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This study focuses on a unique Facebook group: ‘Cyprus Immigrants Organisation’, whose members are mostly refugees who were once held in camps in Cyprus in the late 1940s and their descendants. The study offers a content analysis of 687 posts and comments published by group members during 2022. It reveals how a Facebook group made possible, produced, and promoted narratives of a topic that receives relatively little attention in the literature, media, and other memory spaces. The study highlights the range of memory-related content and activities within a Facebook group. We found three main activities of memory work within the group: (a) Members try to shape a coherent narrative of the events; (b) Members discuss acts of remembrance, suggesting additional activities and sharing personal initiatives; (c) Members aim to emphasise their personal connection and belonging to the Cyprus exiles’ community by sharing photographs, artwork, and documents. These memory practices, alongside processes such as gathering knowledge, sharing memories, shaping narratives, and commemorating, highlight the uniqueness of a Facebook group as a platform for memory. These kinds of activities would not be possible on such a scale without the digital environment or, more specifically, a Facebook group. With numerous narratives and collaborative knowledge gathering, the group exemplifies a democratised process of multi-generational memory work and narrative construction.
Knowledge of academic collocations is important for academic communication. Examining its relationship with knowledge of academic words and general high-frequency words should provide insights into the relative value of prior knowledge of different kinds of single words for the development of collocational knowledge in academic contexts, thus expanding our understanding of vocabulary knowledge beyond the current conception of individual word knowledge. Yet no studies have addressed this issue, mainly due to the lack of validated tests for academic words and collocations. This study employed three pairs of newly developed tests to measure Vietnamese EFL learners’ knowledge of academic collocations, academic words, and general high-frequency words. Results showed that at the form-recall level, both academic word and general high-frequency word knowledge were positively associated with academic collocation knowledge, with academic words having a stronger relationship. At the form-recognition level, only academic words and academic collocations were positively correlated.
Early review of intravenous (IV) antimicrobial therapy is central to antimicrobial stewardship (AMS), however scalable models for general medical patients are limited. We evaluated a pharmacist-led digital intervention to optimize IV antimicrobial prescribing.
Methods:
A prospective, quasi-experimental before-and-after study was conducted between May 2022 to February 2023 across six general medicine units at a tertiary hospital. AMS recommendations were delivered electronically via Microsoft Teams®. Adult inpatients receiving IV antimicrobials for >24 hours were included, excluding those with COVID-19, under Infectious Diseases consultation or receiving palliative care. The primary outcome was median IV antimicrobial duration. Secondary outcomes included AMS recommendation type, recommendation acceptance, length of stay (LOS), 30-day infection-related readmission, IV therapy recommencement, and inpatient mortality. Antibacterial consumption was analyzed from July 2021 to through December 2024 to evaluate sustained impact.
Results:
Among 723 antimicrobial orders (474 treatment episodes in 458 patients), median IV duration was comparable between phases (intensive: 2.75 days; baseline: 3.00 days). LOS was shorter during the intensive phase compared to baseline (5.5 vs 7.6 days; P = .04), particularly in patients without bacteremia. Readmissions and mortality were unchanged. Of 400 AMS recommendations, 67% were IV-to-oral switches; overall acceptance was 78%. Piperacillin-tazobactam use declined, and sustained reductions in aminoglycosides, ampicillin and IV flucloxacillin were observed. A reduction in total antibiotic prescribing (combined IV and oral prescribing) was also observed.
Conclusions:
The digital pharmacist-led AMS intervention did not reduce IV duration, likely reflecting strong baseline prescribing, but was associated with shorter LOS and a reduction in total antibacterial use. This program offered a scalable, sustainable alternative to resource-intensive face-to-face models.
Front-of-package labelling informs consumers about the ‘healthiness’ of foods based on different classification schemes. These schemes reflect competing worldviews for assessing a food’s healthiness, represented by nutrient-, food- or diet-based indices. The Health Star Rating scheme (HSR) has been criticised for failing to appropriately score unhealthy products. Updates to the HSR algorithm were implemented over a two-year period from November 2020. This study investigated alignment between a nutrient-based scheme (HSR), food-based scheme (Nova food processing system) and diet-based scheme (Australian Dietary Guidelines (ADG)).
Setting:
Mintel Global New Products Database
Participants:
Retail foods displaying HSR launched or updated onto the Australian market between November 2020 and June 2023.
Design:
Products were categorised according to the ADG and Nova, descriptive statistics performed for each category and proportion displaying HSR ≤ 2·0 and ≥ 2·5 calculated for discretionary foods, five food group foods, ultra-processed foods (UPF) and non-UPF. Agreement between categories obtained by Kappa.
Results:
Median HSR for UPF and discretionary foods were 3·5 and 2·5, respectively, and 73·7 % of UPF and 58·2 % of discretionary foods displayed HSR ≥ 2·5. Agreement between HSR and Nova was none to slight (k = 0·09, P < 0·001) and HSR and ADG was fair (k = 0·38, P < 0·001). Between 2020–2023, the proportion of UPF displaying HSR ≥ 2·5 increased from 60·2 % to 78·5 % and for discretionary foods 47·0 % to 62·5 %.
Conclusion:
The HSR algorithm calculates ‘healthy’ HSR (≥ 2·5) for a high proportion of UPF and discretionary foods. The HSR’s nutrient-based approach to translate food-and diet-based nutrition recommendations into accurate food ‘healthiness’ assessments is still problematic.
This study aims to assess the perspectives of patients with chronic conditions on the use of the Assessment of Burden of Chronic Conditions (ABCC) tool during consultations with their healthcare providers in primary care.
Background:
The increasing prevalence of chronic conditions, including multimorbidity, poses major challenges to healthcare systems today, particularly in primary care where most chronic care takes place. Effective management strategies are crucial for improving quality of life (QoL). The ABCC tool offers a unique approach to chronic disease management by facilitating shared decision-making and self-management.
Methods:
This qualitative phenomenological study involved semi-structured interviews. Fourteen patients with chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes mellitus (T2DM) and/or chronic heart failure (CHF) were recruited from a previously conducted quasi-experimental study on the effectiveness of the ABCC tool.
Findings:
Participants generally expressed satisfaction with the comprehensive questionnaire, user-friendly design and clear visualisation. They appreciated the opportunity to facilitate discussions with healthcare providers and help with monitoring. However, some confusion around the grey balloons in the tool highlighted the need for clearer explanations. Participants had limited awareness of advanced treatment recommendation functions.
Conclusions:
This study provides valuable insights into patients’ experiences with the ABCC tool. Despite challenges such as recall bias and limited awareness of certain features, participants generally expressed satisfaction with using the tool. Based on these findings, the tool can be further improved and its use should be further supported. However, the ABCC tool shows promise as a valuable instrument for improving consultations in clinical practice.
Let $r, k, n$ be integers satisfying $1\leqslant r\leqslant k\leqslant n/2$. Let ${{\mathcal{R}}}_r(n, k)$ denote the proportion of permutations $\pi \in {{\mathcal{S}}}_n$ that fix a set of size $k$ and have no cycle of length less than $r$. In this note, we determine the order of magnitude of ${{\mathcal{R}}}_r(n, k)$ uniformly for all $2\leqslant r\leqslant k\leqslant n/2$. This result generalises the corresponding estimate of Eberhard, Ford, and Green for the case $r=1$.
Many legal disputes are resolved through settlement. The dominant theory explaining settlements – known as “bargaining in the shadow of the law” – assumes that litigants are informed, rational actors inclined to bargain toward a settlement prior to court proceedings. Yet many settlements are negotiated after litigants have appeared in court expecting to go to trial. This article argues that court organizational mechanisms play an undertheorized role in facilitating settlement agreements. To build theory on organizational mechanisms, we examine the case of eviction settlements. Drawing on ethnographic observations and interviews in a California eviction court, we find that organizational rules and workgroup norms funnel mostly unrepresented tenants – sometimes, in coercive ways – into unregulated hallway conversations with landlord attorneys and/or participation in the court’s mediation program. Through relational interactions with legal professionals in these organizational spaces, tenants are taught the risks of trial and the benefits of settlement. As a result, most tenants in our sample come to recognize their legal culpability and view settlement agreements as legitimate, even as their negotiated settlements reproduce their housing insecurity. We discuss implications for bargaining theory and research on housing insecurity.
Although participatory methods are increasingly used in social care regulation, limited research examines how inspectors apply information from service users. This study addresses this gap through a case study of onsite interviews with children in residential care in Israel. Semi-structured interviews were conducted with inspectors and headquarters staff from Israel’s Ministry of Welfare and Social Affairs. The analysis identified four approaches used by inspectors: assessing care quality against standards, advocating for children as a group, advocating for individual children, and empowering children to address their concerns. These approaches illustrate inspectors’ dual role as regulators and facilitators of participation, balancing oversight with a relational approach that shapes service users’ lives at a personal level. This multifaceted role reflects an evolving view of regulation that extends beyond oversight to include advocacy, protection, and empowerment, emphasising the balance inspectors maintain between regulatory duties and the well-being of service users in social care.
This study presents an in-depth analysis of the energy dissipation and momentum balance during a laminar planar hydraulic jump in a viscous free surface flow, with shallow flow theory used to estimate the relevant jump parameters. The inclusion of momentum and kinetic energy correction factors incorporates the influence of the fluid nature. The fluid is described by the generalised Herschel–Bulkley model with Papanastasiou regularisation, which reduces to the Bingham plastic, power-law and Newtonian models under relevant limiting conditions. The analysis, extensively validated against experimental and simulated data, is explored to understand the physics of free surface flow during jump formation. Energy dissipation increases with an increase in the flow behaviour index n, flow consistency index k and yield stress τo since each of them increases the apparent viscosity. Interestingly, it is higher in the supercritical (upstream) compared with the subcritical (downstream) zone. For constant discharge rate and film thickness, the specific energy depends on the velocity profile and is thus a function of n and τo but not k, and the mechanism of influence of n and τo are also different. For a generalised approach, energy dissipation and jump parameters are discussed as a function of relevant non-dimensional numbers obtained from SFT. Energy dissipation during a hydraulic jump in non-Newtonian liquids is a hitherto unexplored aspect. In fact, energy dissipation during a planar jump in a viscous Newtonian liquid is also rare, although hydraulic jumps are primarily used as energy dissipators in free surface flows.
Administrative burden describes the learning costs, psychological costs, and compliance costs people face when attempting to interface with the government, particularly in seeking a benefit. Algorithmic and automated processes offer the potential of reducing administrative burdens, but scant empirical research has determined to what, if any effect. This study uses the case of criminal record expungement in two policy contexts: traditional, court petition-based systems and newly enacted automated systems, to understand if and how administrative burden persists, and whether and how these burdens operate differently in the context of the criminal legal system. Drawing on interviews with 105 expungement-eligible people, we find that while automated expungement schemes shift the burden from petitioner to state to initiate the process, automation inadvertently creates new administrative burdens via failure to notify, partial clearances, and opaque data processes. Furthermore, respondents described how automation failed to provide a sense of confirmation from the state that their sentence was truly completed, rehabilitation had been acknowledged, or that collateral consequences should no longer wield the same power. Overall, we argue that leveraging automation to reduce burdens must include information availability by design; otherwise policy reforms may fail to fully achieve their goals.
This cross-sectional study examines differentials in age at marriage, collecting data from 665 ever-married women in Howrah district, West Bengal, using a mixed-methods approach across three generational cohorts. Quantitative analyses included ANOVA and multinomial logistic regression, complemented by qualitative interviews to contextualize marriage timing. Results revealed a non-linear trajectory of marriage age across generations. Mean age at marriage was 21.4 years, 23.2 years, and 19.5 years in Generation I, Generation II, and Generation III, respectively, with significant differences. MLR results showed respondents in Generation II had higher odds of marrying at ages 19–24 (RRR = 1.5, CI = 0.6–2.7) and ≥25 years (RRR = 1.4, CI = 0.9–4.0), whereas Generation III women had lower odds at ages 19–24 (RRR = 0.3, CI = 0.2–0.9) and ≥25 years (RRR = 0.6, CI = 0.1–0.9), compared to Generation I. Urban women showed delayed marriage at ages 19–24 (RRR = 3.1, CI = 2.6–11.5) and ≥25 years (RRR = 4.5, CI = 2.2–15.5). Higher educated women increased the likelihood of delaying marriage at ages 19–24 (RRR = 1.6, CI = 0.4–1.9) and ≥25 years (RRR = 1.2, CI = 0.8–1.6). Fathers’ secondary education was associated with marriage at ages 19–24 (RRR = 1.5, CI = 1.0–2.3) and ≥25 years (RRR = 4.6, CI = 1.3–15.8), and fathers’ higher education was associated with marriage at ≥25 years (RRR = 2.6, CI = 1.3–12.8); mothers’ secondary education was associated with marriage at ages 19–24 (RRR = 1.7, CI = 1.0–2.9) and ≥25 years (RRR = 3.1, CI = 1.9–12.3), and mothers’ higher education was associated with marriage at ≥25 years (RRR = 3.2, CI = 1.6–10.4). Respondents in white-collar jobs were more likely to delay marriage at 19–24 (RRR = 1.5, CI = 0.3–2.0) and ≥25 years (RRR = 1.6, CI = 0.8–3.4). White-collar employment of fathers increased the odds of marriage at ages 19–24 (RRR = 1.7, CI = 0.7–2.1) and ≥25 years (RRR = 1.6, CI = 0.4–2.6) and of mothers at ages 19–24 (RRR = 1.2, CI = 0.4–1.6) and ≥25 years (RRR = 1.1, CI = 0.3–1.9). Women from the upper wealth quintile were more likely to marry at ≥25 years (RRR = 1.2, CI = 0.5–2.8). Muslim women showed significantly less likelihood to marry at ≥25 years (RRR = 0.2, CI = 0.1–0.6). Ethnographic narratives revealed tensions between aspirations for daughters’ education and parental anxieties related to employment insecurity, dowry, and premarital relationships, shaping marriage decisions.
Antimicrobial resistance (AMR) is a growing public health threat, and we currently lack accurate measures to track and trend this resistance. We developed the antibiotic resistance index (ARI) that aggregates resistance of Gram-negative bacilli (GNB) into a single metric which can be tracked across healthcare settings and over time.
Methods:
Culture data were collected from adult patients who met the CDC adult sepsis event criteria across 10 Barnes-Jewish HealthCare (BJC) hospitals between January 2018 and December 2023. An antibiotic’s effective spectrum (AES) was calculated as the ratio of susceptible GNB to all identified GNB. The ARI was calculated as the sum of the AES to which the isolate was resistant. Using the 20 most common GNB and 15 most common anti-GNB antibiotics routinely tested in antibiograms, we calculated the ARI for each BJC hospital during the study years.
Results:
18,854 GNB cultured from 12,803 patients meeting CDC adult sepsis event criteria were included. AES varied between 0.15 for ampicillin and 0.94 for amikacin. A. calcoaceticus-baumannii complex had the highest ARI of 6.64 (IQR 4.00–9.28). Median hospital-level ARI fluctuated between 2.12 (IQR 0.40–3.83) in 2018 to 2.20 (IQR 0.34–3.86) in 2023. The ARI trajectories over time varied by medical center.
Conclusion:
ARI aggregates AMR in GNB and may facilitate monitoring across locations and over time. ARI and antibiotic effective spectra redefine narrow and broad spectrum of activity and offer a starting point for antibiotic utilization metrics.
The similarities between the Jericho Episode (Luke 19.1–10) and the second Messenger Speech in Euripides’ Bacchae (1043–152) are so extensive that the most probable explanation is the existence of a direct genetic dependence of the first story on the second. By making this reference, the author of the Gospel portrays the figure of Zacchaeus as a ‘converted Pentheus’, while by comparing Jesus to the cruel Dionysus, who punishes Pentheus for his sin, he reveals the mercy of the God of Israel in a new light.
Adolescence is characterized by heightened sensitivity to social belonging, making loneliness prevalent and consequential for youth. Maladaptive personality traits may further exacerbate loneliness. In this preregistered 14-day Ecological Momentary Assessment study, we examined loneliness across social contexts and timescales in relation to maladaptive personality traits among N = 294 adolescents aged 12–21 years (Mage = 17.5, SD = 2.64; 58.5% female; 86.73% born in Germany). Participants answered 27,503 of 32,340 momentary prompts, indicating high compliance (85.1%). Loneliness (βmomentary = 0.51; βdaily = 0.67) was higher when participants were alone, yet only the presence of close others (e.g., friends) – not weaker ties (e.g., classmates) – reduced loneliness (β = –0.39 to –0.62). Youth who were alone more frequently did not report higher overall loneliness. Maladaptive personality traits were associated with higher (βmomentary = 0.32; βend-of-day = 0.40) and more variable (βmomentary = 0.31; βend-of-day = 0.34) loneliness but amplified the effect of being alone on loneliness only on the between-person level (β = –1.13). Exploratory analyses indicated that social satisfaction partially mediated the association (β = 0.50). These findings underscore the importance of both structural and qualitative aspects of social environments, as well as personality-related vulnerabilities, to better understand loneliness dynamics in youth.
Raramuri Criollo (RC) cattle offer substantial sustainability advantages in arid regions. Their adaptation to harsh conditions and ability to adjust forage use according to the season make them efficient in pasture management. Furthermore, their lighter weight reduces soil pressure, and their preference for low-palatability grasses contributes to improved soil health and reduced erosion. These characteristics from RC make them more adaptable to such terrains and conditions than European cattle breeds. Regarding water usage, and compared to European cattle breeds, RC can wander further from water sources, which proves advantageous in the context of climate change. Moreover, their role in fire ecology involves reducing the risk of fires by altering the characteristics of forest fuels and managing fine fuels, which is crucial for minimizing fire hazards in grasslands. The potential use of this breed to produce high-quality meat derived from their grazing behaviour offers an alternative to new consumers’ demands concerning healthy and efficient production options. This narrative review discusses the role of RC in soil health, water sources and meat production. Overall, attributes from RC cattle make these animals a valuable option for mitigating overgrazing and fostering sustainability in arid regions.
The introduction of the General Certificate of Secondary Education (GCSE) in 1986 marked a significant shift in music education practice across England, Wales, and Northern Ireland. Unlike previous qualifications, the GCSE emphasised a central triumvirate of accessible, practical skills – performing, composing, and appraising – which, forty years later, remain foundational in secondary music education across the three nations. In this article, we therefore analyse how the tripartite performing–composing–appraising structure has shaped the development of the GCSE between 1986 and 2026. Using historical and documentary evidence, we identify four trends of political quiescence, progressive divergence, neoliberal convergence, and neoconservative coalescence, and suggest that across all three nations a subtle shift towards a fourfold performing–composing–knowing–appraising framework is beginning to erode the GCSE as an accessible, practical approach to assessment.