Previous Experience Research Articles

Effect of Stocking Density during CO2 Stunning of Pigs on Induction Time and Activity Level Measured Using AI.

During the CO2 stunning of pigs, a variation in their reaction to the gas and the duration of the induction period is observed. The stunning process can be affected by several conditions, such as stressful events and previous experiences, but the stocking density in the gondola may also have an impact. The objective was to investigate the effect of stocking density on the stunning process under commercial conditions. To quantify the pigs' reactions under industrial settings with a stocking density of up to eight pigs pr. Gondola (3.91 m2), the activity level was measured using an AI solution. Compared with a simulation of the expected induction period, a significantly longer induction period was found in gondolas containing seven and eight pigs (p < 0.001) but not when the gondolas contained three or four pigs. Both high and mean activity levels were significantly higher when stocking density was increased from three or four pigs to seven or eight pigs. The stunning process was thus negatively affected when increasing the stocking density. More knowledge is needed to explain this effect and to make statements on optimal stocking density. The measured activity levels may be a useful tool for obtaining information under commercial conditions and for documenting animal welfare.

Secure Travel Planning Using a Heuristic Algorithm

Security perception in the urban area has a significant effect on travel behaviour, preferences, and tour planning. The perceptions of security risks can vary depending on factors, such as age, gender, and previous experiences. This study aims to consider security risks when developing travel plans and schedules for various activities. An improved heuristic algorithm, based on the Travelling Salesman Problem with security parameter and flexibility aspects, is proposed. Public transport is considered in three situations: fixed, flexible, and flexible-security situations. The outcomes demonstrate that the flexible situation significantly decreases travel times by 21% compared to the basic (fixed) situation. At the same time, with a slightly increased travel time the security risk can be avoided in the flexible-security situation. Travelers can enjoy a higher quality of travelling and enhanced personal experience by minimizing the journey duration and the impact of security risks on the tour schedule. The proposed method provides significant benefits for transport operators by increasing the efficiency of the transportation system and higher customer satisfaction.

Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study.

Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women's decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother's health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.

Comparison of Two Financial Incentives to Encourage the Use of Adalimumab Biosimilars: Results of a French Experiment Close to Clinicians.

In 2018, the French government introduced two mutually exclusive financial incentives to increase etanercept and insulin glargine biosimilar use. The general case redirects 20% of the price difference between the reference product and its biosimilars to hospitals for every biosimilar dispensed in community pharmacies from hospital prescriptions. The experimental case redirects 30% to prescribing clinical units after hospital selection. Adalimumab was added to these incentives in 2019, after its first biosimilar was launched. This retrospective observational study aimed to compare both general and experimental incentives after 19 months to assess the impact of directly incentivizing clinical units for adalimumab biosimilars. The monthly number of adalimumab boxes dispensed in community pharmacies was linked to the corresponding hospital's prescription using IQVIA Xponent data from November 2017 to October 2020. The monthly mean rate of adalimumab biosimilars was compared between incentive groups and subgroups depending on hospitals' prior experience with the etanercept experimental case. General case hospitals had a significantly lower mean biosimilar uptake (16.7% vs 23.2%, p = 0.029) than those included in the experimental case. Twenty-three of the 40 hospitals in the experimental case and ten out of the 91 hospitals studied in the general case had already taken part in the etanercept experiment. Biosimilar uptake was higher, but not statistically significant, for hospitals with prior experience in the adalimumab general case group (p = 0.086). This study confirmed that incentivizing close to physicians was more effective in increasing the biosimilar rate. It also suggested that previous incentive experience positively influenced biosimilar penetration.

Prevalence and determinants of fear of childbirth among pregnant women in Egypt: A cross-sectional study

ProblemFear of childbirth (FOC) is a significant public health concern, and understanding its determinants is crucial for developing effective interventions to support women during pregnancy and childbirth. BackgroundFear of childbirth (FOC) is increasingly recognized as an essential psychological health concern among pregnant women globally. However, research elucidating the prevalence and multifaceted determinants of FOC in the Egyptian context remains scarce. This knowledge is pivotal to informing maternal health practices. AimThis study aimed to investigate FOC prevalence and its determinants among pregnant women in Egypt. MethodsA cross-sectional study was conducted among 460 low-risk pregnant women attending antenatal clinics in El-Beheira Governorate, Egypt, from February 2023 to July 2023. Data were collected using structured questionnaires on sociodemographic and obstetric profiles, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the Multidimensional Scale of Perceived Social Support. ResultsThe prevalence of FOC ranged from mild to severe, with 70.4% of women displaying some degree of fear and 11.3% exhibiting severe FOC. Key determinants associated with greater FOC were younger age, nulliparity, unplanned pregnancy, negative previous birth experiences, and preference for cesarean delivery. An inverse relationship was found between FOC and childbirth self-efficacy. ConclusionsThis study reveals a high FOC prevalence among Egyptian pregnant women, necessitating the need for systematic screening and tailored interventions to mitigate this concern, especially among high-risk groups like young, nulliparous mothers. Fostering childbirth self-efficacy may aid in reducing FOC. These findings can inform the enhancement of holistic maternal health practices in Egypt.

"I feel like I'm changing people's lives, even if it's just two hours at a time": Understanding contingent instructors' emotion management in university teaching.

This article extends existing scholarship on contingent or temporary-contract university instructors' emotional agency by employing the Bolton's emotion management and Cottingham's emotional capital typologies in tandem. In interviews with 40 instructors from universities across Canada, participants described acquiring both primary and secondary emotional capital as an embodied psychosocial resource through past education, upbringing and culture, and knowledge and skills from previous work and training experiences respectively. They then deployed this capital through emotion management based in both social and organizational feeling rules in their capacity as professors. This allowed instructors to reinforce their own sense of purpose, authority and competence as instructors, and to establish fulfilling relationships with students through teaching and mentoring which they infused with personal meaning. However, instructors' agency was also curtailed to varying degrees, by both institutional attitudes around academic contingency and sexist, and in some cases, racist or otherwise patronizing attitudes from students. Despite this, instructors were often able to reaffirm their identities as instructors by using emotion management in self-affirming ways, such as by drawing on self-confidence gained through previous occupations and training, and facilitating cultural backgrounds shared with students through emotional management.

Key decision factors of professional stakeholders (architects, engineers, constructors) when deciding for sustainable construction

The built environment and the construction industry account for a significant share of global harmful emissions. Sustainable construction appears to be an effective strategy to achieve a more sustainable society, although it is still not used enough. It is crucial to understand what the main decision factors of those deciding about building practices are. Professional stakeholders such as architects, engineers, constructors, are the ones advising consumers and deciding about construction. An understanding about their decision factors is needed, in order to increase the implementation of sustainable construction. In this study we provide evidence about key decision factors of professional stakeholders in Slovenia when deciding for sustainable construction practices. By conducting an online survey (questionnaire) we identified and analyzed the main drivers and barriers of professionals when making decisions about sustainable construction solutions. With statistical analysis we found out that professional stakeholders included in the survey mostly already had previous experiences working with sustainable construction. They are familiar with sustainable construction concepts. The most important drivers were connected to the factor of occupant health, and the energy-efficiency of the buildings, while the biggest barrier in their decision making is related to higher cost of sustainable construction and lack of awareness. Professional stakeholders are concerned about climate change and their attitudes towards climate change are affecting their decision related to sustainable construction. Respondent provided many comments, clearly indicating that a simple definition of sustainable construction is needed, and more efforts should be done to raise awareness about sustainable construction. Results are contributing valuable information for professional stakeholders, policymakers and other important stakeholders in the construction ecosystem.

Development index and the challenges of adopting artificial intelligence in improving the quality of e-government services to citizens in Jordan

The purpose of this study is to evaluate the global and continental positions of e-government models in countries such as Jordan by analysing their experiences. The evaluation of the progress of e-government is carried out using a multi-practice methodology, which incorporates a variety of different procedures and techniques. The performance of Jordan is evaluated using the United Nations e-government maturity index, which is comprised of the Telecommunication Infrastructure Index, the Human Capital Index, and the Online Service Index. These indexes are used to compare Jordan’s performance from 2008 to 2015. The purpose of this research is to improve the capabilities of e-government by utilising previous experiences, addressing deficiencies, and making the most of potential. In addition to this, the study investigates the influence that artificial intelligence (AI) has on the confidence of users and the quality of government services that are delivered through online platforms. Specifically, the report underlines the cost-effectiveness and efficiency of adopting and utilising artificial intelligence, as well as the potential of tools and solutions that are driven by artificial intelligence.

Impact on Spanish women of previous workplace victimization experiences of workplace sexual harassment on the responsibility to intervene as bystander: Mediating roles of myth acceptance and perceived severity

BackgroundBystander behaviors can be an important key for preventing all forms of violence against women. Identifying their facilitators and barriers becomes a priority. The aim of this research is to analyze the impact of the previous experiences of women (as sexual harassment victim or bystander) on their perceived responsibility to intervene as bystander in a case of workplace sexual harassment and to determine the possible mediating role of certain attitudinal and evaluative factors. MethodA non-probability convenience sample of 633 Spanish women answered a sociodemographic data questionnaire, a victimization questionnaire designed ad hoc, and the Questionnaire of Intention to Help in VAW Cases. ResultsThe results obtained indicate that previous victimization experiences as a victim or witness of sexual harassment impact the responsibility to intervene, mediated by the acceptance of sexual harassment myths and the perceived severity of workplace sexual harassment. ConclusionsThese results may help to understand how to design prevention programs and which key variables to incorporate.

Implicit Selective Attention: The Role of the Mesencephalic-basal Ganglia System.

The ability of the brain to recognize and orient attention to relevant stimuli appearing in the visual field is highlighted by a tuning process, which involves modulating the early visual system by both cortical and subcortical brain areas. Selective attention is coordinated not only by the output of stimulus-based saliency maps but is also influenced by top-down cognitive factors, such as internal states, goals, or previous experiences. The basal ganglia system plays a key role in implicitly modulating the underlying mechanisms of selective attention, favouring the formation and maintenance of implicit sensory-motor memories that are capable of automatically modifying the output of priority maps in sensory-motor structures of the midbrain, such as the superior colliculus. The article presents an overview of the recent literature outlining the crucial contribution of several subcortical structures to the processing of different sources of salient stimuli. In detail, we will focus on how the mesencephalic- basal ganglia closed loops contribute to implicitly addressing and modulating selective attention to prioritized stimuli. We conclude by discussing implicit behavioural responses observed in clinical populations in which awareness is compromised at some level. Implicit (emergent) awareness in clinical conditions that can be accompanied by manifest anosognosic symptomatology (i.e., hemiplegia) or involving abnormal conscious processing of visual information (i.e., unilateral spatial neglect and blindsight) represents interesting neurocognitive "test cases" for inferences about mesencephalicbasal ganglia closed-loops involvement in the formation of implicit sensory-motor memories.

Comparison Analysis of Unit Prices for Reinforced Concrete Column Work using the 2022 Indonesian National Standard (Sni) Method and Field Data (An Empirical Study On the Construction Project of the National Land Agency Building in Banjarbaru)

In construction management, there are various stages of problems in terms of managing the project budget, so it is necessary to have a design or estimation of the project budget by analyzing construction costs. Currently, service providers tend not to fully calculate unit price analysis based on SNI analysis but rather on their own analysis or previous experience in completing construction work. Based on this, it is necessary to compare unit price analysis between the SNI method and field data. This study aims to determine the unit prices in the field and compare the price differences between the SNI 2022 method and field data in the National Land Agency Building Construction Project in Banjarbaru. The results of this analysis show that the price based on SNI 2022 analysis is Rp368,900,072.55, while the price based on field observations is IDR 269,231,757.50. Based on the analysis results of both methods, the cost difference between the SNI 2022 analysis and the actual field conditions for the National Land Agency Building Construction Project in Banjarbaru is IDR 99,668,315.02.

First Aid Curriculum for Second Year Medical Students.

This small-group workshop is designed for pre-clinical medical students. The workshop can also be offered to other medical students looking to review first aid in the community setting. First aid training in medical students varies based on each student's previous experience. Because of this, medical students in their pre-clinical years have expressed a desire for further training in first aid.1 While most bystanders in an emergency situation do not have a medical background, medical students have received additional training that can provide the skillset to process and respond to emergency situations in a different capacity. Most medical schools have not adopted a universal curriculum in teaching medical students first aid.2 Incorporating first aid into a medical school curriculum can enhance medical students' confidence in emergent situations and lead to better outcomes for patients requiring immediate on-site care. The goal of this workshop was to improve the confidence of medical students in handling emergencies in the community with the use of first aid while also giving them a standard approach to emergencies using an airway, breathing, and circulation approach. The curriculum was evaluated through student-perceived self-efficacy and confidence in handling the provided scenarios, performance on relevant multiple choice questions, and general appeal of the first aid sessions. By the end of this workshop, students will be able to define the goals of "first aid" and first responder actions, describe clinical signs and symptoms suggestive of an airway, breathing, or circulation emergency in the setting of selected medical emergencies, and demonstrate immediate care steps in the setting of selected medical emergencies, specifically the Heimlich maneuver on adults and infants, direct pressure, wound packing, tourniquet application for external bleeding, epinephrine auto-injector administration, and the recovery position for obtunded or unconscious patients. Small group activities were performed with a focus on case-based scenarios combined with hands-on instruction. The four scenarios were choking, seizure, anaphylaxis, and bleeding which were taught by an educator who was either faculty, an emergency medicine resident, or an upper-level medical student. Facilitators were provided an educational handout specific to their station to guide them through the teaching session. A PowerPoint presentation was also provided complete with supporting images and videos to share with the students each session. Students were asked to complete a pre-test and post-test survey to assess knowledge outcome, self-efficacy in first aid, and overall appeal of the workshop. The multiple-choice knowledge outcome data was scored for percent correct on each question as well as overall performance on questions grouped by content. Students were also asked to provide feedback and comments on their overall experience in the workshop. Overall, medical students reported increased knowledge and confidence in responding to various first-aid situations. There was overall improvement in pre-test and post-test evaluations. The appeal of the event as a whole and its usefulness was overwhelmingly viewed as positive. Some participants noted they wanted similar workshops with more first-aid topics. Participants also noted they felt better prepared to respond to the various emergencies included in the workshop. A workshop directed at teaching first aid to medical students increased their confidence and knowledge in responding to various emergencies and can successfully be accomplished through a focused large group didactic session and multiple clinically relevant small group teaching sessions. First aid, airway, breathing, circulation, medical students, choking, seizures, bleeding, anaphylaxis.

Technology Focus: Decarbonization (July 2024)

While significant progress has been made in carbon abatement, evidenced in literature produced over the past year, particularly within the realm of carbon capture and storage (CCS), I’d like to invite your attention to three key topics in this discussion. First, despite more than 3 decades of intense focus on emissions issues, highlighted since the 1980s and formalized with the establishment of the United Nations Framework Convention on Climate Change in 1992, global emissions have only increased instead of going down. It’s imperative to question the efficacy, premises, practicality, and overlooked hurdles of current approaches. Paper SPE 214950, summarized here, sheds light on some of these challenges. It emphasizes that implementing costly carbon-abatement methods in a world marked by sharp regional economic disparities with wealth concentrated in a few countries could worsen economic inequalities by making access to energy even less equitable. Additionally, paper SPE 215050 (included in the list for further reading) underscores the priority of energy security over carbon reduction, citing recent evidence from leading proponent nations of climate action resorting to the use of coal. Failing to address energy security and economic disparity, though these are not the only obstacles, could hinder progress toward societal carbon-reduction goals. My second topic for your kind attention is the progress made on the CCS front, on which an overwhelming number of papers (approximately 75% of those reviewed) were presented at SPE conferences last year. An ongoing challenge with CCS, particularly in deep saline aquifers, is the prolonged period required for injected CO2 to chemically react and solidify for permanent storage. Paper SPE 215352, summarized here, introduces a different perspective based on the author’s exposure to another industry: proposing the coinjection of CaCl2 to expedite the permanent storage of CO2, potentially addressing this issue. The third topic that you will find interesting is developments on the hydrogen front, aimed at replacing direct use of fossil fuels as energy vectors. The cost of producing green hydrogen is expected to come down with advancement of technology, at least in some geographical areas, as the second paper shortlisted for further reading, paper IPTC 23652, suggests. One promising application involves using excess solar power during the day to convert hydrogen and store it underground for use when sunlight is unavailable. This could green the so-called peaker plants. While the approach of underground hydrogen storage (UHS) undoubtedly has the advantage of storing large amounts of energy, it may still struggle to compete with utility-scale battery storage in terms of the associated round-trip energy efficiency. There are many technoeconomic challenges to be solved in the hydrogen-based energy approach, including in the UHS context, before it can be used at a significant scale. Despite some previous experience with controlled and small-scale application of UHS, much remains to be learned about its safety and economics. The risks include leakage hazards, underground chemical reactions, loss from residual trapping, and contamination, among others. However, papers like IPTC 23943, one summarized here, along with the third one selected for further reading, paper SPE 215489, underline the necessity and the strides being made by the engineering community in overcoming these technological challenges. Recommended additional reading at OnePetro: www.onepetro.org. SPE 215050 Energy Transition or Energy Advancement! by Sami A. Alnuaim, King Fahd University of Petroleum and Minerals, et al. IPTC 23652 Sun-Powered Green Hydrogen—A Comparative Analysis From the Kingdoms of Morocco and Saudi Arabia by Waldemar Szemat-Vielma, SLB, et al. SPE 215489 Role of Hydrogen Storage for UK Energy Resilience for Net Zero by S.K. Kimpton, DNV, et al.

Chronic Uterine Inversion in a Young Adult: Case Report

Background: Uterine inversion is a rare but serious complication wherein the uterus is partially or completely turned inside out. It can either be acute or chronic. Unlike acute uterine inversion which occurs as a complication during parturition, which can be promptly managed, chronic uterine inversion poses a diagnostic difficulty even for an experienced gynecologist. We, herein, report a patient who was managed and followed up at our institution for chronic uterine inversion. Case presentation: A 30-year-old female, P4L4 previous all vaginally delivered, presented with complaints of something coming out of her vagina, per vaginal bleeding and foul-smelling discharge. On Physical examination, the patient was severely anaemic and revealed a bleeding, necrotic mass on inspection and the entrance of the cervix felt high up on per speculum and per vaginal examination. The patient was diagnosed as having chronic uterine inversion. The patient was admitted and was made hemodynamically stable with intravenous fluids and three units of blood. Manual reduction using vaginal procedure to reposition the uterus wasn’t successful, hence she was taken up for surgery. Fibroid was resected vaginally. Then Haultain rectification procedure was performed and then the definitive procedure of hysterectomy was done. Postoperatively, the patient was kept under observation and was vitally stable. Histopathology reported leiomyoma. Conclusion: Though non-puerperal uterine inversion is rare, a few cases will still have to be managed without any previous experience. This differential has to be considered as a possibility in a non-pregnant woman presenting with bleeding or mass per vagina with or without hypotension and can very rarely present as postmenopausal bleeding. Irrespective of age or parity, pre-operatively or intra-operatively, associated malignancy is to be ruled out in every case of uterine inversion. The prognosis depends on prompt diagnosis and timely intervention. Keywords: Fibroid, chronic, non-puerperal, uterus, inversion.

Factors Influencing Interest and Engagement in Biomedical Research Among Community Medicine Residents in India: A Descriptive Cross-Sectional Study.

Introduction Medical science must be based on sound and scientific evidence and requires continuous research. Engaging in research allows students and faculty to explore new frontiers, question existing paradigms, and discover innovative solutions to medical challenges. As a specialty, community medicine plays a pivotal role in addressing public health issues. However, the engagement of community medicine residents in biomedical research remains suboptimal, which may impede the generation of evidence-based practices tailored to the Indian context. This study was conducted to find the interest and engagement of community medicine residents, and factors influencing their interest in biomedical research. Methods An online survey was conducted among community medicine residents of Uttar Pradesh, from February to April 2024, using Google Forms having a semi-structured, pretested questionnaire. Results One hundred and ninety-six residents participated in the study, where females (52.6%; 103/196) outnumbered males (47.4%; 93/196). The majority of participants were third-year residents (40.8%). Most participants seemed interested in biomedical research (83.2%) and thought that Basic Course in Biomedical Research (BCBR) helps conduct research projects (75%). Around half had previous experience in research projects, with cross-sectional studies being the most common (75.9%) study design. Enhancing research skills and a desire to contribute to medical knowledge emerged as primary motivators. On the other hand, the lack of time due to being overburdened with academic and educational activities was seen as the most common barrier to conducting research. Conclusions The majority of participants were found interested in research activities. The opportunity to improve research skills, desire to serve the medical fraternity, and a positive impact on resumes were the leading motivating factors for conducting research. Difficulty in sparing time, little knowledge, and poor support from mentors were found as important barriers.

Comparing underwater endoscopic submucosal dissection and conventional endoscopic submucosal dissection for large laterally spreading tumor: a randomized controlled trial (with video)

Background and AimsColorectal endoscopic submucosal dissection (ESD) is challenging despite its usefulness. Underwater ESD (UESD) provides better traction and a clearer view of the submucosal layer than conventional ESD (CESD). This study compared the efficiency of UESD and CESD for large (20–50 mm) laterally spreading tumor (LST). MethodsPreplanned sample size was calculated from our previous experience. As a results, 28 patients were required to UESD group or CESD group, respectively. The primary outcome was total procedure time while the secondary outcome was dissection speed. ResultsFifty-six patients were enrolled and a total of 28 patients were assigned to each group. The mean size of LST was 31.6 mm and 31.3 mm in the UESD and CESD group, respectively. Fibrosis was observed in 67.9% and 60.7% patients in the UESD and CESD group. Total procedure time (mean [SD]) for the UESD group was significantly shorter than that for the CESD group, respectively (49.5 minutes [20.3] vs 75.7 minutes [36.1]; mean difference, -26.2 minutes; 95% CI, -42.0 to -10.5). Dissection speed of the UESD group was significantly faster than that of the CESD group (21.9 mm2/min [6.9] vs 15.2 mm2/min [7.3]; mean difference, 6.7 mm2/minutes; 95% CI, 2.8–10.4). There was no difference between groups in the R0 resection rate or en bloc resection rate. No perforations were observed in either group. ConclusionsUESD was superior to CESD in total procedure time and dissection speed. UESD can be recommended as the preferred method for the resection of large LST.

Psychiatric-Mental Health Nurse Perspectives of Caring for Patients with Disorders of Autism

Autism was initially identified as a discrete entity in 1943. This now recognized group of disorders is often identified in children, but is a lifelong disorder requiring specialized assessment, planning, and care for patients. Nurses practicing in the Saudi Arabian healthcare system are often the first healthcare providers to encounter autism in the clinical setting. To highlight the perspective of practicing mental health nurses in Saudi Arabia regarding their experiences in caring for clients who have this disorder. A qualitative inquiry, made up of two focus groups of five members each, composed of mental health graduate students with experience in the field, facilitated a detailed investigation of nurses’ experiences in providing care for clients with these aspects of autism in clinical settings. Four principal themes and subthemes emerged from the data, which informed researchers about mental health nurses’ experiences with autism: (1) knowledge of autism; (2) previous experience in caring for those with autism; (3) practical applications used; and (4) challenges felt by mental health nurses. The Saudi nursing community appears to be looking for better training in identifying and caring for autistic patients. There also appears to be a desire to open channels of communication between primary and tertiary care facilities to improve client access.

Risk factors associated with medical encounters in ultramarathon race starters – Data from 103,131 race starters over 90 km: SAFER XLI

ObjectivesTo identify the risk factors associated with all medical encounters (MEs) and serious/life-threatening MEs (SLMEs) during the Comrades Marathon. DesignProspective cohort study, with cross-sectional analyses. MethodsDuring the 2014–2019 Comrades Marathon, all MEs (including SLMEs) were recorded in 103,131 starters. For both all MEs and SLMEs, the following risk factors were explored: sex, age, route (“up” vs. “down” race), previous Comrades experience (yes/no), wet-blub globe temperature (WBGT) and race pace. Incidence (per 1000 starters; 95%CI), and the incidence ratio (IR; 95%CI) are presented. ResultsFor all MEs, being female was a significant risk factor (females vs. males IR = 1.47, p < 0.0001), and age was only marginally significant (p = 0.0167). Therefore factors for all MEs were adjusted for sex. Other factors significantly associated with all MEs were: higher WBGT (highest WBGT compared to lowest, IR = 1.33, p = 0.0003), race pace (highest risk for those who finish either among the first quarter [IR = 1.49] or last quarter [IR = 1.46] compared to middle pace; p < 0.0001) and the route (“down” vs. “up”: IR = 1.11; p = 0.0181). Factors associated with higher risk for SLMEs were: females (IR = 1.9; p = 0.0003), “down” vs. “up” route (IR = 1.37; p = 0.0306) and race pace (slower and faster runners vs. mid (6.4–7.1 min/km) race pace category (IR > 2.1, p < 0.0001)). ConclusionsIntrinsic (female, faster and slower race pace) and extrinsic (higher WBGT and the “down” route) are novel risk factors associated with all MEs at this event. These can be considered by the race organizers and the medical team to develop and implement prevention strategies.

Lived experiences of transgender and nonbinary people in the perioperative context: a qualitative study.

Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals. We conducted a qualitative descriptive study influenced by phenomenology by interviewing with TNB adults who underwent surgery in Canada within the previous 5 years. We recruited participants using purposeful and snowball sampling via online social networking sites. Audio recordings were transcribed. Two authors coded the transcripts and derived the themes. We interviewed 21 participants, with a median interview duration of 49 minutes. Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with health care professionals. Participants detailed barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles; they described strength in community and positive interactions with health care professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience. Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people.

Can the Velocity of a 1RM Hang Power Clean Be Used to Estimate a 1RM Hang High Pull?

Suchomel, TJ, Techmanski, BS, Kissick, CR, and Comfort, P. Can the velocity of a 1RM hang power clean be used to estimate a 1RM hang high pull? J Strength Cond Res 38(7): 1321-1325, 2024-The purpose of this study was to estimate the 1-repetition maximum hang high pull (1RM HHP) using the peak barbell velocity of a 1RM hang power clean (HPC). Fifteen resistance-trained men (age = 25.5 ± 4.5 years, body mass = 88.3 ± 15.4 kg, height = 176.1 ± 8.5 cm, relative 1RM HPC = 1.3 ± 0.2 kg·kg-1) with previous HPC experience participated in 2 testing sessions that included performing a 1RM HPC and HHP repetitions with 20, 40, 60, and 80% of their 1RM HPC. Peak barbell velocity was measured using a linear position transducer during the 1RM HPC and HHP repetitions performed at each load. The peak barbell velocity achieved during the 1RM HPC was determined as the criterion value for a 1RM performance. Subject-specific linear regression analyses were completed using slope-intercept equations created from the peak velocity of the 1RM HPC and the peak barbell velocities produced at each load during the HHP repetitions. The peak barbell velocity during the 1RM HPC was 1.74 ± 0.30 m·s-1. The average load-velocity profile showed that the estimated 1RM HHP of the subjects was 98.0 ± 19.3% of the 1RM HPC. Although a 1RM HHP value may be estimated using the peak barbell velocity during the HPC, strength and conditioning practitioners should avoid this method because of the considerable variation within the measurement. Additional research examining different methods of load prescription for weightlifting pulling derivatives is needed.