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The study is an analysis of the reaction of students in a faculty of natural and agricultural sciences (NAS) to subtitles and also includes an investigation of their responses thereto. Reception of and responses to academic English (close to verbatim transcription), plain English, and keyword English subtitles were explored by showing participants subtitled videos related to the content of their module. Participants were then asked to complete demographic and affective questionnaires, and participated in focus group interviews to investigate their reception of the various subtitles. The results show that participants responded particularly well to plain English subtitles. The focus group interviews indicated that they found all three sets of subtitles useful for note-taking purposes, adjusting the speed at which they accessed and processed information by pausing the videos, highlighting important information in the study materials, and being able to engage aurally and visually with the materials. From a higher education perspective, this emphasises students' readiness for subtitles as an academic mediation tool. Contribution: This article aims to fill existing gaps in the fulfilment of higher education institutions' language policies, which have been exposed by the thrust for multilingualism in higher education. Research into academic subtitling as an academic mediation tool can be used to bridge this gap, thereby supporting innovative research in higher education.

BACKGROUND: The trauma mortality rate is higher in the elderly compared with younger patients. Ageing is associated with physiological changes in multiple systems and correlated with frailty. Frailty is a risk factor for mortality in elderly trauma patients. We aim to provide evidence-based guidelines for the management of geriatric trauma patients to improve it and reduce futile procedures. METHODS: Six working groups of expert acute care and trauma surgeons reviewed extensively the literature according to the topic and the PICO question assigned. Statements and recommendations were assessed according to the GRADE methodology and approved by a consensus of experts in the field at the 10th international congress of the WSES in 2023. RESULTS: The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage, including drug history, frailty assessment, nutritional status, and early activation of trauma protocol to improve outcomes. Acute trauma pain in the elderly has to be managed in a multimodal analgesic approach, to avoid side effects of opioid use. Antibiotic prophylaxis is recommended in penetrating (abdominal, thoracic) trauma, in severely burned and in open fractures elderly patients to decrease septic complications. Antibiotics are not recommended in blunt trauma in the absence of signs of sepsis and septic shock. Venous thromboembolism prophylaxis with LMWH or UFH should be administrated as soon as possible in high and moderate-risk elderly trauma patients according to the renal function, weight of the patient and bleeding risk. A palliative care team should be involved as soon as possible to discuss the end of life in a multidisciplinary approach considering the patients directives, family feelings and representatives desires, and all decisions should be shared. CONCLUSIONS: The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage based on assessing frailty and early activation of trauma protocol to improve outcomes. Geriatric Intensive Care Units are needed to care for elderly and frail trauma patients in a multidisciplinary approach to decrease mortality and improve outcomes.

The current small study utilised prospective data collection of patterns of prenatal alcohol and tobacco exposure (PAE and PTE) to examine associations with structural brain outcomes in 6-year-olds and served as a pilot to determine the value of prospective data describing community-level patterns of PAE and PTE in a non-clinical sample of children. Participants from the Safe Passage Study in pregnancy were approached when their child was ∼6 years old and completed structural brain magnetic resonance imaging to examine with archived PAE and PTE data (n = 51 children-mother dyads). Linear regression was used to conduct whole-brain structural analyses, with false-discovery rate (FDR) correction, to examine: (a) main effects of PAE, PTE and their interaction; and (b) predictive potential of data that reflect patterns of PAE and PTE (e.g. quantity, frequency and timing (QFT)). Associations between PAE, PTE and their interaction with brain structural measures demonstrated unique profiles of cortical and subcortical alterations that were distinct between PAE only, PTE only and their interactive effects. Analyses examining associations between patterns of PAE and PTE (e.g. QFT) were able to significantly detect brain alterations (that survived FDR correction) in this small non-clinical sample of children. These findings support the hypothesis that considering QFT and co-exposures is important for identifying brain alterations following PAE and/or PTE in a small group of young children. Current results demonstrate that teratogenic outcomes on brain structure differ as a function PAE, PTE or their co-exposures, as well as the pattern (QFT) or exposure.

Scholars have recommended hybrid learning to combat education problems in emerging economies due to their challenging contexts. It potentially offers a means to address growing demand without sacrificing quality or increasing costs. In this article we report on a new "hybrid" distance teacher education programme in which we sought to address the requirements of new policies (both institutional and national) by combining the blended and distance education approach. We adopted a pragmatic qualitative approach, rooted in a communitarian perspective and distance education theory. Although progressing slower than expected, the programme's implementation to date has provided lessons that bolster the value of blended learning theory and practice in a hybrid model. The study also highlighted the critical role that the mode adopted for teacher training can play in shaping teachers' practice. However, to work more effectively in an emerging economy, a more substantial teaching presence is suggested, coupled with modularised and ongoing information and communication technology (ICT) training and support for staff and students as areas for further research.

Researchers have long been interested in understanding and closing the “reading gap” that exists between White and racially marginalized students. This study explored whether group differences in inference strategies (i.e., bridging and elaboration) and comprehension performance existed among college readers. Three hundred college participants who self-identified as White, Black, or Hispanic completed a think-aloud task along with measures of reading proficiency and comprehension. Results from hierarchical regression models indicated that group differences in elaborative strategies were present, but differences in bridging strategies and comprehension performance disappeared when foundational skills in reading were included in the models. The results are explained in terms of inequities in educational experiences prior to entering college.

Advocacy for social justice is a core duty of the social work profession. Social injustice, oppression, and marginalization in the United States demand that social workers critically evaluate and address systemic oppression, in the profession, society, and social work education. This study sought to explore the attitudes of social work students in institutions of higher education in one Midwestern state concerning social justice, systemic racism, race relations, and policing to measure the impact of social work educational programming on promoting anti-oppressive and anti-racist practice. Survey responses from undergraduate and graduate students (n = 74) from two universities in an upper, Midwestern state were analyzed to assess attitude and beliefs on social justice, policing, and racial relations. Results indicate the majority of students endorsed an understanding of injustice in the world and high perceptions of themselves as advocates and agents of social change. Alternatively, students' responses to items regarding a general belief in the world as providing just rewards and punishments were neutral. These results suggest the need for increased examination of the implicit and explicit curriculum. The use of Critical Race Theory, decolonization practices for higher education which includes diversifying perspectives in course materials and learning activities among other practices, and modeling of the positionality of self by social work instructors is examined.

Abstract Background Mortality data and comparative risk assessments from sub-Saharan Africa are limited. There is an urgent need for high quality population health surveys to be conducted, to improve the national health surveillance system. Our aim was to perform a comparative risk assesment and report on the mortality status and cause of death data of participants from a South African site of the international Prospective Urban Rural Epidemiology study. Methods 1 921 Black participants were included, with a median observational time of 13 years resulting in 21 525 person-years. We performed a comparative risk assessment considering four health status domains: locality (rural vs. urban), socio-economic status (SES) (education and employment), lifestyle factors (physical activity, smoking and alcohol consumption) and prevalent diseases (human immunodeficiency virus (HIV), type 2 diabetes mellitus and hypertension). Next, population-attributable fractions (PAFs) were calculated to determine the mortality risk attributable to modifiable determinants. Results 577 all-cause deaths occurred. Infectious diseases (28.1% of all deaths) were the most frequent cause of death, followed by cardiovascular disease (CVD) (22.4%), respiratory diseases (11.6%) and cancer (11.1%). The three main contributors to all-cause mortality were HIV infection, high SES and being underweight. HIV infection and underweight were the main contributors to infectious disease mortality and hypertension, the urban environment, and physical inactivity to CVD mortality. HIV had the highest PAF, followed by physical inactivity, alcohol and tobacco use and hypertension (for CVD mortality). Conclusion This African population suffers from a quadruple burden of disease. Urban locality, high SES, prevalent disease (HIV and hypertension) and lifestyle factors (physical inactivity, tobacco and alcohol use) all contributed in varying degrees to all-cause and cause-specific mortalities. Our data confirm the public health importance of addressing HIV and hypertension, but also highlights the importance of physical inactivity, tobacco use and alcohol consumption as focal points for public health strategies to produce the most efficient mortality reduction outcomes.

BACKGROUND: The efficacy of simvastatin in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear. METHODS: In an ongoing international, multifactorial, adaptive platform, randomized, controlled trial, we evaluated simvastatin (80 mg daily) as compared with no statin (control) in critically ill patients with Covid-19 who were not receiving statins at baseline. The primary outcome was respiratory and cardiovascular organ support-free days, assessed on an ordinal scale combining in-hospital death (assigned a value of -1) and days free of organ support through day 21 in survivors; the analyis used a Bayesian hierarchical ordinal model. The adaptive design included prespecified statistical stopping criteria for superiority (>99% posterior probability that the odds ratio was >1) and futility (>95% posterior probability that the odds ratio was

Abstract Background This study aimed to assess the usefulness of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire in the South-African context and to validate it as an appropriate tool for measuring health-related quality of life (HRQoL). Method The ExAMIN Youth SA study was designed to investigate lifestyle behaviours, including psychosocial factors that may adversely impact on cardiovascular health of children. Construct validity was examined by using exploratory and confirmatory factor analysis, while internal consistency was tested by Cronbach’s alpha. The final factor structure was confirmed by model fit indices. Results The study included children (n = 1088) aged between 5 and 10 years in North-West, South Africa. The reliability coefficients of the original factors could not be reproduced in this data set, with the Cronbach’s alphas ranging between 0.46 and 0.78. With exploratory factor analysis, including the additional items, our data supported a 7-factor structure with acceptable internal consistency (Cronbach’s alpha: 0.68–0.79; Omega: 0.75–0.85) and acceptable model fit indices (CFI: 0.91; TLI: 0.90; RMSEA: 0.05; SRMR: 0.07). Two factors (emotional wellbeing and everyday functioning) further split into separate factors for positive and negative experiences related to each of these dimensions. Conclusion We confirmed a new factor structure of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire, which can be used in the African context. Although the new factor structure has great overlap with the original structure, some items did not contribute to the factors as expected. Language and cultural differences between the original German group and the current South African study group resulted in a different factor structure.

Abstract Introduction The increasing interest in teledentistry since the COVID-19 pandemic warrants an evaluation of dentists’ willingness to adopt it. This study aimed to develop a questionnaire to assess dentist’s intention to use teledentistry and the associated factors. Methods A literature search was used to identify items for the questionnaire. The Unified Theory of Acceptance and Use of Technology (UTAUT2) was adopted as framework. A Delphi panel was constituted of researchers with relevant publications and the International Association of Dental Research e-Oral Health Network members. Three Delphi consultations were conducted to establish consensus on items. Consensus was set at 80% agreement and content validity ratio (CVR), reaffirmed iteratively. Results Nineteen out of 25 (76%) invited experts participated in the first round, 17 in the second and 15 in the third. The preliminary questionnaire had 81 items in three sections, reduced to 66, 45 and 33 items in the first, second and third rounds. After revision, the final version comprised eight items assessing dentists’ backgrounds in Sect. 1, seven items identifying teledentistry uses in Sect. 2, and 17 items assessing intention to use teledentistry and its determinants in seven dimensions in Sect. 3. The initial CVR was 0.45, which increased to 0.80 at the end of the third round. Conclusion A survey tool was developed to assess the acceptance of teledentistry, and its determinants based on the UTAUT2 framework through consensus among teledentistry experts. The tool had excellent validity and needs further evaluation of its psychometric properties.

Abstract Background Drug overdose is a leading cause of death and opioid-related deaths increased by more than 300% from 2010 to 2020 in New York State. Experts holding a range of senior leadership positions from across New York State were asked to identify the greatest challenges in substance misuse prevention, harm reduction, and treatment continuum of care. Expert input was used to shape funding priorities. Method Individual semi-structured interviews of sixteen experts were conducted in April and May 2023. Experts included academics, medical directors, leaders of substance misuse service agencies, administrators of a state agency, a county mental health commissioner, the president of a pharmacy chain, and a senior vice president of an addiction-related national non-profit. Zoom interviews were conducted individually by an experienced qualitative interviewer and were recorded, transcribed, and coded for content. An initial report, with the results of the interviews organized by thematic content, was reviewed by the research team and emailed to the expert interviewees for feedback. Results The research team identified five major themes: 1. Siloed and fragmented care delivery systems; 2. Need for a skilled workforce; 3. Attitudes towards addiction (stigma); 4. Limitations in treatment access; and 5. Social and drug related environmental factors. Most experts identified challenges in each major theme; over three-quarters identified issues related to siloed and fragmented systems and the need for a skilled workforce. Each expert mentioned more than one theme, three experts mentioned all five themes and six experts mentioned four themes. Conclusions Research, educational, and programmatic agendas should focus on identified topics as a means of improving the lives of patients at risk for or suffering from substance use-related disorders. The results of this project informed funding of pilot interventions designed to address the identified care challenges.

This article explores the use of the concept of “faith” in three non-Christian philosophers. The study begins with Nietzsche, who, while deeply critical of Christian belief throughout his work, offers a positive reformulation of the term in a few key texts. From here, the discussion proceeds to two authors who are deeply influenced by Nietzsche, François Laruelle, and Nishitani Keiji. Laruelle’s recent turn to non-theology sees him engaging directly with Christian theological material and presenting a distinction between a positive form of “faith” in contrast from standard religious “belief,” a distinction I suggest bears close resemblance to Nietzsche’s approach, especially in relation to the Apostle Paul. Finally, Nishitani offers his own account of faith, one inspired primarily by the Buddhist notion of faith, but also referencing Christian theology and specifically the practice of Paul, while also connecting with Nietzsche. The connecting theme for all three thinkers is rooted in Zarathustra’s encouragement to be “faithful to the earth,” a non-transcendent, immanent formulation of faith. Faith, in Nishitani and Laruelle especially, is non-doctrinal, non-dogmatic, and non-intellectual; it is, instead, practical, an immanent existence, a way of life resulting in a different form of connection with the world around us.