Childbirth as Fault Lines: Justifications in Physician-Patient Interactions About Postnatal Rehabilitation.

Research on justifications has shown their significance in advice-giving, decision-making and children disputes. However, the majority of studies gloss over practical functions of justifications in patient-physician interactions as they are often expected and pursued by patients and in turn, are adopted by physicians to support their stance and authority. This study, through conversation analysis (CA), aims to explore a) what are pragmatic functions of justifications in patient-physician interaction? b) how and when do physicians unfold their justifications for treatment recommendations? c) how do physicians deal with different responses based on their epistemic and deontic domains?. A total of 32 video-recordings between postpartum women and physicians are collected and studied. Four pragmatic functions of justifications drawn upon by physicians are explored: justifications as face-saving, reassurance, risk discussion and clarification-seeking. Despite physicians' attempts to justify their positions as less challenged by patients, this is not the entire picture as they demonstrate their desire to resolve patients' concerns and coordinate their viewpoints to achieve the best practice that facilitates patients' well-being.

Facile Synthesis of Ag-Doped Urchin-like MnO2 on Carbon Cloth for Supercapacitors.

Based on MnO2/carbon cloth (CC) composite materials, an Ag-doped MnO2 nanowire, self-assembled, urchin-like structure was synthesized in situ on the surface of CC using a simple method, and a novel and efficient flexible electrode material for supercapacitors was developed. The morphology, structure, elemental distribution, and pore distribution of the material were analyzed using SEM, TEM, XRD, XPS, and BET. The electrochemical performance was tested using cyclic voltammetry (CV) and galvanostatic charge/discharge (GCD). In the three-electrode system, GCD testing showed that the specific capacitance of the material reached 520.8 F/g at 0.5 A/g. After 2000 cycles at a current density of 1 A/g, the capacitance retention rate was 90.6%, demonstrating its enormous potential in the application of supercapacitor electrode materials.

How dignity-related distress interacts with quality of life in young adult patients with cancer during the active treatment stage: A network analysis.

OBJECTIVE: Young adult patients with cancer are a growing concern. By means of network analysis, this study aimed to explore the interplay between dignity-related distress and quality of life (QoL) in young adult patients with cancer when they undergo active treatments. METHODS: In this cross-sectional study, 309 young adults aged 18-39 and diagnosed with malignant tumors were recruited from an oncology center in China between September 2020 and August 2021. Participants completed the Patient Dignity Inventory and SF-36 questionnaires. Network analysis was applied to examine the network structure. RESULTS: Overall, the core facets of dignity-related distress were negatively related to QoL and its corresponding domains, either directly or indirectly. Developmental distress played a central role among estimated networks and strongly interplayed with most QoL domains, especially the mental domains. Symptom distress was the only facet consistently interplayed with the physical domains of QoL (i.e., physical function and bodily pain). The social aspects were also revealed in the association between limited social support and vitality. CONCLUSIONS: Early attention must be paid to guarantee the need of preserving dignity and enhancing QoL for young adult patients.

Effectiveness of a resilience-targeted intervention based on "I have, I am, I can" strategy on nursing home older adults' suicidal ideation: A randomized controlled trial.

BACKGROUND: Despite the potential for benefit, resilience remains an emergent area in late-life mental health care, and evidence of resilience intervention for suicide among nursing home residents is especially limited. This study aims to evaluate the effects of a resilience-targeted program based on the "I have, I am, and I can" strategy on suicidal ideation and related problems. METHODS: From the 562 nursing home residents who were contacted, 68 with suicidal ideation were recruited and then randomly assigned to a resilience intervention group (eight-week resilience training; n = 34) or a wait-list control group (eight-week health education; n = 34). Self-reported suicidal ideation, and depression and anxiety symptoms as outcomes, and resilience as potential mediators were assessed at baseline, postintervention, and one-month follow-up. RESULTS: Resilience training participants reported significant improvement in suicidal ideation (group × time interaction x2=12.564, p = 0.002) and depression symptoms (x2=9.441, p = 0.009) compared to wait-list control group participants. Changes in resilience mediated the intervention's effects on changes in suicidal ideation and depression symptoms. Limitations The observed effects must be considered preliminary due to the small sample size. CONCLUSIONS: The findings support the benefits of resilience training based on the "I have, I am, and I can" strategy in reducing suicidal ideation and suicide-related symptoms in nursing home older adults, and provide insight into possible mechanisms.

The impact of airborne particulate matter on pediatric hospital admissions for pneumonia among children in Jinan, China: A case-crossover study.

This study aims to examine the effect of short-term changes in the concentration of particulate matter of diameter ≤2.5 µm (PM2.5) and ≤10 µm (PM10) on pediatric hospital admissions for pneumonia in Jinan, China. It explores confoundings factors of weather, season, and chemical pollutants. Information on pediatric hospital admissions for pneumonia in 2014 was extracted from the database of Jinan Qilu Hospital. The relative risk of pediatric hospital admissions for pneumonia was assessed using a case-crossover approach, controlling weather variables, day of the week, and seasonality. The single-pollutant model demonstrated that increased risk of pediatric hospital admissions for pneumonia was significantly associated with elevated PM2.5 concentrations the day before hospital admission and elevated PM10 concentrations 2 days before hospital admission. An increment of 10 µg/m3 in PM2.5 and PM10 was correlated with a 6% (95% CI 1.02--1.10) and 4% (95% CI 1.00-1.08) rise in number of admissions for pneumonia, respectively. In two pollutant models, PM2.5 and PM10 remained significant after inclusion of sulfur dioxide or nitrogen dioxide but not carbon monoxide. This study demonstrated that short-term exposure to atmospheric particulate matter (PM2.5/PM10) may be an important determinant of pediatric hospital admissions for pneumonia in Jinan, China. IMPLICATIONS: This study demonstrated that short-term exposure to atmospheric particulate matter (PM2.5/PM10) may be an important determinant of pediatric hospital admissions for pneumonia in Jinan, China, and suggested the relevance of pollutant exposure levels and their effects. As a specific group, children are sensitive to airborne particulate matter. This study estimated the short-term effects attribute to other air pollutants to provide references for relevant studies.