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Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark
No full textAim: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.Methods: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.Results: A total of 774 patients were invasively ventilated during the first two waves and included; 70% were males and the median age was 69 years. 340 (51.5%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6% (IQR 54.5%-96.2%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H2O in 125 (80.6%) patients; prone positioning was used in 44.7% of patients. In ICU, 169 of 774 (21.8%) patients experienced barotrauma and 220 (28.4%) prolonged ventilation. At 90 days, 306 (39.5%) had died.Conclusions: Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently.AIM: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.METHODS: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.RESULTS: A total of 774 patients were invasively ventilated during the first two waves and included; 70% were males and the median age was 69 years. 340 (51.5%) of patients never exceeded tidal volumes of 8 mL/kg. For all patients, tidal volumes under 8 mL/kg were applied in 77.6% (IQR 54.5%-96.2%) of the time on ventilator in the ICU; plateau pressure was below 30 cm H2O in 125 (80.6%) patients; prone positioning was used in 44.7% of patients. In ICU, 169 of 774 (21.8%) patients experienced barotrauma and 220 (28.4%) prolonged ventilation. At 90 days, 306 (39.5%) had died.CONCLUSIONS: Lung protective ventilation and prone positioning were used in many of the Danish ICU patients with COVID-19, but barotrauma, prolonged ventilation and death occurred frequently
Fertility Concerns and Information Needs and Preferences of Australian Women With Chronic Kidney Disease:An Exploratory Qualitative Study
No full textABSTRACT Objective Pregnancy is associated with adverse maternal and fetal outcomes for women with chronic kidney disease (CKD). Yet few women with CKD report receiving information about pregnancy and often experience difficulties making informed childbearing decisions and optimizing pregnancy outcomes. The aim of this study was to identify the fertility and childbearing concerns and related information needs and preferences of women with CKD living in Australia. Methods We completed an exploratory qualitative study. Women with CKD, recruited from a public health service in metropolitan Melbourne, Australia, participated in an online discussion group hosted on WhatsApp. We analyzed the discussion group transcript for key findings. Results Participants ( N = 8) reported wanting children but often had fewer children than desired due to concerns about the impact of pregnancy on their CKD and the possible impact of CKD on a pregnancy or their child, including their baby inheriting CKD, how CKD medications may affect their baby, and the potential effects of a kidney transplant. Participants found it difficult to access relevant, up‐to‐date information about CKD and pregnancy. Conclusions Women with CKD often have concerns about getting pregnant or having a baby but find it difficult to access information especially from their healthcare team. Women with CKD would benefit from relevant and current information provided at specific times such as before and after a kidney transplant or when considering pregnancy to assist them in making informed decisions and achieving their reproductive goals.Objective: Pregnancy is associated with adverse maternal and fetal outcomes for women with chronic kidney disease (CKD). Yet few women with CKD report receiving information about pregnancy and often experience difficulties making informed childbearing decisions and optimizing pregnancy outcomes. The aim of this study was to identify the fertility and childbearing concerns and related information needs and preferences of women with CKD living in Australia.Methods: We completed an exploratory qualitative study. Women with CKD, recruited from a public health service in metropolitan Melbourne, Australia, participated in an online discussion group hosted on WhatsApp. We analyzed the discussion group transcript for key findings.Results: Participants (N=8) reported wanting children but often had fewer children than desired due to concerns about the impact of pregnancy on their CKD and the possible impact of CKD on a pregnancy or their child, including their baby inheriting CKD, how CKD medications may affect their baby, and the potential effects of a kidney transplant. Participants found it difficult to access relevant, up-to-date information about CKD and pregnancy.Conclusions: Women with CKD often have concerns about getting pregnant or having a baby but find it difficult to access information especially from their healthcare team. Women with CKD would benefit from relevant and current information provided at specific times such as before and after a kidney transplant or when considering pregnancy to assist them in making informed decisions and achieving their reproductive goals
The effects of physical activity interventions on prereading, early word recognition and spelling development in children:A systematic review and meta-analysis
No full textBackground: Reading and spelling skills are important abilities to acquire for later success in school and therefore it is highly relevant to examine strategies of facilitating these academic skills. Physical activity integrated with the learning sessions or physical activity added but not integrated with the learning sessions has been identified as possible strategies. Objective: To identify, categorize and examine the characteristics and effects of interventions investigating the effect of physical activity on children's early reading skills. Design: This systematic review follows the PRISMA guidelines. Studies were separated into two categories based on whether physical activity integrates academic content or not, i.e., 1) low integration interventions or 2) high integration interventions. Additionally, high integration interventions were further subgrouped based on the congruency of the activity (i.e., whether the movement supported the learning content). Low integration interventions were subgrouped based on the complexity of the activity (i.e., if the physical activity was cognitively/coordinatively demanding or not). Study quality was assessed, and effects were summarized narratively for each category. Furthermore, a meta-analysis was conducted to quantify both types of interventions. Only studies involving children with an intervention investigating the long-term effects of physical activity on prereading, word recognition, and spelling skills were included. Data sources: PubMed, Web of Science, PsychINFO, Linguistics and Language Behavior Abstracts, ERIC and SportDiscuss. Results: Twenty-three studies were identified and categorized into two groups (thirteen high integration interventions and ten low integration interventions). Across outcome measures, eight of the thirteen high-integration intervention studies reported statistically significant effects on at least one measure of prereading, word recognition, or spelling skills favoring the intervention. In contrast, only two out of ten studies categorized as low integration interventions reported a statistically significant effect. Multilevel meta-analysis showed an insignificant average random-effects model size of Hedges’ g = 0.03 (95% CI: 0.02, 0.09) for low integration and a significant effect size of g = 0.69 (95% CI: 0.12, 1.26) for high integration interventions. The distinction between low and high complexity within the low integration group, and between levels of congruency in high integration interventions, revealed no significant differences between these subgroups. Conclusions: Results from the present review and meta-analysis suggest that the integration of physical activity into the classroom, using activities with a close temporal connection to the academic task (i.e., high integration interventions), appears to be an effective strategy to improve children's word recognition and spelling skills. Due to the limited number and heterogeneity across studies included these findings call for additional studies to clarify specific characteristics of the physical activity needed to support the process of learning to read and spell for children.</p
Psychological predictors of mental well-being in Judo athletes: Exploring the impacts of the coach-athlete relationship, social support, and psychological safety
No full textPsychological predictors of mental well-being are crucial for improving athletes' mental health. Identifying and supporting the mental health of athletes is essential for a well-functional elite sports system. Previous research suggested that the quality of the coach-athlete relationship and a psychologically safe interpersonal environment can positively influence mental health. However, the interplay between these components and the role of social support has yet to be tested empirically. Therefore, the present study explored the impact of coach-athlete relationship quality and psychological safety on mental well-being through perceived social support within and outside sports. A sample of 323 national and international Turkish Judo athletes completed online questionnaires. Structural equation modelling revealed significant positive effects of the coach-athlete relationship on Judo athletes' mental well-being, mediated by social support and psychological safety. These findings demonstrate that the quality of the coach-athlete relationship can enhance perceived support in and outside sport, and perceived social support can contribute to experiencing a psychologically safe environment within which mental health issues are discussed, leading to an elevated well-being. The coach-athlete relationship alone was not a key factor for enhancing a psychologically safe environment related to athletes' mental health. However, the relationship athletes develop with their coach positively influences mental well-being via the perception of received social support and an enhanced psychologically safe environment specifically designed to allow athletes to discuss mental health issues. These results offer practical recommendations for coaches and professionals working in sports to improve athletes’ mental well-being
Dynamic Information Acquisition, Investment, and Disclosure
No full textWe present a dynamic model of information acquisition and disclosure. The manager seeks to maximize future stock prices and collects information privately about the firm's fundamentals. Information acquisition increases the arrival rate of private information. The manager can choose to disclose his private information or withhold it in perpetuity. We study the impact of information acquisition on the accumulation of private information, disclosure, and the firm's initial investment
Changing the Menu:Humpback Whale (Megaptera novaeangliae) Diet Switching in Senyavin Strait, Chukotka
No full textHumpback whales have the most diverse diet of all rorquals. Their ability to use different prey depending on local availability makes them a promising indicator species for ecosystem dynamics. During five summer–fall seasons in 2017–2021, regular observations of humpback whale feeding aggregations were conducted as part of multi-year cetacean monitoring in Senyavin Strait, on the eastern Chukotka Peninsula. The study included assessing the trophic level of the whales using stable isotope analysis, as well as collateral observations of feeding behavior, spatial distribution, and surface activity records. We found that the spatial distribution, daytime activity patterns, and trophic levels of the whales differed significantly between 2017 and 2018–2021. These differences, combined with some additional observations of whale feeding activity, suggest that the whales fed on fish, most likely polar cod, in 2017 and switched to preferentially krill in later years. We suggest that our observations in 2017 coincided with a sporadic schooling event of polar cod. We show that a single humpback whale population can abruptly change its feeding habits and switch from one prey type to another under optimal conditions. The high degree of behavioral plasticity may be one of the keys to the evolutionary success of this species.</p
Under the Responsibility of the Danish State:The History of the Care System for Mentally Disabled People 1902-1980
No full textDen danske stat overtog i 1933 ansvaret for at levere ”omsorg, kur og pleje” til den gruppe mennesker, der blev kategoriseret som åndssvage og anbragt under åndssvageforsorg på anstalter eller i pleje hos enten egen eller i fremmed familier med et lille økonomisk tilskud. At staten påtog sig ansvaret for åndssvageforsorgen, betød ikke, at staten ejede de anstalter eller hjem, hvori de åndssvage blev placeret. Private og selvejende aktører havde allerede fra 1852 udbudt forsorg til åndssvage og fra 1902 med statsligt tilskud. Denne uddelegering af velfærdsopgaven til private forsorgsudbydere eller selvejende anstalter var kendetegnende for ansvarsfordelingen mellem stat og åndssvageforsorg i hele perioden.Formålet med afhandlingen er at undersøge åndssvageforsorgens ud- og afvikling i perioden 1902-1980 med særligt fokus på perioden 1933-1980 og derved give et bidrag til en underbelyst del af den danske velfærdshistorie.Empirisk bygger afhandlingen på et omfattende arkivstudie i Rigsarkivets samlinger, på materiale fra den parlamentariske proces relateret til åndssvage, åndssvageforsorg og generel socialpolitik i perioden samt på faglitteratur fra samtiden. Samlet giver min analyse af det mangefacetterede kildemateriale mig mulighed for at diskutere, hvordan åndssvageforsorgen blev formet af politiske beslutninger, aktører og ikke mindst af skiftende idéer om formålet med åndssvageforsorgen. Det samlede materiale har desuden givet mig mulighed for at give et samlet overblik over institutionens organisation i hele perioden.Jeg tager udgangspunkt i teori om historisk institutionalisme for at analysere de organisatoriske sammenhænge og politiske processer over tid og dermed forstå institutionens kontinuitet og reproduktion. Teorien er med til at rette fokus med de formative momenter i etableringen af åndssvageforsorgen og de forandringer, den gennemgik. Jeg fokuserer på idéers betydning som både forandringsimpulser og stabilitetsskabende faktorer, og dels på de forskellige gradvise forandringsformer, der kan identificeres i skæringspunktet mellem på den ene side kontinuitet og på den anden side omfattende forandring for at indfange stiafhængighed og inkrementel udvikling.Afhandlingens undersøgelsesperiode tager sin begyndelse i 1902, da det i dette år for første gang med lov blev vedtaget, at staten havde en forpligtelse i forhold til anbragte under åndssvageforsorgen. Indtil da havde ”Loven om fattigvæsen” fra 1891 reguleret hjælpen til den åndssvage. På trods af den ovennævnte statslige indblanding i åndssvageanstalternes drift, var staten ikke ansvarlig for de åndssvages ve og vel. Efter flere års forsøg på at foretage en gennemgribende revision af den offentlige forsorg lykkedes det i 1933 at få vedtaget ”Lov om offentlig forsorg”, hvori det blev slået fast, at åndssvages velbefindende ikke længere (kun) skulle være en sag for private aktører. Staten forpligtede sig i lovens § 66 til at drage omsorg for åndssvage enten på statsanerkendte anstalter eller i kontrolleret familiepleje under tilsyn af de føromtalte anstalter. Det er vigtigt at notere sig, at udbyderne af åndssvageforsorg fortsat ikke var statslige. I 1959 blev åndssvageforsorgen et delvist statsligt foretagende med vedtagelsen af ”Lov om forsorgen for åndssvage og andre særlig svagtbegavede” (”Normaliseringsloven”) med oprettelsen af den selvejende institution ”Statens Åndssvageforsorg”. Staten overtog alle anstalter, som udbød åndssvageforsorg, og drev åndssvageforsorg i denne form frem til 1970, hvor den selvejende institution blev lagt ind under den nyoprettede sociale styrelse. Denne organisation eksisterede frem til 1980, hvor åndssvageforsorgen sammen med den øvrige særforsorg blev udlagt til amter og kommuner.Den grundlæggende idé om, at åndssvage skulle gives et værdigt liv blev i 1920’erne koblet samme den eugeniske idé: at nogle liv ikke var værd at reproducere, hvorfor ægteskabsforbud, tvangsabort, -sterilisation og –anbringelser blev en del af åndssvageforsorgen. Parallelt med, at institutionens tilknytning til staten blev stærkere og stærkere, vandt nye idéer frem. Dels en idé om rettigheder og dels en idé om integration af åndssvage i det omkringliggende samfund – det sidste med det rammende slogan ”Et liv så nær det normale som muligt.” Normaliseringsidéen og rettighedstanken fik særligt efter 1960 stor betydning for de åndssvages liv, idet forskellige aktører advokerede for, at negative og positive rettigheder også skulle tildeles denne gruppe borgere i det danske samfund. Udviklingen mod integration af åndssvageforsorgen i det generelle sociale system tog for alvor fat i løbet af 1960’erne, hvor forberedelserne til det ”enstregende” sociale system tog sin begyndelse. Det var ikke muligt både at ”normalisere” og samtidig påberåbe sig retten til at stå uden for de sociale ordninger, der omfattede resten af befolkningen. I 1978 besluttede Folketinget at gøre op med den statslige forsorg ved at udlægge åndssvageforsorgen til amter og kommuner, hvorved mange års statslig indblanding i de åndsvages liv og levned begyndte sin afslutning. Parallelt med først centraliseringen og forberedelserne til decentralisering blev også det eugeniske lovkompleks revideret og endeligt afskaffet. Den eksisterende danske forskning i relation til åndssvageforsorgen har primært haft fokus på individ- eller institutionshistorie og –praksisser, og den institutionelle historie og forsorgens organisation har kun været omtalt i det omfang, det har været relevant for den enkelte anstalts placering i den samlede åndssvageforsorg. Ved at følge åndssvageforsorgens udvikling i en længere periode bidrager afhandlingen med et svar på, hvorfor det oprindelige system med ikke-offentlige forsorgsudbydere blev opgivet til fordel for et offentligt forsorgsvæsen først centralt og siden decentralt.Jeg bidrager med afhandlingen til en forståelse for åndssvageforsorgens institutionelle udvikling, hvorved jeg beriger den eksisterende litteratur om den danske åndssvageforsorg og samtidigt skriver institutionen ind i den samlede danske velfærdshistorie.The Danish state took over the responsibility for providing care and treatment to people who were categorised as mentally disabled in 1933. They were either placed in asylums or in the care of their own or other families with a small economic compensation. The fact that the state took over responsibility for this care did not mean that the state owned and ran the care facilities. Private and independent actors had already been providing care for ‘mentally disabled’ people since 1852, and from 1902 with state subsidies. This delegation of welfare tasks to private care providers or independent institutions characterised the division of responsibility between the state and civil society throughout the years from 1902 to 1980.The purpose of this thesis is to examine the development and decline of care for mentally disabled people in the period 1902-1980, with a particular focus on the period 1933-1980, thereby contributing to a little-known part of Danish welfare history.Empirically, this thesis is based on an extensive archival study of the collections of the Danish National Archives, on material related to the parliamentary process concerning policies related to people with impairments, care for mentally disabled people and general social policy during the period, as well as contemporary scientific literature. Overall, my analysis of the multifaceted source material allows me to discuss how care for mentally disabled people was shaped by political decisions, actors and, not least, changing ideas about the purpose of such care. The material has also enabled me to provide a comprehensive overview of the institution's organisation throughout the period.I apply the theory of historical institutionalism as a starting point to analyse organisational contexts and political processes over time and thus understand the continuity and reproduction of the institution. This theory helps to focus on the formative moments in the establishment of mental disability care and the changes it underwent. I focus on the significance of ideas as both drivers of change and factors promoting stability, and on the various gradual forms of change that can be identified at the intersection between continuity on the one hand and comprehensive change on the other, in order to capture path dependency and incremental development.The study period of the thesis begins in 1902, when it was first passed into law that the state had an obligation towards those mentally disabled people placed in care facilities. Until then, the Poor Law from 1891 had regulated assistance. Despite the above-mentioned state interference in the operation of asylums, the state was not responsible for the provided welfare.After several years of attempts to carry out a thorough review of public welfare, the Public Welfare Act was passed in 1933, stipulating that the welfare of mentally disabled people should no longer be (solely) a matter for private actors. In Section 66 of the Act, the state took over the responsibility for caring for mentally disabled people either in state-approved asylums or in supervised family care under the supervision of the aforementioned asylums. It is important to note that the care facilities were still not state-run. In 1959, care for mentally disabled people became a partially state-run enterprise with the adoption of the ‘Act on Care for the Mentally Disabled and Other Persons with Special Needs’ (‘Normalisation Act’) and the establishment of the self-governing institution ‘Statens Åndssvageforsorg’ (State Care for the Mentally Disabled). The state took over all asylums and homes that provided care ran care services in this form until 1970, when Statens Åndssvageforsorg was placed under the newly established social services authority. This was a central authority under the Ministry of Social Affairs. This organisation existed until 1980, when care for mentally disabled people, together with other special care services for people with all kinds of disabilities, was decentralised and transferred to the counties and municipalities.The fundamental idea that mentally disabled people should be given a dignified life was in the 1920s linked to eugenics: the idea that some lives were not worth reproducing. From this followed marriage bans, forced abortions, sterilisation and forced institutionalisation. As the asylum's ties to the state grew stronger and stronger, new ideas gained ground. These included the idea of rights and the idea of integrating mentally disabled people into the surrounding community – the latter with the catchy slogan ‘A life as close to normal as possible.’ The idea of normalisation and the concept of rights became particularly important for the lives of mentally disabled people after 1960, as various actors advocated that negative and positive rights should also be granted to this group of citizens in Danish society. The move towards integrating care for people with intellectual disabilities into the general social system really took off in the 1960s, when preparations for the ‘unified’ social system began. It was not possible to both ‘normalise’ and claim the right to stay outside the social systems that covered the rest of the population. In 1978, the Danish Parliament decided to abolish the state run welfare provision by transferring care for mentally disabled people to counties and municipalities, thereby bringing to an end many years of central state interference in the lives and livelihoods of mentally disabled people. Parallel to the initial centralisation and preparations for decentralisation, the eugenics legislation was also revised and finally abolished.The existing Danish research on care for mentally disabled people has primarily focused on individuals or asylum history and practice. The organisation of care facilities have only been discussed to the extent that it was relevant to the individual asylum's position in the overall care system. By following the development of care for mentally disabled people over a longer period, the thesis contributes to answering why the original system of non-public care providers was abandoned in favour of a public care system, first central and then decentral.With this thesis, I contribute to an understanding of the institutional development of the care system for mentally disabled people by analysing political decisions, economic frameworks, ideas about ‘the good life’ and the criticism directed at the institution throughout the period. In doing so, I enrich the existing literature on Danish care for mentally disabled people and, at the same time, write the institution into the overall history of Danish welfare
Towards a realist theory of nationalism:Exploring realpolitik and the threshold principle in nineteenth century nationalism
No full textThis article critiques Ernest Gellner's definition of nationalism for not fully capturing the intricacies of nineteenth-century nationalist movements and introduces “realist nationalism” as a more comprehensive framework. By integrating Eric Hobsbawm's threshold principle with the realism prevalent in international relations, this concept emphasises the strategic importance of power and security in nationalist endeavours. Through a detailed historical analysis, the study demonstrates how pre-World War II nationalist movements and state formations were significantly influenced by realpolitik, thereby challenging the conventional dichotomy between nationalism and imperialism. “Realist nationalism” provides a nuanced historical understanding of nationalism's interplay with geopolitical dynamics, offering insights that illuminate the complexities of nationalist movements both in the past and their continuing relevance today.</p
Color Saturation and Perceived Sensory Intensity:An Account of Psychological Proximity
No full textColor saturation is an important and relevant attribute in products and packaging. However, the role of color saturation in relation to sensory attributes beyond the visual sense remains under-investigated. To partially address this broader gap, the present investigation aims to document the effect of color saturation on the anticipated intensity of attributes related to other senses (smell, taste, touch, and sound). Five studies collectively find that higher saturation in products and packaging results in heightened anticipated intensity of sensory attributes and support that psychological proximity is the underlying mechanism of this effect. We test this effect across different product categories (i.e., soap, microfiber towels, cookies, a music album, and fabric) using both the coloring of the product and its packaging, with the effect found across different senses (i.e., scent, touch, sound, taste, smell, and texture). We further rule out processing fluency, novelty, and nostalgia as alternative explanations. These findings highlight color saturation as a product/packaging cue that shapes consumer sensory expectations across multiple senses, offering both theoretical insight and actionable implications for product and packaging design.</p
Community responses to flooding in risk mitigation actions:Evidence from the community rating system
No full textThis paper studies the impact of disaster experiences on communities' engagement in risk mitigation actions, focusing on flooding in the United States. We measure risk mitigation actions using communities' scores in the Community Rating System, an incentive program that scores flood preparedness and mitigation activities and rewards communities with flood insurance premium discounts. Leveraging a panel of communities from 1998 to 2019, we find a significant increase in risk mitigation activities following flood events, in both participation rates and intensity of actions. The effects continue to increase up to 10 years. Communities with greater capacity, particularly those in urban areas, exhibit a much stronger response. The findings highlight the adaptive capacity of communities but also raise several concerns regarding the inefficiency of disaster-driven responses and inequitable outcomes across communities.</p