Substantive Changes Research Articles

STRIVE pilot trial: a protocol for a multicentre pragmatic internal pilot randomised controlled trial of Structured TRaining to Improve fitness in a Virtual Environment (STRIVE) before surgery

IntroductionHome-based, virtually-supported care models may represent the most efficient and scalable approach to delivering prehabilitation services. However, virtual approaches to prehabilitation are understudied. This manuscript describes the protocol for an...

The repatriation of wolves to Isle Royale alters the foraging of meso-carnivores

Abstract Due to the disproportionate role that large carnivores can have on communities and their global decline over the last century, carnivores are increasingly being repatriated across their historic ranges. The reintroduction of gray wolves (Canis lupus) can precipitate substantive changes to communities and ecosystems. Notably, wolves could have strong effects on smaller and subordinate carnivores, especially in altering their foraging behavior and prey selection. Past studies investigating wolf effects on other carnivores, however, have generally been conducted in relatively complex communities featuring a diverse assemblage of carnivores and prey and have lacked baseline (i.e., pre-repatriation) data. Consequently, researchers have quantified what a community looks like after wolf return, with little information on how the community behaved before. To better understand the effect of large carnivore repatriation on the foraging ecology of a carnivore community, we investigated the impact of reintroduced gray wolves on 2 meso-carnivores: Red Fox (Vulpes vulpes); and American Marten (Martes americana) within an insular and simple vertebrate community at Isle Royale National Park before and after wolf reintroduction. We analyzed >600 scats from 20 individual martens and 63 individual foxes as well as the stable isotopes of 9 and 22 tissue samples from martens and foxes, respectively, at both individual and population levels. We found that the wolf reintroduction had little effect on marten diet but strongly influenced fox diet depending on the analysis conducted. At the population level, our analysis revealed that both foxes and martens were dietary generalists consuming an array of food items including small prey, berries, and human food regardless of wolf presence. However, at the individual level, we found that prior to wolf repatriation foxes primarily consumed berries and small prey but following wolf repatriation the diet of foxes shifted to berries and human foods as well as large carrion. This post-wolf reintroduction shift in diet increased the dietary overlap between foxes and martens. Our work provides new insights into how the return of a large carnivore can alter the foraging ecology of small-bodied carnivores and act both to provision carrion resources as well drive other carnivores to consume more human food and increase dietary overlap.

Full-Field Electroretinogram Responses in Rodent Models of Ganglion Cell Injury.

Preclinical studies of optic nerve injury models have led to significant insight into the mechanism underlying retinal ganglion cell neurodegeneration. During the process of ganglion cell injury, morphological changes can occur prior to gross structural changes and cell death. Similarly, following injury, functional changes can occur in the absence of substantive structural changes. These more subtle effects can often be detected using functional tools such as the electroretinogram. Moreover, the electroretinogram is a sensitive and complementary means to quantify treatment efficacy. Here, we describe in vivo electroretinography for assessing ganglion cell injury in rodent models.

Recrafting the accounting curriculum to enhance employability of graduates: A Ghanaian case

This paper examined the need to update the accounting curricula in Ghanaian universities to address the issue of unemployment among accounting graduates, particularly in the context of the fourth industrial revolution (4IR). A qualitative approach involving document analysis and in-depth interviews was employed. Both purposive and snowball sampling methods were used to select a diverse group of participants, comprising government officials, accounting academics, employers, and graduates for the interviews. Data were analyzed using thematic review procedures. The study established the need for substantive changes in the accounting curricula in Ghanaian universities to teach 21st-century multi-disciplinary skills, balance practical and theoretical skills, provide a comprehensive range of financial and management accounting expertise, combine academic and professional credentials, and uphold strong ethical standards and integrity. Substantial modifications must be undertaken to the accounting curriculum to effectively address the issue of unemployment among accounting graduates. The findings require a stronger collaboration among government, academics, employers, graduates, and other interested parties in accounting to create an accounting curriculum that will focus on 21st-century skills and adequately blend theory and practice to reduce unemployment among accounting graduates.

Copyright as an Access Right: Concretizing Positive Obligations for Rightholders to Ensure the Exercise of User Rights

Abstract The legal frameworks that govern access to information are essential for safeguarding a sustainable, creative ecosystem. Institutions, such as libraries, research organizations, educational and other cultural heritage institutions, are gateways to diverse collections of scientific production, media and other cultural artefacts. Enabling access to creative works requires careful balancing of the interest of creators, producers of information, publishers and users of that information. While copyright law has traditionally recognized that rightholders enjoy exclusive rights, courts have only recently emphasized that users of works must also enjoy rights, which better reflects that copyright is based on a social contract with reciprocal obligations. This study explores what positive obligations must be imposed on rightholders as a consequence of the rights users enjoy under copyright law. Although specific access-enabling mechanisms already exist in EU copyright law, they are often not properly implemented or lack efficient enforcement tools. For that purpose, certain exceptions and limitations must be made mandatory, prohibitions on contractual override must apply horizontally, privileged institutions should enjoy enforceable rights to obtain copies on reasonable terms, and the existing ‘lending’ right must become a ‘right to lend’. Supporting these substantive changes is the proposal for a new governance structure for the EU copyright framework through the establishment of an independent EU regulatory body. It is only through a blend of changes that copyright can serve society and that a sound ecosystem for creators and creativity is set up making the EU fit for the knowledge economy.

Chemical Abundance Gradients of Organic Molecules within a Protostellar Disk

Observations of low-mass protostellar systems show evidence of rich, complex organic chemistry. Their low luminosity, however, makes determining abundance distributions of complex organic molecules within the water snowline challenging. However, the excitation conditions sampled by differing molecular distributions may produce substantive changes in the resulting emission. Thus, molecular excitation may recover spatial information from spatially unresolved data. By analyzing spatially unresolved NOrthern Extended Millimeter Array observations of CH3OH and CH3CN, we aim to determine if CH3OH and CH3CN are distributed differently in the protostellar disk around HOPS-370, a highly luminous intermediate-mass protostar. Rotational diagram analysis of CH3OH and CH3CN yields rotational temperatures of 198 ± 1.2 K and 448 ± 19 K, respectively, suggesting the two molecules have different spatial distributions. Source-specific 3D LTE radiative transfer models are used to constrain the spatial distribution of CH3OH and CH3CN within the disk. A uniform distribution with an abundance of 4 × 10−8 reproduces the CH3OH observations. In contrast, the spatial distribution of CH3CN needs to be either more compact (within ∼120 au versus ∼240 au for CH3OH) or exhibit a factor of ≳15 increase in abundance in the inner ∼55 au. A possible explanation for the difference in spatial abundance distributions of CH3OH and CH3CN is carbon-grain sublimation.

On the Importance of Extracurricular Physical Education Activities in the Physical Education of Students of Higher Education Institutions

The article presents material on the organization of extracurricular activities in physical education at a higher educational institution. The relevance of this topic is due to structural and substantive changes in undergraduate educational programs and work programs in physical education, which have led to an increasing role of extracurricular activities in the formation of student's physical culture competence. This circumstance requires consideration of issues of planning, organization and methodological support of this type of pedagogical activity. The purpose of the study is to identify the organizational and educational aspects of student sports and wellness activities conducted in their free time from study at the university. As an example of the organization of extracurricular work carried out by teachers of the Department of Physical Culture and Sports, a number of physical culture and recreation and sports events held at the Omsk State Agrarian University named after P. A. Stolypin are proposed. The analysis and generalization of pedagogical experience in the higher education system, data from literary sources on the problems of physical education of students allowed us to make practical recommendations on the basics of planning, goal-setting and organizational features of extracurricular activities in physical culture. The possibility of increasing the effectiveness of this activity is emphasized due to the uniform distribution of activities throughout the academic year, attracting students with different levels of physical, sports and technical readiness and motivation in the field of physical culture and sports to participate. In addition to the calendar plan, the organizers for each event must define a goal, develop a program, create a festive atmosphere, ensure the safety of spectators and participants, and create conditions for informational coverage of the planned event.

Trends in the healthiness and nutrient composition of packaged products sold by major food and beverage companies in New Zealand 2015 to 2019

BackgroundDietary risk factors are the leading cause of death globally and in New Zealand (NZ). Processed packaged foods are prevalent in the food supply and contribute excess amounts of sodium, saturated fat, and sugar in diets. Improving the nutritional quality of these foods has the potential to reduce population chronic disease risk. We aimed to evaluate the healthiness using the Australasian Health Star Rating (HSR, from 0.5 to 5 stars, with 5 being the healthiest) and nutrient composition (sodium, saturated fat, and total sugar) of packaged products manufactured by the largest NZ-based food and beverage companies in NZ 2015–2019. This analysis relates to a larger study evaluating structured engagement with food companies to improve nutrition-related policies and actions.MethodsData was sourced from Nutritrack, a NZ-branded supermarket-sourced food composition database. The largest NZ-based companies from annual retail sales revenue (n = 35) were identified using 2019 Euromonitor data. All relevant products of the selected companies were extracted for analysis. Products included totalled 17,795 with a yearly range of 3462–3672 products. The primary outcome was a nutrient profile score estimated using HSR. Healthiness was defined as ≥ 3.5 stars. Secondary outcomes were sodium, total sugar, and saturated fat per 100 g/100 mL. All outcomes were assessed overall, by food company, and food category. Change over time was tested using linear mixed models, adjusting for major food categories and cluster effects of food companies controlling for multiple comparisons. Model-adjusted mean differences between years were estimated with 95% confidence intervals.ResultsThere was a small statistically significant increase in mean HSR between 2015 and 2019 (0.08 [0.15,0.01], p = 0.024). Mean total sugar content decreased over the same period (0.78 g/100 g [0.08,1.47], p = 0.020), but there were no significant changes in mean sodium or saturated fat contents. Seven of the 13 categories showed small increases in mean HSR (0.1–0.2). Most categories (9/13) exhibited a reduction in mean total sugar content.ConclusionsBetween 2015 and 2019, there were slight improvements in the nutritional quality of selected packaged foods and drinks in NZ. Much more substantive changes are needed to address the health-related burden of unhealthy diets, supported by stronger government action and less reliance on voluntary industry initiatives.

User Experiences of Transitioning From a Homegrown Electronic Health Record to a Vendor-Based Product in the Department of Veterans Affairs: Qualitative Findings From a Mixed Methods Evaluation.

The Department of Veterans Affairs (VA), the largest nationally integrated health system in the United States, is transitioning from its homegrown electronic health record (EHR) to a new vendor-based EHR, Oracle Cerner. Experiences of the first VA site to transition have been widely discussed in the media, but in-depth accounts based on rigorous research are lacking. We sought to explore employee perspectives on the rationale for, and value of, transitioning from a VA-tailored EHR to a vendor-based product. As part of a larger mixed methods, multisite, formative evaluation of VA clinician and staff experiences with the EHR transition, we conducted semistructured interviews at the Mann-Grandstaff VA Medical Center before, during, and after going live in October 2020. In total, we completed 122 interviews with 26 participants across multiple departments. Before the new vendor-based EHR went live, participants initially expressed cautious optimism about the transition. However, in subsequent interviews following the go-live, participants increasingly critiqued the vendor's understanding of VA's needs, values, and workflows, as well as what they perceived as an inadequate fit between the functionalities of the new vendor-based EHR system and VA's characteristic approach to care. As much as a year after going live, participants reiterated these concerns while also expressing a desire for substantive changes to the transition process, with some questioning the value of continuing with the transition. VA's transition from a homegrown EHR to a vendor-based EHR system has presented substantial challenges, both practical and cultural in nature. Consequently, it is a valuable case study for understanding the sociotechnical dimension of EHR-to-EHR transitions. These findings have implications for both VA leadership and the broader community of policy makers, vendors, informaticists, and others involved in large-scale health information technology implementations.

Neurological Surgery Resident ABNS Written Exam Scores Before and After Introduction of a Weekly Didactic Educational Intervention: A 12-Year Single-Institution Retrospective Study.

United States neurological surgery residency education has undergone substantive changes over the past 2 decades. Neurosurgical professional bodies have developed numerous initiatives providing standardized assessments and training opportunities for residency programs. However, there have been few studies using standardized measures to assess core components of educational programming in individual programs. We conducted a 12-year retrospective review of resident American Board of Neurological Surgery (ABNS) board scores using our institutional data from 2010 to 2021 to determine the effect of introducing a weekly didactic resident education hour (REH) on resident scores in the ABNS written in-training examination. ABNS scaled scores were analyzed before (2010-2016) and after (2017-2021) REH introduction. To account for a practice effect, we used a 2-factor linear regression model with an interaction term. We obtained ABNS scores from 43 residents representing 132 test attempts. The average ABNS scaled score significantly improved after the introduction of REH (319 vs 410, t = -3.44, P = .0008). Accounting for the practice effect revealed a significant interaction effect between the number of attempts taking the ABNS examination and whether formal didactics were taught, accounting for 46.2 points on the examination (t = 2.309, P = .023); however, REH alone did not have a significant effect on the scaled scores (t = -1.649, P = .102). ABNS written board scores represent a standardized metric by which educational initiatives within training programs may be assessed for efficacy. Further research is needed to identify educational approaches that are effective to meet the goal of demonstrated mastery of fundamental knowledge in neurosurgery across a diversity of neurological surgery residency programs.

Foster Care in India from 2010 to 2024—Policy and Humanity Lens

The feature article explores the journey of foster care in India from 2010 to 2024 as an analysis and commentary on the substantive changes between the foster care 2016 model guidelines and the newly released foster care 2024 guidelines. The article highlights the historical context of foster care in India, acknowledging the efforts of pioneers over the past decades. It discusses the challenges of scaling up foster care nationwide, emphasising the need for proper support systems and cultural sensitivity. Reflecting on the journey since 2016, the article acknowledges the slow progress and instances of corruption in foster care implementation. It underscores the importance of trained oversight and social work expertise in ensuring the well-being of children in foster care. Looking ahead to 2024, with the release of new foster care guidelines, the article suggests a shift towards a child-centred approach and emphasises the need for robust monitoring and evaluation mechanisms. In summary, the article advocates for a comprehensive approach to foster care implementation in India, encompassing cultural sensitivity, capacity building, community engagement, legal framework alignment, child-centred practices and effective monitoring and evaluation.

“Take a Deep Breath and Re-Center the Student's Perspective”: Partnering Instructors and Disabled Students for Accessible Teaching

Background Because accessible and anti-ableist teaching is rarely prioritized in instructional development programs, a new initiative was developed at a large, public university. Launched in January 2022, it piloted strategies for shifting instructors’ mindsets about and pedagogical approaches to accessibility. Using a professional learning community model, disabled students served as course consultants to instructors, working closely together in a semester-long partnership. Objective The purpose of this study was to research the program's effects on the participating instructors. Method Multiple raters coded qualitative data collected over a period of five months from meeting notes spanning 30 instructor–student partnership meetings, four all-team meetings, two student focus groups, three instructor focus groups, and six online discussion boards. Results The results showed the mindset shifts and teaching strategies that emerged through this semester-long initiative. They also revealed the program elements that had the greatest impact on instructors. Conclusion This study demonstrates the role that disabled students can play in helping instructors learn about accessibility and how learning community models support substantive changes in teaching. Teaching Implications The results of this study should help psychology teachers and departments improve their courses and engage in ongoing development to improve access and equity in their courses.

Remitted euros are not equal: The complex spending behaviour of Kosovar households

AbstractThis article uses a mixed‐methods approach to evaluate how remittances impact household spending behaviour in Kosovo. Based on a nationally representative data set and using matching techniques, it shows that migration does not cause substantive changes in household spending. While remittances cover basic consumption needs, there are no impacts on budgetary allocations for business investments, health and education. Yet, qualitative research conducted in Kosovo's Opoja region, involving the analysis of 28 open‐ended interviews, unveils a complex remitting mechanism. While migrants send smaller but regular amounts of money to cover basic needs, earmarked transfers are allocated for housing investments and conspicuous consumption only. These earmarked transfers do not enter Kosovar households' budgets, as migrants exercise decision‐making authority over these funds. For policymakers, our findings suggest that standard survey questions fall short of capturing the complexity of the remitting mechanism. When promoting productive investments, it is the migrants who should be targeted as key decision‐makers.

Indigenous Taste

For the Indigenous Sagada Igorots of upland Cordillera in northern Philippines, domesticated pigs and etag (salted and smoked pork slices) continue to play an important role for rituals and as gastronomic vehicles for constituting and performing social relatedness, reciprocity, and redistributive functions through feasting and sharing. These deep historical practices are largely mediated by the elders of Sagada in the face of various kinds of entanglements with the state and markets over time. I characterize this mixed bundle of communal socio-affective and gastronomic ingredients as “Indigenous taste.” This essay discusses recent substantive socioeconomic changes in Sagada due largely to mass tourism and the impacts they have set in motion for the aforementioned practices, and on how Sagada Igorots negotiate with the outside world under these new historical conditions.

Resonating strings: understanding the transition from Hume’s Treatise to Second Enquiry

ABSTRACT What, if anything, changes between Hume's moral theory as presented in the Treatise of Human Nature and then in the Enquiry concerning the Principles of Morals? This question has received increased attention, especially focused on Hume's presentation of sympathy and humanity, and the connection of those principles to Hume's account of moral sentiments. While there is a strong consensus that Hume is making important stylistic changes to the presentation of his views, scholars are divided on the question of whether there are also substantive changes to the views. This paper sides with those who hold that there are substantive changes, offering new evidence for that position. I argue that Hume revised his Treatise account of sympathy to better accommodate cases of affective difference and incapacity. After presenting these cases, I show that Hume's Treatise account of the sympathy mechanism and its role in the production of moral sentiments is more seriously threatened by the problem of affective difference and incapacity than the corresponding account in the second Enquiry. This gives us persuasive evidence in support of the interpretations that hold that there are substantive changes in the second Enquiry, while also helping to explain Hume's motivation for such changes.

Double-edged sword in the quality assurance toolkit: uncovering the influence of self-study on higher education institutions in francophone West Africa

ABSTRACT Policy discussions related to higher education in sub-Saharan Africa often include concerns related to quality. Rather than being an abstract characteristic, quality of higher education is the result of a series of actions and practices, and yet there is limited research on the practices associated with quality in higher education in Africa. This article explores the practice of self-study in West African higher education institutions. After conducting 21 semi-structured interviews with key stakeholders from four public and private institutions in the West African region, which were selected on the basis of their respective strength in quality culture, the study suggests that protecting one’s institutional image can have a significant impact on the uses of self-study. Research participants, regardless of weak or strong quality cultures, were very sensitive about, and even protective of, institutional self-image. The pursuit of a strong institutional image resulted in substantive changes within stronger cultures, or cosmetic changes, among weaker cultures. Having weighed the evidence collected in the study, we argue that the link between self-study and academic activities, including teaching and learning, is weak at best. This study serves as a reminder that self-study is an instrument and therefore its uses are subject to revision and improvement.

From a traditional university to the development of the metaverse: network and target effects

Digital and information technologies are driving changes in traditional business models. Depending on the level of immersion in the digital environment, they are transformed into other formats: from offline business with a "digital shadow" to the creation of platforms and metaverse based on them. The study deals with the economic and target effects arising from the transition of a traditional university to the network business model of an educational metaverse. The concept of network economy and the theory of business models served as a methodological basis; general scientific research methods were used in the paper. Substantive changes in the business model of the university are clarified, the key differences of the educational metaverse are highlighted. The economic efficiency of the metaverse is achieved through the realization of network benefits, which, in turn, transforms the opportunities for achieving its mission as target efficiency.

The Model of Ethnopedagogical Training of Students of a Pedagogical University

The ethnopedagogic orientation of education and upbringing is one of the main ones in the modern educational policy of the Republic of Kazakhstan. This is stated in the platform of the state policy of the Republic of Kazakhstan on socio-cultural development, that special attention is paid to the specifics of the culture of all peoples living in the republic, and that any culture is a unique, incomparable asset, and that a certain population fully presents itself to the world. Therefore, today the university offers conditionally three stages in order to reorient the ethnopedagogic system of education and upbringing. This program contains the content of ethnopedagogic education — a scientifically based system of students’ knowledge, attitude of responsibility to national history, language, culture, traditions, on the basis of which a model of the research problem is proposed through a systematic analysis of structural and substantive changes in ethnopedagogic education and upbringing of students. On the basis of the proposed model, the works of research scientists in the organization of the educational process were analyzed, the pedagogical possibilities of the ethnopedagogic heritage were taken into account, along with theoretical and methodological justification, a meaningful analysis of methodological manuals and educational programs operating in the pedagogical process was carried out in the development of scientific and methodological recommendations.

Changes associated with the COVID-19 pandemic on postpartum screening results in Ontario, Canada: The healthy babies healthy children screening tool.

Research on the impact of the COVID-19 pandemic on mothers/childbearing parents has mainly been cross-sectional and focused on psychological symptoms. This study examined the impact on function using ongoing, systematic screening of a representative Ontario sample. An interrupted time series analysis of repeated cross-sectional data from a province-wide screening program using the Healthy Babies Healthy Children (HBHC) tool assessed changes associated with the pandemic at the time of postpartum discharge from hospital. Postal codes were used to link to neighborhood-level data. The ability to parent or care for the baby/child and other psychosocial and behavioral outcomes were assessed. The co-primary outcomes of inability to parent or care for the baby/child were infrequently observed in the pre-pandemic (March 9, 2019-March 15, 2020) and initial pandemic periods (March 16, 2020-March 23, 2021) (parent 209/63,006 (0.33%)-177/56,117 (0.32%), care 537/62,955 (0.85%)-324/56,086 (0.58%)). Changes after pandemic onset were not observed for either outcome although a significant (p = 0.02) increase in slope was observed for inability to parent (with questionable clinical significance). For secondary outcomes, worsening was only seen for reported complications during labor/delivery. Significant improvements were observed in the likelihood of being unable to identify a support person to assist with care, need of newcomer support, and concerns about money over time. There were no substantive changes in concerns about ability to parent or care for children. Adverse impacts of the pandemic may have been mitigated by accommodations for remote work and social safety net policies.

전환기 슬로베니아 고등교육 개혁의 특징과 결과 연구

At the outset of Slovenia’s transition period, the urgent national task was to establish democracy, liberalism, and pluralistic values across all sectors. This comprehensive transition involved institutional reorganization in society, politics, education, and media, alongside reforms targeting the general public. Education emerged as a crucial tool for fostering and disseminating liberal democratic values, aiming to socialize individuals into understanding the moral, civic, and societal obligations of the new system. Slovenian school reform during this period was grounded in liberal democratic values, human rights, and knowledge. Initially, higher education reform lagged due to internal circumstances, with a focus on complementing previous socialist-era reforms rather than enacting substantive changes. However, upon Slovenia's accession to the European Union, a process of Europeanization swept across the nation, prompting the initiation of higher education reform aligned with the Bologna Process. Despite expectations, the Bologna Process encountered resistance in Slovenian higher education and yielded less favorable outcomes than anticipated. This study examines the foundational values of Slovenia’s educational reform for establishing a liberal democratic system and Europeanizing it, while also analyzing the controversies and results surrounding the ‘Bologna Process’, a key symbol of higher education globalization.