Background Intimate partner violence (IPV) is physical, sexual, or psychological harm perpetrated by a spouse or an intimate partner. Its detrimental effects on women’s physical, mental, sexual, and reproductive health are well-documented. However, its impact on nutritional status is not well-studied, and previous studies have led to contradictory findings. This study aimed to explore the association between intimate partner violence and the nutritional status of married Nepalese women. Methods The study used the 2016 Nepal Demographic Health Survey data, which employed a modified version of the Conflict Tactics Scale to determine women’s exposure to IPV. Anemia and low body mass index (BMI) were used as proxies of nutritional status. Multinomial regression was used to analyze the relationship between BMI and IPV; multivariable logistic regression was used to analyze the association between anemia and IPV. Results The prevalence of underweight, overweight/obesity, and anemia were respectively 13.9%, 25.1%, and 38.7%. The prevalence of physical, sexual, and emotional IPVs experienced in the preceding year were respectively 9.8%, 4.6%, and 7.6%. Likewise, the prevalence of lifetime physical, sexual, emotional, and controlling behavior IPVs were respectively 21.8%, 7.4%, 12.3%, and 32.1%. The low intensity of emotional IPV (AOR 1.62; CI: 1.02–2.56) and moderate intensity of physical IPV (AOR 3.70; CI: 1.64–8.35) experienced in the preceding year, and low intensity of lifetime emotional IPV (AOR 1.69; CI: 1.11–2.58) were associated with an increased risk of overweight/obesity. Moderate intensity of sexual IPV (AOR 2.59; CI: 1.099–6.108) experienced in the preceding year was associated with an increased risk of underweight BMI. The low intensity of lifetime controlling behavior (AOR1.25; CI: 1.03–1.53) was associated with an increased risk of anemia. Conclusions Emotional and Physical IPVs are significantly associated with an increased risk of overweight/obesity. Sexual IPV is significantly associated with an increased risk of underweight BMI, and controlling behavior is significantly associated with an increased risk of anemia. Seeking help could offset the detrimental effects of IPV; therefore, IPV screening should be a part of regular healthcare assessment for married women, and appropriate rehabilitation should be offered to IPV survivors.
Overhead aversion—donors’ negative attitudes toward their donated money being used for overhead costs—has been explored in many contexts. In this study, we first confirm findings from prior research that high overhead costs imposed on project initiators have a negative effect on supporters' funding decisions and that higher overhead costs make project funding less successful in crowdfunding. Thereafter, we investigate how the negative effect of overhead costs on funding performance is moderated by the project initiator's facial expressions in the image on the project webpage. A smiling face mitigates overhead aversion, whereas a sad face amplifies it. We collected a large sample of data from Kiva, a loan-based crowdfunding platform, and used a deep learning algorithm to categorize the facial expressions of project initiators. Subsequently, a propensity score weighting approach was applied to minimize confounding effects. This empirical study indicates that the project initiator's smiling face, rather than a sad face, can alleviate supporters' overhead aversion.
Food insecurity continues to be a problem in the U.S., especially in Arkansas, which ranked second in the nation in food-insecure households in 2020 (Arkansas Food Bank, n.d.). To help address this, community-based food pantries make food available directly to area residents. Food pantry demand has increased during COVID-19, which has exacerbated food insecurity, particularly in the southern U.S. In Arkansas, the Arkansas Food Bank (AFB) serves as the state’s largest nongovernmental food aid provider, working with 310 pantries. Pantries typically distribute food to clients in one of two ways: by using a prefilled bag or box of items (the traditional model), or by allowing clients to select items (the client-choice model). Although research has shown that the client-choice model has a variety of benefits for client health and wellbeing, pantries using the traditional model remain the norm in Arkansas, accounting for 87% of total pantries. Currently, there is limited research that identifies perceived barriers to converting to a client-choice model among pantry managers, and that identifies whether perceived barriers and localized concerns contribute to different operation styles among pantries. To address this, we examined perceived barriers to client-choice conversion using a mixed-method survey conducted with 187 Arkansas food pantry managers. We used common factor analysis to identify four barriers perceived by pantries to converting their traditional pantry to a client-choice pantry: (1) food supply concerns, (2) having limited nonfood resources, (3) food waste concerns, and (4) confusion from clients and nutritional concerns. A cluster analysis of pantry respondents was also used, based on their level of concern for the four identified perceived barriers. Clusters we identified are Potential Converters (18.2%), Confusion Concerned pantries (56.7%), and pantries who are Skeptics (25.1%). Our findings suggest that food pantry stakeholders may need additional outreach and education concerning the various ways that client choice can be implemented. Our results provide valuable information for those involved in distributing food aid to food-insecure households.
Purpose This study examines two components of lexical acquisition and phonological development that occur during the first 50-word stage of language development in neurotypical (NT) children. One component is how children learn words based on their existing speech sound inventories (i.e., in-phonology and out-of-phonology word learning). The other component is the relationship between the children's number of words and the number of phonemes in their speech sound inventories. The goal of this study is to determine if the same two components occur in children with autism spectrum disorders (ASDs) who are older than their NT peers but are in the same stage of lexical development. Method This study involved 20 minimally verbal children with ASDs, ages 28–72 months, who produced five to 50 spoken words. The children's spoken words were obtained from the MacArthur–Bates Communicative Development Inventories. The speech sound inventories were obtained from the utterances produced during assessment/play sessions with the children. The children's spoken words from the Communicative Development Inventories (CDI) were categorized as either in-phonology or out-of-phonology based on whether the words began with a phoneme in the child's existing speech sound inventory. Additionally, the children's number of spoken words on the CDI was compared to the number of phonemes in their speech sound inventories. Results The children in this study produced in-phonology words more often than out-of-phonology words ( z = −3.922; p < .001). Moreover, there was a moderate positive correlation between the children's number of spoken words and the number of phonemes in their speech sound inventories ( r = .534, p = .019). Conclusions The relationship between lexical acquisition and phonological development appears to exist for the children in this study, who are in the first 50-word stage of development. Clinical implications for increasing the expressive language of children with ASDs were discussed.
Although the practitioner and the academic literatures both note the importance of ethno-racial diversity in the nonprofit sector, we pursue a better understanding of this sector’s ethno-racial diversity dynamics by exploring the drivers of ethno-racial diversity at multiple organizational hierarchy levels—boards of directors, executive staff teams, and full-time staff. Using data from nonprofit organizations participating in Candid’s Diversity, Equity, and Inclusion initiative, we find evidence that upward mobility for ethno-racial minority group members remains limited. Our findings also indicate a positive relationship between ethno-racial diversity in a nonprofit’s local community and ethno-racial diversity at each organizational hierarchy level. This relationship is partially mediated by the political liberalness of the local community, with the strongest mediating effects at the board of directors and executive staff organizational levels. This partial mediation suggests that the local environment’s tolerance of societal hierarchies and unequal outcomes may be related to nonprofit organizational diversity, equity, and inclusion efforts.
Using a comprehensive sample of Chinese seasoned equity offerings, we compare three major equity flotation methods employed by listed firms in China: rights issues, public offerings, and private placements. The dominant flotation method changed significantly around 2005. We examine the valuation effects of the three methods before and after 2005 and identify the determinants affecting the choice of flotation method. Our results support the information asymmetry hypothesis in that firms with high levels of information asymmetry tend to choose private placements and avoid either public offerings or rights issues. Ownership structure does not seem to be a key factor in determining the selection of flotation method. Profitability requirements of refinancing prevent many listed firms from raising additional capital externally. The removal of profitability requirements for private placements in 2006 boosts the popularity of private placements and explains the shift from rights issues to private placements to some extent.
With influencer marketing expenditures set to exceed $16 billion in 2022, pet influencers are leveraging their entertaining content to capitalize on this growing market. Utilizing a dataset of 557 posts from 37 pet influencers, we apply Uses and Gratifications Theory and Persuasion Knowledge to suggest textual and visual cues within sponsored posts are capable of disrupting engagement behaviors when consumers are seeking entertainment. We find evidence that sponsorship disclosures, mentions of money, brand logos, and overall saturation of sponsorship content reduce engagement. Our findings offer insights for brands seeking to create content that generates higher levels of engagement.
The New What Is Happening In this Class questionnaire (NWIHIC) was constructed based on Moos’s scheme for human environments. The sample consisted of 2280 students from elementary and secondary schools (grades 5–9). The data were analyzed using SPSS26 and AMOS software version 25. Principal components factor analysis with oblique rotation, as well as convergent and discriminant validity analyses, revealed a strong structure of the questionnaire (χ2 = 3104.307; χ2/dƒ = 2.69; RMR = 0.038; RMSEA = 0.027; GFI = 0.947; AGFI = 0.937; NFI = 0.956; TLI = 0.968; IFI = 0.972; CFI = 0.972). As a result, eight factors emerged: student cohesiveness, teacher support, involvement, task orientation, cooperation, equity, differentiated instruction, and ongoing assessment. Moreover, significant gender and grade differences were also found.
Background Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic weight loss procedure used to treat obesity. The long-term goal of this project is to develop a Virtual Bariatric Endoscopy (ViBE) simulator for training and assessment of the ESG procedure. The objectives of this current work are to: (a) perform a task analysis of ESG and (b) create metrics to be validated in the created simulator.Methods We performed a hierarchical task analysis (HTA) by identifying the significant tasks of the ESG procedure. We created the HTA to show the breakdown and connection of the tasks of the procedure. Utilizing the HTA and input from ESG experts, performance metrics were derived for objective measurement of the ESG procedure. Three blinded video raters analyzed seven recorded ESG procedures according to the proposed performance metrics.ResultsBased on the seven videos, there was a positive correlation between total task times and total performance scores (R = 0.886, P = 0.008). Endoscopists expert were found to be more skilled in reducing the area of the stomach compared to endoscopists novice (34.6% reduction versus 9.4% reduction, P = 0.01). The mean novice performance score was significantly lower than the mean expert performance score (34.7 vs. 23.8, P = 0.047). The inter-rater reliability test showed a perfect agreement among three raters for all tasks except for the suturing task. The suturing task had a significant agreement (Inter-rater Correlation = 0.84, Cronbach’s alpha = 0.88). Suturing was determined to be a critical task that is positively correlated with the total score (R = 0.962, P = 0.0005).Conclusion The task analysis and metrics development are critical for the development of the ViBE simulator. This preliminary assessment demonstrates that the performance metrics provide an accurate assessment of the endoscopist’s performance. Further validation testing and refinement of the performance metrics are anticipated.
We examine how scope of practice reforms that allow nurse practitioners independent practice authority impact children's health. We exploit spatial and temporal variation in independent practice authority to implement a difference‐in‐differences research design using data from the first three waves of the National Survey of Children's Health. We find that these reforms have significant positive impacts on a commonly used and validated measure of children's health: parental evaluation of child health. As a result of this scope of practice reforms, parental evaluations of overall child health improve as parents increasingly rate their child as having Excellent Health. More importantly, we observe these improvements in health are driven primarily by older children and children from lower family income backgrounds. These findings indicate that an expansion in the supply of healthcare through occupational licensing reform can positively influence health outcomes for children. Such findings have important implications for mitigating child health inequality.
Fire regimes in North American forests are diverse and modern fire records are often too short to capture important patterns, trends, feedbacks, and drivers of variability. Tree‐ring fire scars provide valuable perspectives on fire regimes, including centuries‐long records of fire year, season, frequency, severity, and size. Here, we introduce the newly compiled North American tree‐ring fire‐scar network (NAFSN), which contains 2562 sites, >37,000 fire‐scarred trees, and covers large parts of North America. We investigate the NAFSN in terms of geography, sample depth, vegetation, topography, climate, and human land use. Fire scars are found in most ecoregions, from boreal forests in northern Alaska and Canada to subtropical forests in southern Florida and Mexico. The network includes 91 tree species, but is dominated by gymnosperms in the genus Pinus. Fire scars are found from sea level to >4000‐m elevation and across a range of topographic settings that vary by ecoregion. Multiple regions are densely sampled (e.g., >1000 fire‐scarred trees), enabling new spatial analyses such as reconstructions of area burned. To demonstrate the potential of the network, we compared the climate space of the NAFSN to those of modern fires and forests; the NAFSN spans a climate space largely representative of the forested areas in North America, with notable gaps in warmer tropical climates. Modern fires are burning in similar climate spaces as historical fires, but disproportionately in warmer regions compared to the historical record, possibly related to under‐sampling of warm subtropical forests or supporting observations of changing fire regimes. The historical influence of Indigenous and non‐Indigenous human land use on fire regimes varies in space and time. A 20th century fire deficit associated with human activities is evident in many regions, yet fire regimes characterized by frequent surface fires are still active in some areas (e.g., Mexico and the southeastern United States). These analyses provide a foundation and framework for future studies using the hundreds of thousands of annually‐ to sub‐annually‐resolved tree‐ring records of fire spanning centuries, which will further advance our understanding of the interactions among fire, climate, topography, vegetation, and humans across North America.
The study’s purpose was to collect demographic and farm characteristics from Mississippi small farmers and to determine their abilities, experiences, and desires to engage in Farm to School (F2S) activities. The online survey was created using items taken from existing F2S surveys. Invitations to participate were sent via email to farmers beginning in October 2021 and ending in January 2022. Descriptive statistics were used to summarize the data. Of the 258 individuals with valid email addresses, 43 (17%) completed the online survey, and 38 fit the definition of small farm (<USD 250,000 in gross cash farm income). Mean farm acreage was 68 (range 1–480 acres). Twenty-six (70%) farms did not have any certifications. Common selling practices included farm stands/stores (n = 18; 49%) and farmers markets (n = 16; 43%). Only 4 farmers (11%) sold to schools with half indicating the experience was difficult. Common challenges included no relationship with school staff (n = 14; 44%) and guarantying quantity/date (n = 11; 34%). Twenty-six (68%) farmers expressed an interest in at least one F2S activity. To facilitate mutually beneficial relationships between small farmers and school food service staff, work is needed to connect the two groups and guide farmers in navigating school procurement rules and regulations.
Generative adversarial network (GAN) has been successfully extended to solve semi-supervised image classification tasks recently. However, it is still a great challenge for GAN to exploit the unlabeled images for boosting its classification ability when labeled images are very limited. In this paper, we propose a novel CCS-GAN model for semi-supervised image classification, which aims to improve its classification ability by utilizing the cluster structure of unlabeled images and ’bad’ generated images. Specifically, it employs a new cluster consistency loss to constrain its classifier to keep the local discriminative consistency in each cluster of unlabeled images and thus provides implicit supervised information to boost the classifier. Meanwhile, it adopts an enhanced feature matching approach to encourage its generator to produce adversarial images from the low-density regions of real distribution, which can enhance the discriminative ability of the classifier during adversarial training and suppress the mode collapse problem. Extensive experiments on four benchmark datasets show that: the proposed CCS-GAN achieves very competitive performance in semi-supervised image classification tasks when compared with several state-of-the-art competitors.
Purpose: We aim to develop quantitative performance metrics and a deep learning model to objectively assess surgery skills between the novice and the expert surgeons for arthroscopic rotator cuff surgery. These proposed metrics can be used to give the surgeon an objective and a quantitative self-assessment platform. Methods: Ten shoulder arthroscopic rotator cuff surgeries were performed by two novices, and fourteen were performed by two expert surgeons. These surgeries were statistically analyzed. Two existing evaluation systems: Basic Arthroscopic Knee Skill Scoring System (BAKSSS) and the Arthroscopic Surgical Skill Evaluation Tool (ASSET), were used to validate our proposed metrics. In addition, a deep learning-based model called Automated Arthroscopic Video Evaluation Tool (AAVET) was developed toward automating quantitative assessments. Results: The results revealed that novice surgeons used surgical tools approximately 10% less effectively and identified and stopped bleeding less swiftly. Our results showed a notable difference in the performance score between the experts and novices, and our metrics successfully identified these at the task level. Moreover, the F1-scores of each class are found as 78%, 87%, and 77% for classifying cases with no-tool, electrocautery, and shaver tool, respectively. Conclusion: We have constructed quantitative metrics that identified differences in the performances of expert and novice surgeons. Our ultimate goal is to validate metrics further and incorporate these into our virtual rotator cuff surgery simulator (ViRCAST), which has been under development. The initial results from AAVET show that the capability of the toolbox can be extended to create a fully automated performance evaluation platform.
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