In the era of proliferation of large language and image generation models, the phenomenon of"model collapse"refers to the situation whereby as a model is trained recursively on data generated from previous generations of itself over time, its performance degrades until the model eventually becomes completely useless, i.e the model collapses. In this work, we study this phenomenon in the setting of high-dimensional regression and obtain analytic formulae which quantitatively outline this phenomenon in a broad range of regimes. In the special case of polynomial decaying spectral and source conditions, we obtain modified scaling laws which exhibit new crossover phenomena from fast to slow rates. We also propose a simple strategy based on adaptive regularization to mitigate model collapse. Our theoretical results are validated with experiments.
Abstract Background It’s well established that falls are a leading cause of injury among older adults and may be influenced by sleep duration. This study aimed to investigate the association between nighttime sleep duration and fall risk in a nationally representative older population. Methods This population-based cross-sectional study used data from the Turkey Older adults Profile Survey conducted in 2023. A total of 10,321 community-dwelling adults aged 65 years and older were included. Data on demographics, health characteristics, sleep duration, environmental factors, and fall history were collected through structured interviews. Univariable and multivariable logistic regression models were undertaken to estimate the association between nighttime sleep duration (< 7 h, 7–8 h [reference], and > 8 h) and falls. Multivariable models progressively adjusted for age, gender, education, marital status, physical activity, BMI, alcohol use, regular medication, walking difficulty, visual impairment, depression, chronic disease status, self-rated health, and environmental factors. Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated. Results Among the participants (mean age: 72.8 ± 6.4 years; 54.5% female), 20.1% reported falls in the past year. Short sleep duration (< 7 h) was associated with significantly increased odds of falling in both unadjusted (OR = 1.755, 95% CI: 1.584–1.944, p < 0.001) and fully adjusted models (aOR = 1.546, 95% CI: 1.388–1.724, p < 0.001). Long sleep duration (> 8 h) initially indicated an elevated fall risk (OR = 1.224, 95% CI: 1.036–1.447, p = 0.018); however, this association lost statistical significance after fully adjusting for several health and environmental covariates (aOR = 1.091, 95% CI: 0.918–1.297, p = 0.322). Conclusions Nighttime sleep duration less than 7 h was independently associated with an increased risk of falls among older adults. Interventions promoting optimal sleep duration could be a crucial component of fall prevention strategies targeting older populations.
Objective: This paper aims to evaluate the preventive effects of light music on postpartum anxiety and depression in primiparous women. Methods: This retrospective study analyzed 120 primiparous women admitted to our hospital from June 2022 to June 2024. Participants were divided into two groups based on the postpartum nursing methods they received: those who received standard care (standard care group: n = 58) and those who received light music therapy (music therapy group: n = 62). Outcomes included Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS), Pittsburgh Sleep Quality Index (PSQI), salivary cortisol, salivary alpha-amylase (sAA), exclusive breastfeeding (EBF) rates, and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) scale scores at 3-day and 6-week postpartum. Results: At 6 weeks postpartum, the music therapy group showed significantly lower scores of EPDS, PASS, and PSQI compared to the standard care group (P < 0.05). Salivary cortisol and sAA levels were also significantly reduced (P < 0.05). Additionally, the music therapy group exhibited higher EBF rates (79.03% vs. 53.45%, P < 0.05) and significantly improved scores across all domains of WHOQOL-BREF (P < 0.05). Conclusion Light music therapy significantly alleviates postpartum psychological distress, reduces physiological stress, and improves breastfeeding rate and quality of life, which supports its clinical adoption.
Julianna Podolec, Silvia Ciraolo, Joanna Wojda
et al.
Purpose of Research: The research aims to provide an in-depth understanding of CLOVES syndrome, detailing its clinical features, epidemiology, etiology, and diagnostic criteria. It focuses on the role of PIK3CA gene mutations, challenges in diagnosis, and treatment options, including PI3K/AKT/mTOR pathway inhibitors.
Research Materials and Methods: This article is based on a review of the current literature and clinical reports from various sources. The methodology includes a collection and synthesis of clinical data, imaging findings, and genetic analyses from published case studies and medical literature. The primary materials used in the research include: clinical case reports and studies, imaging studies, genetic analysis, therapeutic interventions, epidemiological data, literature review and data analysis.
Basic Results: CLOVES syndrome affects fewer than 200 individuals worldwide, with symptoms appearing at birth or early childhood. It can lead to serious complications such as nerve compression, deep vein thrombosis, and pulmonary embolism. Diagnosis involves genetic testing and imaging, and sirolimus shows potential in managing symptoms.
Conclusions: CLOVES syndrome is a rare, non-hereditary overgrowth disorder caused by a PIK3CA gene mutation. Early diagnosis and a multidisciplinary approach are vital for managing this complex condition and improving patient outcomes.
Sun Hwan Choi MD, Myeong Gu Lee MD, Yoon Je Cho MD
et al.
Introduction Prophylactic surgery for symptomatic incomplete atypical femoral fractures (SIAFFs) has demonstrated favorable outcomes. However, concerns remain regarding surgical intervention for a fracture that has not yet completed. This retrospective study aimed to evaluate the efficacy of conservative treatment using teriparatide (TPTD) as a conservative treatment for SIAFF. Methods This retrospective study reviewed 30 cases with SIAFF who underwent conservative treatment between November 2012 and September 2019. The diagnosis of SIAFF was based on the criteria established by the Task Force of the American Society for Bone and Mineral Research(ASBMR). The treatment protocol included (1) discontinuation of bisphosphonates, (2) use of 2 crutches or a four-point walker, (3) daily subcutaneous TPTD injection until pain subsided, and (4) monthly radiographic follow-up. Radiographs and bone scans were used to assess bone union, and follow-up continued for up to 2 years from protocol initiation. Comparisons between the successful and failed treatment groups were performed using the Student’s t-test for continuous variables and Fisher’s exact test for categorical variables. Results The mean age was 72.6 years (range, 55-87) and all patients were female. 13 cases involved the diaphyseal region and 17 involved the subtrochanteric region. The average duration of TPTD treatment was 6.5 months (range, 3-12), and the average follow-up was 45.5 months (range, 19-84) after the final injection. The mean SIAFF severity score was 9.5 (range, 7-11). Symptom-free bone union was achieved in 23 of 30 cases (76.7%). Five cases (4 with worsening pain, 1 with radiographic progression) underwent prophylactic intramedullary nailing, and 2 cases progressed to complete fracture and were treated with intramedullary nailing. Conclusion The result of this study suggests that the conservative treatment with teriparatide injection may be a potentially effective option for patients with SIAFF.
Blinov V. Dmitry, Antonina G. Solopova, Elena V. Gameeva
et al.
Introduction. Surgical treatment of vulvar cancer (VC) entails mental and somatic disturbances due to pain, body image changes, and sexual dysfunction, which are closely associated with impaired social functioning and reduced overall quality of life. However, the results evaluating the impact of rehabilitation programmes on various components of quality of life in these patients remain limited.
Aim. to evaluate the effectiveness of rehabilitation programs in relation to the psycho-emotional sphere during 36 months following surgical treatment of early-stage VC.
Materials and methods. The randomized controlled study included female patients with VC, divided into two parallel groups of those who received a personalized program of comprehensive rehabilitation (VC-1) and rehabilitation according to the general principles regulated in the national clinical guidelines (VC-2). 36 patients each were randomly assigned to VC-1 and VC-2 groups. The control group included 80 women without female cancer. The VC-2 group was recommended physical activity, psychological support, and anti-edema therapy for lymphostasis. The personalized rehabilitation program in the VC-1 group additionally included lifestyle modification, cognitive-behavioral therapy, intimate hygiene training, magnesium, vitamin B6 and folic acid supplementation, correction of sexual disorders, phytotherapy and physiotherapy from the 3rd month, and climatotherapy and landscape therapy from the 6th month. The “Well-being, Activity, Mood” (WAM) questionnaire was administered at the preoperative visit, 1 week, 1, 3, 6, 12, 24 and 36 months after surgery. Scores were presented as Me [Q25; Q75], differences were considered significant at p 0.05.
Results. In the control group, scores on all WAM domains were within normal values throughout the study. In the 1st week after the surgery, well-being and activity decreased to unfavorable values in both VC-1 and VC-2 groups. Mood, however, showed significant positive dynamics compared to baseline. Subsequently, the improvement in the WAM domains was significantly faster and more pronounced in the VC-1 group than in the VC-2 group, reaching the range of favorable values by the 12th month, but not reaching the control group.
Conclusion. The personalized comprehensive rehabilitation program showed efficacy on well-being, activity and mood on the WAM questionnaire compared to basic rehabilitation. However, rehabilitation measures should be continued one year after surgery.
Abstract Background The benefits of travel for the wellbeing of people of all ages and abilities are well known, though travellers with prostheses have so far been excluded. Limb loss, due to trauma, vascular disease, cancer, or infections requires a prosthesis for cosmesis and functionality. The life-changing event of losing a limb and the considerable psychological adjustment to accept an altered body image influence rehabilitation and self-management as well as the participation in social activities, such as sport and travel. The challenge of travel lies not only in transferring practical impediments encountered at home to another location; familiar coping strategies may require unexpected adjustments. After presenting background information on limb loss and prostheses, the purpose of this paper was to review literature on health advice for travellers with prosthetic limbs. Method All major data bases were searched for peer-reviewed literature using a variation of keyword combinations around travel and prosthetics. Relevant journals were searched individually, and selected authors and university departments contacted. No evidence-based results were obtained. The search then moved to grey literature including documents from relevant organisations, professional bodies, government websites, manufacturers, airlines, prosthetic/physiotherapy clinics, sport organisations to approaching amputees, including veterans and athletes, directly. Result The list of collated travel advice for people with artificial limbs relates to (1) trip preparation, (2) packing (especially considering the mechanical and/or electrical requirements of the prosthesis), (3) travelling by plane as the most covered mode of travel, and (4) navigating airports and airport security, which may be used by travel health practitioners while awaiting evidence-based guidelines. Conclusion This is the first paper on travel with a prosthetic limb in any field, including travel medicine. Therefore, travel health practitioners have no evidence-based guidelines at their disposal required for high-quality care for this neglected population. Preliminary recommendations for clinical practice, advice for required updates in education, and suggestions for urgently needed research are provided to replace current hints and tips with evidence so that travellers with prostheses are no longer ‘out on a limb’.
Elisa dePaula França Resende, Vivian P. Lara, Ana Luisa C. Santiago
et al.
Abstract INTRODUCTION The influence of hippocampal connectivity on memory performance is well established in individuals with high educational attainment. However, the role of hippocampal connectivity in illiterate populations remains poorly understood. METHODS Thirty‐five illiterate adults were administered a literacy assessment (Test of Functional Health Literacy in Adults [TOFHLA]), structural and resting state functional magnetic resonance imaging, and an episodic memory test (Free and Cued Selective Reminding Test). Illiteracy was defined as a TOFHLA score < 53. We evaluated the correlation between hippocampal connectivity at rest and both free recall and literacy scores. RESULTS Participants were mostly female (57.1%) and self‐declared as being Black individuals (84.8%), with a median age of 50 years. The median TOFHLA literacy score was 28.0 [21.0; 42.5] out of 100 points and the median free recall score was 30.0 [26.2; 35] out of 48 points. The median gray matter volume of both the left and right hippocampi was 2.3 [2.1; 2.4] cm3. We observed a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. The right hippocampal connectivity positively correlated with the literacy scores (β = 0.58, P = 0.008). There was no significant association between episodic memory and hippocampal connectivity. Neither memory nor literacy scores correlated with hippocampal gray matter volume. DISCUSSION Low literacy levels correlated with hippocampal connectivity in illiterate adults. The lack of association with memory scores might be associated with low brain reserve in this sample. Highlights A significant link was found between health literacy and hippocampal connectivity. Enhanced hippocampus– ventromedial prefrontal cortex connectivity suggests potential cognitive reserve improvement. Higher cognitive reserve may protect against hippocampal atrophy and neurodegeneration. Health literacy improvements could help prevent cognitive impairment in illiterate populations. Study highlights importance of considering structural racism in brain connectivity research.
Neurology. Diseases of the nervous system, Geriatrics
Robert C Manske, Michael Voight, Chris Wolfe
et al.
Quadriceps muscle injury is a common occurrence, especially among athletes. While a careful history and a thorough physical examination are important steps in the assessment of quadriceps muscle pathology, it is still difficult to differentiate the type and severity of the pathology. Because of this difficulty, musculoskeletal ultrasound (MSK-US) is an invaluable tool in the diagnosis of quadriceps muscle or tendon injury. Utilizing this noninvasive imaging technique, medical professionals can easily diagnose and monitor muscle and tendon disorders to quickly determine the correct treatment plan for each individual case. The ability to view these structures in real-time allows identification of any present pathologies. MSK-US has become a useful component in diagnosing quadriceps muscle and tendon injuries due to its ability to clearly display the affected structures without exposing the patient to radiation or utilizing ionized contrast media. MSK-US provides valuable insight into fluid dynamics around joints and can even detect myotendinous tears that might otherwise be overlooked with the clinical examination or symptoms usually reported by patients. MSK-US can provide precise visualization of edema and can easily distinguish between benign and potentially pathological findings which make it an integral part of any holistic evaluation of quadriceps muscle and tendon injury. Additionally, it can be used to track the progress of physical therapy treatments and monitor tissue healing. This information is invaluable in ensuring an optimal outcome for any quadriceps muscle and tendon injury. Therefore, when used in combination with clinical tests, MSK-US can drastically increase the accuracy of the clinical examination. By utilizing this technology, healthcare practitioners have reliable access to more comprehensive diagnostics for musculoskeletal injuries and diseases than ever before. Clinicians are then able to tailor rehabilitation plans more effectively and ensure their patients receive proper treatment. As a result, recovery times may be shortened, and patients are able to return to their normal activities more quickly.
Problem and objective: To inform about the incidence, causes and prevention measures of sudden cardiac death in sports. Methods: A literature search was performed (PubMed, Web of Science, Researchgate) using the terms sudden cardiac death (SCD), sudden cardiac arrest (SCA), sudden death, cardiopulmonary resuscitation, sport, exercise and athlete. Observational studies, systematic reviews and meta-analyses that examined SCD/SCA during exercise or up to one hour afterwards in recreational, competitive or elite athletes were considered.Results: Of 6350 study titles and abstracts 11 full-text studies were included in this clinical review. When the incidence was calculated based on multiple sports, it varied between populations and ranged from 0.1 to 2.9/100,000 athlete-years (AY). The incidence was highest in male professional basketball players, with 19/100,000 AY. The most frequent cause of SCD/SCA in athletes &gt;35 years was coronary artery disease (CAD), while in younger athletes the predominating underlying pathologies (autopsy-negative sudden unexplained death, myocarditis, cardiomyopathies, coronary artery anomalies and premature CAD) differed by region. The most effective screening tool for cardiovascular disease in athletes is the ECG. Survival after CPR is substantially influenced by the use of an automated external defibrillator (AED).Discussion: SCD/SCA in athletes is a rare but very tragic event. Incidence rates in athletes differ among populations, studies, and sports. Some degree of underreporting can be assumed as there is no mandatory reporting of sports-related SCD/SCA in most countries and few scientific registries exist. Potentially, primary screening measures could be adapted to the regionally different causes of SCD/SCA. In addition, training athletes and staff in the use of an AED is paramount to improving survival rates.Key Words: Athletes, Cardiac Arrest, Cardiovascular Disease
Abstract Background Exercise is postulated to be a promising non-pharmacological intervention for the improvement of neurodegenerative disease pathology. However, the mechanism of beneficial effects of exercise on the brain remains to be further explored. In this study, we investigated the effect of an exercise-induced metabolite, lactate, on the microglia phenotype and its association with learning and memory. Results Microglia were hyperactivated in the brains of AlCl3/D-gal-treated mice, which was associated with cognitive decline. Running exercise ameliorated the hyperactivation and increased the anti-inflammatory/reparative phenotype of microglia and improved cognition. Mice were injected intraperitoneally with sodium lactate (NaLA) had similar beneficial effects as that of exercise training. Exogenous NaLA addition to cultured BV2 cells promoted their transition from a pro-inflammatory to a reparative phenotype. Conclusion The elevated lactate acted as an “accelerator” of the endogenous “lactate timer” in microglia promoting this transition of microglia polarization balance through lactylation. These findings demonstrate that exercise-induced lactate accelerates the phenotypic transition of microglia, which plays a key role in reducing neuroinflammation and improving cognitive function.
Актуальність ролі робочих програм спортивно-оздоровчих занять в організації діяльності клубу з єдиноборств визначається сучасними тенденціями в спорті та фізичній активності, а також потребами суспільства в збереженні й покращанні фізичного та психологічного здоров’я людей. Зростаючий інтерес до фітнесу, спорту й здорового способу життя спонукає клуби з єдиноборств до пошуку нових підходів до організації тренувань та занять. Робочі програми спортивно-оздоровчих занять у цьому контексті стають необхідним інструментом для забезпечення ефективного тренування, адаптованого до потреб різних груп населення. Мета дослідження – визначити роль робочих програм спортивно-оздоровчих занять в організації діяльності клубу з єдиноборств. Методи дослідження. У дослідженні застосовано метод аналізу, синтезу, індукції, системного аналізу та ін. Результати. Визначено роль робочих програм спортивно-оздоровчих занять в організації діяльності клубу з єдиноборств. Сучасна спортивна діяльність у галузі єдиноборств неможлива без упровадження та реалізації науково обґрунтованих методів тренувань. Для забезпечення високої ефективності й досягнення найкращих результатів потрібний систематичний і цілеспрямований підхід до процесів тренування. Один із провідних інструментів цього підходу – розробка робочих програм для спортивно-оздоровчих занять. Ці програми становлять вагомий директивний документ для тренерського колективу та спортсменів, визначаючи структуру, завдання, цілі й послідовність тренувального процесу. Висновки. Дослідження дало змогу визначити роль робочих програм спортивно-оздоровчих занять в організації діяльності клубу з єдиноборств. Проведений дослідницький аналіз етапів формування робочих програм спортивно-оздоровчих занять і їх ролі в організації діяльності клубу з єдиноборств розкриває важливість функціонування спортивної підготовки в цьому контексті.
Udc, Voronenko I. Doсtor, Пріоритетні Напрями Підвищення
et al.
Abstract. Given the complexity of the global epidemiological situation, the struggle for the competitiveness of national economies is exacerbated. For Ukraine, whose economy has now taken the form of deindustrialization, the intensification of innovation is a necessary, extremely important condition for its further development. It was previously thought that the socio-economic development and growth of countries depended mainly on their capital and labor resources, while other lesstangible resources, such as information, training, infrastructure development were treated as external factors influencing market behavior only indirectly. However, overtime, the idea that knowledge management is a determining factor in productivity in both modern and traditional economies is becoming increasingly entrenched. The paper proposes results of the research of Ukraine’s positioning in the global innovation space. It also determines the necessity of priority development of the innovative sphere of the country against the backdrop of crisis phenomena and assesses the position of Ukraine in the Indices characterizing the level of development of the innovative component of the competitiveness of the country’s economy. It underlines the insufficient level of innovation infrastructure development in the country. The authors consider that the basis of Ukrainian innovative competitiveness is the development of institutions, infrastructure and business. These areas need special state support, as their effective implementation is the main competitive advantage of Ukraine. The research was conducted according to the Global Innovation Index sub-indices on the horizon of 2013—2021. Econometric methods are used to generalize the positioning of Ukraine in the global innovation space and the DEA method to study the relative individual effectiveness of the innovation environment and innovation activities in Europe. Keywords: innovation, innovation potential, digitalization, digital transformation, competitiveness, Global Innovation Index. JEL Classification O32, D24, F63 Formulas: 1; fig.: 4; tabl.: 2; bibl.: 20.
Research: Due to the sudden outbreak of COVID-19 and the resulting pandemic situation, universities were forced to rapidly change their traditional pedagogical and didactical approach by shifting from mostly face-to-face teaching to entirely virtual and online teaching methods. Through this, a “forced” distance learning and teaching situation emerged. This study aimed at investigating the effect of these innovations on the implementation, acceptance, and use of the virtual teaching offer within the framework of the technology acceptance model (TAM). Methods: A total of 218 students and 69 lecturers of a German Medical Faculty completed online questionnaires on the acceptance, satisfaction, and usefulness of the forced distance learning (FDL) and teaching (FDT), respectively. An extended version of the TAM was used to assess the acceptance of the students and lecturers of FDL and FDT. In order to estimate the multivariate dependencies, path analysis was employed using structural equation modeling (SEM). Results: In general, students and lecturers reported being satisfied with the implementation of the FDL and FDT. Regarding the TAM model, the fit indices suggested an acceptable model fit for both groups. The model of the students revealed that the perceived usefulness had a strong predictive power on the attitude toward using and the perceived ease of use also predicted the attitude. The existing technical infrastructure as well as the general media affinity and pandemic-related worries proved to be positively associated with the perceived usefulness while data security worries and organization of online teaching predicted the perceived ease of use in students. The strong positive predictive power of the perceived usefulness for the attitude toward using was also evident in the model for the lecturers and the technical infrastructure predicted the perceived ease of use in the lecturers. Conclusion: The TAM is a suitable framework to represent the implementation, acceptance, and use of the virtual teaching offer during the special pandemic situation at the university. However, personal and structural context factors were important predictors for the perceived usefulness and the perceived ease of use in the student group. The forced situation for learning and teaching makes it more difficult to predict the actual use of virtual teaching offers solely based on attitude.
Katharina Lindner, Verena Letzel, Giulia Tarini
et al.
The worldwide school lockdown due to the COVID-19 pandemic has caused major challenges for the school system. For teachers, parents and students the current situation proves to be extremely challenging. Teachers have had to adapt their instruction to distance learning at short notice (e.g. Reimers et al. 2020). Parents (who might be working from home and supporting their children at the same time or who might have lost their jobs) all of a sudden have had to take on a new pedagogical role (e.g. Wu et al. 2020). Finally, students themselves have faced many challenges: e.g. they do not have their usual workspace, they do not have face-to-face support from their teachers, they might be in difficult situations at home and they cannot interact with their peers as usual (OECD 2020a). Within this situation, there are new specific challenges for students with special educational needs (SEN) who require special attention and individualised support from their teachers. Therefore, educational stakeholders need to develop strategies to minimise the potential risk of ‘losing’ students during ongoing and future school lockdowns on an institutional level (Harris 2020; König, Jäger-Biela, and Glutsch 2020). In this context, the OECD (2020a) highlights the importance of monitoring students’ educational commitment through their ‘attendance, behaviour and learning progress’, reducing challenges that may impede students’ commitment, e.g. by providing supporting resources such as digital devices as well as designing teaching and learning situations individually tailored to the individual needs of students. As several studies are investigating the general situation of educational stakeholders during homeschooling, the special issue will shed light to the inclusive education sector by including the voices of different representatives of inclusive education who are having a diagnosis of SEN themselves or who are concerned with students having SEN in relation to teaching and learning during the pandemic. Against the background of this special situation, opportunities and challenges considering the development and experience of students, parents and teachers in line with the homeschooling situation are to be examined. Additionally, implications and strategies for creating resilient educational systems and schools are to be examined to ensure that no student is left behind due to obstructive institutional conditions (OECD 2020b). In considering the context of the COVID-19 quarantine and the new educational demands, the Special Issue encompasses empirical as well as theoretical papers addressing a wide range of topics dealing with inclusive education during homeschooling. Thus, this Special Issue offers opportunities to reflect and discuss the urgent needs in the context of inclusive education that have arisen during these unprecedented times.
ABSTRACT Immunotherapy has established itself as an important component of the treatment armamentarium against various solid as well as hematologic cancers. Immune checkpoint inhibitors (ICI) provide for a very well-tolerated and efficacious treatment option that has improved survival in several cancers. The approved ICIs mainly consist of antibodies targeting cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1) or its ligand, programmed cell death ligand 1 (PD-L1). However, most clinical trials of ICI have excluded patients from high-risk populations, such as those with autoimmune diseases, patients on chronic steroid intake for various reasons or preexisting HIV infections. The older adults are also an underrepresented section of the population enrolled into such trials, most probably due to the higher prevalence of comorbidities and frailty affecting their Eastern Co-Operative Oncology Group performance status, and thus the eligibility for clinical trial enrollment. This paper aimed to briefly review the available evidence and thus guide the decision-making process for use of ICI in such rare and special situations.
Abstract Weather conditions have been recognized as important factors affecting school commute mode choices. This paper aims to explore the modal shift of middle school commutes with respect to the variation in weather-related variables, with empirical emphases on the situation in Beijing, China. Data from the latest Beijing School Commute Survey (2014–2015) were adopted, and multinomial probit (MNP) and multinomial logit (MNL) models were developed. The modeling results are in favor of the MNP model because it has better statistical performance. Weather-related variables, including sky condition, wind speed, highest temperature, humidity, air quality index (AQI), and some interaction terms, were found to have a significant impact on students' commute mode choices. Based on these models, an empirical sensitivity measure was defined as the expected percentage change in the probability of choosing each mode with respect to an order of magnitude change in the influential factors. Most of the results are in line with those of previous studies, and some unique results reflect features of Beijing. For example, on days with extremely poor air quality, students are more likely to turn to public transport rather than use a car from active transportation modes. This is probably due to the special urban traffic regulations that restrict household car ownership and car travel in Beijing. These findings could have implications for promoting active transportation for students and serve as references for policymakers and planners.
Laura Panozzo, Pam Harvey, Meagan-Jane Adams
et al.
Abstract Background Doctors, particularly general practitioners, play a significant role in assisting patients to create advance care plans. When medically indicated, these documents are important tools to promote congruence between end-of-life care and patient’s personal preferences. Despite this, little is known regarding the availability of these documents in hospitals. The aim of this study was to identify the proportion of people who died in hospital without an advance care plan and how many of these had advance care planning (ACP) documents in their general practice records. Methods A retrospective cohort study was conducted of patient hospital records with manual linkage to general practice records. The large regional hospital in Victoria, Australia has a catchment population in excess of 300,000 people. The study sample was patients aged 75 years and over who died in the hospital between 1 January 2016 and 31 December 2017. The hospital records of these patients were examined to identify those which did not have a system alert for ACP documents on the file. Alerted ACP documents were limited to those legislated in the state of Victoria: advance care plan, Enduring Power of Attorney (Medical Treatment) or Enduring Power of Guardianship. Where no ACP document system alert was found in the hospital record, the patient’s nominated general practice was consented to participate and the corresponding general practice record was examined. Data were analysed using descriptive statistics. Results Of the 406 patients who died in hospital, 76.1% (309) did not have a system alert for any ACP document. Of the 309 hospital records without a system alert, 144 (46.7%) corresponding general practice records were examined. Of these, 14.6% included at least one ACP document, including four advance care plans, that were not available in hospital. Conclusions Unless ACP documents are consistently communicated from general practice, patient’s preferences may be unknown during end-of-life care. It is important that both doctors and patients are supported to use connected electronic health records to ensure that documents are readily available to healthcare staff when they are required.
The article analyses the game method, as a method of teaching consecutive interpretation of senior students of a language university. At present, the role of the interpreter as an intercultural intermediary is growing, that implies the mastery of students’ skills in interpretation activities in various communication situations. The exercises-games presented in the article allow teachers to model different types of interpretation situations in the classroom and promote the willingness of future interpreters to carry out interpretation activities in real conditions of intercultural communication.The relevance of the purposeful formation of students' skills in consecutive interpreting is caused, on the one hand, by increased requirements for professional training of an interpreter in the context of reforming the teaching of foreign languages at universities and, on the other hand, insufficiently systematic teaching this important type of interpreting activity to students. In order to increase the effectiveness of teaching students of a language university consecutive interpreting (CI), it is necessary to use various exercises that take into account the psychological characteristics of under taking interpreting activities. As the practitioners of interpreting claim, the specifics of an interpreter’s work is that (s)he often has to deal with subject areas that (s)he is far from due to his/her humanitarian linguistic education. That is why specialists in the field of interpretation training recommend constant expanding their horizons, trying to learn as much as possible special terminology associated with various industries and scientific knowledge. The method described in the article contribute to the process of developing students’ skills and expanding their background knowledge.