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Variations in ten-year cardiovascular disease risk and determinants in five countries
No full textBackgroundThis study assessed ten-year cardiovascular disease (CVD) risk and its determinants in five countries using the World Health Organization (WHO) STEPwise approach to non-communicable disease (NCD) risk factor surveillance (STEPS) data.MethodsAdults aged 40-69 were analysed using multilevel models to identify individual- and community-level factors.ResultsThe mean ten-year CVD risk was 18.3% in Jordan, 8.4% in Afghanistan, 6.8% in Mongolia, 5.3% in Nepal, and 5.0% in São Tomé and Príncipe. Higher ten-year CVD risk was associated with being widowed, divorced or separated in Nepal (β[beta coefficient percent] =1.36, 95%CI=0.19-2.53, p<0.05); urban residence in Afghanistan (β=0.59, 95%CI=0.01-1.17, p<0.05) and Nepal (β=0.46, 95%CI=0.003-0.93, p<0.05); being retired or unable to work in Afghanistan (β=1.49, 95%CI=0.58-2.41, p<0.001), Nepal (β=1.20, 95%CI=0.56-1.85, p<0.001), and Mongolia (β=0.83, 95%CI=0.11-1.56, p<0.05); and low physical activity in Jordan (β = 1.73, 95% CI=0.77-2.69, p<0.001), Mongolia (β = 1.04, 95%CI=0.46-1.61, p<0.001), and Afghanistan (β = 0.81, 95%CI=0.07-1.56, p<0.05).ConclusionsThis study reaffirms differences in primary CVD risk profiles across countries and indicates the need for focused interventions, such as promoting urban-based CVD prevention in Afghanistan and Nepal, increasing physical activity in Jordan and Mongolia, strengthening social support for widowed individuals in Nepal, and improving access to primary CVD prevention for retirees or those unable to work in Afghanistan, Mongolia and Nepal. Future research should assess cost-effectiveness, feasibility, and implementation challenges of interventions. Studies should also investigate the underlying mechanisms that drive primary CVD risk in higher-risk populations
Networked Harassment of Journalists in Nigeria:Motivations, Coping Strategies and Solutions
No full textIn many newsrooms around the world, safety issues have become popularconcerns of both journalists and media organisations. Recent attacks against journalists in Nigeria have shown that anti-press violence is exacerbating, as there has been a noticeable shift beyond trolling and other acute online harassment practices to more insidious, chronic, and escalatory forms of violence (e.g., the burning of media houses and the physical assault of journalists). While studies (Holton et al., 2023; Lewis et al., 2021; Marwick, 2021; Uwalaka & Amadi, 2023a) have focused on the online harassment of journalists, many have focused on the gendered aspects of the attacks or the online harassment experience itself (Bombi et al., 2023; Burch et al., 2024; Uwalaka & Amadi, 2023b, 2023c; Zviyita & Mare, 2023)
Some new characterizations of bi-dagger matrices
No full textThe concept of the bi-dagger matrix was introduced by Hartwig and Spindelböck [8]. In this paper, we provide some new characterizations of bi-dagger matrices. We prove that the index of a bi-dagger matrix is less than or equal to 2 and that a matrix is bi-dagger if and only if it is i-EP, and its index is less than or equal to 2. Specifically, a matrix is bi-dagger if and only if it commutes with its B-T inverse. Finally, we consider Problem 5 in [8] and establish conditions under which a bi-dagger matrix implies bi-normality.</p
In two minds: ambivalence and the pathways to polarisation in the digital public sphere
No full textThis article advances a theory of how attitudinal ambivalence links cross-cutting information flows to polarisation. Democratic ideals presuppose exposure to conflicting information in the public sphere supports deliberative opinion formation. Yet today’s digital communication environment increasingly produces attitude extremity rather than moderation. I position ambivalence – the holding of simultaneous positive and negative evaluations – as a pivotal psychological moderator of these effects. While mixed evaluations about a single attitude object can motivate careful reasoning, subjective ambivalence can generate discomfort that is resolved through attitude amplification, where one side of a conflict is exaggerated to reach a rigid, univalent position. I propose three features of contemporary public spheres that increase the likelihood of amplification among ambivalent individuals: information overload, decision stress, and social stigma. I derive testable propositions for future empirical research that would clarify when cross-cutting exposure deepens divides and how institutional design might steer ambivalence toward constructive deliberation
“The sky is the limit”:Enhancing learner engagement and agency through curriculum negotiation
No full textThe purpose of this study was to better understand how school teachers negotiate the Australian Curriculum to increase learner engagement and agency by managing negotiables and non-negotiables. In-depth interviews with seven teachers across a Foundation to Year 10 school were conducted to gain insights into their perspectives on curriculum negotiation and the processes used by individual teachers to enact it. Data was analysed iteratively, utilising reflexive thematic analysis. All teachers demonstrated a passion for curriculum negotiation and provided examples for aligning curriculum and pedagogy to enhance students’ intellectual and emotional engagement. The study found that teachers who were willing to explore various methods for curriculum negotiation fostered diverse learners’ intellectual development by giving them voice, choice, and ownership over their learning. This paper provides insights into elements of curriculum negotiation undertaken by the teachers, which went beyond basic pedagogy and curriculum work. This study showed that teachers can be transformative and organic intellectuals when they evaluate student related constraints on learning to allow students to be actively engaged in the decision-making processes associated with their own learning.</p
Poetry as a Change in the Language
No full textWhat we find in each and every poem that speaks the world anew is an enactment of – and simultaneously a model for – the dynamic openness at the heart of all of our symbolic systems. The countervailing force to the depressing conformities all around us is that there are actually no rules to any language, at the point of change. To be sure, systems of censorship exist, and these can contract down to the level of one’s workplace, their friendship network, an intimate partner or, perhaps most cogently, the self. But the strange openings in language that Eagleton praises in Auden’s words will persist through all species of tyranny because they are innate to the ways we refer to new things in the world as we speak. And new things come about all the time. Poetry is that reminder
Widening access to medical school in Australia:A realist evaluation
No full textIntroduction: While medical school selection research has largely focused on the validity of tools and processes, less attention has been paid to the quality and impact of widening access (WA) pathways. Existing studies are often limited in scope, focusing on single institutions or interventions. This study aimed to develop transferable insights into WA selection practices through a realist evaluation across four Australian medical schools. Methods: Building on a prior realist review, we employed the RAMESES II protocol to explore how contextual factors and mechanisms interact to influence WA outcomes through four case studies. Data collection included institutional document and website reviews, semistructured interviews and focus groups (41 staff and 17 students). The evaluation framework examined context (diversity within sociocultural settings), interventions (targeted pathways and adjusted selection scores), mechanisms (institutional, dispositional and situational) and outcomes (applicant diversity, selection success). Retroductive context–intervention-mechanism–outcome (CIMO) analysis clarified WA programme theory. Results: Two key interventions were successful across all sites: (1) targeted pathways with selection score adjustments for under-represented groups (e.g., Indigenous, rural and low socio-economic backgrounds) and (2) sustained partnerships with these communities to raise awareness of medicine as a viable career. These partnerships aimed to enhance applicants' dispositions and readiness for selection. However, structural changes within institutions posed significant risks to the sustainability of WA. The resulting programme theory identified five mechanisms underpinning effective WA: visionary leadership, Indigenous cultural safety, longitudinal relational engagement, tailored applicant support and preparation for selection processes. Discussion: This realist evaluation highlights how institutional commitment, shaped by federal policy and accreditation standards, has driven demographic shifts, particularly in rural and Indigenous representation, over a 10- to12-year period; however, the scope of WA remains narrow. We argue for a national, coordinated approach to WA in medical education, underpinned by long-term investment, robust evaluation and a broader conceptualisation of equity in access. WA must be embedded as a core institutional commitment rather than a peripheral initiative.</p
PainFormer:a Vision Foundation Model for Automatic Pain Assessment
No full textPain is a manifold condition that impacts a significant percentage of the population. Accurate and reliable pain evaluation for the people suffering is crucial to developing effective and advanced pain management protocols. Automatic pain assessment systems provide continuous monitoring and support decision-making processes, ultimately aiming to alleviate distress and prevent functionality decline. This study introduces PainFormer, a vision foundation model based on multi-task learning principles trained simultaneously on 14 tasks/datasets with a total of 10.9 million samples. Functioning as an embedding extractor for various input modalities, the foundation model provides feature representations to the Embedding-Mixer, a transformer-based module that performs the final pain assessment. Extensive experiments employing behavioral modalities–including RGB, synthetic thermal, and estimated depth videos–and physiological modalities such as ECG, EMG, GSR, and fNIRS revealed that PainFormer effectively extracts high-quality embeddings from diverse input modalities. The proposed framework is evaluated on two pain datasets, BioVid and AI4Pain, and directly compared to 75 different methodologies documented in the literature. Experiments conducted in unimodal and multimodal settings demonstrate state-of-the-art performances across modalities and pave the way toward general-purpose models for automatic pain assessment.</p
Investigating the influence of perceived humanization of service encounters on value creation of chatbot-assisted services
No full textPurposeWhile prior research has examined customer acceptance of humanized chatbots, the mechanisms through which they influence customer value creation remain unclear. This study aims to investigate the emerging concept of Perceived Humanization (PH), examining how hedonic motivation, social influence and anthropomorphism influence value creation through the serial mediation of PH and trust. The moderating roles of rapport and social presence are also explored.Design/methodology/approachBased on data from an online survey involving 257 respondents, this study employs Partial Least Squares Structural Equation Modeling utilizing SmartPLS3 software.FindingsHedonic motivation leads to value creation via two routes: PH and affective trust; and PH and cognitive trust. Social influence and anthropomorphism also positively impact value creation through similar pathways. Rapport moderates the impact of social influence on PH, while social presence moderates the relationship between PH and both affective and cognitive trust. A cross-cultural analysis of China, India and New Zealand highlights varying cultural dimensions influencing PH and its effects on value creation.Practical implicationsFor practitioners in the tourism industry, the findings highlight the strategic importance of enhancing PH in chatbot interactions. By understanding and optimizing these elements, businesses can significantly improve their customer value-creation process.Originality/valueThis study contributes to the service marketing literature by generating a comprehensive framework for the comprehension and application of PH. Its cross-cultural perspective provides rich insights, offering valuable information for service marketers aiming to thrive in the dynamic and competitive tourism industry
Sociodemographic Factors and Presentation Features of Individuals Seeking Mental Health Care in Emergency Departments:A Retrospective Cohort Study
No full textEmergency Department (ED) presentations for Mental Health (MH) help-seeking have been rising rapidly, with EDs as the main entry point for most individuals in Australia. The objective of this retrospective cohort study was to analyse the sociodemographic and presentation features of people who sought mental healthcare in two EDs located in a regional coastal setting in New South Wales (NSW), Australia from 2016 to 2021. This article is a part of a broader research study on the utilisation of machine learning in MH. The objective of this study is to identify the factors that lead to the admission of individuals to an MH inpatient facility when they seek MH care in an ED. Data were collected using existing records and analysed using descriptive univariate analysis with statistical significance between the two sites was determined using Chi squared test, p < 0.05. Two main themes characterise dominant help-seeking dynamics for MH conditions in ED, suicidal ideation, and access and egress pathways. The main findings indicate that suicidal ideation was the most common presenting problem (38.19%). People presenting to ED who ‘Did not wait’ or ‘Left at own risk’ accounted for 10.20% of departures from ED. A large number of presentations arrived via the ambulance, accounting for 45.91%. A large proportion of presentations are related to a potentially life-threatening condition (suicidal ideation). The largest proportion of triage code 1 ‘Resuscitation’ was for people with presenting problem of ‘Behavioural Disturbance’. Departure and arrival dynamics need to be better understood in consultation with community and lived experience groups to improve future service alignment with the access and egress pathways for emergency MH care.</p