Diary Entry Research Articles

Exploring College-Aged Student Anxiety: Aggravating Factors and Coping Strategies

<i>Undergraduate college-aged students are increasingly experiencing anxiety. Yet, many struggle to cope effectively, resulting in poor school performance and compromised health and well-being. Our goal was to identify common anxiety-inducing and aggravating stressors, as well as preferred adaptive coping strategies, in this exploratory study to inform anxiety intervention development. A total of 19 undergraduate students (17 female and 2 male) were recruited. Students previously diagnosed or treated for anxiety by a clinician participated in a two-week, daily diary entry study. A total of 219 diary entries were transcribed and thematically analyzed for student reports of awareness variables and associated coping responses. Data were compared and triangulated. Framed by cognitive-behavioral approaches to anxiety and the transactional theory of stress and coping, we identified five primary categories of anxiety-inducing or aggravating stressors: academic time management and performance, communication anxiety, competing life stressors, others’ presence and problems, and </i><i>generalized uncertainty. In addition, we found that students primarily utilized adaptive coping strategies, employing a mix of intrapersonal (e.g., alone time, breaks, hobbies/music, and staying productive) and interpersonal techniques (e.g., hanging out with and talking with friends and family). Findings highlight common anxiety stressors and demonstrate preferred and efficacious coping strategies employed by students, providing valuable insight into best practices for student well-being interventions beyond a clinical setting to manage anxiety and improve student well-being.</i>

High precision in epileptic seizure self-reporting with an app diary

People with epilepsy frequently under- or inaccurately report their seizures, which poses a challenge for evaluating their treatment. The introduction of epilepsy health apps provides a novel approach that could improve seizure documentation. This study assessed the documentation performance of an app-based seizure diary and a conventional paper seizure diary. At two tertiary epilepsy centers patients were asked to use one of two offered methods to report their seizures (paper or app diary) during their stay in the epilepsy monitoring unit. The performances of both methods were assessed based on the gold standard of video-EEG annotations. In total 89 adults (54 paper and 35 app users) with focal epilepsy were included in the analysis, of which 58 (33 paper and 25 app users) experienced at least one seizure and made at least one seizure diary entry. We observed a high precision of 85.7% for the app group, whereas the paper group’s precision was lower due to overreporting (66.9%). Sensitivity was similar for both methods. Our findings imply that performance of seizure self-reporting is patient-dependent but is more precise for patients who are willing to use digital apps. This may be relevant for treatment decisions and future clinical trial design.

Columns: Telescopes: Possibilities in YAL: The Misadventures of an Accidental Boob Tap

Queer author and illustrator Laura Gao recounts how a mortifying diary entry spins into a meaningful school visit.

Capturing the perspectives of African American informal dementia caregivers: a phenomenological study

ABSTRACT Dementia can be overwhelming to families and their caregivers. Informal caregiving is a widespread mode of providing dementia care in African American communities, yet impact of caregiving on informal or family caregivers in African American communities is burdensome. This study aimed to describe the lived experiences of informal caregivers of African American People Living with Dementia (PLWD) to understand their perceptions of dementia and dementia care, caregiver support needs, and service needs. Interpretive phenomenological qualitative inquiry guided this study to understand caregivers’ experiences and needs. Ten family caregivers of African American PLWD in the community participated in this study. Data were collected through in-depth interviews and a diary study approach to document and interpret caregivers’ experiences. The data analysis was based on procedures of content analysis. Four major themes emerged from the in-depth interviews: caregiver burden, familism, lack of information and community-based resources, and desire and need for culturally appropriate community-based resources. Triangulated diary entry data complemented the in-depth interviews with similar themes. This study highlights how African American informal caregivers of PLWD face various caregiving needs and challenges in dementia care including lack of culturally appropriate community resources and information. The study illustrates that African American cultural beliefs of familism are significant aspects of their caregiving experience and their coping strategies. These study results provide a useful foundation for various stakeholders to develop culturally targeted interventions and programs to support African American informal caregivers and their family members with dementia.

Attention-deficit/hyperactivity disorder is associated with more alcohol problems and less substance-free reinforcement: A behavioral economics daily diary study of college student drinkers.

Behavioral economic theory suggests that alcohol risk is related to elevated alcohol reinforcing efficacy (demand) combined with diminished availability of reinforcing substance-free activities, but little research has examined these reward-related processes at the daily level in association with comorbid conditions that might influence behavioral patterns and reward. Young people with attention-deficit/hyperactivity disorder (ADHD) report high levels of risky drinking, and this risk may be due in part to elevated demand for alcohol and diminished engagement in enjoyable and valued substance-free activities. College student drinkers (N = 101; 48.5% female; 68.3% White; 18-22 years old) with (n = 51) and without (n = 50) ADHD completed 14 consecutive daily diaries (diary entry n = 1,414). We conducted a series of multilevel path models to examine (a) the associations among ADHD and average daily alcohol demand, substance-free enjoyment, and response contingent positive reinforcement (RCPR) for goal-directed behaviors; (b) the associations among concurrent daily alcohol demand, substance-free reinforcement, and RCPR for goal-directed behaviors and daily alcohol use and alcohol-related negative consequences; and (c) the moderating effect of ADHD on these within-day associations. ADHD was significantly associated with more daily alcohol-related negative consequences and less daily substance-free enjoyment and RCPR. Regardless of ADHD status, there were significant associations among behavioral economic risk factors and alcohol use and negative consequences, though effects differed within and between persons. There were no moderating effects of ADHD on within-person associations. Results expose areas of impairment specific to drinkers with ADHD and advance theory on ADHD and hazardous drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Long-term seizure diary tracking habits in clinical studies: Evidence from the Human Epilepsy Project

ObjectiveTo characterize seizure tracking patterns of people with focal epilepsy using electronic seizure diary entries, and to assess for risk factors associated with poor tracking. MethodsWe analyzed electronic seizure diary data from 410 participants with newly diagnosed focal epilepsy in the Human Epilepsy Project 1 (HEP1). Each participant was expected to record data each day during the study, regardless of seizure occurrence. The primary outcome of this post-hoc analysis was whether each participant properly tracked a seizure diary entry each day during their study participation. Using finite mixture modeling, we grouped patient tracking trajectories into data-driven clusters. Once defined, we used multinomial modeling to test for independent risk factors of tracking group membership. ResultsUsing over up to three years of daily seizure diary data per subject, we found four distinct seizure tracking groups: consistent, frequent at study onset, occasional, and rare. Participants in the consistent tracking group tracked a median of 92% (interquartile range, IQR: 82%, 99%) of expected days, compared to 47% (IQR:34%, 60%) in the frequent at study onset group, 37% (IQR: 26%, 49%) in the occasional group, and 9% (IQR: 3%, 15%) in the rare group. In multivariable analysis, consistent trackers had lower rates of seizure days per tracked year during their study participation, compared to other groups. SignificanceFuture efforts need to focus on improving seizure diary tracking adherence to improve quality of outcome data, particularly in those with higher seizure burden. In addition, accounting for missing data when using seizure diary data as a primary outcome is important in research trials. If not properly accounted for, total seizure burden may be underestimated and biased, skewing results of clinical trials.

Taking the plunge, juggling acts, and friendly fire

Students embarking on higher education confront many challenges. Particularly since the Covid-19 pandemic, universities have become increasingly concerned to address these challenges and to develop comprehensive strategies to nurture student wellbeing. Distance learning courses create additional pressures, however, and not only because online students tend to be older than typical undergraduate student cohorts and therefore present with an array of social and caring responsibilities at the point of enrolment. The present study’s objectives were to explore how distance learning students describe their experiences of online learning, with a particular focus on their engagement with their course, their lifestyle and wellbeing challenges, and their interactions with staff and fellow students. Developing Shinebourne and Smith’s (2010) innovative phenomenology coupled with experiential metaphor methodology, we employed a two-stage data collection methodology based on participant diaries and follow-up interviews. In Stage 1, diaries captured student experiences in real time. Diary entry data subsequently informed the schedules of the semi-structured interviews that followed in Stage 2. Metaphorical analysis provided insight into online students’ lifeworlds, in terms of the practical challenges of balancing roles with time pressures, the existential struggle of forging a new identity, and the search for meaningful interpersonal connections. Six inter-related metaphors were unearthed: ‘Plunging into the Deep’; ‘Impostor Syndrome’; ‘A Precariously Balanced Juggling Act’; ‘The Gift of Time’; ‘Hostile Territories and Friendly Fire’; and ‘House of Cards’. Confirming and extending previous work, our findings demonstrate that online distance learning is a journey of self-doubt and discovery interrupted by both traumatic and transformative moments as students strive to succeed against multiple existential threats. We recommend that universities devote resources to facilitating an understanding of online students’ unique circumstances to provide them with informed and effective wellbeing support at the start of and throughout their journeys.

Новое о Мандельштаме в Грузии

The article provides a detailed commentary on the first-ever publication in Russian of an entry from the diary of Georgian poet Galaktion Tabidze, dated October 31, 1930. This entry refers to Osip Mandelstam, Boris Pasternak, and the Georgian poetic group “The Blue Horns.” It reveals that Pasternak’s journey to Georgia in 1931 was conceived as early as the preceding year, 1930. Additionally, Tabidze’s diary entry contains crucial information about Mandelstam's attitude toward Pasternak in the late 1920s to early 1930s. Mandelstam perceived the invitation extended by Georgian poets to Pasternak to Tiflis as a personal offense. Finally, from this entry, one can understand why members of the “Blue Horns” group, particularly Titsian Tabidze, did not maintain contact with Mandelstam when he visited Georgia for the third time in his life in the autumn of 1930.

Kowalewski Apropos the Chinese Book “Ming Xin Bao Jian”: Following up a Diary Entry

This article examines the notes of the prominent Russian mongolist of Polish origin Józef Kowalewski (1801–1878) in his “Diary of studies for 1832”, the manuscript of which is kept in the Department of Manuscripts of the Vilnius University Library. This diary entry has been previously published several times in the form of a facsimile. It is an excerpt in English from the annotation on the Chinese book Ming xin bao jian (明心寶鑑, Precious Mirror for the Enlightenment of the Mind) from the Protestant missionary magazine published in Malacca. The article clarifies and significantly supplements the previously published commentary on this entry, defines The Indo-Chinese Gleaner magazine as the source of the English annotation and William Milne (1785–1822) as its author. It is assumed that J. Kowalewski’s acquaintance with W. Milne’s note had determined later choice of Ming xin bao jian as a Chinese language teaching material at The Imperial Kazan University. The very fact of choosing this book by a Protestant missionary to be presented as an important manual on the Chinese language and the traditional worldview of the Chinese is discussed. The conclusion is made that, formally remaining in opposition to the earlier Catholic missionary work, Protestant preachers in assessing Ming xin bao jian were in consent with their predecessors.

App-based intervention for parents of children with crying, sleeping, and feeding problems: Usability, usefulness and implications for improvement

BackgroundThere is a lack of evidence-based app guidance for parents of children with crying, sleeping, and feeding problems who are often highly burdened and not likely to seek professional help. A new psychoeducational app for parents providing scientifically sound information via text and videos, a diary function, selfcare strategies, a chat forum and a regional directory of specialized counseling centers may serve as a low-threshold intervention for this target group. ObjectiveWe investigated how parents perceived the app in terms of the following: (1) overall impression and usability, (2) feedback on specific app functions regarding usefulness and (3) possible future improvements. MethodsOur clinical sample of N = 137 parents of children aged from 0 to 24 months was recruited from a cry baby outpatient clinic in Southern Germany between 2019 and 2022. A convergent parallel mixed methods design was used to collect and analyse cross-sectional data on app evaluation. After app use within the framework of a clinical trial, parents filled in an app evaluation questionnaire. ResultsMost participants used the app at least once a week (86, 62.8 %) over an average period of 19.06 days (SD = 15.00). Participants rated overall impression and usability as good, and the informational texts, expert videos and regional register of counseling centers as appealing and useful. The diary function and chat forum were found to be helpful in theory, but improvements in implementation were requested, such as a timer function for the diary entry. Regarding future functionality, parents posed several suggestions such as the option to contact counseling centers directly via app, and the inclusion of the profile of their partners. ConclusionsPositive ratings of overall impression, usability, and specific app functions are important prerequisites for the app to be effective. App-based guidance for this target group should include easy-to-use information. The app is intended to serve as a secondary preventive low-threshold offer and to complement professional counseling.

‘Dance against the void’: Derek Jarman, dance, queer classical receptions

Abstract This article considers three moments from the beginning, middle and end of Derek Jarman’s artistic career: Lindsay Kemp’s opening dance in Sebastiane (1976), Jarman’s words on a performance by Michael Clark in the 1980s, and Jarman’s last film Blue (1993), while holding onto the affective registers of his final diary entry (1994). Considering the ways in which Jarman indexed the ephemeral myth-making processes of queer life and art, the author develops a new kinetic-temporal methodology for exploring reception based on the fleeting queer modalities of dance. As such this article makes a series of important connections between classical reception studies, queer theory, critical theory, and dance studies. It argues that, despite the fleeting, erotic, and partial engagements with the past offered by Jarman — which challenge ideas of fixity or lineage — an identification nevertheless emerges with the hierarchies of white supremacist imperialism.

The feasibility of using ecological momentary assessment to understand urinary and fecal incontinence experiences in adults with spina bifida: A 30-day study.

In this paper, we evaluate the feasibility of using ecological momentary assessment (EMA) to understand urinary (UI) and fecal (FI) incontinence in adults with spina bifida (SB). As part of a larger 30-day prospective study to understand the incontinence in adults with SB (N = 89), participants completed end-of-day EMA diaries assessing the frequency and context of UI and FI. We used these data to assess the method feasibility across six dimensions: (a) compliance, or data entry which is consistent with study protocol and substantially complete; (b) reactivity, or behavior change attributed to study participation; (c) participant acceptability, or convenience and ease of method beneficial to compliance; (d) data capture, or the volume of incontinence behaviors collected; (e) the accuracy of incontinence reports; and f) participant-provided feedback for future studies. Participants were highly compliant with diary entry protocol and schedule: submitting 95.7% (2576/2700) of the expected total daily entries. The average completion time was two minutes. Neither the total number of submissions nor the completion time varied by demographic characteristics or health history. A sufficient volume of incontinence and affective outcomes were captured, with small downtrends in reporting of UI and affect over time. Exit survey recall was highly correlated with diary reports. Participants found the methodology to be acceptable, reported their experiences honestly, enjoyed and felt comfortable participating in the study and would engage in similar study in the future. Accurate information about the daily context of UI and FI is a key factor in the success of intervention or education programs relying on this information. Our findings demonstrate that EMA is a feasible way to describe UI and FI in adults with SB.

A Novel System for the Device-Based Measurement of Physical Activity, Sedentary Behavior, and Sleep (Motus): Usability Evaluation.

Device-based measurements of physical behavior, using the current methods, place a large burden on participants. The Motus system could reduce this burden by removing the necessity for in-person meetings, replacing diaries written on paper with digital diaries, and increasing the automation of feedback generation. This study aims to describe the development of the Motus system and evaluate its potential to reduce participant burden in a two-phase usability evaluation. Motus was developed around (1) a thigh-worn accelerometer with Bluetooth data transfer; (2) a smartphone app containing an attachment guide, a digital diary, and facilitating automated data transfer; (3) a cloud infrastructure for data storage; (4) an analysis software to generate feedback for participants; and (5) a web-based app for administrators. We recruited 19 adults with a mean age of 45 (SD 11; range 27-63) years, of which 11 were female, to assist in the two-phase evaluation of Motus. A total of 7 participants evaluated the usability of mockups for a smartphone app in phase 1. Participants interacted with the app while thinking aloud, and any issues raised were classified as critical, serious, or minor by observers. This information was used to create an improved and functional smartphone app for evaluation in phase 2. A total of 12 participants completed a 7-day free-living measurement with Motus in phase 2. On day 1, participants attempted 20 system-related tasks under observation, including registration on the study web page, reading the information letter, downloading and navigating the smartphone app, attaching an accelerometer on the thigh, and completing a diary entry for both work and sleep hours. Task completion success and any issues encountered were noted by the observer. On completion of the 7-day measurement, participants provided a rating from 0 to 100 on the System Usability Scale and participated in a semistructured interview aimed at understanding their experience in more detail. The task completion rate for the 20 tasks was 100% for 13 tasks, >80% for 4 tasks, and <50% for 3 tasks. The average rating of system usability was 86 on a 0-100 scale. Thematic analysis indicated that participants perceived the system as easy to use and remember, and subjectively pleasing overall. Participants with shift work reported difficulty with entering sleep hours, and 66% (8/12) of the participants experienced slow data transfer between the app and the cloud infrastructure. Finally, a few participants desired a greater degree of detail in the generated feedback. Our two-phase usability evaluation indicated that the overall usability of the Motus system is high in free-living. Issues around the system's slow data transfer, participants with atypical work shifts, and the degree of automation and detail of generated feedback should be addressed in future iterations of the Motus system. RR2-10.2196/35697.

Internet Book Clubs

With over 252,000 subscribers as of July 2023, “Dracula Daily” has made newsletter-based internet book clubs a growing trend. Starting in 2021, artist Matt Kirkland decided to take advantage of the epistolatory nature of the beloved public domain novel Dracula to create an email newsletter that read the story in real time. On each day that Bram Stocker’s Dracula had a letter or diary entry dated, that section of the novel would be sent straight to subscribers’ emails, as if they were getting correspondence from Jonathan Harker himself (DraculaDaily 2023). While the first year had mild success, the 2022 read through became a viral internet sensation that inspired a wide variety of art, memes, and spinoffs (Connors 2022). Now in 2023, “Dracula Daily” is running its third year of reading Dracula in chronological order and has inspired a variety of different internet book clubs using the affordances of public domain to collectively read classical literature via email.

Хронотоп сельских картинок в «Легком дыхании»: Бунин – Жемчужников – Пушкин

The article is devoted to the study of the chronotope of Bunin’s story “Light Breathing” in connection with Bunin’s cosmogonic conceptual system, which includes ideas about the opposite processes of destruction and regeneration of the world, about breaking the whole into parts and simultaneous collecting the whole from the parts, where the parts are identical, a part is equal to the whole and vice versa. Similar relationships exist between space and time as two components of the chronotope, as well as between languages in a multilingual code, which Bunin used to expand the possibilities of textual deployment of the system. Two cycles of poems by A.M. Zhemchuzhnikov with the same names “Rural pictures and impressions” and the poem “Winter Morning” by A.S. Pushkin play an important role in the formation of the chronotope of the story. The intertext does not act as a collection of disparate references to the texts of predecessors, but represents a systematic formation. The use of the noted pretexts is not accidental: it is built into the Faustian code that connects the ideas about Faust and Fasts and is used by Bunin for the textual deployment of his cosmogonic-eschatological system. The temporal and spatial components of the chronotope as a whole undergo metamorphoses, which reveal the commonality of spatial and temporal characteristics. The space in the story is divided into urban and suburban (countryside); the latter includes the cemetery and the village. The spatial component of the chronotope is characterized by constant circular movements between them. A variety of textual and non-textual techniques contribute to the close identification of these loci, as well as more fractional loci of Olya Meshcherskaya’s rural walk. In a similar way, the circular movement of the annual year is combined with the emphasis on individual events of the story (summer events described in Olya Meshcherskaya’s diary entry, Olya’s conversation with the primary gymnasium, class lady at Olya’s grave). Each of them is identical to all the others and, consequently, to the whole year. The chronotope includes the city of Yelets, unnamed in the story, whose status in Bunin’s conceptual system simultaneously covers both urban and rural loci, and these loci themselves show a tendency to move into the world dimension.

Capturing dynamics in nursing: a diary study of nurses' job characteristics and ability and willingness to continue working.

This study aimed to gain insight into (1) the dynamics of job characteristics (demands and resources) of nurses and (2) how job characteristics relate to nurses' ability and willingness to continue working (understood as employability). Job characteristics are profession-specific and vary over time, but studies often overlook these dynamics. Moreover, job characteristics relate to nurses' employability, which is under pressure due to a rapidly changing work environment. It is necessary to gain insight into the dynamic job characteristics of nurses to develop targeted workplace interventions that help nurses remain employable. This study adopted a mixed methods diary approach, with a strong emphasis on qualitative analysis. 46 Nurses from two hospitals in a large Dutch city completed a structured diary at six points over 3 weeks, resulting in 225 diary entries in total. The nurses used a custom-made application on their mobile devices to describe in their own words what they experienced as demanding and resourceful throughout the shifts and how they experienced their employability. Prior to the diaries, nurses completed an intake survey. A within-person analysis highlighted the day-to-day dynamics in the nursing profession. The job characteristics a nurse mentioned in the first diary entry often were completely different from the job characteristics the same nurse mentioned in the other diary entries. This analysis also showed variety within nurses' employability, demonstrating that perceptions of employability vary over time. A between-person analysis highlighted links between job characteristics and nurses' employability: social interactions strengthen a nurse's employability, a strict task approach threatens it, and aspects such as a strong drive to care, professional development, and autonomy (clustered as aspects that enable to "act professionally") create opportunities to enhance employability. Insights from this study show that job characteristics typical to the nursing profession can be linked to nurses' perceptions of employability. Also, it stems from this research that not only job characteristics but also employability are dynamic in the short run. Understanding and enhancing employability in a nursing context requires capturing these dynamics, for instance by collecting data at several points in time or by using mixed-method studies to understand employability scores within their context.

Online sleep diaries: considerations for system development and recommendations for data management.

To present development considerations for online sleep diary systems that result in robust, interpretable, and reliable data; furthermore, to describe data management procedures to address common data entry errors that occur despite those considerations. The online sleep diary capture component of the Sleep Healthy Using the Internet (SHUTi) intervention has been designed to promote data integrity. Features include diary entry restrictions to limit retrospective bias, reminder prompts and data visualizations to support user engagement, and data validation checks to reduce data entry errors. Despite these features, data entry errors still occur. Data management procedures relying largely on programming syntax to minimize researcher effort and maximize reliability and replicability. Presumed data entry errors are identified where users are believed to have incorrectly selected a date or AM versus PM on the 12-hour clock. Following these corrections, diaries are identified that have unresolvable errors, like negative total sleep time. Using the example of one of our fully-powered, U.S. national SHUTi randomized controlled trials, we demonstrate the application of these procedures: of 45,598 total submitted diaries, 487 diaries (0.01%) required modification due to date and/or AM/PM errors and 27 diaries (<0.001%) were eliminated due to unresolvable errors. To secure the most complete and valid data from online sleep diary systems, it is critical to consider the design of the data collection system and to develop replicable processes to manage data. Sleep Healthy Using The Internet for Older Adult Sufferers of Insomnia and Sleeplessness (SHUTiOASIS); https://clinicaltrials.gov/ct2/show/NCT03213132; ClinicalTrials.gov ID: NCT03213132.

Experience and measurement of fatigue in adults with Crohn’s disease: results from qualitative interviews and a longitudinal 2-week daily diary pilot study

BackgroundFatigue has a detrimental impact on health-related quality of life and functioning in patients with Crohn’s disease (CD). We aimed to confirm the relevance and importance of fatigue, establish the content validity of the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), qualitatively explore meaningful change in fatigue experience, and assess the measurement properties of the FACIT-F in patients with moderate-to-severe CD.MethodsThis was a mixed-methods observational study consisting of a cross-sectional qualitative interview (Part A) and a longitudinal 2-week daily diary pilot study (Part B) in participants aged ≥ 18 years with a clinical diagnosis of moderate-to-severe CD. Part A included open-ended questions related to the participant’s overall experiences with CD, fatigue, and impact on daily activities and a cognitive debriefing of several patient-reported outcomes (PROs), including the FACIT-F. Part B consisted of participants completing an electronic daily diary that included the FACIT-F and other PROs for 14 days. Item performance, test–retest reliability, and construct validity were assessed at baseline (Day 1), Day 7, and Day 14.ResultsThirty-five participants (mean age 45.1 years; 65.7% female) completed an interview (Part A). Ninety-one percent of the interview participants reported fatigue as a symptom attributed to CD. Participants indicated that fatigue had a major impact on their daily activities (e.g., recreation/ hobbies, work/school, yard work and housework), social activities, and emotional health. The FACIT-F was well understood by the interview participants.Seventy-six participants (mean age 41.9 years; 66% female) completed at least the Day 1 diary entry (Part B). Potential floor and ceiling effects were observed for several FACIT-F items, but test–retest reliability and construct validity were all strong and within the ranges hypothesized a priori.ConclusionsThe interviews indicate that fatigue is a frequent and bothersome symptom experienced by most patients with moderate-to-severe CD and support the content validity of the FACIT-F in this population. Daily diary study results indicate that the FACIT-F scale demonstrates adequate reliability and validity among patients with CD. These study findings suggest that the FACIT-F would be a reliable, valid, and useful measure of fatigue in patients with moderate-to-severe CD.

Heart rate responses in critical care trainees during airway intubation: a comparison between the simulated and clinical environments

ObjectiveThis study aimed to compare the heart rate response to stress during airway intubations in clinical practice and a simulated environment.MethodsTwenty-five critical care registrars participated in the study over a 3-month period. Heart rate data during intubations was recorded by a FitBit® Charge 2 worn by each participant during their clinical practice, and during a single simulated airway management scenario. The heart rate range was calculated by subtracting the baseline working heart rate (BWHR) from the maximum functional heart rate (MFHR). For each airway intubation performed participants recorded an airway diary entry. Data from intubations performed in the clinical environment was compared to data from a simulated environment. Heart rate changes were observed in two ways: percentage rise (median) across the 20-min intubation period and; percentage rise at point of intubation (median).ResultsEighteen critical care registrars completed the study, mean age 31.8 years (SD = 2.015, 95% CI = 30.85–32.71). Throughout the 20-min peri-intubation recording period there was no significant difference in the median change in heart rates between the clinical (14.72%) and simulation (15.96%) environment (p = 0.149). At the point of intubation there was no significant difference in the median change in heart rate between the clinical (16.03%) and the simulation (25.65%) environment groups (p = 0.054).ConclusionIn this small population of critical care trainees, a simulation scenario induced a comparable heart rate response to the clinical environment during intubation. This provides evidence that simulation scenarios are able to induce a comparable physiological stress response to the clinical environment and thus facilitates effective teaching of a high-risk procedure in a safe manner.

Dialogue of the forever living (diary entries of Oleksandr Dovzhenko and Yevhen Sverstiuk in the context of the 20th – 21st centuries)

In the proposed philosophical-Ukrainian studies, and therefore – literary studies as an integral part of Ukrainian studies, the study examines the understanding of the deep beginnings of the tragic history of Ukraine and Ukrainianism. The constant principles of the spiritual-intellectual and all-time-essential Resistance defined by him in the totalitarian realities of the 1930s–50s, which were unprecedentedly cruel to Ukrainians, are outlined. The phenomenon of O. Dovzhenko as a visible confirmation of such Ukrainian spiritual-intellectual and material Resistance is undeniable. Philosophical and Ukrainian studies and reflections of Ye. Sverstiuk, in which the phenomenon of O. Dovzhenko’s resistance to the foreign Ukrainian identity of the reality of Moscow-communist totalitarianism is thoroughly and uncommittedly studied, is a visible testimony of this. In the same way, Dovzhenko’s memories-visions-reflections, which are studied in this studio, are prognostic-perspective for Ukraine and Ukrainianness. Dovzhenko’s diary visions – «dreams» often not only stated the Ukrainian realities of the occupation-imperial context, but also worldview and artistically preceded the works of world-famous creators of dystopias such as George Orwell with the dystopia novel «1984» written in 1949. Dovzhenko’s «Dream», recorded in a diary entry dated August 16, 1945, is not only a direct reference to Shevchenko’s classic poem «Dream», in which the axiological philosophy of «dreams and dreams» was manifested on a large scale long before Z. Freud, but is dystopian in by its nature. The phenomenon of Dovzhenko as a transcendental artist-thinker who overcomes the borders and transience of eras can be traced in the proposed studio in view of his perspective worldview and worldview. Ye. Sverstiuk’s ideas, revealed in his diary entries published in 2018 under the telling title «Eternal Longing for the Real», not only comprehensively update O. Dovzhenko worldview and poetic universals, but also excavate their meaning in the still-unexplored expanse of Ukrainian studies. The dialogue between O. Dovzhenko and Ye. Sverstiuk continues, and the contextually determined remarks in this dialogue are, at first glance, unexpected statements from the memoirs of the Ukrainian state-builder, historian, minister of foreign affairs of the Hetmanate era, D. Doroshenko, and, quite unexpectedly, a letter from a friend of A. Tolstoy, the author of the novel «Peter the First» by A. Radin, dated 1933, in which he testifies that only participation in the productions of the then half-repressed Ukrainian director Les Kurbas in Moscow theaters can save the theatrical life of Russia. This cultural context is also a powerful and still unexplained universe of continued dialogue between the eternally living. But also in this dialogue of the eternally living Poets – artists-thinkers of the 20th century – V. Svidzinskyi and V. Symonenko participate. Their conceptual visions are immanently consonant with the comprehensive Ukrainian-centric and Ukrainian-scientific creative semiospheres of O. Dovzhenko and Ye. Sverstiuk.