Thematic Categories Research Articles

Factors Influencing Medication Adherence in Heart Failure Patients-A Survey among Cardiac Healthcare Providers.

Adhering to medication regimens is key behavior to alleviate symptoms and slow disease progression in heart failure (HF). This study explores cardiac healthcare providers' perceptions and experiences of factors influencing medication adherence (MA) in HF patients, with findings contributing to developing a HF-specific MA assessment scale. Using a cross-sectional, mixed methods design, we conducted an online survey with both closed and open-ended questions distributed to cardiac healthcare providers, working at the National University Hospital in Iceland. The survey consisted of 103 questions divided into 18 themes. Analysis included descriptive statistics of the participants' responses to closed responses with simplified scoring. Free-text responses were grouped into thematic categories and then into subthemes. Of 104 healthcare providers invited, 73 (70%) participated. Key factors identified as most beneficial for supporting MA included supportive patient-provider relationships (97%), selecting suitable drug formulation (96%), healthcare support at home (95%), and multi-dose dispensing from pharmacies (93%). The youngest and oldest HF patients were believed to be at the highest risk of medication non-adherence, particularly among males. Other patients estimated at increased risk included those with alcohol and/or substance abuse (89%), those with limited knowledge of medication effects (89%), those perceiving medication as useless (88%), and those with cognitive impairment (86%). Most participants (73%) agreed that healthcare providers should assess and document MA in clinical care. These findings provide a comprehensive overview of factors that cardiac healthcare providers believe influence non-adherence in HF patients, contributing to the development of a HF-specific MA scale.

Open-source LLMs for text annotation: a practical guide for model setting and fine-tuning

This paper studies the performance of open-source Large Language Models (LLMs) in text classification tasks typical for political science research. By examining tasks like stance, topic, and relevance classification, we aim to guide scholars in making informed decisions about their use of LLMs for text analysis and to establish a baseline performance benchmark that demonstrates the models’ effectiveness. Specifically, we conduct an assessment of both zero-shot and fine-tuned LLMs across a range of text annotation tasks using news articles and tweets datasets. Our analysis shows that fine-tuning improves the performance of open-source LLMs, allowing them to match or even surpass zero-shot GPT-3.5 and GPT-4, though still lagging behind fine-tuned GPT-3.5. We further establish that fine-tuning is preferable to few-shot training with a relatively modest quantity of annotated text. Our findings show that fine-tuned open-source LLMs can be effectively deployed in a broad spectrum of text annotation applications. We provide a Python notebook facilitating the application of LLMs in text annotation for other researchers.

Defining the transition from new to normal: a qualitative investigation of the clinical change process

BackgroundUnderstanding how and when a new evidence-based clinical intervention becomes standard practice is crucial to ensure that healthcare is delivered in alignment with the most up-to-date knowledge. However, rigorous methods are needed to determine when a new clinical practice becomes normalized to the standard of care. To address this gap, this study qualitatively explores how, when, and why a clinical practice change becomes normalized within healthcare organizations.MethodsWe used purposive sampling to recruit clinical leaders who worked in quality improvement and/or implementation science in diverse health contexts. Enrolled participants completed semi-structured interviews around implementing evidence-based practices. Qualitative data was inductively and deductively analyzed, and was guided by a modified version of the Normalization Process Theory (NPT) framework to identify salient themes. Additionally, identified normalization strategies were mapped to the Expert Recommendations for Implementation Change (ERIC) project.ResultsA total of 17 individuals were interviewed. Two categories of themes emerged: 1) signals of when a new clinical practice is considered to be normalized within clinical care; and 2) strategies utilized to normalize new clinical innovations. Participants described four key signals for identifying when a novel clinical practice becomes the new normal: 1) integrated seamlessly into existing workflows; 2) scaled across the entire organizational unit; 3) has strong staff buy-in and ownership; and 4) no longer needs monitoring and evaluation to be sustained. Major strategies to normalize new clinical interventions included: 1) taking a patient approach that starts slow and gains momentum; 2) identifying and using methods to gain staff buy-in and ownership; and 3) conducting ongoing measurement of progress towards normalization.ConclusionsThe results offer valuable insight into the indicators that signify when a novel clinical practice becomes normalized, and the strategies employed to facilitate this transition. These findings can inform future research to develop instruments that implementation leaders can use to systematically measure the clinical change process.

Publicly Insured Hispanic Families' Perspectives on Well-Being and Challenges During the COVID-19 Pandemic.

Previous studies have identified negative impacts of the COVID-19 pandemic on the mental and physical health of children in the United States, including exacerbation of previously existing disparities according to income, race, and ethnicity. However, a knowledge gap exists regarding the experience of minority families who were disproportionately affected by the pandemic. This qualitative study explores publicly insured Hispanic families' experiences with school, physical, and sedentary activities and overall health and well-being during the pandemic and subsequent lifting of stay-at-home orders. Fourteen (7 Spanish-speaking, 7 English-speaking) caregivers participated in semi-structured, language-concordant telephone interviews. Through an iterative coding process, this study identified 3 thematic categories: (1) challenges with virtual learning, (2) changes in children's activity, and (3) resilience and silver linings. Minority populations suffered substantial morbidity and mortality in the United States, and so their experiences are critical as we document the significant impacts of the global pandemic on underserved populations.

“What Made Me Change”: Transformative Experiences in the Jihadist Radicalization Process

ABSTRACT Disentangling the roots of radicalization leading to violence is a worldwide challenge. Unfortunately, empirical data are scarce. Through fieldwork conducting interviews with Muslim persons deprived of liberty (PDL) in Spanish prisons, this research examines transformative experiences that may have influenced radicalization leading to violence from the 3N model and the life-course perspective lenses. PDL because of jihadist terrorism (n = 30), common criminals who carry out proselytizing work (n = 22), and non-radicals (control group, n = 64) were asked about the turning point in their lives. Their responses were coded into exclusive thematic categories following an inductive-deductive mixed approach. Jihadists and proselytizers identified experiences linking their personal identity to religion—ideological ties—as a transformative point that provided them purpose and sparked the desire for leaving their criminal lifestyle behind. Also, proselytizers referred to family-related experiences—familial ties—as a turning point which also prompted them to criminal desistance, whereas this was not mentioned by jihadists. All groups had in common the experience of incarceration as a major turning point and a moderate level of self-reported religiosity. Overall, these findings contribute to the understanding and prevention of jihadist radicalization.

Performance of large language models in the National Dental Licensing Examination in China: a comparative analysis of ChatGPT, GPT-4, and New Bing.

The objective of the present study was to investigate the clinical understanding and reasoning abilities of large language models (LLMs); namely, ChatGPT, GPT-4, and New Bing, by evaluating their performance in the NDLE (National Dental Licensing Examination) in China. Questions from the NDLE from 2020 to 2022 were selected based on subject weightings. Standardized prompts were utilized to regulate the output of LLMs for acquiring more precise answers. The performance of each model across each subject category and for the subjects overall was analyzed employing the McNemar's test. The percentage scores obtained by ChatGPT, GPT-4, and New Bing were 42.6% (138/324), 63.0% (204/324), and 72.5% (235/324), respectively. Significant variance was seen between the performance of New Bing compared with ChatGPT and GPT-4. GPT-4 and New Bing outperformed ChatGPT across all subjects, with New Bing surpassing GPT-4 in most subjects. GPT-4 and New Bing exhibited promising capabilities in the NDLE. However, their performance in specific subjects such as prosthodontics and oral and maxillofacial surgery requires improvement. This performance gap can be attributed to limited dental training data and the inherent complexity of these subjects.

Enti ecclesiastici e Tassa comunale sui rifiuti nella recente normativa e giurisprudenza nazionale

The taxation of ecclesiastical bodies for waste tax in the recent national law and jurisprudence ABSTRACT: The heterogeneity of activities that can take place in properties owned by ecclesiastical entities raises questions of considerable systemic and tax relevance. This is probably related to the uncertainty surrounding the notion of ecclesiastical bodies, so much so that it has always occupied a prominent place in the reflections of ecclesiastical doctrine. In this regard, it is important to point out how the notion of ecclesiastical bodies indicates a category proper to the state system and not to the canonical system such that, in addition to the widespread Catholic entities, it also concerns those of different cults, so that no disparity of treatment or undue favor towards any particular denomination is configured. From a tax-law perspective, the subjective category of ecclesiastical entities does not identify a monolithic legal species of the subjective category of non-commercial entities under Article 73, paragraph 1(c) of the TUIR, as evidenced by the existence of a articulated and complex regulatory framework. With reference to this aspect, it looms interesting to examine the discipline concerning the waste tax for the ecclesiastical bodies in the light of concrete application. SOMMARIO: 1. Introduzione - 2. Brevi considerazioni sull’esordio e la nature giuridica della TARI - 3. La Convenzione tra Italia e Santa Sede in materia di scambio di informazioni fiscali - 4. Il percorso argomentativo seguito dalla giurisprudenza di Cassazione in tema di esenzione ai fini TARI per gli enti ecclesiastici - 5. Notazioni conclusive

Factors Influencing School‐Based Mental Health Program Selection: Insights From Educational Stakeholders

ABSTRACTSchool mental health programs are an important component of the national response to the current student mental health crisis. However, evidence‐based programs often face numerous barriers to their selection, scale‐up, and sustainability in real‐world settings. In this study, we interviewed 15 educational stakeholders to examine what influences their selection of school‐based mental health programs. Interviews focused on factors influencing the selection and sustainability of mental health programs in schools. We coded transcribed interview data using a hybrid, iterative process, and generated themes from these codes. We identified five categories of themes related to key decision‐making criteria: program fit with student and school needs, evidence of program effectiveness, stakeholder buy‐in, logistical considerations for staff delivering programs, and cost and resource requirements. Findings have implications for researchers who wish to improve dissemination strategies for school‐based mental health prevention programs and for policymakers who wish to shape funding priorities to support greater diversity in program availability. Findings are also useful to practitioners who may use these insights to reflect on their own program selection practices or may see their own experiences reflected and normalized through the lens of the key themes presented here.

Patterns of proximity and maternal-infant engagement in a neonatal intensive care unit.

Mother-infant relationship development is influenced by maternal presence, proximity, and the frequency and duration of engagement. Proximity and dyadic engagement can be challenging when an infant is hospitalized in a neonatal intensive care unit (NICU). This study examined patterns of maternal proximity and engagement in a NICU in the Southwestern United States and identified thematic categories of alternate activities to engagement. Trained observers conducted 52h of NICU observations, documenting maternal presence, patterns of proximity, engagement, nonengagement, and alternate activities to nonengagement and focused engagement. Results include data from 88 mother-infant dyads. Of the time mothers were in proximity to their infants, 83% of these instances occurred without active engagement. In contrast, focused dyadic engagement was noted in 97% of these observations, while unfocused engagement was recorded in 65% of instances. Mothers in proximity but not actively engaged were most often observed using a smartphone, a trend that was also observed when mothers were in unfocused engagement during nurturing social contexts. While it is expected that occasional interruptions to mother-infant interaction in the NICU will occur, more studies are needed to determine the implications of both brief and prolonged disruptions during dyadic interactions on interaction quality in the NICU.

Automated Text Analysis in Theology: An Application

ABSTRACT This article examines the use of NLP methods in theology. We analyzed a corpus of 37 homilies written by Josemaría Escrivá, a Spanish priest who founded the Catholic Church institution “Opus Dei”. We assumed no prior knowledge of Escrivá and used automated text analysis methods like topic categorization, machine learning algorithms, and network science to examine his presentation of Christ as the center of creation and Christian existence. Our results match the findings of previous studies by numerous Escrivá scholars. We discuss opportunities and risks of incorporating NLP methods into theological research.

Population censuses and identity politics in the Republic of Croatia

ABSTRACT This article explores the interrelation between the construction of ethnonational nomenclatures in population censuses and identity politics in the construction and representation of the ‘nation’ through the lens of ‘statistical objectivity’. Population census in the context of national identification and nation-building can be seen as a discursive practice. Through its performative effect, it objectifies the ethnonational nomenclature of the census and differentiating the social body into different identity categories through the effect of numbers, producing seemingly homogeneous ethnicised collectives in the public space. The politicization of the population census process is investigated by analysing the ambivalences in the individual-collective relations during the objectification of subjective categories of belonging, as well as by analysing the conceptualization and operationalization of these categories. The categories used in censuses and the methods employed in population censuses conducted after Croatia’s independence in 2001, 2011, and 2021 are analysed and compared.

Examining the Use of Virtual Reality to Support Mindfulness Skills Practice in Mood and Anxiety Disorders: Mixed Methods Study.

Virtual reality (VR) has been proposed as a technology to support mindfulness practice through promoting increased engagement and presence. The proposed benefits of this technology have been largely unexamined with clinical populations. Further research is required to understand its clinical potential and utility in improving and managing mental health symptoms. This study aims to investigate the proximal impacts of a single, brief, VR-supported mindfulness practice for individuals with a mood or anxiety disorder and to understand user experiences, which may affect the acceptability and efficacy of VR mindfulness for this population. This mixed methods study recruited 28 participants with a primary diagnosis of major depressive disorder, bipolar disorder, or anxiety disorder. Participants completed a mindfulness practice wearing a VR headset that was presenting an omnidirectional video of a forest scene, which was overlaid with a guided audio voiceover. Before and after the practice, measures were completed assessing state mindfulness (Toronto Mindfulness Scale), affect (Positive and Negative Affect Schedule), and anxiety (State-Trait Anxiety Inventory Y-1; n=27). Semistructured interviews were then held inquiring about the user experience and were analyzed using thematic analysis (n=24). After completing the VR-supported mindfulness practice, both measures of state mindfulness on the Toronto Mindfulness Scale, mean curiosity and decentering, increased significantly (Cohen d=1.3 and 1.51, respectively; P<.001). Negative affect on the Positive and Negative Affect Schedule (Cohen d=0.62; P=.003) and State-Trait Anxiety Inventory Y-1 state anxiety (Cohen d=0.84; P<.001) significantly reduced. There was no significant change in positive affect (Cohen d=0.29; P=.08). Qualitative analysis of interviews identified 14 themes across 5 primary theme categories. The results suggested that being mindful during the use of the app was experienced as relatively effortless because of the visual and immersive elements. It was also experienced as convenient and safe, including when compared with prior traditional experiences of mindfulness. Participants also identified the uses for VR-supported mindfulness in managing emotions and symptoms of mental illness. The results provide preliminary evidence that VR-supported mindfulness can improve emotional states and manage mental health symptoms for those with mood or anxiety disorders. It offers some potential clinical applications for those with mood or anxiety disorders for exploration within future research.

Exploring Thematic Diversity in Classical Chinese Poetry: A Novel Dataset and a BERT-Enhanced Ensemble Learning Approach

Classical Chinese poetry, as an essential aspect of cultural heritage, exhibits rich theme diversity often overlooked in natural language processing research. To address this gap, we aim to explore the classification of thematic categories within this literary domain. We curate a dataset of 2,918 annotated poems spanning 7 common themes and propose a BERT-based ensemble learning approach for effective classification. Although this method integrates existing models, it achieves an accuracy and F1 score of over 72% in the 7-class task, surpassing established baselines, and providing a baseline for future research. The experimental findings reveal the effectiveness of ensemble strategies in improving individual base model performance and highlight the potential of the MLP-based ensemble technique. The study contributes to a deeper understanding of thematic categories and textual features in classical Chinese poetry and offers an automated classification system for classical Chinese poems.

It’s Risky Out Where We Are: Exploring Intersectional Factors of Intentional Overdose Among People Who Use Drugs in Regional Queensland, Australia

Objective Globally, drug-related deaths impact both urban and non-urban areas. In Australia, regional areas face a concerning rise in drug-induced fatalities and suicides, exacerbated by structural factors like limited services and stigma. We sought to explore the experiences of people who use drugs (PWUDs) in regional Queensland to understand the structural vulnerabilities influencing drug-induced deaths. Methods The sample comprised 19 PWUDs from regional Queensland, Australia who had experienced overdose. Semi-structured interviews explored participants’ overdose experiences and contributing factors, focusing on regionality. Iterative coding was used to develop thematic categories. Results Participants highlighted the complex interplay of trauma, coping and drug use influencing overdose dynamics. Regional challenges, including limited access to support services, exacerbate risks for PWUDs. Structural inequalities perpetuate cycles of harm, with rural areas disproportionately affected. Participants emphasized the need for systemic changes to facilitate effective suicide prevention efforts, advocating for enhanced service engagement and legislative reforms. Conclusions These findings challenge systemic factors such as stigma and healthcare accessibility, which appear to be driving drug-related harm. Based on the findings, recommendations are made for systemic change, represented by comprehensive, community-driven interventions to address structural inequalities, and improve access to support services.

The intercultural caring-coping patterns of disaster-displaced families in temporary shelters

This integrative research review sought to explore the concepts of caring and coping in the context of the disaster-displacement phenomenon. It intended to describe and characterize the process of human flourishing amidst crisis through the caring and coping experiences of people living temporarily in emergency shelters after having been forcefully displaced following a devastating disaster event. This review adopted the 11-step method introduced by Tawfik and his colleagues in 2019. Three databases were utilized which included CINAHL, PubMed, and ProQuest. Papers needed to be published in English, with full-text availability for their inclusion. A total of 16 references met the inclusion criteria for the final review. To construct a logical and coherent integration of the important points, four categories of themes were developed: i) disaster impacts on daily life patterns and cultural lifeways; ii) caring patterns during disaster displacement; iii) coping patterns during disaster displacement; and iv) cultural learnings for disaster-based practitioners. It was noted that despite the challenges of crises, disaster victims often recover naturally and return to their previous levels of functioning. Resilient caring-coping mechanisms enable people to flourish in adversity, with culture and traditions playing a vital role in shaping their adjustment and adaptation to current circumstances.

The Importance Of Accounting Transparency In Public Management For The Strengthening Of Social Control

Background: Transparency in public accounting is essential to promote trust in institutions, ensure the efficient management of resources, and allow society to participate in social control. In Brazil, regulations such as the Fiscal Responsibility Law (LRF) and the Access to Information Law (LAI) have sought to strengthen accountability in public administration. However, challenges such as cultural resistance and low popular participation still hinder the effectiveness of these initiatives. Materials and Methods: This study is characterized as a bibliographic review, with consultation of academic publications and legal regulations available on the Google Scholar platform. Search terms such as "transparency in public accounting", "governance", "accountability" and "social control" were used. In addition, normative documents were analyzed, such as the Federal Constitution of 1988 (art. 37), the LRF and the LAI, with the objective of understanding how these norms contribute to promoting a more transparent public administration. The content analysis technique was used to organize the data into thematic categories: governance and accountability, transparency and ICTs, and social control. Results: The results indicate that, although transparency in Brazilian public administration has advanced, cultural resistance within public organizations limits the full adoption of accountability practices. Information and Communication Technologies (ICTs), such as the Managerial Treasury (TG) and SIAFI, have facilitated access to financial information, but insufficient training of public servants compromises their effectiveness. In addition, factors such as civic education and social engagement were identified as determinants for transparency to translate into effective social control. Conclusion: It is concluded that transparency and accountability are fundamental to strengthen public governance. However, a joint effort is needed involving cultural transformation, continuous training of civil servants and civic education, to encourage the active participation of society and ensure the effective use of digital tools. The integration between regulations, technology, and cultural change is essential to consolidate

Essential competencies required of nurse managers in times of COVID-19: A scoping review.

To identify the essential competencies required of nurse managers in healthcare services during the COVID-19 pandemic. Nurse managers play a vital role in healthcare services organization, requiring a diverse set of competencies. The increasing occurrence of epidemics in recent decades underscores the importance of understanding these competencies in pivotal junctures. The challenges faced during the COVID-19 pandemic present valuable opportunities to recognize the competencies of nurse managers and guide their responsiveness in addressing future health crises. A scoping review following the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines was conducted. A comprehensive search was conducted across six databases (LILACS, BDENF, EMBASE, MEDLINE, SCOPUS, and Web of Science). Results were categorized according to the nurse manager competencies model by the American Organization for Nursing Leadership and were analyzed using the competing values framework model. Out of 2033 potentially relevant sources identified, 17 studies met inclusion criteria. A total of 52 competencies were identified and categorized into four thematic categories: (1) the ability to collaborate in times of crisis; (2) maintaining control during a crisis; (3) adapting to changes caused by the crisis; and (4) preserving competitiveness through the crisis. The findings highlight communication, decision-making, training, adaptability to change, and leadership as essential competencies required of nurse managers to address crises, such as pandemics. This body of knowledge can serve as a reference point to enhance the response of nurse managers in the face of future health crisis scenarios. Additionally, it can serve as a framework for healthcare organizations to develop or improve their crisis management training programs.

“The World Isn't Black and White”: Adolescent Youth of Color Reflect on School Ethnic‐Racial Climate, Context, and Identity in Middle School

ABSTRACTContemporary scholars of race contend that the long‐heralded “American Dream” rhetoric continues to thrive within the ideology of colorblindness, whereby race is deemed insignificant. Public schools are not insulated from this, and recent political assaults the teaching of “divisive” concepts have already had a chilling effect on classroom content, posing a threat to the affirmation of racially marginalized students. Using qualitative interviews, we examined the salience of ethnicity‐race and ethnic‐racial identity for students of varied ethnic‐racial groups (n = 22) in a middle school community that was ethno‐racially diverse, but where White students constituted a large segment of the population. Guided by critical race theory (CRT) and phenomenological variant of ecological systems theory (PVEST), our analyses generated five thematic categories upon which ethnicity‐race were relevant to students: learning and appreciation for diversity, ethnic‐racial identity, teacher behaviors, student treatment, and same‐race peer connections and support. Findings are discussed in terms of implications for teachers and counselors to stand in solidarity with youth in challenging hegemonic whiteness in schools.

From Mine Waste to Construction Materials: A Bibliometric Analysis of Mining Waste Recovery and Tailing Utilization in Construction

This article presents a comprehensive scientometric analysis of mining waste valorization, focusing on tailings utilization in construction materials from 2010 to 2024. Through examination of 1096 Web of Science publications and utilizing CiteSpace mapping and network analyses, we analyze the intellectual structure of this field. Subject category analysis reveals materials science, construction technology, and environmental engineering as the dominant disciplines, interconnected through 168 links across 64 thematic nodes. Our co-citation analysis identifies 12 major research clusters, with materials science and environmental engineering serving as primary disciplinary pillars. Keyword co-occurrence analysis of 532 nodes connected by 1181 links highlights the field’s emphasis on fly ash, concrete applications, and mechanical properties. Recent citation bursts indicate growing research focus on thermal stability, heavy metal treatment, and innovative processing methods. Through synthesizing these scientometric indicators, this review provides strategic insights for advancing sustainable construction practices through mining waste utilization. Research gaps identified include long-term durability assessment, standardization needs, and scalability challenges. By synthesizing these diverse scientometric indicators, this review provides strategic insights for researchers, industry practitioners, and policymakers, contributing to the advancement of sustainable construction practices through mining waste utilization.

”Decolonization“ discourse in anti-russian telegram channels aimed at north Caucasus (a content analysis)

In recent years social media has turned out to be a new way of controlling minds of people and forming the way they view the world. North Caucasus has always been a complex multi-ethnic and multi-religious region. Territorial disputes and old (but not forgotten) conflicts make North Caucasus easy to try manipulating to stir it away from Russia. The idea of ”decolonization“ of Russia has resurfaced again after the Special military operation. The article presents an analysis of Telegram channels which are connected by anti-Russian rhetoric, promote “decolonization” and are focused on North Caucasus. The social graph method is used to create visual representation of the network of channels and connections between them. The quantitative content analysis method was used to analyze the text. We were able to identify five main thematic categories: “Special military operation in Ukraine”, “Islam”, “pan-Caucasian identity”, “history”, “genocide of the peoples of the North Caucasus”. The main purpose of these publications is to create a negative image of Russia, as well as to create an image of the oppressed North Caucasus colonized peoples. The level of influence of these posts on the real population of the region is the main question. We suggest that there are several information spaces: internal regional (news channels and local bloggers) and external (all the anti-Russian channels). It will be possible to talk about their merger only in two cases: if permanent connections emerge between them or if the thematic content of publications becomes sufficiently similar.