burden of lymphatic filariasis (LF) relies on the information from the Mass Drug Administration (MDA) programme where Community Health Volunteers (CHVs) passively report cases identified. Consequently, the exact prevalence of morbidity cases is not always accurate. The use of mobile phone technology to report morbidity cases was piloted in Ghana using a text-based short messaging service (SMS) tool by CHVs. Though successful, illiterate CHVs could not effectively use the SMS tool. The aim of this study was to evaluate the use of a mobile phone-based Interactive Voice Response System (mIVRS) by CHVs in reporting LF morbidity cases and acute dermatolymphangioadenitis (ADLA) attacks in Ghana. The mIVRS was designed as a surveillance tool to capture LF data in Kassena Nankana Districts of Ghana. One hundred CHVs were trained to identify and report lymphedema and hydrocele cases as well as ADLA attacks by calling a hotline linked to the mIVRS. The system asked a series of questions about the disease condition. The ability of the CHV to report accurately was assessed and the data from the mIVRS were compared with the paper records from the CHVs and existing MDA programme records from the same communities and period. Higher numbers of lymphedema and hydrocele cases were recorded by the CHVs using the mIVRS (n = 590 and n = 103) compared to the paper-based reporting (n = 417 and n = 76) and the MDA records (n = 154 and n = 84). Female CHVs, CHVs above 40 years, and CHVs with higher educational levels were better at paper-based reporting (P = 0.007, P = 0.001, P = 0.049 respectively). The system, when fully developed and linked to national databases, may help to overcome underreporting of morbidity cases and ADLA attacks in endemic communities. The system has the potential to be further expanded to other diseases. Author summary The goal towards the elimination of lymphatic filariasis as indicated by Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to

In the last decades, statistical methodology has developed rapidly, in particular in the field of regression modeling. Multivariable regression models are applied in almost all medical research projects. Therefore, the potential impact of statistical misconceptions within this field can be enormous Indeed, the current theoretical statistical knowledge is not always adequately transferred to the current practice in medical statistics. Some medical journals have identified this problem and published isolated statistical articles and even whole series thereof. In this systematic review, we aim to assess the current level of education on regression modeling that is provided to medical researchers via series of statistical articles published in medical journals. The present manuscript is a protocol for a systematic review that aims to assess which aspects of regression modeling are covered by statistical series published in medical journals that intend to train and guide applied medical researchers with limited statistical knowledge. Statistical paper series cannot easily be summarized and identified by common keywords in an electronic search engine like Scopus. We therefore identified series by a systematic request to statistical experts who are part or related to the STRATOS Initiative (STRengthening Analytical Thinking for Observational Studies). Within each identified article, two raters will independently check the content of the articles with respect to a predefined list of key aspects related to regression modeling. The content analysis of the topic-relevant articles will be performed using a predefined report form to assess the content as objectively as possible. Any disputes will be resolved by a third reviewer. Summary analyses will identify potential methodological gaps and misconceptions that may have an important impact on the quality of analyses in medical research. This review will thus provide a basis for future guidance papers and tutorials in the field

This paper explores the significance of narrative in collaborative reasoning using a qualitative case study of two teams of intelligence analysts who took part in an exercise using an online collaborative platform. Digital ethnographic methods were used to analyze the chat transcripts of analysts as they reasoned with evidence provided in a difficult, fictional intelligence-type problem and produced a final intelligence report. These chat transcripts provided a powerful "microscope" into the reasoning processes and interactions involved in complex, collaborative reasoning. We found that Individuals and teams used narrative to solve the kinds of complex problems organizations and intelligence agencies face daily. We observed that team members generated what we term "micro-narratives", which provided a means for testing, assessing and weighing alternative hypotheses through mental simulation in the context of collaborative reasoning. The creation of micro-narratives assisted in the teams' reasoning with evidence, an integral part of collaborative reasoning and intelligence analysis. Micro-narratives were combined into, and compared with, an ideal or 'virtual' narrative which informed the judgements the team came to in their final intelligence report. The case study developed in this paper provides evidence that narrative thought processes play an important role in complex collaborative problem-solving, reasoning with evidence and problem-solving. This is contrary to a widespread perception that narrative thinking is fundamentally distinct from formal, logical reasoning.

Background Both laparoscopic surgery and computer games make similar demands on eye-hand coordination and visuospatial cognitive ability. A possible connection between both areas could be used for the recruitment and training of future surgery residents. Aim The goal of this study was to investigate whether gaming skills are associated with better laparoscopic performance in medical students. Methods 135 medical students (55 males, 80 females) participated in an experimental study. Students completed three laparoscopic tasks (rope pass, paper cut, and peg transfer) and played two custom-designed video games (2D and 3D game) that had been previously validated in a group of casual and professional gamers. Results There was a small significant correlation between performance on the rope pass task and the 3D game, Kendall's tau(111) = -.151,P= .019. There was also a small significant correlation between the paper cut task and points in the 2D game, Kendall's tau(102) = -.180,P= .008. Overall laparoscopic performance was also significantly correlated with both the 3D game, Kendall's tau(112) = -.134,P= .036, and points in the 2D game, Kendall's tau(113) = -.163,P= .011. However, there was no significant correlation between the peg transfer task and both games (2D and 3D game),P= n.s.. Conclusion This study provides further evidence that gaming skills may be an advantage when learning laparoscopic surgery.

Morbidity burden of lymphatic filariasis (LF) relies on the information from the Mass Drug Administration (MDA) programme where Community Health Volunteers (CHVs) passively report cases identified. Consequently, the exact prevalence of morbidity cases is not always accurate. The use of mobile phone technology to report morbidity cases was piloted in Ghana using a text-based short messaging service (SMS) tool by CHVs. Though successful, illiterate CHVs could not effectively use the SMS tool. The aim of this study was to evaluate the use of a mobile phone-based Interactive Voice Response System (mIVRS) by CHVs in reporting LF morbidity cases and acute dermatolymphangioadenitis (ADLA) attacks in Ghana. The mIVRS was designed as a surveillance tool to capture LF data in Kassena Nankana Districts of Ghana. One hundred CHVs were trained to identify and report lymphedema and hydrocele cases as well as ADLA attacks by calling a hotline linked to the mIVRS. The system asked a series of questions about the disease condition. The ability of the CHV to report accurately was assessed and the data from the mIVRS were compared with the paper records from the CHVs and existing MDA programme records from the same communities and period. Higher numbers of lymphedema and hydrocele cases were recorded by the CHVs using the mIVRS (n = 590 and n = 103) compared to the paper-based reporting (n = 417 and n = 76) and the MDA records (n = 154 and n = 84). Female CHVs, CHVs above 40 years, and CHVs with higher educational levels were better at paper-based reporting (P = 0.007, P = 0.001, P = 0.049 respectively). The system, when fully developed and linked to national databases, may help to overcome underreporting of morbidity cases and ADLA attacks in endemic communities. The system has the potential to be further expanded to other diseases. Author summary The goal towards the elimination of lymphatic filariasis as indicated by Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to

Recent deep learning methods for fruits classification resulted in promising performance. However, these methods are with heavy-weight architectures in nature, and hence require a higher storage and expensive training operations due to feeding a large number of training parameters. There is a necessity to explore lightweight deep learning models without compromising the classification accuracy. In this paper, we propose a lightweight deep learning model using the pre-trained MobileNetV2 model and attention module. First, the convolution features are extracted to capture the high-level object-based information. Second, an attention module is used to capture the interesting semantic information. The convolution and attention modules are then combined together to fuse both the high-level object-based information and the interesting semantic information, which is followed by the fully connected layers and the softmax layer. Evaluation of our proposed method, which leverages transfer learning approach, on three public fruit-related benchmark datasets shows that our proposed method outperforms the four latest deep learning methods with a smaller number of trainable parameters and a superior classification accuracy. Our model has a great potential to be adopted by industries closely related to the fruit growing and retailing or processing chain for automatic fruit identification and classifications in the future.

OBJECTIVES: Qualitative studies nested within clinical trials can provide insight into the treatment experience, how this evolves over time and where improved supportive care is required. The purpose of this qualitative study is to describe the lived experiences of men with advanced prostate cancer participating in the TheraP trial; a randomised trial of 177Lu-PSMA-617 compared with cabazitaxel chemotherapy. METHODS: Fifteen men with advanced prostate cancer were recruited from the TheraP clinical trial with interviews conducted at three timepoints during the trial. An interpretative phenomenological approach was used, and interviews analysed using thematic analysis. This research paper reports the results from the mid-point, conclusion and follow up interviews, focusing specifically on participants' experiences of trial participation. RESULTS: Three themes were identified representing the lived experiences of men with advanced prostate cancer participating in the TheraP trial: (1) facing limited options; (2) anticipating outcomes and (3) coping with health changes. CONCLUSIONS: Men who enrol in clinical trial of anti-neoplastic treatments for prostate cancer need targeted psychological and supportive care that includes attention to unique aspects of the experience of having prostate cancer and being in a clinical trial. As part of their trial experience, men with advanced prostate cancer need to be regularly assessed for survivorship needs, fully informed, supported and referred to services for regular care and support across the trajectory of their disease. TRIAL REGISTRATION: NCT03392428. Registered on 8 January 2018 (ANZUP1603).

BACKGROUND: Little is known about the emotional experience and benefits of undertaking direct acting antiviral (DAA) treatment for hepatitis C. A better understanding of individual treatment outcomes can inform acceptable treatment delivery and promotion. We aimed to explore participant-perceived emotional benefits and transformations throughout DAA treatment among people who inject drugs, who were initiating treatment. METHODS: Participants were recruited from either a community based clinical trial or community health clinics. Semi structured interviews were conducted with each participant before, during and following treatment. Interviews focussed on treatment perceptions, physical and mental wellbeing and modifiable health behaviours. Interviews were recorded, transcribed verbatim and thematically analysed. Participant and cohort matrices were produced to assess at which time point themes were present and whether themes changed or remained stable over time. RESULTS: This paper presents analysis from 19 participants interviewed between 2017-2019. Most participants were male, with no or mild fibrosis. At baseline, all but one participant had injected drugs in the past month. Three themes relating to the emotional wellbeing and behaviour change described a common treatment experience; 'hopes for better wellbeing', 'lifting the weight' and 'closing the chapter'. Participants were hopeful treatment would improve their emotional wellbeing. Hopes were actualised during treatment as participants began to feel uncertainty and stress easing. Completing treatment improved some participants perceptions of self. Some participants consciously changed their injecting behaviours during treatment. CONCLUSION: Undertaking and completing treatment was an emotionally and behaviourally transformative period. Participant perceived benefits should be used to inform how treatment benefit is conceptualised and how treatment is promoted in primary care settings.

Maintenance of epidermal thickness is critical to the barrier function of the skin. Decreased tissue thickness, specifically in the stratum corneum (the outermost layer of the tissue), causes discomfort and inflammation, and is related to several severe diseases of the tissue. In order to maintain both stratum corneum thickness and overall tissue thickness it is necessary for the system to balance cell proliferation and cell loss. Cell proliferation in the epidermis occurs in the basal layer and causes constant upwards movement in the tissue. Cell loss occurs when dead cells at the top of the tissue are lost to the environment through a process called desquamation. Desquamation is thought to occur through a gradual reduction in adhesion between cells, due to the cleaving of adhesion proteins by enzymes, in the stratum corneum. In this paper we will investigate combining a (mass action) subcellular model of desquamation with a three dimensional (cell centre based) multicellular model of the interfollicular epidermis to better understand maintenance of epidermal thickness. Specifically, our aim is to determine if a hypothesised biological model for the degradation of cell-cell adhesion, from the literature, is sufficient to maintain a steady state tissue thickness. These investigations show the model is able to provide a consistent rate of cell loss in the multicellular model. This loss balances proliferation, and hence maintains a homeostatic tissue thickness. Moreover, we find that multiple proliferative cell populations in the basal layer can be represented by a single proliferative cell population, simplifying investigations with this model. The model is used to investigate a disorder (Netherton Syndrome) which disrupts desquamation. The model shows how biochemical changes can cause disruptions to the tissue, resulting in a reduced tissue thickness and consequently diminishing the protective role of the tissue. A hypothetical treatment result is also investigated

Background Exposure to prolonged periods in microgravity is associated with deconditioning of the musculoskeletal system due to chronic changes in mechanical stimulation. Given astronauts will operate on the Lunar surface for extended periods of time, it is critical to quantify both external (e.g., ground reaction forces) and internal (e.g., joint reaction forces) loads of relevant movements performed during Lunar missions. Such knowledge is key to predict musculoskeletal deconditioning and determine appropriate exercise countermeasures associated with extended exposure to hypogravity. Objectives The aim of this paper is to define an experimental protocol and methodology suitable to estimate in high-fidelity hypogravity conditions the lower limb internal joint reaction forces. State-of-the-art movement kinetics, kinematics, muscle activation and muscle-tendon unit behaviour during locomotor and plyometric movements will be collected and used as inputs (Objective 1), with musculoskeletal modelling and an optimisation framework used to estimate lower limb internal joint loading (Objective 2). Methods Twenty-six healthy participants will be recruited for this cross-sectional study. Participants will walk, skip and run, at speeds ranging between 0.56-3.6 m/s, and perform plyometric movement trials at each gravity level (1, 0.7, 0.5, 0.38, 0.27 and 0.16g) in a randomized order. Through the collection of state-of-the-art kinetics, kinematics, muscle activation and muscle-tendon behaviour, a musculoskeletal modelling framework will be used to estimate lower limb joint reaction forces via tracking simulations. Conclusion The results of this study will provide first estimations of internal musculoskeletal loads associated with human movement performed in a range of hypogravity levels. Thus, our unique data will be a key step towards modelling the musculoskeletal deconditioning associated with long term habitation on the Lunar surface, and thereby aiding the design of Lunar e

This paper uses extensive database research, film viewing and literature review to show how the field of surgery was staged in the early days of film history. It can be shown that-although surgical medicine was a subject in transition, and many scientific breakthroughs (anesthesia und antisepsis) made surgery less painful and more complication-free-filmmakers still frequently resorted to horror memories of the past and created a questionable, or ambivalent image of the surgeon, sometimes as extreme as the lunatic with a scalpel stereotype, blurring the line between genius and madness. But there were also positive staging's: The surgical intervention was often captured on the screen as a last resort for clinically hopeless cases, with the surgeon often presented as a deus ex machina, the savior out of nowhere. Other specialties, however, such as plastic surgery, were mostly positively dramatized, which reveals a stark contrast to research about the representation of the field in the sound film era. A view at the fields of neurosurgery and (selectively) opthalmo-surgery rounds out the panorama of forty-one surgical films. In summary, it is shown that the early surgical film depicts the specialty and the surgeon in a highly ambivalent way, from savior to monster thereby reflecting one of the most significant transitions in the history of surgery and showing us what image was presented to the public-and thus to potential patients-in the movie theaters.

The ethical discourse surrounding patients agential capacities, vis-a-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: "Fundamental Variability in Patient Capacity", "Patient Participation: Narration or Compliance?", "Antagonism Rooted in Power Struggles", and "System Structure Thwarts Patient Release". While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress., Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2014-4024, 2018-01409]; Swedish Research Council (VR) [2014-40]

IntroductionThe emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students' awareness of ID specialists and future career choices. MethodThis cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students' knowledge and future intentions of becoming ID specialists. ResultsWe obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists. ConclusionWe observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic.

The ethical discourse surrounding patients agential capacities, vis-a-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: "Fundamental Variability in Patient Capacity", "Patient Participation: Narration or Compliance?", "Antagonism Rooted in Power Struggles", and "System Structure Thwarts Patient Release". While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress., Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2014-4024, 2018-01409]; Swedish Research Council (VR) [2014-40]

Academic networks are expected to enhance scientific collaboration and thereby increase research outputs. However, little is known about whether and how the initial steps of getting to know other researchers translates into effective collaborations. In this paper, we investigate the evolution and co-evolution of an academic social network and a collaborative research network (using co-authorship as a proxy measure of the latter), and simultaneously examine the effect of individual researcher characteristics (e.g. gender, seniority or workplace) on their evolving relationships. We used longitudinal data from an international network in primary care cancer research: the CanTest Collaborative (CanTest). Surveys were distributed amongst CanTest researchers to map who knows who (the 'academic social network'). Co-authorship relations were derived from Scopus (the 'collaborative network'). Stochastic actor-oriented models were employed to investigate the evolution and co-evolution of both networks. Visualizing the development of the CanTest network revealed that researchers within CanTest get to know each other quickly and also start collaborating over time (evolution of the academic social network and collaborative network respectively). Results point to a stable and solid academic social network that is particularly encouraging towards more junior researchers; yet differing for male and female researchers (the effect of individual researcher characteristics). Moreover, although the academic social network and the research collaborations do not grow at the same pace, the benefit of creating academic social relationships to stimulate effective research collaboration is clearly demonstrated (co-evolution of both networks).

BACKGROUND: Sulfadoxine-pyrimethamine (SP) is recommended in Africa in several antimalarial preventive regimens including Intermittent Preventive Treatment in pregnant women (IPTp), Intermittent Preventive Treatment in infants (IPTi) and Seasonal Malaria Chemoprevention (SMC). The effectiveness of SP-based preventive treatments are threatened in areas where Plasmodium falciparum resistance to SP is high. The prevalence of mutations in the dihydropteroate synthase gene (pfdhps) can be used to monitor SP effectiveness. IPTi-SP is recommended only in areas where the prevalence of the pfdhps540E mutation is below 50%. It has also been suggested that IPTp-SP does not have a protective effect in areas where the pfdhps581G mutation, exceeds 10%. However, pfdhps mutation prevalence data in Africa are extremely heterogenous and scattered, with data completely missing from many areas. METHODS AND FINDINGS: The WWARN SP Molecular Surveyor database was designed to summarize dihydrofolate reductase (pfdhfr) and pfdhps gene mutation prevalence data. In this paper, pfdhps mutation prevalence data was used to generate continuous spatiotemporal surface maps of the estimated prevalence of the SP resistance markers pfdhps437G, pfdhps540E, and pfdhps581G in Africa from 1990 to 2020 using a geostatistical model, with a Bayesian inference framework to estimate uncertainty. The maps of estimated prevalence show an expansion of the pfdhps437G mutations across the entire continent over the last three decades. The pfdhps540E mutation emerged from limited foci in East Africa to currently exceeding 50% estimated prevalence in most of East and South East Africa. pfdhps540E distribution is expanding at low or moderate prevalence in central Africa and a predicted focus in West Africa. Although the pfdhps581G mutation spread from one focus in East Africa in 2000, to exceeding 10% estimated prevalence in several foci in 2010, the predicted distribution of the marker did not expand in 2020, however

The ethical discourse surrounding patients agential capacities, vis-a-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: "Fundamental Variability in Patient Capacity", "Patient Participation: Narration or Compliance?", "Antagonism Rooted in Power Struggles", and "System Structure Thwarts Patient Release". While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress., Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2014-4024, 2018-01409]; Swedish Research Council (VR) [2014-40]

The ethical discourse surrounding patients agential capacities, vis-a-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: "Fundamental Variability in Patient Capacity", "Patient Participation: Narration or Compliance?", "Antagonism Rooted in Power Struggles", and "System Structure Thwarts Patient Release". While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress., Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2014-4024, 2018-01409]; Swedish Research Council (VR) [2014-40]

The ethical discourse surrounding patients agential capacities, vis-a-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: "Fundamental Variability in Patient Capacity", "Patient Participation: Narration or Compliance?", "Antagonism Rooted in Power Struggles", and "System Structure Thwarts Patient Release". While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress., Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2014-4024, 2018-01409]; Swedish Research Council (VR) [2014-40]

BACKGROUND: Preventative chemotherapy and mass drug administration have been identified as effective strategies for the prevention, treatment, control and elimination of several NTDs in the Asia-Pacific region. Qualitative research can provide in-depth insight into the social dynamics and processes underlying effective implementation of and adherence to mass drug administration programs. This scoping review examines published qualitative literature to examine factors influencing community perceptions and acceptability of mass drug administration approaches to control NTDs in the Asia-Pacific region. METHODOLOGY: Twenty-four peer reviewed published papers reporting qualitative data from community members and stakeholders engaged in the implementation of mass drug administration programs were identified as eligible for inclusion. FINDINGS: This systematic scoping review presents available data from studies focussing on lymphatic filariasis, soil-transmitted helminths and scabies in eight national settings (India, Indonesia, Philippines, Bangladesh, Laos, American Samoa, Papua New Guinea, Fiji). The review highlights the profoundly social nature of individual, interpersonal and institutional influences on community perceptions of willingness to participate in mass drug administration programs for control of neglected tropical diseases (NTD). Future NTD research and control efforts would benefit from a stronger qualitative social science lens to mass drug administration implementation, a commitment to understanding and addressing the social and structural determinants of NTDs and NTD control in complex settings, and efforts to engage local communities as equal partners and experts in the co-design of mass drug administration and other efforts to prevent, treat, control and eliminate NTDs. CONCLUSION: For many countries in the Asia-Pacific region, the "low hanging fruit has been picked" in terms of where mass drug administration has worked and transmission has been stopp

Knowledge and motivation of a teacher are two unchallenged, essential characteristics for successful education. Whilst the relevance of teachers' professional knowledge for successful students' learning has been studied in a sophisticated manner for years, the meaning of teachers' motivational orientations for students' performance still lacks a differentiated consideration. This construct is conceptualized by three domains: (1) self-efficacy, (2) subject-specific enthusiasm, and (3) enthusiasm for teaching the subject. Motivational orientations overall have shown to be relevant predictors of students' learning. However, there are several dimensions of motivation and their relative importance remains unclear. Our study goes beyond the available findings by considering in detail each of the three domains' relations to students' performance. Thus, we aim to further contribute to the clarification of the predictors of students' performance in school teaching. For this purpose, we conducted a study with 48 biology teachers and their 1036 students. To assess the three domains of teachers' motivational orientations, we applied paper and pencil tests. Concept maps and paper and pencil tests were used to measure students' performance. By specifying multilevel structural equation models, we examined the relationship between the domains of teachers' motivational orientations and the performance of the students. Our results reveal no relationship between teachers' self-efficacy and students' performance, but a significant positive relationship between the latter and teachers' subject-specific enthusiasm. Moreover, our results show a positive trend in the relationship between enthusiasm for teaching the subject and students' performance. The results provide a differentiated picture about the importance of motivational orientations for the characterisation of an effective teacher. We discuss our findings in terms of possible effect mechanisms and their relevance for further rese

BACKGROUND: Despite several decades of evidence supporting the benefits of taking medications in various diseases and healthcare settings, a significant proportion of prescribed treatments are not taken. This review sought to synthesise qualitative research exploring experiences of medication taking around the world, and to determine whether there were consistent messages arising from these studies. METHODS AND FINDINGS: 5 databases (MEDLINE, PsycINFO, EMBASE, SCOPUS, CINAHL) were systematically searched to identify published research papers using qualitative methodologies, which explored medication-taking experiences in patients, citizens, carers, relatives and clinicians. Data were extracted independently by at least two clinician reviewers. Implications for practice from individual papers were charted and coded using thematic content analysis. These were then cross-tabulated with research paper categories to explore emergent patterns with particular implications for practice. 192 papers from 34 different countries were included in the review. Implications for practice fitted into 11 categories: increase family involvement, increase clinician involvement, promote personalised management, address practical barriers, provide ongoing support, promote self-management, adopt a patient-centred approach, improve patient education, address system barriers, increase access to non-prescribing clinicians and improve clinician training. These implications for practice were generally evenly spread across research paper categories. CONCLUSIONS: Implications for practice from the published qualitative literature exploring medication-taking are notably consistent across research methods, disease categories and geographical settings. More recent clinical trials of interventions to improve adherence have started to draw on these findings by focussing on improving clinical interactions and involving patients in healthcare decisions. Promoting patient education and self-management ha

Knowledge and motivation of a teacher are two unchallenged, essential characteristics for successful education. Whilst the relevance of teachers' professional knowledge for successful students' learning has been studied in a sophisticated manner for years, the meaning of teachers' motivational orientations for students' performance still lacks a differentiated consideration. This construct is conceptualized by three domains: (1) self-efficacy, (2) subject-specific enthusiasm, and (3) enthusiasm for teaching the subject. Motivational orientations overall have shown to be relevant predictors of students' learning. However, there are several dimensions of motivation and their relative importance remains unclear. Our study goes beyond the available findings by considering in detail each of the three domains' relations to students' performance. Thus, we aim to further contribute to the clarification of the predictors of students' performance in school teaching. For this purpose, we conducted a study with 48 biology teachers and their 1036 students. To assess the three domains of teachers' motivational orientations, we applied paper and pencil tests. Concept maps and paper and pencil tests were used to measure students' performance. By specifying multilevel structural equation models, we examined the relationship between the domains of teachers' motivational orientations and the performance of the students. Our results reveal no relationship between teachers' self-efficacy and students' performance, but a significant positive relationship between the latter and teachers' subject-specific enthusiasm. Moreover, our results show a positive trend in the relationship between enthusiasm for teaching the subject and students' performance. The results provide a differentiated picture about the importance of motivational orientations for the characterisation of an effective teacher. We discuss our findings in terms of possible effect mechanisms and their relevance for further rese

Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field.

Most philosophers believe that a person can have an obligation only insofar as she is able to fulfil it, a principle generally referred to as "Ought Implies Can". Arguably, this principle reflects something basic about the ordinary concept of obligation. However, in a paper published recently in this journal, Wesley Buckwalter and John Turri presented evidence for the conclusion that ordinary people in fact reject that principle. With a series of studies, they claimed to have demonstrated that, in people's judgements, obligations persist irrespective of whether those who hold them have the ability to fulfil them. We argue in this paper that due to some problems in their design, Buckwalter & Turri's conclusions may not be warranted. We present the results of a series of studies demonstrating the problems with their design and showing that, with an improved design, people judge that obligation depends on ability after all.

Introduction: The Swedish Register of Palliative Care (SRPC) is a national quality register that collects data about end-of-life care from healthcare providers that care for dying patients. Data are used for quality control and research. Data are mainly collected with an end-of-life questionnaire (ELQ), which is completed by healthcare staff after the death of a patient. A previous validity assessment of the ELQ showed insufficient validity in some items including symptom relief. The aim of this study was to examine the validity of the revised ELQ. Materials and methods: Data from 100 consecutive patients' medical records at two specialised palliative care units were used to complete new ELQs, which were then compared to the ELQ registrations from the SRPC for the same patients. The level of agreement was calculated for each ELQ item. To account for the possibility of the agreement occurring by chance, Cohen's kappa was calculated for suitable items. To examine the extent of registration mistakes when transferring the paper form to the web, the original paper versions of the ELQ filled out at the units were compared to data from the ELQs reported to the SRPC. Results: Level of agreement between ELQ registrations from the SRPC and the new ELQs based on the medical records varied between 0.55 and 1.00, where 24 items showed level of agreement above 0.80 and 9 items showed level of agreement below 0.80. Cohen's kappa with 95% confidence intervals was calculated for 24 items. The kappa values showed that two items had poor agreement, four fair agreement, 11 moderate agreement, five good agreement and two very good agreement. The level of agreement varied between 0.93 and 1.00 when comparing the ELQ registrations in the SRPC and the paper forms. Conclusion: The revised ELQ contains more items with high levels of agreement between registrations in the SRPC and notes in the patients' medical records when compared to the previous version. Validating issues around symptom as

Introduction: The Swedish Register of Palliative Care (SRPC) is a national quality register that collects data about end-of-life care from healthcare providers that care for dying patients. Data are used for quality control and research. Data are mainly collected with an end-of-life questionnaire (ELQ), which is completed by healthcare staff after the death of a patient. A previous validity assessment of the ELQ showed insufficient validity in some items including symptom relief. The aim of this study was to examine the validity of the revised ELQ. Materials and methods: Data from 100 consecutive patients' medical records at two specialised palliative care units were used to complete new ELQs, which were then compared to the ELQ registrations from the SRPC for the same patients. The level of agreement was calculated for each ELQ item. To account for the possibility of the agreement occurring by chance, Cohen's kappa was calculated for suitable items. To examine the extent of registration mistakes when transferring the paper form to the web, the original paper versions of the ELQ filled out at the units were compared to data from the ELQs reported to the SRPC. Results: Level of agreement between ELQ registrations from the SRPC and the new ELQs based on the medical records varied between 0.55 and 1.00, where 24 items showed level of agreement above 0.80 and 9 items showed level of agreement below 0.80. Cohen's kappa with 95% confidence intervals was calculated for 24 items. The kappa values showed that two items had poor agreement, four fair agreement, 11 moderate agreement, five good agreement and two very good agreement. The level of agreement varied between 0.93 and 1.00 when comparing the ELQ registrations in the SRPC and the paper forms. Conclusion: The revised ELQ contains more items with high levels of agreement between registrations in the SRPC and notes in the patients' medical records when compared to the previous version. Validating issues around symptom as

Introduction: The Swedish Register of Palliative Care (SRPC) is a national quality register that collects data about end-of-life care from healthcare providers that care for dying patients. Data are used for quality control and research. Data are mainly collected with an end-of-life questionnaire (ELQ), which is completed by healthcare staff after the death of a patient. A previous validity assessment of the ELQ showed insufficient validity in some items including symptom relief. The aim of this study was to examine the validity of the revised ELQ. Materials and methods: Data from 100 consecutive patients' medical records at two specialised palliative care units were used to complete new ELQs, which were then compared to the ELQ registrations from the SRPC for the same patients. The level of agreement was calculated for each ELQ item. To account for the possibility of the agreement occurring by chance, Cohen's kappa was calculated for suitable items. To examine the extent of registration mistakes when transferring the paper form to the web, the original paper versions of the ELQ filled out at the units were compared to data from the ELQs reported to the SRPC. Results: Level of agreement between ELQ registrations from the SRPC and the new ELQs based on the medical records varied between 0.55 and 1.00, where 24 items showed level of agreement above 0.80 and 9 items showed level of agreement below 0.80. Cohen's kappa with 95% confidence intervals was calculated for 24 items. The kappa values showed that two items had poor agreement, four fair agreement, 11 moderate agreement, five good agreement and two very good agreement. The level of agreement varied between 0.93 and 1.00 when comparing the ELQ registrations in the SRPC and the paper forms. Conclusion: The revised ELQ contains more items with high levels of agreement between registrations in the SRPC and notes in the patients' medical records when compared to the previous version. Validating issues around symptom as

Introduction: The Swedish Register of Palliative Care (SRPC) is a national quality register that collects data about end-of-life care from healthcare providers that care for dying patients. Data are used for quality control and research. Data are mainly collected with an end-of-life questionnaire (ELQ), which is completed by healthcare staff after the death of a patient. A previous validity assessment of the ELQ showed insufficient validity in some items including symptom relief. The aim of this study was to examine the validity of the revised ELQ. Materials and methods: Data from 100 consecutive patients' medical records at two specialised palliative care units were used to complete new ELQs, which were then compared to the ELQ registrations from the SRPC for the same patients. The level of agreement was calculated for each ELQ item. To account for the possibility of the agreement occurring by chance, Cohen's kappa was calculated for suitable items. To examine the extent of registration mistakes when transferring the paper form to the web, the original paper versions of the ELQ filled out at the units were compared to data from the ELQs reported to the SRPC. Results: Level of agreement between ELQ registrations from the SRPC and the new ELQs based on the medical records varied between 0.55 and 1.00, where 24 items showed level of agreement above 0.80 and 9 items showed level of agreement below 0.80. Cohen's kappa with 95% confidence intervals was calculated for 24 items. The kappa values showed that two items had poor agreement, four fair agreement, 11 moderate agreement, five good agreement and two very good agreement. The level of agreement varied between 0.93 and 1.00 when comparing the ELQ registrations in the SRPC and the paper forms. Conclusion: The revised ELQ contains more items with high levels of agreement between registrations in the SRPC and notes in the patients' medical records when compared to the previous version. Validating issues around symptom as

Introduction: The Swedish Register of Palliative Care (SRPC) is a national quality register that collects data about end-of-life care from healthcare providers that care for dying patients. Data are used for quality control and research. Data are mainly collected with an end-of-life questionnaire (ELQ), which is completed by healthcare staff after the death of a patient. A previous validity assessment of the ELQ showed insufficient validity in some items including symptom relief. The aim of this study was to examine the validity of the revised ELQ. Materials and methods: Data from 100 consecutive patients' medical records at two specialised palliative care units were used to complete new ELQs, which were then compared to the ELQ registrations from the SRPC for the same patients. The level of agreement was calculated for each ELQ item. To account for the possibility of the agreement occurring by chance, Cohen's kappa was calculated for suitable items. To examine the extent of registration mistakes when transferring the paper form to the web, the original paper versions of the ELQ filled out at the units were compared to data from the ELQs reported to the SRPC. Results: Level of agreement between ELQ registrations from the SRPC and the new ELQs based on the medical records varied between 0.55 and 1.00, where 24 items showed level of agreement above 0.80 and 9 items showed level of agreement below 0.80. Cohen's kappa with 95% confidence intervals was calculated for 24 items. The kappa values showed that two items had poor agreement, four fair agreement, 11 moderate agreement, five good agreement and two very good agreement. The level of agreement varied between 0.93 and 1.00 when comparing the ELQ registrations in the SRPC and the paper forms. Conclusion: The revised ELQ contains more items with high levels of agreement between registrations in the SRPC and notes in the patients' medical records when compared to the previous version. Validating issues around symptom as

BACKGROUND: Globally violence is a matter of public health concern with severe physical and mental health implications and social consequences. Evidence suggest that adolescents have an elevated risk of exposure to physical and sexual violence. However, there is a lack of nationally representative research on violence and its associated factors in Nepal to inform interventions. This paper attempts to find the factors associated with various forms of physical and sexual violence among school-going adolescents in Nepal. METHODS: We analysed the cross-sectional data from the Global School-based Student Health Survey (GSHS) 2015. The GSHS survey applied a two-stage cluster sampling process to select a representative sample of 7 to 11 grade students from 74 schools across the country. We applied logistic regression analysis to identify the factors associated with physical and sexual violence. RESULTS: Out of the total 6,529 participants, 45.24% of them faced a physical attack, 39.25% were involved in a physical fight, and 11.65% were victims of sexual violence in the survey administered between 7 August 2015 to 14 March 2016. In a multiple regression analysis, the age of participants, parental supervision, feeling unsafe at school, and the number of close friends were found to be associated with a physical attack. Participants who were bullied, had multiple sex partners, and had received corporal punishment in school had a higher engagement in a physical fight. Likewise, school grade, having parents who understand the problems, having multiple sex partners, and corporal punishment at school were associated with instances of sexual violence. CONCLUSION: The study identified multiple factors associated with experiences of physical attacks, involvement in a physical fight, and sexual violence among school-going adolescents. This study results can have important implications for school administration, parents, and policymakers alike to plan appropriate anti-violence strategi

Introduction The global COVID-19 pandemic has radically changed the way health care is delivered in many countries around the world. Evidence on the experience of those receiving or providing maternity care is important to guide practice through this challenging time. Methods A cross-sectional study was conducted in Australia. Five key stakeholder cohorts were included to explore and compare the experiences of those receiving or providing care during the COVID-19 pandemic. Women, their partners, midwives, medical practitioners and midwifery students who had received or provided maternity care from March 2020 onwards in Australia were recruited via social media and invited to participate in an online survey released between 13th May and 24th June 2020; a total of 3701 completed responses were received. Findings While anxiety related to COVID-19 was high among all five cohorts, there were statistically significant differences between the responses from each cohort for most survey items. Women were more likely to indicate concern about their own and family's health and safety in relation to COVID-19 whereas midwives, doctors and midwifery students were more likely to be concerned about occupational exposure to COVID-19 through working in a health setting than those receiving care through attending these environments. Midwifery students and women's partners were more likely to respond that they felt isolated because of the changes to the way care was provided. Despite concerns about care received or provided not meeting expectations, most respondents were satisfied with the quality of care provided, although midwives and midwifery students were less likely to agree. Conclusion This paper provides a unique exploration and comparison of experiences of receiving and providing maternity care during the COVID-19 pandemic in Australia. Findings are useful to support further service changes and future service redesign. New evidence provided offers unique insight into key stake

It has been evidenced that in attention-window tasks, the participants fixate on the center of a screen while inspecting two stimuli that appear at the same time in parafoveal vision. Such tasks have successfully been used to estimate a person's breadth of attention under various conditions. While behavioral investigations of visual attention have often made use of response accuracy, recent research has shown that the pupil size can also be used to track shifts of attention to the periphery. The main finding of previous studies is that the harder the evaluation of the stimuli becomes, e.g., because they appear farther away from the central fixation point, the stronger the pupils dilate. In this paper, we present experimental data suggesting that in an attention-window task, the pupil size can also be used to assess whether the participants attend to static, non-moving, or dynamic, moving stimuli. That is, regression models containing information on presentation mode (static vs. dynamic) and the visual angle between spatially separated stimuli better predict accuracy of perception and pupil dilation than model without these sources of information. This finding is useful for researchers who aim at understanding the human attentional system, including potential differences in its sensitivity to static and dynamic objects.

To fight the spread of COVID-19, many countries implemented social distancing policies. This is the first paper that examines the effects of the German social distancing policies on behavior and the epidemic's spread. Exploiting the staggered timing of COVID-19 outbreaks in extended event-study models, we find that the policies heavily reduced mobility and contagion. In comparison to a no-social-distancing benchmark, within three weeks, the policies avoided 84% of the potential COVID-19 cases (point estimate: 499.3K) and 66% of the potential fatalities (5.4K). The policies' relative effects were smaller for individuals above 60 and in rural areas.

Objectives: Parenting is an integral component of obesity treatment in early childhood. However, the link between specific parenting practices and treatment effectiveness remains unclear. This paper introduces and validates a new parenting questionnaire and evaluates mothers' and fathers' parenting practices in relation to child weight status during a 12-month childhood obesity treatment trial. Methods: First, a merged school/clinical sample (n = 558, 82% mothers) was used for the factorial and construct validation of the new parenting questionnaire. Second, changes in parenting were evaluated using clinical data from the More and Less Study, a randomized controlled trial (RCT) with 174 children (mean age = 5 years, mean Body Mass Index Standard Deviation Score (BMI SDS) = 3.0) comparing a parent support program (with and without booster sessions) and standard treatment. Data were collected at four time points over 12 months. We used linear mixed models and mediation models to investigate associations between changes in parenting practices and treatment effects. Findings: The validation of the questionnaire (9 items; responses on a 5-point Likert scale) revealed two dimensions of parenting (Cronbach's alpha >= 0.7): setting limits to the child and regulating one's own emotions when interacting with the child, both of which correlated with feeding practices and parental self-efficacy. We administered the questionnaire to the RCT participants. Fathers in standard treatment increased their emotional regulation compared to fathers in the parenting program (p = 0.03). Mothers increased their limit-setting regardless of treatment allocation (p = 0.01). No treatment effect was found on child weight status through changes in parenting practices. Conclusion: Taken together, the findings demonstrate that the new questionnaire assessing parenting practices proved valid in a 12-month childhood obesity trial. During treatment, paternal and maternal parenting practices followe