Prior Engagement Research Articles

Students Exploring Health Disparities in Undergraduate Kinesiology Course

ABSTRACT Kinesiology courses that implement health disparities (HD) topics into the undergraduate curriculum engage students in critical and conscious thinking about health outcomes and strategies as they prepare for careers as future health and medical professionals. Health disparities are disproportionate differences in health based on race, gender, socioeconomic status, sexuality, and environmental factors that are preventable for providing opportunities to achieve optimal health. Implementing HD topics into undergraduate courses increases knowledge and awareness and inspires long-term interest in health equity work. This ethnographic case study assessed how 142 undergraduate Kinesiology majors navigated HD topics with critical consciousness as a guiding framework. Three themes emerged from student exploration: eye-opening experiences, lived experiences, and learning experiences. Upper-level students reported an increase in HD (75%–95%) awareness of the meaning of the term and the communities impacted. The lack of prior engagement (29%) with HD ignited tensions around learning experiences. Students who engage in HD topics earlier in their academic programs increase their knowledge and strategies for integrating HD into future learning and practices.

Exploring Consumer Participation in Brand Metaverse Communities, Focusing on the Metaverse Features—Fantasy Experiences and Self‐Expansion

ABSTRACTIn light of brands entering the metaverse, understanding consumer behavior in these virtual spaces becomes crucial. This study aims to explore how consumers' intentions to engage in building brand communities within the metaverse are influenced by their fantasy experiences in the brands' virtual stores where consumers are immersed in sensory‐rich, imaginative digital environments. By applying self‐expansion theory to brand–consumer relationships and the concept of temporarily expanding the boundary of the self through consumer metaverse experiences, this research examines the mediating role of self‐expansion in the relationship between fantasy experiences and brand community intentions. A total of 196 responses were collected among Zepeto users through consumer panels. Data were analyzed using AMOS 23.0 for confirmatory factor analysis and the Process macro in SPSS 23.0 for mediation and moderation analysis. Findings reveal direct positive effects of fantasy experiences on consumers' intentions to participate in metaverse brand communities. Users deeply engaged in the metaverse's fantasy experience could expand the sense of self, fostering active contributions to brand community activities. The study also investigates the influences of prior experiential activities in the metaverse, showing that prior engagement enhances the effects of fantasy experiences on self‐expansion. Among users with prior metaverse experiential activities, fantasy experiences exert more significant influences on self‐expansion, driving higher intentions to participate in brand communities.

Osteoarthritis Across Joint Sites in the Million Veteran Program Cohort: Insights From Electronic Health Records and Military Service History.

To characterize the relationship between the frequency of idiopathic osteoarthritis (OA) and characteristics including demographics, comorbidities, military service history, and physical health in a veteran population. We performed a cohort study in the Million Veteran Program (MVP) using International Classification of Diseases, 9th and 10th revision codes to define the frequency of site-specific OA across 3 joints or unspecified OA in veterans with respect to demographics (eg, age, sex, race and ethnicity), military service data, detailed electronic health records, military branch, and war era. We validated previous reports of sex- and age-dependent differences in OA frequency, and we identified that unspecified OA was associated with a higher frequency of 16 Deyo-Charlson comorbidities. These associations generally persisted within each isolated joint site-specific OA. Depending on military branch, prior military engagement was differentially associated with the frequency of OA. Prior United States Army and Navy service were associated with higher and lower risk, respectively, of OA across all joint sites; however, multivariable-adjusted models adjusting for a range of covariates, including age, sex, and ancestry, reversed the apparent protective effect of prior Navy service. These findings highlight the breadth of factors associated with OA in the MVP veteran population and suggest that physical status may be a modifiable risk factor for OA. This work may help in the design of strategies to optimize appropriate detection, intervention, treatment, and even rehabilitation for OA in veterans and the general population.

The COVID-19 American Association for Geriatric Psychiatry (AAGP) Online Trainee Curriculum: Program Evaluation and Future Directions

ObjectivesThe COVID-19 pandemic caused substantial disruptions in geriatric psychiatry education. In response, the AAGP created the “AAGP COVID-19 Online Trainee Curriculum” (Curriculum) a free online resource consisting of 33 recorded lectures. This study examined the uptake and impact of the Curriculum. MethodsAdministrative data established the number of unique users. Surveys assessed demographics, prior AAGP engagement, prior experiences working with older adults, and each lecture's impact on participant knowledge, enthusiasm and confidence related to the module's topic area. ResultsFrom May 2020 through April 2023, 860 individuals utilized the Curriculum. Of 251 survey respondents, 54% were general psychiatry residents (37%, n=91) or medical students (16%, n=41). Surveys from the two most-accessed lectures showed an increase in knowledge and confidence in clinical skills. ConclusionsThe Curriculum reached medical students and general psychiatry residents. Post-pandemic, the Curriculum may serve as a valuable resource to enhance geriatric psychiatry education and knowledge.

Outcomes of a policy to prioritize populations with expected healthcare barriers for subsidized PrEP care in Amsterdam, the Netherlands: a cross-sectional study.

The Dutch HIV pre-exposure prophylaxis (PrEP) pilot provided subsidized PrEP care to maximum 2,900 individuals at a time in Amsterdam. Populations with expected barriers to accessing PrEP elsewhere were prioritized for program inclusion. We evaluated their prior sexual health service engagement and PrEP need. Cross-sectional analysis using enrolment data. We included individuals ever enrolled in the PrEP program at the Center for Sexual Health (CSH) Amsterdam between 2019-2023. We calculated the proportion belonging to higher-priority groups (i.e.,<25 years old, transgender, sex worker, uninsured or migrant). We defined classes of sexual health service engagement in the 12 months preceding enrolment using latent class analysis (LCA). We compared engagement classes, sexual behavior and positivity of HIV and sexually transmitted infections (STI) between higher- and lower-priority groups. 2,004/4,075 (49%) individuals enrolled belonged to higher-priority groups. LCA showed three classes of prior engagement: "Newly engaged" (14%,n = 551) were new to the CSH-Amsterdam; "PrEP initiators" (40%,n = 1,642) previously visited the CSH-Amsterdam but had not used PrEP; "PrEP experienced" individuals (46%,n = 1,882) previously accessed PrEP. Higher-priority groups were more often "newly engaged" or "PrEP-initiators" than "PrEP-experienced". Higher-priority groups less often had condomless anal sex with casual partners or chemsex in the prior six months. Positivity of bacterial STI was similar between higher-priority (n = 300/2,004, 15.0%) and lower-priority (n = 315/2,071, 15.2%) groups. 13/14 HIV diagnoses at enrolment were in higher-priority groups. Higher-priority populations had less often previously used sexual health services and accounted for most new HIV diagnoses at enrolment. Engaging these populations in sexual healthcare, including PrEP, should be stressed.

Emergent bilingual preschoolers’ verbal and embodied engagement behaviors in read aloud

Shared reading is a crucial site for children’s emerging reading skills when children engage affectively, behaviorally, and cognitively in the reading process. To inform a more holistic, collective, and inclusive view of observable engagement in read aloud (RA) behaviors, authors examined EB preschoolers’ micro-moment engagement behaviors to understand how they recruit their verbal and embodied modes to attend to RAs and how these behaviors align with prior engagement typologies. A phenomenological approach was implemented to examine EB preschool students’ moment-to-moment, multimodal forms of engagement across three video recorded RAs that consisted of 258 units of analysis. Findings reveal that EB preschoolers’ attentiveness and attention divergence during RA activities were showcased across a multimodal continuum but did not necessarily indicate disengagement or inattention. Opportunities for children’s contemplation were constrained by social and behavioral expectations of their compliance, and within less dialogic RAs, these expectations undermined children’s multimodal means of textual engagement in favor of their quiet, undivided display of attention. Findings have implications for recognizing the role of young children’s multimodal expression in supporting their engagement and interactions in RA in ways that may contribute to their developing reading skills and outcomes.

Impact of Volunteerism on the Mental Health and Academic Performance of Medical Students: A Saudi-Based Cross-Sectional Study.

Introduction The term "volunteering" refers to any endeavor in which one's time is devoted voluntarily to the benefit of another individual, group, or organization, and without the expectation of receiving compensation. Several studies have discovered that engagement in volunteer work is substantially predictive of improved mental and physical health, self-esteem, diminished depressive symptoms, and psychological distress, in addition to having a positive correlation with mental well-being. Aim The objective of this study was to investigate the correlation between medical student participation in volunteer work and their mental well-being. Subject and methods A cross-sectional survey was carried out in Riyadh, Saudi Arabia, involving medical students enrolled in Princess Nourah bint Abdulrahman University and Imam Mohammad Ibn Saud Islamic University, both of which are government institutions, as well as Almarefah College, a private medical school. The students were provided with a self-administered questionnaire. Sociodemographic information, prior volunteer experience, and an evaluation of the mental health status of medical students are all components of the questionnaire. Results A total of 827 medical students participated; 798 (96.5%) of them fell between 18 years and 25 years and only 29 (3.5%) were between 25 years and40 years. Themales accountedfor 594 students (71.8%) and girls accounted for 233 students (28.2%). Among the students, 387 (46.8%) fell within the age range of 21 to 22 years, and 401 (48.5%) had a prior engagement in voluntary activities at school or college. Significant factors that influence participation in volunteering activities consist of attending a governmental institution, 616 students (74.5%); maintaining a grade point average (GPA) ranging from 2.75 to 3.74, 337 students (40.7%); and expressing a preference for participating in medical-related endeavors, 455 students (55%). There is no statistically significant correlation between medical students' engagement in volunteering activities and their mental health state (p>0.05). Conclusion A significant proportion of medical students actively engaged in volunteer work.Contrary to earlier findings, this study establishes that there is no correlation between engaging in volunteer work and the mental health conditions of medical students. Additional longitudinal studies are necessary to establish the correlation between engagement in volunteer work and the mental health of medical students.

237. THE PROGNOSTIC VALUE OF NODAL SKIP METASTASIS IN PATIENTS WITH ESOPHAGEAL CANCER

Abstract Background Nodal skip metastasis (NSM), a common form of lymphatic spread in esophageal cancer (EC), refers to metastatic involvement of distant lymph nodes (LNs) without prior engagement of adjacent LNs. Previous studies examining the association between NSM and survival outcomes in EC patients have yielded inconsistent and even contradictory results. This systematic review and meta-analysis aim to assess the prognostic value of NSM and summarize NSM definitions used in prior studies. Methods Four databases were employed for this meta-analysis. The relationship between NSM and overall survival (OS) was assessed using pooled hazard ratios (HRs) and their 95% confidence intervals (CIs). Sensitivity analysis and funnel plots were utilized to evaluate publication bias. Results This meta-analysis incorporated nine studies, and the pooled results revealed no significant association between NSM and OS (HR = 0.99, 95% CI: 0.75–1.31; P = 0.951). Sub-group analyses based on histological features, method of lymphadenectomy, node staging system, and NSM definitions also failed to identify a significant association between NSM and OS. Conclusions Based on the available evidence, NSM cannot be considered a prognostic factor for EC patients. Future studies examining the prognostic value of NSM should focus on employing three-field lymphadenectomy with an adequate number of harvested LNs. NSM definitions based on lymph node station and anatomical compartment could both serve as feasible classifications for EC.

Prior Engagement in Physical Activity Correlates with Enhanced Quality of Life Perceptions among Older Adults during COVID-19 Lockdown.

This longitudinal study aimed to evaluate whether prior engagement in a physical exercise program correlated with enhanced perceptions of quality-of-life components among older adults during the COVID-19 lockdown period. The cohort comprised elderly individuals (aged ≥ 65 years) who had previously partaken in a 12-week randomized controlled trial investigating the effects of a mixed aerobic-anaerobic, moderate-intensity exercise program. Participants' health-related quality of life was assessed using the Short Form Health Survey-12 item (SF-12) at the beginning of the initial trial and, again, one year later during the COVID-19 lockdown. In the exercise group, 44 participants were included, while the control group consisted of 49 participants, with computer-based, double-blind randomization conducted in Cagliari, Italy. The differences in scores for each SF-12 item between the two groups from T0 to T1 were compared using one-way ANOVA with Bonferroni corrections. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27. No statistically significant differences were observed on average by age (exercise group vs. control group 72.20 ± 4.78 vs. 72.91 ± 4.77; F = 0.513, p = 0.476). A decrease from T0 to T1 towards a better score on the SF-12 was observed in the exercise group compared to the control group in item 1 (F = 67.463, p < 0.0001); in item 5 (F = 4.319, p = 0.041); item 8 (F = 4.269, p = 0.041); item 9 (F = 10.761, p = 0.001); item 10 (F = 170.433, p < 0.001); and item 11 (F = 4.075, p = 0.046). The results suggest that participation in a moderate physical exercise program one year prior may have equipped older adults with better coping mechanisms to navigate the stress and isolation imposed by the COVID-19 lockdown, as reflected by their enhanced scores on quality-of-life components pertaining to mental well-being. Exercise may confer a protective effect against the adverse psychological impacts of stressful events like the pandemic, even among older adults with chronic conditions. This study underscores the potential benefits of exercise interventions for promoting quality of life and preventing mood disorders in the elderly population.

Ampersand Aesthetics: Spatula&amp;Barcode’s &lt;i&gt;Foodways Philippines&lt;/i&gt;

This essay documents and reflects on a complex of social practice art actions addressing hunger that the authors, who work under the name Spatula&amp;Barcode, undertook in the Philippines in 2022 in collaboration with Jazmin Llana. The article gives background on Spatula&amp;Barcode’s prior work with food, art, and performance and their prior engagement with hunger as a theme, then describes several exploratory actions and two larger-scale community-based projects. The theoretical section takes up themes of agency, sovereignty, and hospitality as ethical concerns in both hunger action more broadly and in the possible role of artists in enhancing that work. The essay concludes with a discussion of the “lagniappe”—something extra, above and beyond the necessary—and the symbolism of the ampersand in the artists’ thinking about their work.

Application of Cognitive Load Theory in VR Development and Its Impact on Learning: A Perspective on Prior Knowledge, Learning Interest, Engagement, and Content Comprehension

This research examines the utilization of Virtual Reality (VR) and its implications for the learning process, specifically focusing on learning interest, prior knowledge, learning engagement, and content comprehension. The central objective is to establish a comprehensive model that unravels the intricate interplay between these factors within the context of VR-based learning. The study also aims to shed light on the impact of integrating Cognitive Load Theory into VR development and its effects on the learning experience. Adopting an observational design, this study elucidates the intricate relationships among learning interest, prior knowledge, learning engagement, and content comprehension in VR-based education. The VR technology employed in this research has previously undergone rigorous feasibility testing. The VR application was designed following cognitive load theory principles. Its immersive content offers users a lifelike immersion into the natural habitats of diverse animal species across various global regions. By leveraging VR technology, elementary school students engage in a more profound and authentic learning journey. A total of 85 participants, encompassing fourth and fifth-grade elementary school students, were involved in the study. These students were drawn from schools situated in rural areas in particular regions in Indonesia and had moderate to low economic backgrounds. The variables under examination include Prior Knowledge, Learning Interest, Engagement, and Content Comprehension as learning outcomes. Data analysis was conducted utilizing a blend of linear regression and path analysis techniques, with a confidence level of 95%. The Guttman scale questionnaire was used, and total scores were transformed into a ratio scale through a conversion process. The study reveals a positive correlation between learning interest and learning outcomes, highlighting that a strong interest in a subject contributes to improved learning results. Additionally, both learning interest and prior knowledge influence learning engagement. Students with higher learning interests and prior knowledge are more likely to actively engage in the learning process actively, underscoring internal factors' role in motivating participation. Learning engagement moderates the relationships between learning interest, prior knowledge, and learning outcomes. By enhancing the effect of learning interest and prior knowledge on learning outcomes, engagement enables more comprehensive and practical information processing.

Explaining sender–receiver gaps in signalling: Australia’s ‘Pacific Step-up’ and Solomon Islands’ multi-alignment

Amid growing strategic competition, regional powers have intensified their engagement with Pacific Island Countries. This article examines Australia’s ‘Pacific Step-up’, a signature foreign policy initiative of the Scott Morrison government (2018–2022), from a signalling perspective. Through the Step-up, Australia sought to affirm its resolve to be partner of choice for Pacific Island Countries. This was not cheap talk but led Canberra to invest substantially in its ties with the region. Despite this and significant prior Australian engagement leading to a bilateral security pact, Solomon Islands’ government signed an additional security agreement with China in 2022. How can we explain this sender–receiver gap? I argue that close attention to the agency of domestic actors on the receiver side and the context in which such agency occurs – in this case, an extended history of insecurity in the Pacific country – provides us with analytical leverage when examining concrete instances of signalling.

Neuromuscular Adaptations in Response to Disuse and Weight-Training Rehabilitation are Enhanced in Resistance Trained Individuals

INTRODUCTION: Lower-limb disuse from immobilization results in a decrease in muscle strength, volume, and function. However, muscle atrophy from disuse does not entirely account for the observed strength and functional declines. Additionally, prior engagement in resistance training (RT) has been linked to the preservation of muscular strength and neuromuscular function. Therefore, the purpose of this study was to assess the influence of a single-leg immobilization protocol, followed by structured RT rehabilitation protocol, on muscle strength, volume, and neural activation in healthy young adults with and without previous strength training experience. Methods: Participants (10 Trained (T): 8 men, 2 women; 11 Untrained (UT): 8 men, 3 women) underwent 2-weeks of left-knee immobilization at 90° knee-flexion with a hinged immobilizer knee-brace. Participants were given a pair of axillary crutches for ambulation during this time. Following immobilization, all participants underwent an 8-week structured RT rehabilitation protocol. Participants visited the laboratory for three testing sessions (baseline test on Day 0; post-immobilization at the end of week 2; and post-RT rehab at the end of week 10). Maximal knee extensor isometric strength at 45°was quantified using an isokinetic dynamometer (Biodex). Voluntary muscle activation was quantified as the root mean square (RMS) of the interference electromyography (EMG) signals derived from two indwelling fine-wire electrodes in the vastus-lateralis muscle. Additionally, a continuous wavelet transform (CWT) was performed on the EMG to determine amplitude versus frequency characteristics of the signals and how this amplitude varied with time in the 13-30 (beta) and 30-60 (piper) Hz bands. Mid-thigh muscle cross-sectional area (mCSA) and density were also quantified using peripheral quantitative computed tomography (pQCT) during all testing sessions. Results: The T group was significantly stronger (p=0.019), had greater muscle density (p=0.005) and mid-thigh mCSA (p&lt;0.001) across all sessions when compared with the UT group. However, there were no significant time or interaction effects for strength or muscle density losses (p&gt;0.05). While both groups demonstrated increased muscle activation across sessions (RMS: p=0.04; CWT: p=0.021), the T group demonstrated a greater increase in the neural drive from baseline to week 10 when compared with the UT group (RMS: p= 0.002; CWT: p=0.027). CONCLUSION: In younger adults with or without prior strength training experience, we find that losses in knee extensor isometric strength, muscle density, and mid-thigh mCSA are minimal following a 2-week immobilization protocol. However, certain neuromuscular adaptations during immobilization and following weight-training rehabilitation are enhanced to a greater degree in those with prior training, which is seemingly indicative of greater synchrony in descending cortical drive and motor unit recruitment. These latter findings warrant continued investigation using additional innovative methodologies (e.g., fMRI, TMS, etc.) for assessing the mechanisms underlying the effects of prehab protocols on neuromuscular adaptations. PGRF and Nix family foundation scholarship to Marina Meyer. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effect of clinical engagement on value, standardisation, decision-making and savings in NHS product procurement.

UK healthcare expenditure is now £193.8 billion a year. The procurement function is seen as central to driving efficiencies within the NHS. This comes with an increasing onus on clinicians, including nurses and allied health professionals, to accept procurement outcomes to realise efficiency savings, with or without prior engagement. This empirical study seeks to examine whether clinical engagement in the procurement of healthcare products in the NHS is necessary to achieve value, savings and standardisation; it will thereby address a gap in the research. A multi-method qualitative case study design was used, which included a survey and eight semi-structured interviews. Results identified three factors that influence the achievement of value, savings and standardisation around clinical engagement: micro-level processes for clinical engagement; clinical stakeholders and clinical procurement professionals as experts at the centre of procurement activity; and clinical value in standardisation. A shift away from standardisation to resilience was identified, resulting from current market supply pressures. This research brings empirically derived findings to address gaps in research, supports the benefit of clinical engagement through specific forums for collaboration at a trust level and provides a clinical/expert impact/preference matrix as a resource for procurement professionals to facilitate clinical engagement.

Study regarding the influence of a student’s personality and an LMS usage profile on learning performance using machine learning techniques

Academic performance (AP) is crucial for lifelong success. Unfortunately, many students fail to meet expected academic benchmarks, leading to altered career paths or university dropouts. This issue is particularly pronounced in the early stages of higher education, highlighting the need for the instructors of these foundational courses to have access to simple yet effective tools for the early identification of students at high risk of academic failure. In this study, we propose a streamlined conceptual model inspired by the Model of Human Behavior (MHB) to which we have incorporated two dimensions: capacity and willingness. These dimensions are assessed through the definition of three variables: Prior Academic Performance (PAP), Personality and Academic Engagement, whose measurements can easily be obtained by the instructors. Furthermore, we outline a Machine Learning (ML) process that higher education instructors can use to create their own tailored models in order to predict AP and identify risk groups with high levels of transparency and interpretability. The application of our approach to a sample of 322 Spanish undergraduates studying two mathematical subjects at a Spanish university demonstrates its potential to detect failure early in the semester with a precision that is comparable with that of more complex models found in literature. Our tailored model identified that capacity was the primary predictor of AP, with a gain-to-baseline improvement of 21%, and the willingness variables increasing this to 27%. This approach is consistent over time. Implications for instructors are discussed and an open prediction and analysis tool is developed.

Peer Recovery Specialists and Referrals to Treatment: Clinical Correlates Among Patients of an Opioid Overdose Recovery Program in New Jersey.

Peer recovery programs increase recovery support and treatment engagement among individuals with opioid use disorder. Peer recovery specialists (PRS) are critical in the cascade of care of treating addiction and related conditions. Work remains to help identify the benefits of PRS, particularly time spent with a PRS as a clinical indicator associated with referral to substance use treatment services. Gaps in the literature do not consider the nested hierarchical intercorrelations of opioid recovery data within multiple emergency departments. The current study examined demographic and clinical correlates with referral to substance use treatment services including prior engagement within an opioid overdose recovery program, mental health diagnosis, the number of naloxone administrations, prior overdoses, and hospital-level variability of PRS time associated with treatment referrals. This study used data collected by providers among patients who engaged in an opioid overdose recovery program. Data were collected between January 2016 and September 2020. Generalized linear mixed effect multilevel regression analyses tested the associations on clinical referral to substance use services. A total of 5655 patients participated in the study (male: 68.91%; age: mean = 37.75 ± 12.43; White non-Hispanic: 62.48%). Significant individual-level associations were identified between demographic and clinical variables and referral to substance use treatment services. At the hospital level, recovery specialist time spent with the patient also showed a positive and significant association with referral to substance use treatment services. The cross-level interaction effect displayed that any period of time spent with PRS played an important role for those patients with a greater number of prior overdoses on referral to treatment. Results provide important information on the role of PRS in the cascade of care, as well as the time spent with those in this role for both individuals with varying number of prior overdoses.

Experiencing Literary Audiobooks: A Framework for Theoretical and Empirical Investigations of the Auditory Reception of Literature

Abstract While the act of listening to narratives has deep historical roots, it has gained renewed prominence in the contemporary literary landscape through the rise of audiobooks. Despite their resurgence, research on literary audiobooks, particularly within the realm of literary studies, remains notably limited. The audiobook has struggled to gain acceptance among the humanities as a legitimate aesthetic form, which can be attributed to the fact that it is often compared to the printed book as the leading medium for experiencing literature. By transforming a written text through the performativity of the voice into a spoken, analog, or digitally recorded, repeatable audio text, it becomes a completely different object of research that must be analyzed with different premises and approaches than the underlying written literary work. Nevertheless, literary analysis has predominantly focused on the visual and cognitive aspects of reading, thereby overlooking the auditory dimension. Especially in literary theory, there is a lack of both differentiated, proven descriptive criteria that take into account the specific auditory signification processes, including all the relevant paralinguistic features, and a theoretical foundation. This article aims to address this gap by developing a comprehensive framework for investigating the auditory reception of literature that seeks to elucidate the transition from reading to listening and its profound implications for the literary experience. By delving into the intricacies of auditory reception, literary theory can gain deeper insight into the cognitive and emotional facets of literary experiences, contributing to a more comprehensive understanding of how individuals engage with literary works. Reviewing the still fragmented and nascent state of audiobook research, which barely focuses on the aspect of reception, the proposed framework explores five key dimensions: text, medium, listeners, situations and practices, and the resulting effects of auditory engagement with literature. Through a meticulous examination of these multifaceted factors, this article endeavors to provide a holistic understanding of the auditory reception of literary texts. Moreover, this avenue of research underscores the dynamic nature of literature, providing a richer perspective on the interplay between text, medium, recipients, situational context, and practices, thereby enriching the tapestry of literary theory. For example, a reexamination and customization of narratological categories is crucial, particularly concerning the incorporation of the physical voice, which is now actually present and independent of Genette’s category ›voice‹. Similarly, the transition into the auditory medium necessitates a reevaluation of situational context and its associated practices. This reassessment is driven by the temporal co-occurrence of cognitive processes and physical activities, facilitated by the liberation of hands and eyes from their prior engagement with printed books. This contribution does not solely aim to establish a theoretical foundation for the research field and identify essential factors related to literary listening; instead, the framework is substantiated with empirical evidence drawn from diverse academic disciplines. This synthesis of empirical data and theory sheds light on audiobooks, offering an approach that transcends conventional research paradigms. Moreover, it underscores the need for interdisciplinary collaboration in the investigation of audiobooks. Ultimately, the integrative framework presented here serves as a foundation for further research, offering a nuanced and comprehensive approach and terminology for exploring the evolving landscape of listening to literature.

Hemoglobin on Admission for Childbirth and Postpartum Acute Care Use in a Southeastern Health Care System.

Our objective was to evaluate whether hemoglobin on admission for childbirth is associated with postpartum acute care use (ACU). We conducted a retrospective cohort study of patients giving birth at a southeastern quaternary care hospital from January 2018 through June 2021 using electronic health records. Predelivery hemoglobin was categorized as <9, 9- < 10, 10- < 11, 11- < 12, and ≥12 g/dL. Acute care was defined as a visit to obstetric triage, the emergency department, or inpatient admission within 90 days postpartum. Generalized estimating equations quantified the crude and multivariable-adjusted association between predelivery hemoglobin and ACU. Among 8,677 pregnancies, 1,467 (17%) used acute care in the system within 90 days postpartum. In unadjusted models, those with predelivery hemoglobin <9 had twice the risk of postpartum ACU compared to those with hemoglobin ≥12 (95% confidence interval [CI]: 1.59-2.69), with a decrease in risk for each increase in hemoglobin category (9- < 10 g/dL: risk ratio [RR]: 1.47, CI: 1.21-1.79; 10- < 11 g/dL: RR: 1.44, CI: 1.26-1.64; 11- < 12 g/dL: RR: 1.20, CI: 1.07-1.34). The adjusted model showed a similar trend with smaller effect estimates (<9 g/dL: RR: 1.50, CI: 1.14-1.98; 9- < 10 g/dL: RR: 1.22, CI: 1.00-1.48; 10- < 11 g/dL: RR: 1.22, CI: 1.07-1.40; 11- < 12 g/dL: RR: 1.09, CI: 0.98-1.22). Low hemoglobin at childbirth admission was associated with increased postpartum ACU. Low hemoglobin on admission could signal to providers that additional follow-up, resources, and ongoing support are warranted to identify and address underlying health needs. Because hemoglobin is routinely assessed during the childbirth hospitalization, this indicator may be especially valuable for risk assessment among patients with limited prior engagement in health care. · Low hemoglobin on admission for birth is associated with postpartum acute care use.. · Hemoglobin on admission may aid in risk-stratification during childbirth hospitalization.. · Point-of-care metrics may help identify high-risk patients with limited preventive health care..

Exploring Senior Tourist Engagement Behaviour in Social Networking Sites Advertising – A Study of Senior Tourist Users on WeChat

This study delves into senior tourists’ engagement behaviour in social networking site advertisements (SNSA) and the underlying factors influencing their behaviour. Using a qualitative research approach, 19 senior tourists with prior SNSA engagement experience were interviewed. The findings reveal three distinct patterns in senior tourists’ SNSA engagement: 1) Proactive Engagement, 2) Passive Engagement, 3) Positive Consciousness Driven Engagement. These insights provide valuable guidance for the hospitality and tourism industry. By understanding the multifaceted nature of senior tourists’ engagement with SNSA, industry participants can tailor their marketing strategies to better target and engage this demographic.

Knowledge, Attitude and Awareness of Oman Emergency Physicians and Residents Regarding Radiation Emergencies.

Radiological emergency preparedness and response are increasingly acknowledged as vital components of both emergency readiness and public health. Previous studies have shown that medical providers feel unprepared to respond to radiation incidents. The existing level of knowledge, attitudes, and awareness held by emergency medicine residents and physicians in Oman, remain unexplored. This study aims to evaluate the knowledge, attitude, and awareness level of emergency residents and physicians in Oman regarding the management of radiation emergencies. An electronic survey was distributed to 44 emergency residents and 57 emergency physicians. The response rate was 62.7% (N = 69/110). Notably, 62% reported no prior engagement in radiation emergency training. The majority of participants had neither employed nor received training in operating radiation detection devices. A significant gap in knowledge emerged, with the median self-reported knowledge score of 50/100. The majority of participants (59%) expressed a need for educational programs and materials. Our findings underscore the imperative for enhanced training in radiological incident preparedness for emergency medicine residents and physicians in Oman. The study reveals a clear necessity to bridge the existing gaps in knowledge and attitudes to bolster the readiness of health-care professionals to respond effectively to radiation emergencies.