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Longitudinal qualitative inquiry from a social gerontological perspective can offer unique insights into older adults’ wellbeing and home care service trajectories. This temporal case study of 12 older home care clients analysed 136 interviews over three time points with 53 home care network actors in Manitoba and Nova Scotia. Many clients and families grappled with service changes almost daily, even if the level or type of service appeared officially stable. The pandemic added further disruption, shaping clients’ lives, wellbeing, and relationships, as well as their access to and use of service. Notably, changes in clients’ wellbeing and needs for help were not necessarily straightforward nor always apparent to case coordinators, especially when these were tied to social, emotional, or relational wellbeing, or to clients’ living arrangements, housing, family, and community integration. Findings can enhance theorizing of change for older adults receiving home care and guide equity-informed policy and practice.
Levodopa-induced dyskinesia (LID) is a disabling symptom of Parkinson’s disease (PD). There have been prior attempts to find risk factors contributing to this symptom, but risk factors for the severity of LID have not been comprehensively studied. We aimed to evaluate factors that correlate with LID severity in patients with PD based on the Unified Dyskinesia Rating Scale (UDysRS).
Methods:
A cross-sectional study was designed on 52 idiopathic PD patients who were referred for LID between 2023 and 2024. Their demographic and clinical records were studied. Furthermore, cognitive decline (MoCA), PD severity (Hoehn and Yahr) and the severity of dyskinesia (UDysRS) were examined. The association between factors and LID severity was evaluated by carrying out univariate regression and multivariate regression backward elimination analysis.
Results:
The mean age of patients with LID was 59.9 ± 11.4 years. Results of univariate regression analysis indicated that male sex (β = −0.24, P = 0.04), BMI (β = −0.3, P = 0.005), H&Y (β = 0.4, P = 0.002), diabetes mellitus (β = 0.3, P = 0.018) and levodopa dosage per kilogram (β = 0.37, P = 0.01) were significant factors involved in the severity of dyskinesia. The univariate regression model results showed that lack of constipation (P = 0.04), hyperlipidemia (P = 0.04) and total daily levodopa dosage per kilogram (P = 0.01) were associated with the severity of end-dose dystonia.
Conclusion:
This study revealed that female sex, more advanced PD, diabetes mellitus, daily levodopa dosage per kilogram body weight and BMI are associated with the severity of LID. Also, it suggests that hyperlipidemia and lack of constipation are associated with the severity of end-dose dystonia.
In this paper, we establish the $L^p$ bounds for partial polynomial Carleson operators along polynomial curves for $p \gt 1$, which depend only on $p$ and the number of monomials in the defining polynomial. Additionally, we study two classes of oscillatory integral operators of Radon type and derive uniform $L^2$ bounds.
Uniform momentum zones (UMZs) are widely used to describe and model the coherent structure of wall-bounded turbulent flows, but their detection has traditionally relied on relatively narrow fields of view which preclude fully resolving features at the scale of large-scale motions (LSMs). We refine and extend recent proposals to detect UMZs with moving-window fields of view by including physically motivated coherency criteria. Using synthetic data, we show how this updated moving-window approach can eliminate noise contamination that is likely responsible for the previously reported, high fractal dimension of UMZ interfaces. By applying the approach to channel flow direct numerical simulation (DNS), we identify a significant number of previously undetected, large-scale UMZ interfaces, including a small fraction of highly linear interfaces with well-defined streamwise inclination angles. We show that the inclination angles vary inversely with the size of the UMZ interfaces and that this relationship can be modelled by the opposing effects of shear-induced inclination and vortex-induced lift-up on hairpin packets. These geometric properties of large-scale UMZ interfaces play an important role in the development of improved stochastic models of wall-bounded turbulence.
To live meaningfully, we can’t just be receptacles for the right sorts of activities – it has to matter that it’s us living our lives. Something is missing in valuable activities, if the same value could be achieved by anyone who performs the task. Meaningfulness requires that it be our own ideals, personalities, and priorities contributing to the value of what we do. Recognizing this can shed light on our relationship with meaning in three ways. First, it shows a distinctive reason that autonomy is important: what we do without autonomy will lack meaning. Second, it helps us understand a challenge we encounter when facing trade-offs between different types of meaning, navigating between opportunities to have a few of our characteristics matter widely (e.g., as a filmmaker or an activist) and intimate contexts in which much more of who we are matters to a small group of people. Finally, if living meaningfully involves our central characteristics shaping what’s valuable about our actions, then discovering pre-set purposes (e.g., from fate, God, or the cosmos) might actually undermine our capacity to live meaningful lives.
This study presents a comprehensive analysis of the frequency response characteristics in a gas generator cycle liquid rocket engine, employing modular decomposition and linearised frequency-domain modeling to simulate dynamic behaviours under forced oscillations. The engine is dissected into key subsystems, including liquid pipelines, turbopump assembly, valves, flow regulation components, thrust chamber, gas generator and pyrotechnic starter, highlighting features such as centrifugal pump pressurisation, staged combustion and cavitation mitigation via venturis. Three oscillation scenarios are examined: supply system responses to thrust chamber pressure disturbances, combustion component responses to fluid disturbances and combustion component responses to pump speed disturbances. Simulations over 0–2000 Hz reveal acoustic-dominated traits in the thrust chamber with oxidiser pathway dominance, low-frequency emphasis in the gas generator driven by fuel disturbances, and heightened instability risks from pump pulsations. Parametric analyses demonstrate that increased pipeline lengths shift resonant frequencies downward, elevated injector pressure drops enhance stability margins by 1.6% with a 20% pressure drop increase, and chamber structural/gas parameter variations erode system stability. These insights, validated against benchmark models, inform strategies for mitigating combustion instability, optimising design parameters, and improving reliability in high-thrust propulsion applications.
The programme of radiocarbon dating undertaken at Stanwick, Northamptonshire, demonstrates the value of scientific dating of Romano-British sites, including those with good pottery sequences and large numbers of datable coins and other finds. It has refined and clarified the chronology and phasing of the site, particularly in its final phase of occupation. It confirmed some of our original dating of the human burials, and showed other dates were significantly wrong. It also addresses issues relating to the calibration of radiocarbon dates and dietary isotopes in the period. This has enabled us to identify activities, material culture and burial practices current at Stanwick and elsewhere in the immediate post-Roman period.
Evaluate and improve the accuracy of disaster triage decisions for pediatric patients among clinicians of various training levels using the Sort, Assess, Life-Saving Intervention, Treatment/Transport (SALT) triage system.
Methods
We used an online pediatric disaster triage module to evaluate and improve accuracy of triage decisions. During a pre- and post-test activity, participants triaged 20 fictional patients. Between activities, participants completed a didactic covering concepts of disaster triage, SALT triage, and pediatric limitations of triage systems. We assessed accuracy and improvement with non-parametric tests.
Results
There were 48 participants: 27 pediatric emergency medicine attendings (56%), 9 pediatric emergency medicine fellows (19%), 12 pediatric residents (25%). The median (interquartile range [IQR]) pre-test percent accuracy across all participants was 75 (IQR 65-85). Attendings scored higher than residents 80 (IQR 73-88) compared to 60 (IQR 55-65, P < 0.01) but not significantly higher than fellows 75 (IQR 70-85, P = 0.6). For the 44 participants who completed both the pre- and post-test, median score significantly improved from 75 (65-85) to 80 (75-90), P < 0.01.
Conclusions
The accuracy of triage decisions varies at different training levels. An online module can deliver just-in-time triage training and improve accuracy of triage decisions for pediatric patients, especially among pediatric residents.
This article proposes a topic modeling method that scales linearly to billions of documents. We make three core contributions: i) we present a topic modeling method, tensor latent Dirichlet allocation, that has identifiable and recoverable parameter guarantees and sample complexity guarantees for large data; ii) we show that this method is computationally and memory efficient (achieving speeds over 3$\times $–4$\times $ those of prior parallelized latent Dirichlet allocation methods), and that it scales linearly to text datasets with over a billion documents; and iii) we provide an open-source, GPU-based implementation of this method. This scaling enables previously prohibitive analyses, and we perform two real-world, large-scale new studies of interest to political scientists: we provide the first thorough analysis of the evolution of the #MeToo movement through the lens of over two years of Twitter conversation and a detailed study of social media conversations about election fraud in the 2020 presidential election. Thus, this method provides social scientists with the ability to study very large corpora at scale and to answer important theoretically-relevant questions about salient issues in near real-time.
We derive effective Boussinesq and Korteweg–de Vries equations governing nonlinear wave propagation over a structured bathymetry using a three-scale homogenization approach. The model captures the anisotropic effects induced by the bathymetry, leading to significant modifications in soliton dynamics. Homogenized parameters, determined from elementary cell problems, reveal strong directional dependencies in wave speed and dispersion. Our results provide new insights into nonlinear wave propagation in structured shallow-water environments, and consequently motivate further fundamental and applied studies in wave hydrodynamics and coastal engineering.
The West Area of Samos Archaeological Project (WASAP) conducted fieldwork over four years (2021–4), with the aim of investigating the western portion of the island of Samos. This article presents the results of the work undertaken in the southern part of the WASAP study area. WASAP fieldwork in this area was focused on the plain of Marathokampos, and areas of the southern coastline between Koumeiika in the east and Limnionas in the west. The data collected sheds new light on activity in this area between the Archaic and Byzantine periods.
In recent years a redating of relief-patterned tiles has been proposed, which argues against an established Flavian to Antonine chronology in favour of an earlier and much shorter Claudio-Neronian chronology. This paper tests the chronological underpinning of this important hypothesis by revisiting the dating for relief-patterned tiles in Roman London, which has produced by far the largest corpus of these tiles from any settlement in Roman Britain. The results provide considerable support for the traditional chronology, but do not necessarily rule out an earlier start date for this keying technique or the continued use of these tiles beyond the second century. The technique may have initially been used by certain tile makers supplying building projects that were largely outside London.
The Khojas are a caste-based community that emerged in the fourteenth century across Sindh, Kutch, and Kathiawar.* For centuries, they maintained a distinct identity that blended Hindu and Islamic traditions, which resisted rigid classification within either religious framework. The nineteenth century, however, brought profound change through two major schisms that reshaped their religious and social identity. The first, rooted in disputes over the authority of the Aga Khan, culminated in the 1866 Aga Khan Case and prompted some to align with Sunni Islam. The second, a theological rupture, led to the rise of Isna Ashari Khojas. This shift was influenced by Twelver Shiʿi mujtahids in Najaf and Karbala, who, through Indian Shiʿi ʿulamāʾ and mullās, reshaped Khoja religious identity. This article explores the central role of Twelver Shiʿi networks and their transregional reach in shaping this transformation. It focuses on how changes in legal identity, religious authority, and migratory patterns across Bombay, Zanzibar, and the shrine cities of Iraq contributed to the emergence of a distinct Isna Ashari Khoja identity. In doing so, it situates Khoja transformations within a wider historical context of religious affiliation and social organisation across South Asia and East Africa.
The Ghana–Togo border separates the Ewe people from their ritual spaces and objects. In Nyive, a border town divided into Ghana Nyive and Togo Nyive, these ritual spaces and objects are in Togo Nyive. The liminal space of the border complicates ritual practice by preventing community members from moving the ritual drum Aɖaʋatram (madness has led me astray) across the river and the international border. Nonetheless, communities in Nyive use ritual archives to maintain their identities in the context of colonial separation. They remake their identities through the symbolism, origin narrative, handling, and use of the drum Aɖaʋatram.
Numerous infants are placed into care shortly after birth due to safeguarding concerns. This paper explores the themes and therapeutic needs of mothers who undergo the distressing experience of having their babies removed, leading to the development of complicated grief and trauma, and how maternal mental health services can support them. Drawing from existing literature, this paper identifies key therapeutic needs, including issues of identity, guilt, and shame, as well as feelings of isolation experienced by affected mothers. In the absence of specialised guidelines, this paper advocates for adaptions of existing evidence-based treatment modalities such as trauma-focused cognitive behavioural therapy, eye movement desensitisation and reprocessing, and narrative therapy. For each approach existing literature is utilised to discuss how these approaches can effectively address the unique needs of mothers affected by infant removals. This paper underscores the urgent need for robust evidence-based guidelines to guide maternal mental health services in effectively supporting mothers affected by infant removals. By highlighting the importance of appropriate timing for engagement, multi-disciplinary collaboration, and clear treatment recommendations, it aims to pave the way for a compassionate and effective approach to promoting the mental well-being of these mothers and fostering positive outcomes for both parent and child.
Key learning aims
(1) To understand the therapeutic needs of women who have experienced the removal of their babies at birth.
(2) To examine existing evidence regarding interventions for other types of loss and explore adaptions to support women who have experienced infant removal.
(3) To recognise the necessity for further research in developing recommendations for therapy interventions and enhancing the ability of maternal mental health services to effectively support these women.