Balancing Act Research Articles

Pre-medical assessment of root-canal-filled teeth with asymptomatic apical periodontitis-A multifaceted balancing act.

Prior to certain medical therapies, dental assessment and treatment of oral foci of infection are recommended. The aim of the present study was to acquire a deeper understanding of the decision-making process regarding the pre-medical management of root-canal-filled teeth with asymptomatic apical periodontitis (AAP). Hospital-affiliated dentists in Sweden were contacted for a semi-structured, in-depth interview. The absolute inclusion criterion was that the dentists had experienced and could recount at least two authentic cases involving root-canal-filled teeth with AAP-one case having resulted in pre-medical treatment, and one having resulted in expectancy. Fourteen interviews, with fourteen informants, were conducted and included in the study. During the interviews, open-ended questions and comments encouraging the informants to elaborate and clarify their experiences were offered. The interviews were digitally recorded, transcribed verbatim and analysed using Qualitative Content Analysis with an inductive approach. A theme describing the latent content was identified through interpretation of the collected data: A multifaceted balancing act characterized by a sometimes-difficult risk-benefit-estimation, where an increased uncertainty entails an increased reliance on external opinions. Three main categories, comprising four sub-categories, describing the manifest content were recognized: The tipping scale, The team effort and The frame of reference. The current interview study found pre-medical decision-making regarding root-canal-filled teeth with AAP to be a multifactorial and contextual process marked by uncertainty and collaborative measures. Further research, resulting in the development of evidence-based treatment guidelines, is suggested necessary.

Epidemic modelling of monitoring public behavior using surveys during pandemic-induced lockdowns

BackgroundImplementing a lockdown for disease mitigation is a balancing act: Non-pharmaceutical interventions can reduce disease transmission significantly, but interventions also have considerable societal costs. Therefore, decision-makers need near real-time information to calibrate the level of restrictions.MethodsWe fielded daily surveys in Denmark during the second wave of the COVID-19 pandemic to monitor public response to the announced lockdown. A key question asked respondents to state their number of close contacts within the past 24 hours. Here, we establish a link between survey data, mobility data, and hospitalizations via epidemic modelling of a short time-interval around Denmark’s December 2020 lockdown. Using Bayesian analysis, we then evaluate the usefulness of survey responses as a tool to monitor the effects of lockdown and then compare the predictive performance to that of mobility data.ResultsWe find that, unlike mobility, self-reported contacts decreased significantly in all regions before the nation-wide implementation of non-pharmaceutical interventions and improved predicting future hospitalizations compared to mobility data. A detailed analysis of contact types indicates that contact with friends and strangers outperforms contact with colleagues and family members (outside the household) on the same prediction task.ConclusionsRepresentative surveys thus qualify as a reliable, non-privacy invasive monitoring tool to track the implementation of non-pharmaceutical interventions and study potential transmission paths.

The Evaluation Gap in Astronomy—Explained through a Rational Choice Framework

The concept of evaluation gaps captures potential discrepancies between what researchers value about their research, in particular research quality, and what metrics measure. The existence of evaluation gaps can give rise to questions about the relationship between intrinsic and extrinsic motivations to perform research, i.e., how field-specific notions of quality compete with notions captured via evaluation metrics, and consequently how researchers manage the balancing act between intrinsic values and requirements of evaluation procedures. This study analyses the evaluation gap from a rational choice point of view for the case of observational astronomers, based on a literature review and 19 semi-structured interviews with international astronomers. On the basis of the institutional norms and capital at play in academic astronomy, I shed light on the workings of the balancing act and its consequences on research quality in astronomy. I find that astronomers experience an anomie: they want to follow their intrinsic motivation to pursue science in order to push knowledge forward, while at the same time following their extrinsic motivation to comply with institutional norms. The balancing act is the art of serving performance indicators in order to stay in academia, while at the same time compromising research quality as little as possible. Gaming strategies shall give the appearance of compliance, while institutionalised means to achieve a good bibliometric record are used in innovative ways, such as salami slicing or going for easy publications. This leads to an overall decrease in research quality.

In whose pockets? How small Danish patient organisations balance legitimacy, representation and dependency in collaboration with public sector medical researchers and the life science industry

It is a commonly accepted idea that complex structural challenges can be solved if private actors, NGOs, and the public authorities collaborate (Brogaard in Politica 47(4):541–560, 2015), a view that has come to frame several publicly funded network activities in Denmark. This article takes its point of departure in one such project aimed at setting up a collaborative network between researchers, patient associations, and life science partners to stimulate growth in research and development. We analyse this project as a social arena with a focus on what is at stake for patient organisations in such a collaboration. Using social worlds and arena theory, we map the negotiation of discourses, images, and positions, thereby answering the questions: What kind of relationships emerge as patient organisations network with researchers and the life science industry in the name of patient centricity and how do patient organisations balance legitimacy, representation, and independence in such collaboration? We argue that patient organisations’ positions are expanding and taking new forms as they perform a balancing act, from which a ‘multiplayer position’ seems to have emerged. Lastly we propose that patient organisations’ complex interdependencies should be acknowledged, and introduce an understanding of ‘cumulative drives’ to capture the nature of these complexities.

Annexin A1, A2, A5, and A6 involvement in human pathologies.

The human genome codes for 12 annexins with highly homologous membrane-binding cores and unique amino termini, which endow each protein with its specific biological properties. Not unique to vertebrate biology, multiple annexin orthologs are present in almost all eukaryotes. Their ability to combine either dynamically or constitutively with membrane lipid bilayers is hypothetically the key property that has led to their retention and multiple adaptation in eukaryotic molecular cell biology. Annexin genes are differentially expressed in many cell types but their disparate functions are still being discovered after more than 40 years of international research. A picture is emerging from gene knock down and knock out studies of individual annexins that these are important supporters rather than critical players in organism development and normal cell and tissue function. However, they appear to be highly significant "early responders" toward challenges arising from cell and tissue abiotic or biotic stress. In humans, recent focus has been on involvement of the annexin family for its involvement in diverse pathologies, especially cancer. From what has become an exceedingly broad field of investigation, we have selected four annexins in particular: AnxA1, 2, 5, and 6. Present both within and external to cells, these annexins are currently under intensive investigation in translational research as biomarkers of cellular dysfunction and as potential therapeutic targets for inflammatory conditions, neoplasia, and tissue repair. Annexin expression and release in response to biotic stress appears to be a balancing act. Under- or over-expression in different circumstances appears to damage rather than restore a healthy homeostasis. This review reflects briefly on what is already known of the structures and molecular cell biology of these selected annexins and considers their actual and potential roles in human health and disease.

A balancing act: sex selection after pre-implantation genetic testing for aneuploidy for first versus second baby.

How often do patients undergoing frozen embryo transfer (FET) after preimplantation genetic testing for aneuploidy (PGT-A) choose to select for sex and do sex selection rates differ before and after successful delivery of a first baby? When a choice was available between male and female embryos, patients selected the sex more frequently when trying to conceive the second child (62%) as compared to the first child (32.4%) and most commonly selected for the opposite sex of the first child. Sex selection is widely available in US fertility clinics. However, the rate of sex selection for patients undergoing FET after PGT-A is unknown. This is a retrospective cohort study of 585 patients that took place between January 2013 and February 2021. The study took place at a single, urban academic fertility center in the USA. Patients were included if they had a live birth after single euploid FET and returned for at least one subsequent euploid FET. The primary outcomes were the rates of sex selection for first versus second baby. Secondary outcomes were rate of selection for same versus opposite sex as first live birth and overall rate of selection for males versus females. Five hundred and eighty-five patients underwent a total of 1560 single euploid FETs resulting in either one or two live births. A choice between male and female euploid embryos was available for 919 FETs (first child: 67.5% (519/769) versus second child: 50.6% (400/791), P < 0.01). When a choice was available, patients selected the sex more frequently when trying to conceive the second child (first child: 32.4% (168/519) versus second child: 62.0% (248/400), P < 0.01). When sex was selected after first live birth, the opposite sex of the first child was selected 81.8% (203/248 FETs) of the time. Of transfers that involved sex selection, rates of male and female selection were similar for the first child, but selection for females was greater for the second child (first child: 51.2% (86/168) male versus 48.9% (82/168) female, second child: 41.1% (102/248) male versus 58.9% (146/248) female, P < 0.04). The study was performed at one urban academic medical center in the Northeastern US, which may limit generalizability to other settings where PGT-A may be performed less frequently, or sex selection may be limited or not permitted. In addition, we could not reliably account for whether patients or their partners had prior children and if so, of what sex. Patients undergoing PGT-A with both male and female euploid embryos were more likely to select for sex when attempting a second child and usually selected for the opposite sex of their first child. These findings highlight the potential for family balancing for patients who undergo PGT-A in settings where sex selection is permitted. This study received no funding. The authors have no conflicts of interest to declare. N/A.

Tension between Journalistic and Entertainment Values in Live Soccer TV Commentary: The Commentator’s Perspective

This article examines the tension between journalistic and entertainment values in live soccer TV commentary from the perspective of German commentators. We situate journalistic and entertainment values within the commentators’ wider understanding of their roles as sports journalists and commentators, looking at a specific type of sports journalist who has different responsibilities from the general sports reporter. We asked how soccer commentators assess the role of journalistic and entertainment values in their work, and what constraints they face, such as how the perceived expectations of their employer affect this assessment. We interviewed 28 TV commentators, one radio commentator, and one expert working for relevant German TV channels and streaming platforms, such as ZDF, Sky, and DAZN. While all interviewees see themselves as companions telling the story of the match, most commentators in the sample value journalistic values over entertainment values, a surprising finding in the hyper-commercialized world of sports television. Well-founded journalistic expertise and soccer knowledge are considered most important. However, this assessment depends on factors such as the broadcaster’s guidelines and the nature of the match. In summary, the role of the commentator is either an ‘objective mediator’ or an ‘emotional entertainer’, but this is a balancing act.

“A balancing act of keeping the faith and maintaining wellbeing”: perspectives from Australian faith communities during the pandemic

PurposeThe pandemic presented many new challenges is all spheres of life including faith communities. Around the globe, lockdowns took pace at various stages with varying restrictions that included the closure of places of worship which significantly affected the way people serve God and gather as a community. The purpose of this study was to investigate the impact of the Covid-19 pandemic on the wellbeing and resilience of members of Christian faith communities in Melbourne (Australia) who had experienced one of the longest lockdowns in the world.Design/methodology/approachThe authors draw on online survey N = 106 collected between November 2021 and May 2021. Participants were over the age of 18 from Catholic, Anglican, Uniting Church, Baptist and Pentecostal/Evangelical faith communities. They employ thematic analysis to analyze, and code open-ended responses from four questions in relation to the research question: In what ways has your wellbeing been impacted during the pandemic?FindingsMelbourne experienced one of the longest lockdown periods in the world between 2020 and 2021 when blended modes of worship forced people to congregate in new and different ways. The empirical insights of participants express their views in relation to celebrating faith and hope, connecting with community, pursuing leisure activities and pursuing leisure in relation to the PERMA model of wellbeing. The findings may resonate with other faith communities in Melbourne and around the globe. They may also lead to new and innovative ways of planning and envisioning modes of worship that may be helpful in a variety of faith contexts.Research limitations/implicationsThe research was limited by its sample size (N = 106) and its geographical restriction of Christian faith communities in the Melbourne metropolitan area. This means that broad generalizations cannot be made. Nevertheless, the findings may resonate with other faith communities in Australian and in other parts of the world.Practical implicationsIn highlighting the impact COVID-19 had in Australia and ways people balanced their sense of faith and wellbeing, this study raises concerns about the lack of funding that supports mental health initiatives in faith settings and the wider community. The study recommends that faith community leaders and members use informal communication channels to foster hope building wellbeing and resilience, and that pastoral care networks be established in the wider community to promote leisure activities that nurtures social connection, builds faith and resilience.Social implicationsWhilst the pandemic has provided new openings for members of faith communities to engage with God, the scriptures, each other and leisure, it remains “a balancing act of keeping the faith and maintaining wellbeing”. Such a balancing act may positively enliven a sense of wellbeing and resilience as people continue to navigate the uncertainty inherent in a milieu beginning to be named as “post-Covid”.Originality/valueThis is an original work carried out by the authors. It raises concerns about the lack of funding that supports mental health initiatives in faith settings and the wider community. While much research, news and social media discussed the pandemic's impact on communities, there is an urgent need for ongoing research that encourages, supports and connects people to faith and to leisure activities in order to promote a continued sense of wellbeing as communities begin to transition to a “post-Covid” world. This study contributes to the growing body of knowledge about the impact COVID-19 had in Australia and ways people balanced their sense of faith and wellbeing.

Democracy, Nazi Trials, and Transitional Justice in Germany, 1945–1950

Devin Pendas has written a stimulating study of the question of the relationship between early Nazi trials and the concept of Transitional Justice (TJ). He is less concerned with the extent to which contemporary concepts (TJ emerged in the 1980s) can be applied to historical cases than with verifying or falsifying an existing theoretical concept through historical-empirical research. This is an interesting spin on the topic, as it puts the spotlight on historically grounded studies in a field dominated by political and social scientists looking at current cases. However, this also raises the question of who Pendas’s study is aimed at. He attempts the balancing act of presenting new insights for historians of German history and of Nazi trials, for TJ scholars and for legal historians. The latter come into the picture because Pendas concentrates on a specific aspect of transitional justice: criminal trials, in this case against Nazi perpetrators in the years 1945 to 1950.

A balancing act: how interpreters affect the therapeutic alliance in psychotherapy with trauma-affected refugees-a qualitative study with therapists.

The therapeutic alliance (TA) has the highest predictive value concerning the success of psychotherapy. The presented study aimed to explore how the presence of an interpreter affects the TA when working with trauma-affected refugees. Semi-structured interviews were conducted with seven psychologists working in an outpatient clinic specialized in mental health care for migrant and refugee patients with trauma-related mental health problems in Denmark. Interviews were transcribed verbatim and analyzed using a structuring content analysis approach. TA has been described as a dynamic therapist-interpreter-patient alliance triangle consisting of three distinct but highly intertwined and mutually influential dyadic alliances. Specific factors affecting the quality of the TA were identified, e.g., interpreter being emotionally attuned yet not overly involved; interpreter being barely visible yet present as a human being. Characteristics of trauma-affected refugee patients affecting the TA formation were also identified, e.g., a high level of personal distrust, different understandings of mental disorders and psychotherapy, stigmatization, perceptions of authorities. The presence of interpreters was perceived ambivalently and the formation of a good TA seems to be a balancing act. Based on the findings, recommendations for forming and maintaining a good TA in interpreter-mediated psychotherapy are provided.

Trading wood for water and carbon in peatland forests? Rewetting is worth more than wood production

While traditional forest management systems aim at maximizing timber production, sustainable forest management focuses on the multiple benefits of entire forest landscapes. The latter is now at the top of policy agendas. This calls for learning through evaluation to support the implementation of policies aiming towards multi-functional forest landscapes. The aim of this study is to quantify the economic trade-offs among natural, current, and re-wetted peatland forests using seven indicators, viz. drainage maintenance, rewetting, water retention, wood production, and three types of carbon sequestration as economic indicators. We discuss ways to adapt to and mitigate effect of forest draining on climate change toward securing multi-functional forest landscapes. The cost benefit analysis showed that in a potential natural state, Lithuania's peatland forests would deliver an economic benefit of ∼€176.1 million annually. In contrast, compared to natural peatland forests, the drainage of peatland forests for wood production has caused a loss of ∼€309 million annually. In comparison, peatland forest rewetting is estimated to increase the economic value by ∼€170 million annually. This study shows that satisfying different ecosystem services is a balancing act, and that a focus on wood production has resulted in net losses when foregone values of water storage and carbon sequestration are considered. Valuation of different sets of ecosystems service benefits and disservices must be assessed, and can be used as a tool towards creating, implementing and monitoring consequences of policies on both sustainability and biodiversity.

The balancing act: A qualitative study on remote work and childcare during the COVID-19 lockdown in South Africa

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many employees' world by forcing some to remote work while caring for children. Methods: This study explored the remote working experiences of child caregivers in balancing work and childcare during the South African COVID-19 lockdown period (from 26 March 2020 to 31 December 2020). A qualitative descriptive design was employed to collect data through an online qualitative questionnaire with semi-structured questions. A final sample of 22 participants was included using purposive and snowball sampling. Results: Findings indicate that White South African employees experienced difficulty balancing work and childcare, which prompted them to use personal and organisational resources to restore work-life balance. These resources included people, spaces and time. Conclusions: This study provides insight for employers and healthcare workers into how remote workers balance work and childcare and can promote conversations or interventions on improving employee remote work experiences - especially in the unique South African context.

Perfect Preparation.

Perfect Preparation.

A balancing act: Negotiating authenticity in luxury lodges

This study explores the negotiation process underpinning the creation of authentic experiences in luxury lodges. The findings of this study highlight how this is a balancing act performed by the hosts through the provision of an authentic experiential platform connecting guests with unique places and genuine people and is of a luxurious nature. Staged experiences are authenticated by the guests through their bodies and minds, activating, in turn, experiences of existential authenticity. Contributing to service marketing and management literature, the study departs from purely abstract authenticity conceptualisations by applying an experience design and management lens to understanding authentic experiences. Practically, our findings demonstrate how authenticity is operationalised in luxury lodges and how these experiences are understood and valued by tourism and hospitality consumers and providers, providing crucial implications for luxury accommodation marketers and managers.

Axons will not be silenced! A balancing act of attractive receptors

Axons crossing the CNS midline regulate their responsiveness to both attractive and repulsive cues. In this issue, Dailey-Krempel etal. find different modes of action for DCC isoforms and uncover evidence against the silencing model of axon guidance.

The vaccine mandates judgment: Some reflections.

This paper scrutinises the Supreme Court Judgment of May 2, 2022, in a vaccine mandate-related petition. The Hon'ble Court's Order reasserts the primacy of right to privacy and Articles 14 and 21 of the Constitution of India. However, in the interest of protection of communitarian health, the Court felt that the Government is entitled to regulate issues of public health concern by imposing certain limitations on individual rights, which are open to scrutiny by constitutional Courts. However, such mandatory vaccination directives with preconditions cannot invade an individual's right to personal autonomy and right to access means of livelihood, and must meet the threefold criteria laid down in K.S.Puttaswamy, a landmark judgment of 2017. This paper examines the validity of the arguments adopted in the Order and suggests certain infirmities therein. Nevertheless, the Order is a balancing act, and worth celebrating. The paper concludes, as a cup that is "a quarter full", as a victory for human rights and as a safeguard against unreasonableness and arbitrariness in medico-scientific decision-making that takes the citizen's compliance and consent for granted. If the State runs amok by way of mandatory health directives, this Order may come to the rescue of the hapless citizen.

Can hands-on supervision get out of hand? The correlation between directive supervision and doctoral student independence in a Danish study context.

ABSTRACT Much of the supervision literature revolves around the delicate balance between directive supervision and student independence. Yet there remains a paucity of empirical research about the balancing act. This is the first study based on survey data to undertake a large-scale empirical analysis of the assumed relation between doctoral supervisor direction and student independence. Data were collected from 1,243 doctoral students at a research-intensive Danish University. Factor analysis revealed that directive supervision encompasses two dimensions: (1) controlling and (2) advising. Through regression analysis, we found that student independence is affected positively by advising and negatively by controlling. Interestingly, we also found that student satisfaction was affected positively by both advising and controlling. Our findings suggest that directive supervision is complex, but the benefit of advising supervision could outweigh the harm of controlling supervision. Supervisors should therefore be less concerned with being too hands-on, but more concerned with being too hands-off.

The compleX balancing act of controlling X-chromosome dosage and how it impacts mammalian germline development.

In female mammals, the two X chromosomes are subject to epigenetic gene regulation in order to balance X-linked gene dosage with autosomes and in relation to males, which have one X and one Y chromosome. This is achieved by an intricate interplay of several processes; X-chromosome inactivation and reactivation elicit global epigenetic regulation of expression from one X chromosome in a stage-specific manner, whilst the process of X-chromosome upregulation responds to this by fine-tuning transcription levels of the second X. The germline is unique in its function of transmitting both the genetic and epigenetic information from one generation to the next, and remodelling of the X chromosome is one of the key steps in setting the stage for successful development. Here, we provide an overview of the complex dynamics of X-chromosome dosage control during embryonic and germ cell development, and aim to decipher its potential role for normal germline competency.

Sustainable food packaging: An updated definition following a holistic approach

Food packaging solutions need to be redesigned to be more sustainable, but determining which solution is ‘more optimal’ is a very difficult task when considering the entire food product value chain. Previous papers paved the way toward a sustainable food packaging definition, but it is far from being commonly accepted or well usable in the broad food systems domain, which further results in uninformed choices for sustainable food packaging made by all stakeholders in the value chain: producers, distributors, practitioners and consumers. Therefore, this work aims first at giving a state-of-the-art overview of sustainable food packaging terms (38 similar terms were identified and grouped into four clusters: Sustainable, Circular, Bio and Other sustainable packaging) and definitions using systematic (narrative) review analysis and ‘controlled expert opinion feedback’ methodology. Second, it aims to offer an updated definition for sustainable food packaging, which is also specific to food packaging and be simple, coherent, easily understandable, and communicable to everybody. The applied holistic approach intends to include all aspects of the food-packaging unit, to consider food safety and packaging functionality, while taking into account different disciplines and challenges related to food packaging along the supply chain. Being a balancing act, a sustainable food packaging may not be a perfect solution, but contextual, suboptimal and in need of constant validation.

Private View? The Organisational Performance of ‘Privateness’ and ‘Publicness’ at an Art Gallery

This article takes a cultural approach to analysing the profound privatisation of the public in one of the many places in which it manifests: an art gallery. I argue that, as well as categories of political and economic bearing, ‘privateness’ and ‘publicness’ are cultural categories through which lived experiences are made meaningful. They are therefore performable by organisations that have dual public and private accountabilities. I draw on the cultural pragmatics understanding of ‘performance’ as well as a mesosociological attention to groups to study a private view as one example of such a performance. Through the manipulation of arenas, relations and histories I show how the art gallery staff managed to uphold the meanings of both privateness and publicness at this occasion, and manipulate them according to the different desired outcomes of social contexts. In conclusion, I argue that organisational performances of privateness and publicness are in a dynamic tension with one another; that the performative balancing act is a central part of the day-to-day work of such organisations; and that the cultural approach can help us unravel organisational strategies to paper over the social exclusions that characterise their ‘publics’.