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This study aims to determine the differences in the involvement of pre-hospital emergency physicians (PHEPs) within the ambulance service over time and between the federal states and identify possible reasons for the differences.

The federal state-specific PHEP rates from 2012 to 2017 were analysed using publicly available data or data provided by the responsible state ministries. In addition, various correlations between PHEP rates and sociodemographic and health data were calculated.

The PHEP rates differ significantly between the 16 federal states. In 2017, Schleswig–Holstein had a PHEP participation rate of 19.00%, while in Mecklenburg-Western Pomerania the rate was 41.08%. In all surveyed states, the rate fell over time. Only in Mecklenburg-Western Pomerania, the rate increased from 37.68% in 2012 to 41.08% in 2017 (OR: 1.15 [95% CI: 1.14; 1.17]). Federal state-specific PHEP rates indicated strong deviations from the overall PHEP rate of all included federal states with ORs ranging from 0.61 (95% CI: 0,61; 0,62) for Schleswig–Holstein to 1.82 (95% CI: 1.81; 1.84) for Mecklenburg-Western Pomerania. Socioeconomic factors indicated (inverse) correlations with the federal state-specific PHEP rate.

The PHEP rates differ significantly between the federal states. The correlations indicate possible connections but do not show clear causes within state-specific characteristics. Consequently, the occupational autonomy of paramedics differs between the states.

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

This study investigates the following research question: What pedagogical strategies are necessary for the success of HyFlex course design? The findings to this question are based in new media literacies and help to further pedagogy in an emerging HyFlex model while also grounding in needed theorization.

This study uses design-based research (DBR) across two iterations and four doctoral, higher education courses, using mixed methods of data collection and analysis.

Six pedagogical strategies influential for HyFlex research are presented, each grounded in a new media literacy skill.

These six pedagogical strategies help practitioners grappling with the HyFlex or blended learning model merge traditional pedagogy with how this might be tailored for students entrenched in a participatory culture.

Play and playful literacies shape essential spaces for belonging, connection, transformation and joy: from embodied immersions into fantasy worlds, to the creation of interest-led groups overflowing with varied knowledges and identities, and the disruption of societal hierarchies through roleplayed restorying. Yet, theorizations delineating playful possibilities – while plentiful and varied – are often rigidly constructed in relation to neoliberally/biopolitically motivated notions of value, use and productivity. Imbued with forms of modern power, play’s full flourishing has been regulated and quelled, particularly within the realm of education. This study, a literature review, seeks to defy this fatuous notion of a frivolous play.

Drawing from research within the fields of literacy and educational studies, the author centers playful methods commonly trivialized in contemporary discourse, including in global out-of-school spaces (e.g. gaming clubs, improvisational theater groups), with popular culture texts (e.g. picture books, digital fanfiction) and for older youth and adults.

This exploration of play’s potential across lifespans, formal/informal learning ecologies and worldwide contexts foregrounds its intrinsic nature and essential entwining with socio-culturally/materially mediated forms of knowledge and communication.

With a unique focus on the playful literacies emerging across ages, spaces and places, this review advocates a turn toward the imaginative, messy, uncontrollable worlds of play in future research and practice.

This chapter presents the findings of an extracurricular online beta test of a competition between students of the University of Wales Trinity Saint David and the International University of Malaya-Wales. The competition is intended to promote the concept of harmonious entrepreneurship and the creation of student-led harmonious enterprises that address the global sustainability challenge and deliver a triple bottom line in which profit, people, and planet are in harmony. It reveals that extracurricular learning can attract students from disciplines other than business and can educate the participants, both staff and students, not just about harmonious entrepreneurship but also how to identify and launch an innovative harmonious enterprise that addresses a sustainability challenge. The test identifies how the competition may be improved prior to its global launch and makes recommendations for students, educators, mentors, providers, and universities as to how it might best be implemented. Once revised and launched the competition will be further tested to better understand how extracurricular learning can help advance the delivery of both entrepreneurship and sustainability education in universities and colleges around the globe.

Women involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of victimization). The purpose of this study is to explore perspectives on potential strategies to connect women in the CS to pre-exposure prophylaxis (PrEP) services.

This study conducted in-depth interviews with 27 women involved in the CS eligible for PrEP. Using vignettes, interviews explored attitudes, barriers and facilitators toward PrEP screening, referral and linkage facilitated via a CS stakeholder, an mHealth application or providing PrEP service referrals during detention via a navigator.

Most women were, on average, 41.3 years, from racial and ethnic minority groups (56% black/African American; 19% Latinx). Inductive thematic analysis revealed CS involved women expressed mostly positive attitudes toward CS-based PrEP implementation. Younger women were more accepting of and interested in mHealth interventions. Implementation facilitators included leveraging relationships with trusted allies (e.g. “peers”) and existing systems collaborations. Recommended implementation strategies included providing HIV and PrEP-specific education and training for system stakeholders and addressing issues related to privacy, system mistrust and stigma.

Results provide a critical foundation for the implementation of interventions to improve PrEP access for women involved in the CS and have important implications for implementation strategies for all adults involved in the CS. Improving access to PrEP among this population may also support progress toward addressing national disparities in PrEP uptake, where women, black and Latinx populations have substantial unmet need.

This study aims to unlock a ritual chain mechanism that promotes socio-mental (or socio-psychological) resilience. This study draws on interaction ritual chains theory and the concept of transformative service to answer the question of how people could be inspired toward an elevated level of group solidarity, emotional energy, morality and, thus, socio-mental resilience.

This study took a qualitative approach resting upon online reviews and observations from an augmented food festival about hot pot delicacies dedicated to medical workers fighting hard amid the early coronavirus outbreak.

The results of this study point to four primary ritual outcomes (e.g. emotional energy, group solidarity, symbols of relationships and standards of morality) along with a two-tier micro–macro socio-mental resilience sustainability paradigm.

Empirical findings from this study could help operators to justify their transformative initiatives as means for customers to replenish their depleted physical and mental resources.

This inquiry presents new nuances to interaction ritual chains. This study also extends the transformative role of hospitality services to accentuate a linkage among individuals, communities and the society.

Despite the pervasiveness of teen-targeted food advertising on social media, little is known about the persuasive elements (or power) found within those ads. This research study aims to engage with the concept of “visual style” to explore the range of visual techniques used in Instagram food marketing to teenagers.

A participatory study was conducted with 57 teenagers, who used a specially designed mobile app to capture images of the teen-targeted food marketing they encountered for seven days. A visual thematic analysis was used to assess and classify the advertisements that participants captured from Instagram and specifically tagged with “visual style”.

A total of 142 food advertisements from Instagram were tagged with visual style, and classified into five main styles: Bold Focus, Bespoke, Absurd, Everyday and Sensory.

This study contributes to an improved understanding about how the visual is used as a marketing technique to capture teenagers’ attention, contributing to the persuasive power of marketing messages.

Food marketing is a significant part of the young consumer’s marketplace, and this study provides new insight into the sophisticated nature of such marketing – revealing the visual styles used to capture the attention of its brand-aware audience.