Mobilization Strategies Research Articles

Revisiting Neolithic Ali Kosh: New Insights into Settlement Sustainability, Human Mobility, and Subsistence Strategies

ABSTRACT In western Asia, the Zagros foothills played a fundamental role in the formulation of early explanatory hypotheses on the origins of agriculture. The excavations at the emblematic Neolithic site of Ali Kosh, Deh Luran, led to the development of the so-called “marginal zone hypothesis.” However, some chronological inconsistencies remained until a new stratigraphic excavation was carried out in 2017 to revise the findings. According to the new evaluation, Ali Kosh was occupied from ca. 7500–6500 cal b.c. During the Boz Mordeh phase (ca. 7500–7350 b.c.), the inhabitants occupied the site seasonally, but they became increasingly sedentary in the succeeding Ali Kosh phase (ca. 7350–7000 b.c.). In addition to obsidian, they also imported beads of stone and sea shell. Moreover, they increasingly relied on herding sheep and fully domesticated goats. The emergence of Neolithic life in the lowlands was a direct consequence of cultural changes in the central Zagros. It is not yet known whether this was a result of climatic deterioration or population pressure in the highlands.

GIFTS: Geriatric Intensive Functional Therapy Sessions-for the older trauma patient.

Considering resources for comprehensive geriatric care, it would be beneficial for geriatric trauma patients (GTPs) and medical patients to be comanaged in one program focusing on ancillary therapeutics (AT): physical therapy, occupational therapy, speech language pathology, respiratory therapy, and sleep wake hygiene. This pilot study describes outcomes of GTPs in a hospital-wide program focused on geriatric-specific AT. Geriatric trauma patients and geriatric patients were screened by program coordinator for enrollment at one Level II trauma center from August 2021 to December 2022. Enrolled patients (EPs) were admitted to trauma or medicine floors and received repetitive AT with attention to sleep wake hygiene throughout hospitalization and compared with similar nonenrolled patients (NEPs). Excluded patients had any of the following: indication of geriatric syndrome with a fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) score of 5, no frailty with a FRAIL score of 0, comfort focused plans, or arrived from skilled care. Retrospective chart review of demographics and outcomes was completed for both EPs and NEPs. A total of 224 EPs (28 trauma [TR]) were compared with 574 NEPs (148 TR). Enrolled patients showed shorter length of stay (mean, 3.8 vs. 6.1; p = 0.0001), less delirium (3.1% vs. 9.6%, p = 0.00222), less time to ambulation (13 hours vs. 39 hours, p = 0.0005), and higher likelihood to discharge home (56% vs. 27%, p < 0.0001) as compared with NEPs. The median FRAIL score was 3 for both groups. Enrolled medical patients ambulated the soonest at 11 average hours, compared with 23 hours for enrolled trauma patients and 39 hours for NEPs. There were zero delirium events among enrolled trauma patients; 25% was found among nonenrolled trauma patients ( p = 0.00288). Despite a small trauma cohort, results support feasibility to include GTPs in hospital-wide programs with geriatric-specific AT. Mobility and cognitive strategies may improve opportunities to avoid delirium, decrease length of stay, and influence more frequent disposition to home. Therapeutic/Care Management; Level III.

The Stroll Safe Outdoor Falls Prevention Program: Participant Experiences in Naturally Occurring Retirement Community Program Sites

Abstract Date Presented 03/21/24 The qualitative findings from an efficacy trial for the Stroll Safe outdoor falls prevention program will be presented. Results reveal a number of program benefits, including increased safe community mobility strategy use. Primary Author and Speaker: Tracy Chippendale Contributing Authors: Szu-Wei Chen

Mobilization strategies with and without plerixafor for autologous stem cell transplant in patients with multiple myeloma.

Autologous stem cell transplantation is a standard treatment strategy for patients with multiple myeloma that requires effective mobilization and apheresis of peripheral blood progenitor cells; however, in the current era of novel myeloma induction therapies, the optimal mobilization regimen to enhance stem cell yield while limiting toxicity and resource utilization remains unknown. In this multicenter retrospective study, we assessed apheresis and transplant outcomes in myeloma patients mobilized with granulocyte colony stimulating factor (G-CSF) alone (n = 62), G-CSF with chemotherapy (n = 43), or G-CSF with the CXCR4 antagonist plerixafor (n = 417). Compared to patients treated with G-CSF alone, the plerixafor group required significantly fewer median apheresis sessions (1 vs 2, p = 0.0023) with higher CD34+ stem cell yield (9.9 vs 5.8 × 106 cells/kg, p < 0.001) and had significantly faster engraftment of neutrophils (HR 1.54, 95% CI 1.17-2.03) and platelets (HR 2.24, 95% CI 1.69-2.96) after transplant. Additionally, the plerixafor group showed a significantly better toxicity profile and lower adverse event rate than patients treated with G-CSF alone (p = 0.0028) or chemomobilization (p < 0.0001), with a trend toward reduced survival in chemomobilization patients. Taken together, these data support the routine use of plerixafor-based mobilization to increase apheresis efficiency and reduce toxicity in myeloma patients undergoing transplant.

Weaving social networks from cultural similarities on the neolithisation process in the Western Mediterranean: Evolutionary trajectories using projectile tools.

In this paper, we concentrate on the neolithisation process in Mediterranean Iberia through a diachronic view (from 8600-6800 cal. BP), focusing on social interaction as a factor in articulating new cultural ties. To do this, we apply techniques centred on similarities in material culture by applying Social Network Analysis (SNA). For the first time, we point to the geometric projectiles, taking into account their recurrence in both Mesolithic and Neolithic groups as part of their characteristic hunting equipment. We hypothesise that patterns of cultural variability would express the changing flow of information between communities according to their mobility strategies (last hunter-gatherer groups), including economic and social behaviour, and that these relationships will be restructured with the arrival of the newcomer farmers and herders and their new spatial and social arrangement. The results obtained allow us to describe a connected and homogeneous Late Mesolithic network dramatically structured by the Neolithic arrival. Since then, a heterogenous pattern emerged, involving connected periods, network ruptures, and small-world phenomena. The emergence of this characteristic could support the flow of information when the network presents a clustered structure, the last probably due to regionalisation events. These diachronic dynamics fit well with demographic and socioecological trends observed from regional literature.

Feasibility and accuracy of mobile QT interval monitoring strategies in bedaquiline-enhanced prophylactic leprosy treatment.

Some anti-mycobacterial drugs are known to cause QT interval prolongation, potentially leading to life-threatening ventricular arrhythmia. However, the highest leprosy and tuberculosis burden occurs in settings where electrocardiographic monitoring is challenging. The feasibility and accuracy of alternative strategies, such as the use of automated measurements or a mobile electrocardiogram (mECG) device, have not been evaluated in this context. As part of the phase II randomized controlled BE-PEOPLE trial evaluating the safety of bedaquiline-enhanced post-exposure prophylaxis (bedaquiline and rifampicin, BE-PEP, versus rifampicin, SDR-PEP) for leprosy, all participants had corrected QT intervals (QTc) measured at baseline and on the day after receiving post-exposure prophylaxis. The accuracy of mECG measurements as well as automated 12L-ECG measurements was evaluated. In total, 635 mECGs from 323 participants were recorded, of which 616 (97%) were of sufficient quality for QTc measurement. Mean manually read QTc on 12L-ECG and mECG were 394 ± 19 and 385 ± 18 ms, respectively (p < 0.001), with a strong correlation (r = 0.793). The mean absolute QTc difference between both modalities was 11 ± 10 ms. Mean manual and automated 12L-ECG QTc were 394 ± 19 and 409 ± 19 ms, respectively (n = 636; p < 0.001), corresponding to moderate agreement (r = 0.655). The use of a mECG device for QT interval monitoring was feasible and yielded a median absolute QTc error of 8 ms. Automated QTc measurements were less accurate, yielding longer QTc intervals.

Effectiveness of a Mobile Phone Messaging-Based Message Framing Intervention for Improving Maternal Health Service Uptake and Newborn Care Practice in Rural Jimma Zone, Ethiopia: Protocol for a Cluster Randomized Controlled Trial.

Ethiopia has high rates of maternal and neonatal mortality. In 2019 and 2020, the maternal and newborn mortality rates were estimated at 412 per 1,000,000 births and 30 per 10,000 births, respectively. While mobile health interventions to improve maternal and neonatal health management have shown promising results, there are still insufficient scientific studies to assess the effectiveness of mobile phone messaging-based message framing for maternal and newborn health. This research aims to examine the effectiveness of mobile phone messaging-based message framing for improving the use of maternal and newborn health services in the Jimma Zone, Ethiopia. A 3-arm cluster-randomized trial design was used to evaluate the effects of mobile phone-based intervention on maternal and newborn health service usage. The trial arms were (1) gain-framed messages (2) loss-framed messages, and (3) usual care. A total of 21 health posts were randomized, and 588 pregnant women who had a gestational age of 16-20 weeks, irrespective of their antenatal care status, were randomly assigned to the trial arms. The intervention consisted of a series of messages dispatched from the date of enrolment until 6-8 months. The control group received existing care without messages. The primary outcomes were maternal health service usage and newborn care practice, while knowledge, attitude, self-efficacy, iron supplementation, and neonatal and maternal morbidity were secondary outcomes. The outcomes will be analyzed using a generalized linear mixed model and the findings will be reported according to the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth) statement for randomized controlled trials. Recruitment of participants was conducted and the baseline survey was administered in March 2023. The intervention was rolled out from May 2023 till December 2023. The end-line assessment was conducted in February 2024. This trial was carried out to understand how mobile phone-based messaging can improve maternal and newborn health service usage. It provides evidence for policy guidelines around mobile health strategies to improve maternal and newborn health. Pan African Clinical Trials Registry PACTR202201753436676; https://tinyurl.com/ykhnpc49. DERR1-10.2196/52395.

Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study

Background: There is no concrete evidence to define the optimal mobilization strategy following zone I/II flexor tendon repair. The Saint John Protocol is an active motion regime which utilizes wrist movement to facilitate better clinical outcomes. Our objective was to compare the outcomes of patients who underwent the conventional Kleinert protocol versus the Saint John protocol. Methods: 20 fingers in the Kleinert group and 18 fingers in the Saint John group were included in this retrospective study. Pain score, range of movement, grip strength, and complications were studied at 6 and 12 weeks postoperatively. Results: The Saint John protocol showed significantly less pain at 6 week (0.167 vs 1.08, P = 0.032) and less flexion contracture at the PIPJ at 6 weeks (3.33 vs 12.25, P = 0.032). Both groups showed similar rerupture rates (5.5% vs 5%). Conclusions: Saint John protocol demonstrated better clinical outcomes while not sacrificing the integrity of repair.

Reindeer prey mobility and seasonal hunting strategies in the late Gravettian mammoth steppe

Reindeer are part of the faunal suite that dominated central Europe during the last glacial cycle. Their importance to Late Gravettian hunters as prey and a source of raw materials (hide, bone, antler) is well attested, however the context of Late Gravettian reindeer predation is lesser understood. This paper presents an investigation of human and reindeer predator-prey interactions at the Late Gravettian kill-butchery site of Lubná VI, Czech Republic. We reconstruct seasonal mobility (87Sr/86Sr, δ18O), diet (δ13C, δ15N) and season of death (dental cementum) of up to nine reindeer prey, to inform on the strategic choices made by Late Gravettian hunters. Results indicate that most hunted reindeer lived year-round in the foothills of the Bohemian-Moravian highlands near where Lubná is located, at altitudes between ~ 200–450 m above present sea level, while a smaller number showed evidence of seasonal migration between this area and the open plains of the Elbe river corridor (Bohemian Cretaceous basin). No evidence for long distance migration of reindeer was detected, indicating that productive local environments were supporting reindeer herds within a single annual territory. Meanwhile, areas higher than ~ 450 m above present sea level were avoided entirely by all analysed individuals, consistent with these areas being topographic barriers to movement due to climate severity. We conclude that hunters visited Lubná as part of a logistically-organised subsistence strategy, deliberately targeting reindeer in late autumn when fat supplies, hides and antler are in prime condition knowing that they would reliably encounter their prey at this location.

Barriers to the quality delivery of seasonal malaria chemoprevention in Chad and Burkina Faso: a qualitative exploration of caregivers and community distributors’ perspectives

BackgroundRecommended since 2012 by the World Health Organization (WHO), seasonal malaria chemoprevention (SMC) is a community-based intervention to prevent malaria in children in African regions where malaria transmission follows a seasonal pattern. Following the publication of consolidated WHO guidelines for malaria, SMC is expected to reach more children in new geographies in future years. Though SMC has been shown to reduce malaria-related morbidity and mortality, there is potential for quality improvement of the intervention implementation. Assisted by ten quality standards from a framework developed by Malaria Consortium, this paper aims to better understand the quality of SMC implementation and identify potential barriers to quality delivery of SMC.MethodsA qualitative thematic analysis on data collected after the annual SMC rounds implemented in Burkina Faso and Chad in 2019 was conducted. Sixteen focus group discussions conducted with caregivers and community distributors were analysed. Three selected quality standards for SMC delivery; planning and enumeration; community engagement; and administration of SMC medicines provided overarching quality themes under which subthemes were identified.ResultsEight subthemes relating to the three quality standards were identified. Although SMC was well accepted by communities in both settings, common barriers to the quality delivery of SMC were identified including difficulty ensuring adherence to the SMC administration protocol; difficulties reaching mobile populations; concerns around adverse drug reactions; rumours, and concerns about SMC safety; and community distributors’ working conditions. Context-specific barriers included: the suboptimal timeliness of the SMC round in Burkina Faso, and the lack of involvement of female caregivers in mobilization activities in Chad.ConclusionIn the context of increased adoption of SMC, this paper provides relevant insights and recommendations for the improved implementation of SMC programmes. These include the integration of strategies addressing communities’ concerns around adverse drug reactions, gender-specific mobilization strategies, and attention to community distributors’ working conditions. It also highlights the importance and utility of further, robust research on the quality of SMC delivery.

Assessing the viability of parking slot utilization as transhipment points for parcel carriers: a case study in Barcelona

AbstractThe measures proposed in the sustainable and smart mobility strategy developed by the European commission are crucial for achieving the environmental objectives for 2030. This strategy includes measures specifically aimed at reducing the impact of e-commerce distribution. One widely adopted strategy for mitigating the impact of e-commerce distribution is the establishment of urban consolidation centres (UCCs). While this infrastructure quickly demonstrates its environmental success in urban areas, achieving long-term economic sustainability proves challenging. In this paper, we introduce a methodology aimed at incentivizing parcel carriers to shift towards an economically feasible and environmentally sustainable distribution mode within urban areas by leveraging their own transhipment space. This methodology includes a mathematical program for determining the quantity and locations of parking slots, taking into account the number of parcels and transportation vehicles used. It also utilizes the Continuous Approximation technique to assess the transportation and environmental costs of the proposed solutions. The proposed methodology is implemented for the city of Barcelona, considering three different sizes of parcel carriers: the carrier handling the largest volume of parcels, the carrier handling the lowest volume of parcels, and an intermediate case. The vehicles considered for delivery from the transhipment points include vans, cargo bikes, and trolleys for distribution on foot. The results indicate that a significant reduction in both transport and environmental costs is achieved when using zero-emissions vehicles for delivery from transhipment points for any of the parcel carriers considered.

A Critical Study on the Rise of Regional Party and Weakening of National Party in Tamil Nadu with Special Reference to Chennai

The political landscape of Tamil Nadu has witnessed a significant transformation characterised by the ascendancy of regional parties and the concurrent weakening of national parties. This research delves into the underlying factors contributing to this phenomenon and its implications for the state's political trajectory.Drawing on a combination of qualitative and quantitative methodologies, this study examines historical trends, electoral data, party manifestos, and socio-political dynamics to elucidate the rise of regional parties such as the All India Anna Dravida Munnetra Kazhagam (AIADMK) and the Dravida Munnetra Kazhagam (DMK), alongside the diminishing influence of national parties like the Indian National Congress (INC) and the Bharatiya Janata Party (BJP).Key drivers identified include linguistic identity politics, regional pride, historical grievances, charismatic leadership, and effective mobilization strategies. Additionally, socio-economic factors such as caste dynamics, welfare policies, and regional disparities play a crucial role in shaping voter preferences and party allegiances.The ramifications of this shift extend beyond electoral outcomes to governance, policy formulation, and federal dynamics. The dominance of regional parties has led to the prioritization of state-centric issues and the articulation of Tamil Nadu's distinct socio-cultural identity within the Indian federal framework.By offering a comprehensive analysis of the rise of regional parties and the decline of national parties in Tamil Nadu, this research contributes to a deeper understanding of sub-nationalism, federalism, and political decentralisation within the Indian context.This research follows a empirical research method and a total of 202 samples have been collected through questionnaire.

Impact of Anti-CD38 Monoclonal Antibody Therapy on CD34+ Hematopoietic Stem Cell Mobilization, Collection, and Engraftment in Multiple Myeloma Patients-A Systematic Review.

This systematic review examines the available clinical data on CD34+ cell mobilization, collection, and engraftment in multiple myeloma patients treated with the anti-CD38 monoclonal antibodies daratumumab and isatuximab in clinical trials and in real life. Twenty-six clinical reports were published between 2019 and February 2024. Most studies documented lower circulating CD34+ cells after mobilization compared to controls, leading to higher plerixafor requirements. Although collection yields were significantly lower in approximately half of the studies, the collection target was achieved in similar proportions of daratumumab- and isatuximab-treated and nontreated patients, and access to autologous stem cell transplant (ASCT) was comparable. This could be explained by the retained efficacy of plerixafor in anti-CD38 monoclonal antibody-treated patients, while no chemotherapy-based or sparing mobilization protocol proved superior. Half of the studies reported slower hematopoietic reconstitution after ASCT in daratumumab- and isatuximab-treated patients, without an excess of infectious complications. While no direct effect on stem cells was observed in vitro, emerging evidence suggests possible dysregulation of CD34+ cell adhesion after daratumumab treatment. Overall, anti-CD38 monoclonal antibodies appear to interfere with CD34+ cell mobilization, without consistently leading to significant clinical consequences. Further research is needed to elucidate the underlying mechanisms and define optimal mobilization strategies in this patient population.

Path optimization algorithm for mobile sink in wireless sensor network

In order to alleviate the limitation of mobile sink in Wireless Sensor Network (WSN) by environmental and power problems, this paper proposes a new signal collection method for network communication in wireless sensor network with the goal of shortening the path of the mobile sink, and then proposes the ACO-TU (Ant Colony Optimization-Team Up) algorithm based on ant colony algorithm by adding concepts such as node pheromone. The algorithm groups the mobile units of the ant colony algorithm and further optimizes the sink path in the wireless sensor network by specific mobile strategies. Experimental results show that the method of sink moving path optimization proposed has a significant improvement in reducing power consumption and distance shortening, which can further increase the service life of the mobile sink and improve the quality of signal transmission. The results of comparison with the most recent relevant algorithms show that the ACO-TU algorithm has the best optimization performance, which proves the effectiveness of the algorithm.

Quantized control for interconnected PDE systems via mobile measurement and control strategies

This paper deals with the Rϵ-stabilization for interconnected partial differential equation systems (IPDESs) by mobile measurement and control strategies. First, compared to the static measurement and control strategies, the mobile ones are employed to improve the dynamic response of the closed-loop system, while reducing the number of sensors and actuators effectively. Moreover, considering the constrained transmission channel bandwidth, the hysteresis quantizer with an adjustable parameter is introduced to save the communication resources in the network, while can balance the quantization effect and the control performance by adjusting the parameter. Further, the output quantization controller is designed to ensure that the closed-loop system is Rϵ-stable, which converges to a given interval in finite time. Finally, a simulation example of chemical non-isothermal tubular reactors is provided to illustrate the validity of the presented design method.

Strategic Mobility Plan for Employees of Coolwood SA Company

In contemporary business environments, effective management of employee mobility has become paramount for companies striving to maintain competitiveness and sustainability. Neglecting to develop suitable mobility strategies can result in decreased productivity, increased operational costs, and environmental concerns, jeopardising a company's long-term success. Coolwood SA, a middle-sized furniture production company, is planning to relocate its headquarters from Maastricht to Hasselt by 2030, necessitating the design of a sustainable and cost-efficient mobility plan for its employees. This study aims to address this challenge by crafting a tailored mobility strategy that facilitates a seamless transition to the new headquarters. Drawing on insights from literature and empirical research, this study emphasises the importance of effective mobility planning in enhancing employee satisfaction, productivity, and operational efficiency while reducing environmental impact and costs. By analysing employee profiles, mobility measures, and various scenarios, the study identifies the most suitable mobility strategy for Coolwood SA. Through rigorous cost calculations and scenario comparisons, Scenario Two emerges as the most favourable option, offering significant cost reductions and accommodating employees' diverse needs and preferences. The study's findings underscore the importance of strategic and personalised mobility planning for companies undergoing relocation or expansion. By considering factors such as employee profiles, transportation modes, and cost implications, organisations can optimise decision-making and ensure a smooth transition to new locations while promoting long-term economic success and sustainability. This research provides valuable insights and recommendations for Coolwood SA and other companies navigating similar mobility challenges, highlighting the critical role of mobility planning in achieving organisational objectives and fostering employee well-being.

Improving Bus Passenger Flow Prediction Using Bi-LSTM Fusion Model and SMO Algorithm

Bus passenger flow prediction integrates data analytics and modelling techniques to forecast the number of passengers using bus services, incorporating historical usage patterns, demographics, weather, and events for optimal scheduling and resource allocation. The Bi-LSTM fusion model enhances accuracy by processing past and future features simultaneously, leveraging bidirectional LSTM layers and an attention mechanism to capture temporal dependencies. This approach not only refines insights crucial for urban mobility challenges like traffic management and demand forecasting but also improves route planning and service efficiency. The SMO algorithm initializes with a diverse spider monkey population exploring solution spaces. Through local and global leader phases, it iteratively updates positions based on fitness and probabilistic selections, maintaining a balance between exploration and exploitation. Perturbation-based updates in the local leader phase ensure adaptability, preventing premature convergence, while the global leader phase guides towards better solutions, enhancing efficiency in complex optimization tasks and promoting dynamic adaptation. In Dataset 1, the proposed model achieved a training time of 137 seconds, slightly longer than HA (115s), SARIMA (112s), GRU (123s), and ST-ResNet (113s). It demonstrated superior accuracy at 89%, surpassing HA (66%), SARIMA (68%), GRU (63%), DeepST (78%), and ST-ResNet (84%). In Dataset 2, the model exhibited the lowest RMSE, MAE, and MAPE%, indicating superior predictive accuracy over SVR, CNN, GCN, LSTM, and CONV LSTM models. These findings validate the proposed model's effectiveness in enhancing predictive capabilities for transit forecasting, underscoring its potential to optimize urban mobility and transportation management strategies significantly.

Fast, high-quality, and unshielded 0.2 T low-field mobile MRI using minimal hardware resources.

To propose a deep learning-based low-field mobile MRI strategy for fast, high-quality, unshielded imaging using minimal hardware resources. Firstly, we analyze the correlation of EMI signals between the sensing coil and the MRI coil to preliminarily verify the feasibility of active EMI shielding using a single sensing coil. Then, a powerful deep learning EMI elimination model is proposed, which can accurately predict the EMI components in the MRI coil signals using EMI signals from at least one sensing coil. Further, deep learning models with different task objectives (super-resolution and denoising) are strategically stacked for multi-level post-processing to enable fast and high-quality low-field MRI. Finally, extensive phantom and brain experiments were conducted on a home-built 0.2 T mobile brain scanner for the evaluation of the proposed strategy. 20 healthy volunteers were recruited to participate in the experiment. The results show that the proposed strategy enables the 0.2 T scanner to generate images with sufficient anatomical information and diagnostic value under unshielded conditions using a single sensing coil. In particular, the EMI elimination outperforms the state-of-the-art deep learning methods and numerical computation methods. In addition, 2 × super-resolution (DDSRNet) and denoising (SwinIR) techniques enable further improvements in imaging speed and quality. The proposed strategy enables low-field mobile MRI scanners to achieve fast, high-quality imaging under unshielded conditions using minimal hardware resources, which has great significance for the widespread deployment of low-field mobile MRI scanners.

First initiation of mobilization out of bed after cardiac surgery – an observational cross-sectional study in Sweden

BackgroundCardiac surgery is associated with a period of postoperative bed rest. Although early mobilization is a vital component of postoperative care, for preventing complications and enhancing physical recovery, there is limited data on routine practices and optimal strategies for early mobilization after cardiac surgery. The aim of the study was to define the timing for the first initiation of out of bed mobilization after cardiac surgery and to describe the type of mobilization performed.MethodsIn this observational study, the first mobilization out of bed was studied in a subset of adult cardiac surgery patients (n = 290) from five of the eight university hospitals performing cardiothoracic surgery in Sweden. Over a five-week period, patients were evaluated for mobilization routines within the initial 24 h after cardiac surgery. Data on the timing of the first mobilization after the end of surgery, as well as the duration and type of mobilization, were documented. Additionally, information on patient characteristics, anesthesia, and surgery was collected.ResultsA total of 277 patients (96%) were mobilized out of bed within the first 24 h, and 39% of these patients were mobilized within 6 h after surgery. The time to first mobilization after the end of surgery was 8.7 ± 5.5 h; median of 7.1 [4.5–13.1] hours, with no significant differences between coronary artery bypass grafting, valve surgery, aortic surgery or other procedures (p = 0.156). First mobilization session lasted 20 ± 41 min with median of 10 [1–11]. Various kinds of first-time mobilization, including sitting on the edge of the bed, standing, and sitting in a chair, were revealed. A moderate association was found between longer intubation time and later first mobilization (ρ = 0.487, p < 0.001). Additionally, there was a moderate correlation between the first timing of mobilization duration of the first mobilization session (ρ = 0.315, p < 0.001).ConclusionsThis study demonstrates a median time to first mobilization out of bed of 7 h after cardiac surgery. A moderate correlation was observed between earlier timing of mobilization and shorter duration of the mobilization session. Future research should explore reasons for delayed mobilization and investigate whether earlier mobilization correlates with clinical benefits.Trial registrationFoU in VGR (Id 275,357) and Clinical Trials (NCT04729634).

Refugee agency in secondary mobility decision-making: a systematic literature review

Decisions made by millions of refugees about where to go, how to make a living and how to secure a future are fundamental drivers of secondary movements. While a substantial body of literature addresses factors contributing to migrants’ decision-making, a comprehensive understanding of the central role of refugees in secondary mobility decision-making, including agency and strategies employed, remains underexplored. This is partly due to the belief that refugees are constrained by external and structural factors and cannot exercise agency, which we challenge. This article provides a systematic analysis of the literature on refugees’ secondary mobility decision-making processes. Using a systematic literature review (SLR) methodology, it presents an in-depth analysis of 40 peer-reviewed, English-language research articles selected from the Web of Science and Scopus databases published before September 2022. The article critically examines the drivers, prevailing dichotomies and conceptual frameworks surrounding refugee categorization, agency, and mobility. By synthesizing a wide range of literature, our paper presents emerging alternative concepts and frameworks that shed light on the complex dynamics of decision-making.