Walden University

The paper analyses Soviet influence in Albanian education and culture from 1949–1961. In pursuit of its objectives during the Cold War, the Soviet Union sought to foster a sense of unity across the various elements of society in the Eastern Bloc and satellite states, with the ultimate goal of creating a cohesive and integrated Soviet society. This article uses published archival materials and unpublished and rarely studied records from the State Archives of Albania. As a result, Albanian education and culture were built around the Soviet model and contributed to the Sovietization of Albanian society to immerse Albanians in Russia’s cultural and artistic values. Such values had an enduring impact on future generations of Albanians.

This basic qualitative study explored the intercultural development and experiences of thirteen US undergraduate faculty members. It was grounded in the theoretical frameworks of intercultural development and constructive-developmental theory. Data included two Intercultural Development Inventories® 3–6 months apart; a Subject Object Interview; and a demographic questionnaire. Findings included qualitatively different experiences among participants who did and did not grow interculturally. For example, participants who stayed at the intercultural stage of Minimization experienced wanting to “get it right” but worrying about “getting it wrong” with intercultural interactions. Participants who grew from Minimization to Acceptance described leaning into the fear of getting it wrong. One who grew from Acceptance to Adaptation described valuing risking getting it wrong. Constructive-developmental stage findings suggest that to grow from Minimization to Acceptance, it may be necessary to have some Self-Authorship capacity, including an internally generated value system and an ability to reflect on one’s own assumptions.

Background/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality in the United States (U.S.), with rates varying by disease severity, comorbidities, and sociodemographic factors. Cognitive impairment has been independently associated with increased mortality, but has not been well studied in relation to COPD despite being a frequently overlooked comorbidity in COPD patients. The purpose of this nationwide study was to assess the relationship between low cognitive performance and the risk of mortality among older adults with COPD while adjusting for major sociodemographic and health-related characteristics. Methods: This study utilized the 1999-2002 National Health and Nutrition Examination Survey (NHANES) and the respiratory mortality data of noninstitutionalized US adults aged over 65 years. Survival curves showing the combined effect of cognitive decline and COPD using the Kaplan-Meier product-limit method to estimate the percent survival of the subject at each point in time were used. Results: The final sample included 2013 older adults, with 39.1% showing low cognitive performance and 12.7% having COPD. Those with low cognitive performance were older, less educated, had lower income, were more likely to be racial/ethnic minorities, and had a history of cardiovascular diseases (CVD); they were also more likely to have COPD or chronic kidney disease (CKD). The adjusted hazard ratio for respiratory-related mortality risk was highest for individuals with both COPD and low cognitive performance (hazards ratio = 8.53), people with COPD alone also had a higher respiratory-related mortality risk (hazards ratio = 4.92), but low cognitive performance alone did not significantly increase respiratory-related mortality risk. Conclusions: These findings provide clearer insights into how cognitive impairment affects mortality risk in older adults with COPD and we discuss potential strategies to address this dual chronic health challenge effectively.

Overactivation of mineralocorticoid receptors occurs in cardiorenal diseases. Many patients with type 2 diabetes often progress to chronic kidney disease (CKD) and require dialysis. Finerenone is the first oral non-steroidal mineralocorticoid receptor antagonist used in patients with diabetic kidney disease and heart failure. Finerenone (Kerendia®) is more potent than spironolactone in reducing inflammation and fibrosis in CKD and exerts its effect equally on the heart and kidneys, improving cardiovascular outcomes. Research demonstrates that finerenone improves proteinuria and glomerular filtration rate if taken alone or in combination with sodium-glucose transporter 2 inhibitors. Finerenone has been found to decrease mortality in patients with diabetic renal disease and improve quality of life. Its side effects, unlike those of spironolactone, do not include gynecomastia. However, it can result in hyperkalemia, which needs to be monitored. In this review, we aim to investigate the mechanisms of action of finerenone and its implications in patients with type 2 diabetes.

This essay reviews three recent books on topics related to inequality: The Great Polarization: How Ideas, Power, and Policies Drive Inequality, edited by Rudiger L. von Arnim and Joseph E. Stiglitz; Key Concepts and Contemporary Approaches to Structured Inequality: Capital, Power and Status, by Carl Bankston III; and Conflict, Demand and Economic Development: Essays in Honour of Amit Bhaduri, edited by Deepankar Basu and Debarshi Das.

Purpose Chronic Kidney Disease (CKD) and food insecurity are widely prevalent among adult Americans, but the long term impact of food insecurity on CKD outcomes is not well explored. Thus, the purpose of this investigation was to prospectively assess the impact of food insecurity on mortality risk among American adults with CKD. Methods The National Health and Nutrition Examination Survey (NHANES, years 1999 to 2010) data on adults ≥ 50 years of age were analyzed by prospectively following up these individuals for mortality analysis through December 31, 2019, using the National Death Index (NDI) death certificate records. The study population was stratified based on CKD or food insecurity status and multiple Cox regression models were constructed to examine group differences in the risk of mortality among people with CKD (based on their food security status) after adjusting for sociodemographic and health-related characteristics of participants. Mortality was estimated with hazard ratios (HR, 95%CI). Results A total of 13,512 NHANES participants were included in the study sample with more than a fifth (21.5%) living with CKD and 6.58% reporting food insecurity. Overall, individuals with CKD had a higher risk of mortality (HR = 1.46, 95% CI = 1.19-1.79) upon follow-up. Individuals with food insecurity but without CKD did not have a higher risk of mortality. However, individuals with CKD and no food insecurity (HR = 1.37, 95% CI = 1.10-1.71) or those with both CKD and food insecurity (HR = 2.28, 95% CI = 1.34-3.88) had a significantly higher risk of mortality. Across all group comparisons, age and smoking were the two factors consistently influencing the relationship between CKD, food insecurity, and mortality. Conclusions Food insecurity and smoking must be considered as critical components for interventions aimed at reducing CKD progression and premature mortality among high-risk populations.

Background and objectives Melanoma, a major skin cancer, has seen varying trends in incidence, prevalence, stage at diagnosis, and survival. This study examines these trends using the United States Cancer Statistics (USCS) database, covering the period from 1999 to 2021. Methods We extracted data from the USCS database, which integrates the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) program and the Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries (NPCR). The analysis included new melanoma cases, prevalence estimates (using a 20-year limited duration), stage at diagnosis, and five-year relative survival rates. Incidence rates were adjusted for age using the 2000 United States standard population. Descriptive and trend analyses were performed using IBM SPSS Statistics software, version 29 (IBM Corp., Armonk, NY). Results The analysis of melanoma trends from 1999 to 2021 reveals a significant increase in the annual age-adjusted incidence rate, rising from 15.1 per 100,000 (95% CI: 14.9- 15.2) in 1999 to 23.0 per 100,000 (95% CI: 22.8- 23.1) in 2021. This upward trend is consistent across gender and racial/ethnic groups. The prevalence of melanoma over a 20-year period was 0.279 (95% CI: 0.276-0.282), with males showing a higher prevalence (0.302, 95% CI: 0.298-0.306) compared to females (0.256, 95% CI: 0.252-0.260). The distribution of melanoma stage at diagnosis indicated that 77% of cases were localized (95% CI: 76.5-77.5%), 9.5% regional (95% CI: 9.2-9.8%), 4.7% distant (95% CI: 4.4-5.0%), and 8.8% unstaged (95% CI: 8.5-9.1%). Survival analysis showed a five-year relative survival rate of 99.4% (95% CI: 99.2-99.6%) for localized melanoma and 35.6% (95% CI: 33.7-37.6%) for distant melanoma, highlighting significant disparities in survival based on stage at diagnosis. Conclusions The study highlights a rising incidence of melanoma and emphasizes the critical role of early detection in improving survival outcomes. The findings underscore the effectiveness of early diagnosis and the necessity for ongoing efforts to improve melanoma outcomes across diverse populations.

This study aims to assess the impact of an educational intervention on the knowledge, attitudes, and intentions of oral health providers regarding the recommendation of the human papillomavirus (HPV) vaccine. A qualitative evaluation was conducted in 2021 with dental professionals who participated in a training program focused on HPV vaccination. Saturation was reached at 12. Results showed increased knowledge and awareness of the link between HPV infection and oropharyngeal cancers among participants. Intention to recommend was universally endorsed. The use of role-play with youth actors was highly regarded as an effective method for improving communication skills and confidence in recommending the vaccine. These findings emphasize the importance of targeted interventions to enhance oral health professional education and the intention to recommend HPV vaccine.

Overactivation of mineralocorticoid receptors occurs in cardiorenal diseases. Many patients with type 2 diabetes often progress to chronic kidney disease (CKD) and require dialysis. Finerenone is the first oral non-steroidal mineralocorticoid receptor (MR) antagonist used in patients with diabetic kidney disease and heart failure. Finerenone (also known as Kerendia) is more potent than spironolactone in reducing the progression of CKD and exerts its effect equally on the heart and kidneys, improving cardiovascular outcomes. Research demonstrates that finerenone improves proteinuria and glomerular filtration rate (GFR) if taken alone or in combination with sodium-glucose transporter 2 inhibitors (SGLT2i). Finerenone has been found to decrease mortality in patients with diabetic renal disease and improve quality of life. Its side effects, unlike those of spironolactone, do not include gynecomastia. However, it can result in hyperkalemia, which needs to be monitored. In this narrative review, we aim to investigate the mechanisms of action of finerenone and its implications in patients with type 2 diabetes.

With the advent of readily accessible generative artificial intelligence (GAI), a concern exists within the academic community that research data collected in the context of conducting doctoral dissertation research is authentic. The purpose of the present study was to explore the role of GAI in the production of new research paying particular attention to the use of GAI in collecting new data for a doctoral dissertation. This study employed qualitative methodology examining how GAI, specifically ChatGPT, responded to interview questions from a previously published article by the researchers to determine how closely chatbots mimic responses from the actual study participants. The researchers found that data integrity in qualitative research may be at risk if higher education institutions do not set clear policies and specific parameters for how doctoral research data is obtained and validated in light of GAI.

Although women drivers engage in fewer risky behaviors and have a lower involvement in traffic accidents than men, there is a commonly held stereotype that they are bad drivers. To understand this perception, various psychosocial factors related to sexism have been studied. However, very little is known about sexist attitudes towards women drivers, especially when studied through implicit attitude models. The aim of this study was to understand implicit and explicit sexist attitudes towards women drivers. A sample of N = 104 participants from Mar del Plata, Argentina, completed a stimulus classification task using response times to measure implicit attitudes, and three self-reporting measures of explicit attitudes, ambivalent sexism, and control of prejudices. The results indicated more positive implicit attitudes and low explicit antipathy towards women drivers. No age differences were found, but gender differences were observed (i.e., women showed more positive implicit and explicit attitudes towards their own group). Implicit and explicit attitudes showed a moderate correlation with each other and were not associated with a concern with acting prejudiced scale. Hostile sexism was a predictor of sexist driving attitudes. The results are discussed in the context of previous evidence on sexism in driving and implicit attitude models.