Recent Submissions

  • 'Wrong treatment': doctors’ take on medical futility in a low-resource ICU

    Onyeka, Tonia; Okonkwo, Ikem; Aniebue, Uzochukwu; Ugwu, Innocent; Chukwuneke, Felix; Agom, David; University of Nigeria; Ebonyi State University (University of Toronto, 2019-08-31)
    Background: Health caregivers in Intensive Care Units (ICUs) in developed countries have documented accounts of futile care for patients admitted into the Intensive Care Unit (ICU). But, evidence gaps exist in medical literature from developing countries on futility. While costs of establishing and running ICUs are astronomical in resource-poor countries, administration of medically futile care can further compound problems for ICU patients, family caregivers, health caregivers and hospital establishments. We sought and analysed the opinions of anaesthetists working in ICUs, highlighting the concept of medically futile care as perceived by health caregivers in low-middle income ICUs. Materials & Methods: Using a phenomenological framework, this study involved face-to-face in-depth interviews conducted with 15 resident doctors working in two ICUs of a tertiary health institution in South-East Nigeria. Transcripts were analysed using Interpretive Phenomenological Analysis (IPA). Results: Five core themes emerged: Unnecessary procedures and interventions; intrinsic and extrinsic factors of medically futile care; family caregiver influences; negative notions of medical futility; ICU outcomes. One participant was of the view that not intervening medically might be best for some patients admitted into the ICU. Other participants described cases where patients received care which participants considered futile, noted possible causes of futile treatments and proffered strategies to correct such situations. Conclusion: The surveyed doctors commonly view care to be futile in low-resource ICUs. Several factors are implicated including lack of goals in patient care, poor communication, lack of specialist training in intensive care and lack of protocols. Medical futility, in the opinion of these doctors, may contribute substantially to the challenges of running an ICU. This calls for multiple strategies for its reduction so as to ensure efficient use of scarce resources and improved outcomes in ICUs located in resource-limited settings.
  • An ethnographic study of palliative and end-of-life care in a Nigerian hospital: impact of education on care provision and utilization

    Agom, David; Onyeka, Tonia; Ominyi, Jude; Sixsmith, Judith; Neill, Sarah; Allen, Stuart; Poole, Helen; University of Northampton; University of Nigeria; University of Dundee; et al. (SAGE Publications Inc., 2020-09-08)
    Most clinicians receive little or no palliative care (PC) education. Similarly, patients and their families receive little or no information on PC. Our study explored education in PC, while examining for its impacts on service delivery and utilization from the perspective of health care professionals (HCPs), patients, and their families. An ethnographic approach was utilized to gather data from 41 participants. Spradley’s ethnographic analytical framework guided data analysis. Two themes identified were inadequate HCPs’ knowledge base and impact of service-users’ inadequate health education. The findings show that most HCPs had no formal education in PC, attributed to the lack of PC residency programs and the absence of educational institutions that provide such education. Patients and families also conveyed poor understandings of their illness and palliation, rooted in the HCP culture of partial disclosure of information about their diagnosis, care, and prognosis. Findings suggest a cultural shift that supports PC education for professionals is required to promote realist medical approach in the care for patients with life-limiting illnesses.
  • A qualitative examination of the perceived impact of bureaucratic managerialism on evidence-based practice implementation in Nigeria: a collective case study

    Ominyi, Jude; Agom, David; Ekuma, Chidiebere Valentine; ; University of Northampton; Ebonyi State University (SAGE Publications Ltd, 2019-12-04)
    Background: Evidence-based practice (EBP) is widely recognised as an essential aspect of contemporary healthcare delivery. However, the rise in cost containment and quest for profitability in healthcare management is found to be compromising implementation of evidence-based initiatives aimed at improving care quality. Aims: The aim of this work was to examine perspectives of nurses regarding the impact of bureaucratic managerialism on EBP implementation in the Nigerian acute care setting. Methods: A qualitative case study methodology was utilised to gather data from two large acute care settings. Drawing on semi-structured interviews, 12 staff nurses, 21 ward managers and 2 nurse managers were interviewed. Data were inductively analysed and themes generated. Results: The managerial practice in this context is founded on bureaucratic managerialism, which in turn generated hierarchical constraints that denied nurses the opportunity to self-govern. Implementation of evidence-based initiatives was consequently opposed by the managerial desire to maximise throughput. Conclusions: There is need for nurse managers to have greater managerial influence, which would allow opportunities for implementing EBPs to be created. Managerial autonomy for nurse managers would allow them to create enabling environments capable of facilitating successful implementation.
  • Construction of meanings during life-limiting illnesses and its impacts on palliative care: ethnographic study in an African context

    Agom, David; Neill, Sarah; Allen, Stuart; Poole, Helen; Sixsmith, Judith; Onyeka, Tonia; Ominyi, Jude; ; University of Northampton; University of Warwick; et al. (John Wiley and Sons Ltd, 2019-08-20)
    Objective: Knowledge about how people make meaning in cancer, palliative, and end-of-life care is particularly lacking in Africa, yet it can provide insights into strategies for improving palliative care (PC). This study explored ways in which cancer patients, their families, and health care professionals (HCPs) construct meaning of their life-limiting illnesses and how this impact on provision and use of PC in a Nigerian hospital. Methods: This ethnographic study utilised participant observation, informal conversations during observation, and interviews to gather data from 39 participants, comprising service users and HCPs in a Nigerian hospital. Data were analysed using Spradley's framework for ethnographic data analysis. Results: Meaning-making in life-limiting illness was predominantly rooted in belief systems. Most patients and their families, including some HCPs, perceived that cancer was caused by the devil, mystical, or supernatural beings. They professed that these agents manifested in the form of either spiritual attacks or that wicked people in society used either poison or acted as witches/wizards to inflict cancer on someone. These beliefs contributed to either nonacceptance of, or late presentation for, PC by most of patients and their families, while some professionals depended on supernatural powers for divine intervention and tacitly supporting religious practices to achieve healing/cure. Conclusions: Findings revealed that cultural and religious world views about life-limiting illnesses were used in decision-making process for PC. This, therefore, provided evidence that could improve the clinicians' cultural competence when providing PC to individuals of African descent, especially Nigerians, both in Nigerian societies and in foreign countries.
  • Environmental CSR, customer equity drivers and travellers’ critical outcomes: a stimulus-organism-response framework

    Vatankhah, Sanaz; Sepehrmanesh, A.; Zaeri, E.; Altinay, Levent; (SAGE, 2023-02-25)
    While environmental corporate social responsibility (CSR) has gained increased attention in sustainable tourism research, little is known about its impacts on customers in the context of the airlines. This study investigates the impact of environmental CSR on two critical customer outcomes namely purchase intention (PI) and switching behaviour (SB). In light of the stimulus-organism-response (S-O-R) framework, this study further examines the joint mediating impact of customer equity drivers (CEDs) in the previously mentioned relationships. With a sample of Iranian air travellers, the results of the structural equation model revealed that environmental CSR significantly affects CEDs. While CEDs predict PI, they failed to reduce SB. Hence, CEDs jointly mediate the impact of environmental CSR on PI only. The results of the current study revealed nuances to the service marketing research by extending the impact of environmental CSR on travellers' PI and SB via CEDs. Theoretical and practical implications are provided.
  • Exploring organizational culture regarding provision and utilization of palliative care in a Nigerian context: An interpretive descriptive study

    Agom, David; Ominyi, Jude; Onyeka, Tonia; Anyigor, Chukwuma N.; ; Buckinghamshire New University; Ebonyi State University; University of Nigeria (Wolters Kluwer Medknow Publications, 2020-08-29)
    Background: Palliative care (PC) continues to be underutilized in Nigeria, but there is a lack of studies that explore organizational cultural dynamics regarding PC in Nigeria. The study aimed to understand the organizational culture in order to identify organizational enablers and inhibitors of the provision and utilization of PC in a Nigerian context. Methods: Identification of the organizational culture was developed using a qualitative interpretive descriptive design. Cultural enablers and inhibitors were mapped out using semi-structured interviews with 38 participants, consisting of medical staff, patients, and their relatives. Thematic analysis was used to identify and analyze patterns within the collected data. Results: Three themes were identified: cross-departmental collaborative practice, financial support practice, and continuity of care. The findings suggest that fundamental cultural changes, such as a policy for intradepartmental referral practices, telemedicine, and a welfare support system, are typically required as remedies for the failure to use PC in Nigeria and other similar contexts. Conclusions: This study offered a new understanding that not revealing deeper shared assumptions, and a shared way of thinking that underpins the PC practice within an organization, will have a negative bearing on organizational PC outcomes.
  • Social and health system complexities impacting on decision-making for utilization of oncology and palliative care in an African context: a qualitative study

    Agom, David; Allen, Stuart; Neill, Sarah; Sixsmith, Judith; Poole, Helen; Onyeka, Tonia; Ominyi, Jude; ; University of Northampton; University of Warwick; et al. (SAGE Publications Ltd, 2019-12-16)
    Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.
  • Understanding the organization of hospital-based palliative care in a Nigerian hospital: an ethnographic study

    Agom, David; Poole, Helen; Allen, Stuart; Onyeka, Tonia; Ominyi, Jude; ; University of Northampton; University of Warwick; University of Nigeria (Wolters Kluwer Medknow Publications, 2019-04-01)
    Context: Organization and delivery of palliative care (PC) services vary from one country to another. In Nigeria, PC has continued to develop, yet the organization and scope of PC is not widely known by most clinicians and the public. Objectives: The aim of the study is to identify PC services available in a Nigerian Hospital and how they are organized. Methods: This ethnographic study, utilized documentary analysis, participant observation, and ethnographic interviews (causal chat during observation and individual interviews) to gather data from members of PC team comprising doctors (n = 10), nurses (n = 4), medical social workers (n = 2), a physiotherapist, and a pharmacist, as well nurses from the oncology department (n = 3). Data were analyzed using Spradley's framework for ethnographic data analysis. Results: PC was found to be largely adult patient-centered. A hospital-based care delivery model, in the forms of family meetings, in-and out-patients' consultation services, and a home-based delivery model which is primarily home visits conducted once in a week, were the two models of care available in the studied hospital. The members of the PC team operated two shift patterns from 7:00 am to 2.00 pm and a late shift from 2:00 pm to 7:00 pm instead of 24 h service provision. Conclusions: Although PC in this hospital has made significant developmental progress, the organization and scope of services are suggestive of the need for more development, especially in manpower and collaborative care. This study provided knowledge that could be used to improve the clinical practice of PC in various cross-cultural Nigerian societies and other African context, as well as revealing areas for PC development.
  • A systematic review of interventions targeting physical activity and/or healthy eating behaviours in adolescents: practice and training

    Allcott-Watson, Hannah; Chater, Angel M.; Troop, Nicholas A.; Howlett, Neil; University of Bedfordshire; University of Hertfordshire; University College London (Taylor & Francis, 2023-02-01)
    Despite the many health benefits of physical activity (PA) and healthy eating (HE) most adolescents do not meet current guidelines which poses future health risks. This review aimed to (1) identify whether adolescent PA and HE interventions show promise at promoting behaviour change and maintenance, (2) identify which behaviour change techniques (BCTs) are associated with promising interventions, and (3) explore the optimal approaches to training deliverers of adolescent PA/HE interventions. Nine databases were searched for randomised controlled, or quasi-experimental, trials targeting 10-19 year olds, with a primary aim to increase PA/HE, measured at baseline and at least six months post-intervention, in addition to papers reporting training of deliverers of adolescent PA/HE interventions. Included were seven PA studies, three HE studies and four studies targeting both, with two training papers. For PA studies, two were promising post-intervention with two promising BCTs, and five were promising for maintenance with two promising BCTs. For HE studies, three were promising at post-intervention and four at maintenance, both with four promising BCTs. There is preliminary evidence that interventions support adolescents to improve their PA and HE behaviours over a period of at least six months.
  • Barriers to the provision and utilization of palliative care in Africa: a rapid scoping review

    Agom, David; Onyeka, Tonia; Iheanacho, Peace N.; Ominyi, Jude; ; University of Northampton; Ebonyi State University; University of Nigeria (Wolters Kluwer Medknow Publications, 2021-02-17)
    Palliative care (PC) has continued to be less available, underutilized, and unintegrated in many of the healthcare systems, especially in Africa. This scoping review synthesized existing published papers on adult PC in Africa, to report the barriers to PC and to assess the methodologies used in these studies. Eight electronic databases and Google Scholar were searched to identify relevant studies published between 2005 and 2018. Overall, 42 publications (34 empirical studies and 9 reviews) that reported issues related to barriers to adult PC were selected. Three themes identified were individual-level, system-level, and relational barriers. The studies reviewed predominantly utilized cross-sectional and retrospective study design, underscoring the need for more studies employing qualitative design. Findings highlight the need for health education, training opportunities, more funding, communication, and timely referral. Future works could focus on underlying factors to these barriers and ethno-religious perspectives to PC in Africa.
  • The impact of input format on written performance in a listening-into-writing assessment

    Westbrook, Carolyn; British Council; University of Bedfordshire (Elsevier Ltd, 2022-12-06)
    Over the last five decades, research in teaching and testing (academic) listening has investigated different foci. Initially, teaching listening involved bottom-up approaches (Dirven and Oakeshott-Taylor, 1984) then both higher- and lower-level processes were integrated (Voss, 1984). In the early 2000s, different input formats (Read, 2002) and discourse features of lectures (Thompson, 2003) were the subjects of academic listening research. More recently, EAP tests have increasingly taken an integrated approach to reflect real-world tasks, yet few studies have looked at integrated listening-into-writing tasks (Cubilo and Winke, 2013). This counter-balanced measures design study investigates how test taker performance differs on an integrated EAP listening-into-writing task when lecture input is presented as audio only in one half and video in the other half of the input. Two groups of test takers took part in the current study. A Hotelling's T2 test revealed a statistically significant effect on scores when test takers were presented with the audio only input first but there was no significant effect on scores when the video input was presented first. Data on test taker preferences revealed that more people preferred the video input to audio only.
  • Effect of intake charge temperature on oxy-fuel combustion in an HCCI diesel engine under different carbon dioxide dilutions

    Mobasheri, Raouf; Aitouche, Abdel; Mumputu, J.B.; Li, Xiang; Peng, Zhijun; University Lille; Junia, Smart Systems and Energies; University of Bedfordshire; University of Lincoln (American Society of Mechanical Engineers (ASME), 2022-10-20)
    Carbon dioxide is one of the leading contributors to global warming. Oxy-fuel combustion (OFC) integrated with carbon capture and storage (CCS) technology is an efficient way to reduce carbon dioxide emissions. In OFC, pure oxygen (O2) is used instead of air to react with hydrocarbon fuel. Consequently, the products of combustion mainly include carbon dioxide (CO2) and water vapor (H2O) under lean conditions. Meanwhile, due to the absence of N2 in the intake charge, nitrogen-related emissions such as NOx are greatly removed from the exhaust gases. In the present study, the effect of intake charge temperature on OFC has been investigated in a diesel engine under the homogeneous charge compression ignition (HCCI) mode. In order to control combustion temperature and avoid overheating problems caused by oxygen in OFC, a portion of the exhaust CO2 was added to the O2. For this purpose, different CO2 dilutions ranging from 79-85% have been employed. It has been found that OFC can significantly reduce CO and particulate matter (PM) emissions while eliminating NOx emissions. With a higher intake charge temperature, combustion occurs earlier with shorter main stages, reducing the indicated mean effective pressure (IMEP) and increasing the indicated specific fuel consumption (ISFC), whereas, with a lower intake charge temperature, combustion stability deteriorates leading to incomplete OFC. By raising the intake charge temperature from 140 C to 220 C and applying 21% O2 and 79% CO2 v/v, the indicated thermal efficiency (ITE) is reduced from 34.6% to 29.2% while ISFC is increased from 0.24 to 0.285 Kg/kWh.
  • Life cycle assessment tool for food supply chain environmental evaluation

    da Costa, Tamíris; Gillespie, James; Pelc, Katarzyna; Adefisan, Abi; Adefisan, Michael; Ramanathan, Ramakrishnan; Murphy, Fionnuala; University College Dublin; Ulster University; University of Bedfordshire; et al. (MDPI, 2022-12-31)
    Food is at the centre of efforts to combat climate change, reduce water stress, pollution, and conserve the world’s wildlife. Assessing the environmental performance of food companies is essential to provide a comprehensive view of the production processes and gain insight into improvement options, but such a tool is currently non-existent in the literature. This study proposed a tool based on the life cycle assessment methodology focused on six stages of the food chain, raw materials acquisition, supplier, manufacturing, distribution, retail and wastes. The user can also evaluate the implementation of Internet of Things (IoT) technologies to reduce food waste applied in the real-world problems. The tool was validated through a case study of a food manufacturing company that prepares frozen meals via vending machines. The LCA results provided by the tool showed that food raw materials production is the main hotspot of nine impact categories. The IoT technologies’ contribution increased the company’s impact by around 0.4%. However, it is expected that employing these monitoring technologies would prevent food waste generation and the associated environmental impacts. Therefore, the results of this paper provide evidence that the proposed tool is suitable for determining environmental impacts and savings of food supply chain companies.
  • A case study of human milk banking with focus on the role of IoT sensor technology

    Ramanathan, Usha; Pelc, Katarzyna; da Costa, Tamíris; Ramanathan, Ramakrishnan; Shenker, Natalie; Nottingham Trent University; University of Bedfordshire; University College Dublin; University of Essex; Imperial College London; et al. (MDPI, 2022-12-23)
    Human milk is the biological norm for newborn nutrition, with breast milk from the mother being recognized as the best source of nutrition for infant health. When the mother’s milk is unavailable, donor human milk is the best alternative for infants with low birthweights. Growing recognition of the benefits of donor human milk has led to increasing global interest in monitoring and controlling human milk’s quality to fulfil the need for donor human milk. In response to this need, the REAMIT project proposed to adapt and apply existing innovative technology to continuously monitor and record human milk quality and signal potential milk quality issues. IoT sensors and big data technology have been used to monitor conditions that may increase spoilage (such as temperature and humidity) in the transportation stage. The sensors were installed in the insulated bags used to transport the milk from the donor’s home or hospital to the human milk bank and vice versa. The temperature and humidity were collected every 30 min, whilst the GPS locator sent data every 2 min. The data are collected in the cloud using GPRS/CAT-M1 technology. An algorithm was designed to send alerts when the milk temperature is above the prespecified threshold specified by the organisation, i.e., above −20 °C. The experience showed evidence that IoT sensors can efficiently be used to monitor and maintain quality in supply chains of high-quality human milk. This rare product needs a high level of quality control, which is possible with the support of smart technologies. The IoT technology used can help the human milk supply chain in five different aspects, namely by reducing waste, assuring quality, improving availability, reducing cost and improving sustainability. This system could be extended to various supply chains of rare and precious commodities, including further medical supplies such as human blood and organs, to completely avoid waste and ensure total quality in supply chains.
  • Comparative investigation on macroscopic and microscopic characteristics of impingement spray of gasoline and ethanol from a GDI injector under injection pressure up to 50 MPa

    Li, Xiang; Li, Dayou; Dimitriou, Pavlos; Ajmal, Tahmina; Aitouche, Abdel; Mobasheri, Raouf; Rybdylova, Oyuna; Pei, Yiqiang; Peng, Zhijun; University of Bedfordshire; et al. (Elsevier Ltd, 2023-01-09)
    Particulate Matter (PM) emissions from passenger vehicles have attracted considerable interest over the last decade. In order to reduce PM emissions, improving maximum injection pressure has been a developing trend for new generation GDI engines. However, comparing gasoline and ethanol impingement spray characteristics from a GDI injector under high injection pressure is still unclear. In this paper, a comparative investigation on both the macroscopic and microscopic characteristics of impingement spray from a GDI injector fuelled with gasoline and ethanol was performed under injection pressure up to 50 MPa, providing new findings to promote a more homogeneous air–fuel mixture and reduce PM emissions. The experimental results show that under the same PI (injection pressure), rebound height of gasoline impingement spray is a bit higher than ethanol. AS (spray area) of gasoline is slightly higher than ethanol under PI=10MPa. However, under PI=30MPa and PI=50MPa, AS of gasoline is gradually exceeded by that of ethanol as time progresses. By increasing PI to 50 MPa, the difference in DN (diffusion distance of the near side) between gasoline and ethanol is greatly reduced, meantime DF (diffusion distance of the far side) becomes weaker than ethanol. For both gasoline and ethanol, with the increase PI from 10 MPa to 50 MPa, VN (average normal component of droplet velocity) and VT (average tangential component of droplet velocity) of incident droplets increase by around 1 m/s. Meantime, there is a slight decrease in the absolute value of VN and VT of reflected droplets. DSMD (Sauter mean diameter of droplets) presents a significant decreasing trend with the increase of PI. Besides, a smaller DSMD can be seen for the gasoline impingement spray compared to ethanol under the same PI.
  • Gut microbiota and time-restricted feeding/eating: a targeted biomarker and approach in precision nutrition

    Zeb, Falak; Osaili, Tareq; Obaid, Reyad Shakir; Naja, Farah; Radwan, Hadia; Cheikh Ismail, Leila; Hasan, Hayder; Hashim, Mona; Alam, Iftikhar; Sehar, Bismillah; et al. (MDPI, 2023-01-04)
    Each individual has a unique gut microbiota; therefore, the genes in our microbiome outnumber the genes in our genome by about 150 to 1. Perturbation in host nutritional status influences gut microbiome composition and vice versa. The gut microbiome can help in producing vitamins, hormones, and other active metabolites that support the immune system; harvest energy from food; aid in digestion; protect against pathogens; improve gut transit and function; send signals to the brain and other organs; oscillate the circadian rhythm; and coordinate with the host metabolism through multiple cellular pathways. Gut microbiota can be influenced by host genetics, medications, diet, and lifestyle factors from preterm to aging. Aligning with precision nutrition, identifying a personalized microbiome mandates the provision of the right nutrients at the right time to the right patient. Thus, before prescribing a personalized treatment, it is crucial to monitor and count the gut flora as a focused biomarker. Many nutritional approaches that have been developed help in maintaining and restoring an optimal microbiome such as specific diet therapy, nutrition interventions, and customized eating patterns. One of these approaches is time-restricted feeding/eating (TRF/E), a type of intermittent fasting (IF) in which a subject abstains from food intake for a specific time window. Such a dietary modification might alter and restore the gut microbiome for proper alignment of cellular and molecular pathways throughout the lifespan. In this review, we have highlighted that the gut microbiota would be a targeted biomarker and TRF/E would be a targeted approach for restoring the gut-microbiome-associated molecular pathways such as hormonal signaling, the circadian system, metabolic regulators, neural responses, and immune-inflammatory pathways. Consequently, modulation of the gut microbiota through TRF/E could contribute to proper utilization and availability of the nutrients and in this way confer protection against diseases for harnessing personalized nutrition approaches to improve human health.
  • Mental health disorders and recidivism among incarcerated adult offenders in a correctional facility in South Africa: a cluster analysis.

    Shishane, Kwanele; John-Langba, Johannes; Onifade, Eyitayo; ; University of Bedfordshire; University of KwaZulu-Natal; Clark Atlanta University (Plos One, 2023-01-19)
    The contribution of mental illness, substance use, and appetitive aggression to recidivism has significant policy and practice implications. Offenders with untreated mental illness have a higher recidivism rate and a greater number of criminogenic risk factors than those without mental illness. Previous research has demonstrated that the likelihood of appetitive aggression increases in violent contexts where individuals perpetrate aggressive acts. Using the Ecological Systems Theory, this study investigated the association between mental health disorders and recidivism among incarcerated adult offenders in South Africa, and the intervening role of appetitive aggression and substance use. Using a cross-sectional quantitative research design, a sample of 280 incarcerated male and female adult offenders aged 18-35 with no known psychiatric disorders were sampled at a correctional facility in South Africa. The re-incarceration rate, mental health disorders, substance use, and appetitive aggression symptomology were assessed using the Hopkins symptoms checklist, the CRAFFT measure of substance use, and the appetitive aggression scale. Findings indicate a 32.4% recidivism rate (n = 82). Cluster analysis indicated that the combination of anxiety, depression, substance use, and appetitive aggression increased the likelihood of recidivism. Appetitive aggression median differences between clusters 2 and 3 played a key role in distinguishing recidivism risk among recidivist and non-recidivist participants. Chi-square analysis highlighted group differences in education levels among the established clusters [x2 (3, n = 217) = 12.832, p = .005, which is < .05] as well as group differences in the type of criminal offence [x2 (3, n = 187) = 24.362, p = .000, which is < .05] and cluster membership. Combined factors that increase the likelihood of recidivism provide a typology for classifying offenders based on particular recidivism risk determinants, which offers insights for developing tailored interventions that address a combination of factors.
  • The effects of language learning and math mindsets on academic success in an engineering program

    Kaya, Sibel; Yuksel, Dogan; Curle, Samantha; (Wiley, 2022-12-29)
    Background Mindsets are based on two basic assumptions: some people think that their intellectual abilities can be developed through hard work and instruction (i.e., a growth mindset), whereas others believe that nothing can change their level of intellectual ability (i.e., a fixed mindset). The association between mindsets and academic achievement has been examined in different academic subjects, such as biology and math. However, no previous study has examined the effects of language learning mindsets (LLMs) and math mindsets (MMs) on academic success in an English medium instruction (EMI) setting in which English, rather than the first language of the students, is used for teaching content (e.g., mechatronics engineering). Purpose/Hypothesis This study explores the relationship between Turkish mechatronics engineering undergraduate students' domain-specific mindsets, LLMs and MMs, and their academic success. Design/Method Student test scores for English medium and first-language medium courses were collected from fourth-year students studying mechatronics engineering (n = 68) at a public university in Turkey. Students also completed the LLM and MM inventories. Results Regression analyses revealed that growth LLM and MM were positive predictors of EMI and Turkish medium of instruction (TMI) academic success, whereas fixed LLM and MM were negative predictors of EMI and TMI academic success. Conclusions In both EMI and TMI courses, a growth mindset in math and language learning can profoundly predict students' academic achievement in a mechatronics engineering program. We argue that domain-specific mindsets can effectively explain the self-theories of intelligence and achievement.
  • Impact of nutrition interventions for reduction of anemia in women of reproductive age in low- and middle-income countries: a meta-review

    Panchal, Pooja; Ravalia, Anal; Rana, Ritu; Puthussery, Shuby; Vaze, Gauri; Mavlankar, Dileep; Menon, Kavitha (Oxford University Press, 2022-12-31)
    The UN Sustainable Development Goal aims at a 50% reduction of anemia in women of reproductive age (WRA) by 2030. Several nutrition-specific and sensitive interventions are targeted across low- and middle-income countries (LMICs) to reduce anemia. In this meta-review we comprehensively assessed the effectiveness of nutrition-specific and -sensitive interventions on hemoglobin (Hb) and serum ferritin (SF) concentrations and the prevalence of iron deficiency and anemia among WRA, pregnant women, and lactating women from LMICs. The preparation of the present meta-review followed a double-blinded synthesis process with 3 stages: screening, quality appraisal, and data extraction in Eppi Reviewer. A comprehensive search was performed for systematic reviews (SRs) published between January 2000 and May 2022 using 21 international, national, and regional databases. The methodological quality appraisal of included studies was conducted using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist. A total of 23 SRs evaluated the effects of various nutrition-specific interventions included in the final synthesis. The included SRs included analyses of nutrition-specific interventions such as supplementation of the nutrients iron (n = 7), iron and folic acid (n = 4), vitamin A (n = 3), calcium (n = 2), multiple micronutrients (n = 7), and intravenous iron sucrose (n = 2). Also, SRs on fortification of nutrients included multiple micronutrients (n = 6), iron and folic acid (n = 4), and iron (n = 4). Of the 23 SRs, 22 were of high quality. Iron with or without folic acid supplementation and fortification and vitamin A supplementation consistently showed positive effects on either reduction in the prevalence of anemia or iron deficiency and improving the Hb or SF concentrations in WRA and pregnant women from LMICs. The comprehensive meta-review reported the beneficial effects of iron with or without folic acid, multiple micronutrient supplementation/fortification, and vitamin A supplementation in reducing the prevalence of anemia or iron deficiency and increasing Hb or SF concentrations in WRA from LMICs.
  • Breaking up sitting with short frequent or long infrequent physical activity breaks does not lead to compensatory changes in appetite, appetite-regulating hormones or energy intake

    Maylor, Benjamin David; Zakrzewski-Fruer, Julia K.; Stensel, David J.; Orton, Charlie J.; Bailey, Daniel Paul; ; University of Bedfordshire; Leicester General Hospital; Loughborough University; Waseda University; et al. (Elsevier, 2022-12-30)
    The aim of this study was to determine the appetite-related responses to breaking up prolonged sitting with physical activity bouts differing in frequency and duration among adult females. Fourteen sedentary females aged 34 ± 13 years with a body mass index of 27.1 ± 6.3 kg/m2 (mean ± SD) took part in a randomised crossover trial with three, 7.5 h conditions: (1) uninterrupted sitting (SIT), (2) sitting with short frequent 2-min moderate-intensity walking breaks every 30 min (SHORT-BREAKS), and (3) sitting with longer duration, less frequent 10-min moderate-intensity walking breaks every 170–180 min (LONG-BREAKS). The intensity and total duration of physical activity was matched between the SHORT-BREAKS and LONG-BREAKS conditions. Linear mixed models were used to compare the outcomes between conditions with significance being accepted as p ≤ 0.05. There were no significant between-condition differences in hunger, satisfaction, prospective food consumption or overall appetite area under the curve (AUC) (all p ≥ 0.801). Absolute ad libitum energy intake and relative energy intake (REI) did not differ significantly between conditions (all p ≥ 0.420). Acylated ghrelin and total peptide YY incremental and total AUC did not differ significantly between conditions (all p ≥ 0.388). Yet, there was a medium effect size for the higher acylated ghrelin incremental AUC in SHORT-BREAKS versus SIT (d = 0.61); the reverse was seen for total AUC, which was lower in SHORT-BREAKS versus SIT (d = 0.69). These findings suggest that breaking up sitting does not lead to compensatory changes in appetite, appetite hormones or energy intake regardless of physical activity bout duration and frequency among adult females.

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